Addiction Center, Department of Psychiatry, University of Michigan, Michigan, MI, USA.
Injury Prevention Center, University of Michigan, Michigan, MI, USA.
Addiction. 2021 Aug;116(8):2067-2075. doi: 10.1111/add.15370. Epub 2021 Jan 6.
Research from cohorts of individuals with recreational cannabis use indicates that cannabis withdrawal symptoms are reported by more than 40% of those using regularly. Withdrawal symptoms are not well understood in those who use cannabis for medical purposes. Therefore, we prospectively examined the stability of withdrawal symptoms in individuals using cannabis to manage chronic pain.
DESIGN, SETTING, PARTICIPANTS: Using latent class analysis (LCA) we examined baseline cannabis withdrawal to derive symptom profiles. Then, using latent transition analysis (LTA) we examined the longitudinal course of withdrawal symptoms across the time points. Exploratory analyses examined demographic and clinical characteristics predictive of withdrawal class and transitioning to more or fewer withdrawal symptoms over time. A cohort of 527 adults with chronic pain seeking medical cannabis certification or re-certification was recruited between February 2014 and June 2015. Participants were recruited from medical cannabis clinic waiting rooms in Michigan, USA. Participants were predominantly white (82%) and 49% identified as male, with an average age of 45.6 years (standard deviation = 12.8).
Baseline, 12-month and 24-month assessments of withdrawal symptoms using the Marijuana Withdrawal Checklist-revised.
A three-class LCA model including a mild (41%), moderate (34%) and severe (25%) symptom class parsimoniously represented withdrawal symptoms experienced by people using medical cannabis. Stability of withdrawal symptoms using a three-class LTA at 12 and 24 months ranged from 0.58 to 0.87, with the most stability in the mild withdrawal class. Younger age predicted greater severity and worsening of withdrawal over time.
Adults with chronic pain seeking medical cannabis certification or re-certification appear to experience mild to severe withdrawal symptoms. Withdrawal symptoms tend to be stable over a 2-year period, but younger age is predictive of worse symptoms and of an escalating withdrawal trajectory.
对有娱乐性大麻使用习惯的个体进行的队列研究表明，经常使用大麻的人中，有 40%以上的人报告有大麻戒断症状。对于出于医疗目的使用大麻的人，大麻戒断症状尚未得到很好的理解。因此，我们前瞻性地检查了使用大麻治疗慢性疼痛的个体中戒断症状的稳定性。
设计、地点、参与者：使用潜在类别分析（LCA），我们检查了基线大麻戒断以得出症状特征。然后，使用潜在转移分析（LTA），我们检查了在时间点之间戒断症状的纵向过程。探索性分析检查了人口统计学和临床特征，这些特征预测了戒断类别以及随着时间的推移向更多或更少戒断症状的转变。2014 年 2 月至 2015 年 6 月，我们招募了一个寻求医学大麻认证或重新认证的慢性疼痛患者队列，共 527 名成年人。参与者是从美国密歇根州的医疗大麻诊所候诊室招募的。参与者主要是白人（82%），49%为男性，平均年龄为 45.6 岁（标准差=12.8）。
使用修订后的大麻戒断清单（Marijuana Withdrawal Checklist-revised），在基线、12 个月和 24 个月时评估戒断症状。
一个包括轻度（41%）、中度（34%）和重度（25%）症状类别的三类别 LCA 模型，简洁地代表了使用医用大麻的人的戒断症状。使用三类别 LTA 在 12 个月和 24 个月时的戒断症状稳定性范围为 0.58 至 0.87，轻度戒断类别最稳定。年龄越小，预示着随着时间的推移，戒断症状的严重程度和恶化程度越高。
寻求医学大麻认证或重新认证的慢性疼痛成年人似乎会经历轻度到重度的戒断症状。戒断症状在 2 年内趋于稳定，但年龄较小预示着症状更差，戒断轨迹呈上升趋势。
