Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
Subst Use Misuse. 2021;56(5):697-703. doi: 10.1080/10826084.2021.1892137. Epub 2021 Mar 22.
Some ecological studies found lower rates of opioid overdose in states with liberalized cannabis legislation, but results are mixed, and the association has not been analyzed in individuals. We quantified the association between cannabis use and nonfatal opioid overdose among individuals enrolled in methadone maintenance treatment (MMT) for opioid use disorder (OUD).
We recruited a convenience sample of individuals enrolled in four MMT clinics in Washington State and southern New England who completed a one-time survey.Descriptive statistics and multivariate logistic regression compared the prevalence and risk of nonfatal opioid overdose in the past 12 months between participants reporting frequent (at least weekly) or infrequent (once or none) cannabis use in the past month.
Of 446 participants, 35% ( = 156) reported frequent cannabis use and 7% ( = 32) reported nonfatal opioid overdose in the past year. The prevalence of nonfatal opioid overdose was 3% among reporters of frequent cannabis use, and 9% among reporters of infrequent/no use ( = 0.02). After imputing missing data and controlling for demographic and clinical factors, the likelihood of self-reported nonfatal opioid overdose in the past year was 71% lower among reporters of frequent cannabis use in the past month (adjusted RR = 0.29, 95% CI 0.10-0.80, = 0.02).
Among individuals enrolled in MMT, frequent cannabis use in the past month was associated with fewer self-reported nonfatal opioid overdoses in the past year. Methodological limitations caution against causal interpretation of this relationship. Additional studies are needed to understand the prospective impact of co-occurring cannabis on opioid-related outcomes.
一些生态学研究发现，在大麻法律放宽的州，阿片类药物过量的发生率较低，但结果不一，且尚未在个体中分析这种关联。我们量化了大麻使用与接受美沙酮维持治疗（MMT）治疗阿片类药物使用障碍（OUD）的个体中非致命性阿片类药物过量之间的关联。
我们招募了华盛顿州和新英格兰南部的四个 MMT 诊所中参加的便利样本的个体，他们完成了一次调查。描述性统计和多变量逻辑回归比较了过去 12 个月中报告频繁（至少每周一次）或不频繁（一次或无）过去一个月内使用大麻的参与者中，非致命性阿片类药物过量的发生率和风险。
在 446 名参与者中，35%（156 人）报告频繁使用大麻，7%（32 人）报告过去一年中发生非致命性阿片类药物过量。在报告频繁使用大麻的人中，非致命性阿片类药物过量的发生率为 3%，而在报告不频繁/不使用的人中，发生率为 9%（0.02）。在对缺失数据进行插补并控制人口统计学和临床因素后，过去一个月频繁使用大麻的报告者在过去一年中自我报告的非致命性阿片类药物过量的可能性降低了 71%（调整后的 RR = 0.29，95%CI 0.10-0.80， = 0.02）。
在接受 MMT 的个体中，过去一个月频繁使用大麻与过去一年中自我报告的非致命性阿片类药物过量的次数减少相关。方法学限制告诫我们不要对此关系进行因果解释。需要进一步的研究来了解同时发生的大麻对阿片类药物相关结果的前瞻性影响。
