Ramadan Majed M, Banta Jim E, Bahjri Khaled, Montgomery Susanne B
Department of Health Policy and Leadership, School of Public Health, University of Loma Linda, 24951 North Circle Drive, Nichol Hall 1107, Loma Linda, CA, 92350, USA.
Center for Leadership in Health Systems, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall 1107, Loma Linda, CA, 92350, USA.
J Cannabis Res. 2020 Oct 20;2(1):38. doi: 10.1186/s42238-020-00043-z.
While the link between frequent cannabis use and alcohol use disorders is well documented, it is not clear whether alcohol drinkers who use cannabis less frequently are also vulnerable to alcohol use disorders. We estimate the association of frequency of past 12-months cannabis use with alcohol-associated adverse effects variables in the same time frame: alcohol dependence, heavy drinking, driving under alcohol influence, alcohol-related interpersonal problems, use after interpersonal problems, alcohol-related risky behaviors, and alcohol-related legal problems.
We analyzed data from U.S. individuals aged 12 to 25 years who participated in annual, cross-sectional U.S. National Surveys on Drug Use and Health from 2002 to 2014. Logistic regression models were used to examine the association of cannabis use with six alcohol-associated adverse effects variables. Frequency of cannabis use served as the primary independent variable, and were divided into four categories: frequent use (21-30 days per month), less frequent use (1-20 days per month), no use over the past 12 months, and no lifetime cannabis use. Alcohol dependence and six alcohol-associated adverse effects variables served as our primary outcomes.
The study included 465,090 respondents aged 12 to 25 years, among all past-year cannabis users, (47.5%) were less frequent (1-20 days/month) users. Less frequent cannabis use was highest among male, 15-25-year-olds, and non-Hispanic white 11.8, 84 and 10.6%, respectively. In adjusted models, past-year less frequent cannabis use (1-20 days/month) was significantly associated with past-year alcohol dependence (adjusted odds ratio aOR 5.57, 95% confidence interval (CI) 5.5-6.4); heavy drinking in the past-year (aOR 3.41, 95% CI 3.2-3.5); alcohol-related interpersonal problems in the past-year (aOR 7.33, 95% CI 7.0-7.5); use after interpersonal problems (aOR 5.17, 95% CI 4.8-5.5); alcohol-related risky behaviors (aOR 7.29, 95% CI 7.0-7.5), and, driving under influence of alcohol (aOR 7.19, 95% CI 6.9-7.4). No cannabis use past-year were more likely to report alcohol dependence (aOR 2.81, 95% CI 2.6-3) compared with no lifetime cannabis use.
These findings indicated that within the general population, not only frequent cannabis user (21-30 days per month) but even less frequent cannabis use (1-20 days/month) was significantly associated with past-year alcohol dependence and alcohol-associated adverse effects than no lifetime cannabis use. These adverse alcohol-related outcomes associated with less frequent cannabis use, should be taken under careful consideration in alcohol use disorder treatment setting and policy planning.
虽然频繁使用大麻与酒精使用障碍之间的联系已有充分记录，但尚不清楚较少频繁使用大麻的饮酒者是否也易患酒精使用障碍。我们估计过去12个月内大麻使用频率与同一时间范围内酒精相关不良反应变量之间的关联：酒精依赖、大量饮酒、酒后驾车、与酒精相关的人际问题、人际问题后使用、与酒精相关的危险行为以及与酒精相关的法律问题。
我们分析了2002年至2014年参加美国年度横断面全国药物使用和健康调查的12至25岁美国个体的数据。使用逻辑回归模型来检验大麻使用与六个酒精相关不良反应变量之间的关联。大麻使用频率作为主要自变量，分为四类：频繁使用（每月21 - 30天）、较少频繁使用（每月1 - 20天）、过去12个月未使用以及终生未使用过大麻。酒精依赖和六个酒精相关不良反应变量作为主要结局。
该研究纳入了465,090名12至25岁的受访者，在所有过去一年使用过大麻的人群中，（47.5%）是较少频繁使用者（每月1 - 20天）。较少频繁使用大麻在男性、15 - 25岁人群以及非西班牙裔白人中比例最高，分别为11.8%、84%和10.6%。在调整模型中，过去一年较少频繁使用大麻（每月1 - 20天）与过去一年的酒精依赖显著相关（调整后的优势比aOR为5.57，95%置信区间（CI）为5.5 - 6.4）；过去一年的大量饮酒（aOR为3.41，95% CI为3.2 - 3.5）；过去一年与酒精相关的人际问题（aOR为7.33，95% CI为7.0 - 7.5）；人际问题后使用（aOR为5.17，95% CI为4.8 - 5.5）；与酒精相关的危险行为（aOR为7.29，95% CI为7.0 - 7.5）以及酒后驾车（aOR为7.19，95% CI为6.9 - 7.4）。与终生未使用过大麻相比，过去一年未使用过大麻的人更有可能报告酒精依赖（aOR为2.81，95% CI为2.6 - 3）。
这些发现表明，在一般人群中，不仅频繁使用大麻者（每月21 - 30天），而且较少频繁使用大麻者（每月1 - 20天）与过去一年的酒精依赖及酒精相关不良反应的关联都显著高于终生未使用过大麻者。在酒精使用障碍治疗环境和政策规划中，应仔细考虑这些与较少频繁使用大麻相关的不良酒精相关后果。
