Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States.
Drug Alcohol Depend. 2021 Jan 1;218:108383. doi: 10.1016/j.drugalcdep.2020.108383. Epub 2020 Oct 26.
Time from first cannabis use to cannabis dependence (latency) may be an important prognostic indicator of cannabis-related problems and treatment outcomes. Gender differences in latency have been found; however, research in this general area is limited. As cannabis use increases and perceived risk declines, a better understanding of how these factors interact in predicting treatment outcomes is critical.
A secondary data analysis of a randomized, double-blind, placebo-controlled pharmacotherapy trial for cannabis dependence (N = 302) examined the associations between age of cannabis use onset, time to cannabis dependence (latency), and gender on cannabis use during the trial. Mediation analysis tested whether the association between age of onset and cannabis use during the trial was mediated by latency to cannabis dependence differentially for men and women.
Age of use initiation was inversely correlated with latency to dependence prior to treatment [HR(95% CI) = 1.18 (1.06, 1.30); p = .002] and cannabis use during treatment (β=-1.27; SE = 0.37; p < .001). There was a significant mediation effect between age of onset, latency, and cannabis use that varied by gender. Earlier age of onset predicted longer latency, and subsequently, greater cannabis use during the trial in men (21.4% mediated; p < .05), but not women. Other substance use, race, and past psychiatric diagnosis did not predict latency either independently or in interaction models.
Findings support existing evidence that early cannabis use onset is associated with worse outcomes and add new knowledge on the differential associations between age of onset, latency to cannabis dependence, and treatment outcomes for men and women.
首次使用大麻到出现大麻依赖（潜伏期）的时间可能是大麻相关问题和治疗结果的一个重要预后指标。已经发现潜伏期存在性别差异；然而，该领域的研究有限。随着大麻使用的增加和感知风险的降低，更好地了解这些因素如何相互作用来预测治疗结果至关重要。
一项针对大麻依赖的随机、双盲、安慰剂对照药物治疗试验（N=302）的二次数据分析，考察了大麻使用起始年龄、到达大麻依赖的时间（潜伏期）以及性别与试验期间大麻使用之间的关系。中介分析测试了年龄与试验期间大麻使用之间的关联是否通过潜伏期的中介作用而有所不同，这种中介作用因性别而异。
使用起始年龄与治疗前依赖潜伏期呈负相关[风险比（95%置信区间）=1.18（1.06，1.30）；p=0.002]，且与治疗期间的大麻使用呈负相关（β=-1.27；SE=0.37；p<0.001）。年龄、潜伏期和大麻使用之间存在显著的中介效应，且这种中介效应因性别而异。较早的起始年龄预示着潜伏期较长，随后男性在试验期间的大麻使用量也较大（21.4%为中介；p<0.05），但女性则不然。其他物质使用、种族和既往精神科诊断无论是单独预测还是在交互模型中都不能预测潜伏期。
研究结果支持了早期大麻使用与较差结果相关的现有证据，并增加了关于男性和女性大麻使用起始年龄、到达大麻依赖潜伏期和治疗结果之间的不同关联的新知识。
