Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Inflamm Bowel Dis. 2020 Aug 20;26(9):1401-1406. doi: 10.1093/ibd/izz272.
It is unknown whether cannabis users self-medicating their inflammatory bowel disease (IBD) symptoms are more likely to have comorbid mental health or personality risk factors associated with an increased potential for substance misuse compared with recreational cannabis users.
We surveyed individuals with IBD about their cannabis use, their mental health symptoms, and personality risk factors associated with substance misuse. We compared risk factors for substance misuse between individuals using cannabis to manage IBD symptoms and those using cannabis recreationally.
Of 201 persons with IBD who completed the questionnaire, 108 reported lifetime cannabis use. Of those, a larger proportion of Crohn's disease patients used cannabis to manage IBD symptoms (53% [34/64] vs 28% [12/43]; P = 0.010). Individuals self-medicating with cannabis were more likely to use cannabis for coping reasons (P = 0.016) and demonstrated higher levels of impulsivity (P = 0.004) and depressive symptoms (P = 0.012) when compared with individuals using cannabis recreationally. Logistic regression revealed that cannabis was 4.1 times (P = 0.05) and 3.7 times (P = 0.05) more likely to be used for IBD symptoms by smokers and individuals with moderate-severe depressive symptoms, respectively. Individuals high in impulsivity were 4.1 times more likely to use cannabis for their IBD symptoms than those low in impulsivity (P = 0.005).
Persons with IBD self-medicating with cannabis have characteristics associated with increased vulnerability to substance misuse when compared with those using cannabis recreationally. Screening for mental health comorbidities and vulnerability to substance misuse should be undertaken if cannabis is to be used to treat IBD symptoms.
目前尚不清楚，与消遣性大麻使用者相比，那些用大麻治疗炎症性肠病（IBD）症状的自诊患者是否更有可能存在与精神健康或人格相关的共病风险因素，这些因素可能增加物质滥用的潜在风险。
我们调查了患有 IBD 的个体有关他们的大麻使用情况、精神健康症状以及与物质滥用相关的人格风险因素。我们比较了因 IBD 症状而使用大麻与消遣性使用大麻的个体之间物质滥用的风险因素。
在完成问卷调查的 201 名 IBD 患者中，有 108 人报告有过终生大麻使用史。其中，更大比例的克罗恩病患者使用大麻来治疗 IBD 症状（53% [34/64] 与 28% [12/43]；P=0.010）。与消遣性使用大麻的个体相比，自我诊断并使用大麻的个体更有可能出于应对原因而使用大麻（P=0.016），并且表现出更高水平的冲动性（P=0.004）和抑郁症状（P=0.012）。Logistic 回归显示，大麻分别是 4.1 倍（P=0.05）和 3.7 倍（P=0.05），更有可能被吸烟和中重度抑郁症状的个体用于治疗 IBD 症状。与冲动性低的个体相比，冲动性高的个体更有可能将大麻用于治疗 IBD 症状，其几率是后者的 4.1 倍（P=0.005）。
与消遣性大麻使用者相比，用大麻治疗 IBD 症状的患者具有与物质滥用易感性增加相关的特征。如果要使用大麻治疗 IBD 症状，则应进行精神健康共病和物质滥用易感性筛查。
