Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA.
J Psychopharmacol. 2020 Jun;34(6):654-662. doi: 10.1177/0269881120914211. Epub 2020 Apr 8.
Cannabinoids may potentiate opioid analgesia and therefore could be used to reduce reliance on opioids for analgesia.
The current study evaluated whether the concurrent availability of cannabis influences opioid consumption using a behavioral economic demand framework.
An online survey assessed cannabis and opioid use frequency and dependence measures, pain severity, and demand for both cannabis and opioids alone and when concurrently available using hypothetical purchase tasks. Adults reporting current use of opioids for pain management and past 30-day cannabis exposure (=155) completed two hypothetical purchase tasks in which only grams of cannabis or units of participants' index opioids were available for purchase, and two hypothetical tasks in which both were concurrently available and the price of one drug increased whereas the other was kept constant. Paired-sample -tests compared the demand of each drug alone with when it was available concurrently with an alternative.
Demand intensity was significantly reduced and demand elasticity was significantly increased for both cannabis and opioids when the alternate commodity was available, although the reductions in cannabis consumption were more pronounced than they were for opioid consumption in the presence of the alternate commodity.
These data provide behavioral economic evidence that cannabis access may modestly reduce demand for opioids in persons who have pain. Additional clinical studies that evaluate the analgesic effects of cannabis and cannabis-opioid effects on pain are warranted.
大麻素可能增强阿片类药物的镇痛作用,因此可用于减少对阿片类药物镇痛的依赖。
本研究采用行为经济学需求框架评估大麻的同时可及性是否会影响阿片类药物的消费。
一项在线调查评估了大麻和阿片类药物使用频率和依赖程度、疼痛严重程度,以及在单独和同时使用假设购买任务时对大麻和阿片类药物的需求。报告目前正在使用阿片类药物治疗疼痛且过去 30 天内有大麻暴露史的成年人(=155 人)完成了两个假设购买任务,在这两个任务中,仅可购买一定克数的大麻或参与者的主要阿片类药物单位数,还有两个假设任务中,两种药物都可同时购买,一种药物的价格上涨而另一种药物保持不变。配对样本检验比较了每种药物单独使用时与同时与替代药物一起使用时的需求。
当有替代商品时,大麻和阿片类药物的需求强度显著降低,需求弹性显著增加,尽管在有替代商品的情况下,大麻消费的减少幅度大于阿片类药物消费的减少幅度。
这些数据提供了行为经济学证据,表明大麻的可及性可能会适度降低有疼痛的人的阿片类药物需求。需要进一步的临床研究来评估大麻的镇痛作用和大麻-阿片类药物对疼痛的影响。