Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA.
Director, Central Texas Poison Center, Temple, TX, USA.
Drug Chem Toxicol. 2022 Jul;45(4):1739-1747. doi: 10.1080/01480545.2020.1868494. Epub 2021 Jan 7.
Increasing numbers of older adults use cannabis and cannabis-derived products that can have adverse effects. This study examined management site and level of healthcare services for older adult poison control center cases involving cannabis products. Using the American Association of Poison Control Centers' (PCC) National Poison Data System, 2016-2019, we extracted the 3109 cases aged 50+ for which cannabis was the only or primary substance. Multinomial logistic regression models were fit to examine associations between specific cannabis forms and management/care site (on site [mostly at home], at a healthcare facility [HCF], or no follow-up due to referral refusal or leaving against medical advice) and level of healthcare services for cases managed at a HCF. The results show that between 2016 and 2019, PCC cannabis cases involving older adults increased twofold, largely due to cases of cannabidiol, edibles, and concentrated extracts. Plant form and synthetic cannabinoid cases declined substantially. Compared to plant forms, synthetic cannabinoid cases had 4.22 (95% CI = 2.59-6.89) greater odds of being managed at, rather than outside, a HCF and 2.17 (1.42-3.31) greater odds of critical care unit admission. Although e-cigarette cases, compared to plant form cases, had lower odds of being managed at a HCF, HCF-managed e-cigarette cases had 3.43 greater odds (95% CI = 1.08-10.88) of critical care unit admission. Synthetic cannabinoid cases also had 1.86 (95% CI = 1.03-3.35) greater odds of no follow-up, and the presence of a secondary substance was also a significant factor. Stricter regulations for listing chemical ingredients and providing safety guidelines are needed for cannabis-derived products.
越来越多的老年人使用大麻和大麻衍生产品，这些产品可能会产生不良影响。本研究调查了涉及大麻产品的老年中毒控制中心病例的管理场所和医疗服务水平。我们使用美国毒物控制中心协会（PCC）的国家毒物数据系统，提取了 2016-2019 年年龄在 50 岁以上的 3109 例仅涉及大麻或主要物质的病例。多变量逻辑回归模型用于检验特定大麻形式与管理/护理场所（现场[主要在家中]、医疗保健机构[HCF]或因拒绝转介或违反医嘱而未跟进）和 HCF 管理病例的医疗服务水平之间的关联。结果表明，2016 年至 2019 年，PCC 涉及老年人的大麻病例增加了两倍，主要是由于大麻二酚、可食用大麻和浓缩提取物的病例增加。植物形式和合成大麻素病例大幅下降。与植物形式相比，合成大麻素病例在 HCF 内管理而不是在 HCF 外管理的可能性高 4.22 倍（95%置信区间=2.59-6.89），进入重症监护病房的可能性高 2.17 倍（95%置信区间=1.42-3.31）。尽管电子烟病例与植物形式病例相比，在 HCF 管理的可能性较低，但在 HCF 管理的电子烟病例进入重症监护病房的可能性高 3.43 倍（95%置信区间=1.08-10.88）。合成大麻素病例也有 1.86 倍（95%置信区间=1.03-3.35）的可能性不进行后续治疗，而存在次要物质也是一个重要因素。需要对大麻衍生产品的化学成分列名和提供安全指南制定更严格的规定。
