Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, 78702, USA.
Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, 19131, USA; Bayhealth Medical Center, Dover, DE, 19901, USA.
Drug Alcohol Depend. 2021 Aug 1;225:108842. doi: 10.1016/j.drugalcdep.2021.108842. Epub 2021 Jun 24.
Despite increasing rates of nonmedical and/or medical cannabis use in the 50+ age group, scant research exists on the associations between cannabis use and prescription medication use. In this study, we examined associations of use of prescription tranquilizers, sedatives, stimulants, and pain relievers, tobacco products, any/binge/heavy alcohol, and illicit drugs with cannabis use and use characteristics among U.S. adults aged 50+ years with past-year mental illness (n = 6454).
Data are from the 2015-2019 National Survey on Drug Use and Health (NSDUH). We used logistic regression models to examine associations of past-month use of each substance with (1) cannabis use among all those with past-year mental illness, and (2) cannabis use characteristics among cannabis users, controlling for severity of mental illness and sociodemographic and health characteristics.
Of individuals aged 50+, 14.1 % had any past-year mental illness, and 9.7 % of those with mental illness, compared to 4.0 % of those without, reported past-month cannabis use. Compared to nonusers, cannabis users had higher odds of using each substance except antidepressants, with adjusted odds ratios ranging from 1.3 (sedatives) to 3.6 (illicit drugs). Compared to nonmedical cannabis users, medical users had 2-2.5 times higher likelihood of co-use of tranquilizers, sedatives, and prescription pain relievers but lower odds of binge and heavy alcohol use.
Cannabis users, especially medical cannabis users, are significantly more likely to use prescription psychotropic or pain medications. Healthcare professionals should assess for poly-substance use and potential adverse effects among older adults with mental illness.
尽管 50 岁以上人群中非医疗和/或医疗用大麻的使用率不断上升，但关于大麻使用与处方药使用之间关联的研究甚少。在这项研究中，我们调查了美国 50 岁以上有过去一年精神疾病史的成年人（n=6454）中，使用处方镇静剂、安定、兴奋剂和止痛药、烟草制品、任何/狂饮/大量饮酒和非法药物与大麻使用及其使用特征之间的关联。
数据来自 2015-2019 年全国药物使用与健康调查（NSDUH）。我们使用逻辑回归模型，检验了过去一个月每种物质的使用与（1）所有过去一年有精神疾病的人中的大麻使用，以及（2）大麻使用者中的大麻使用特征之间的关联，同时控制了精神疾病的严重程度以及社会人口统计学和健康特征。
在 50 岁以上的人群中，14.1%有过去一年的精神疾病史，而在有精神疾病的人群中，有 9.7%的人报告过去一个月使用过大麻，而在没有精神疾病的人群中，这一比例为 4.0%。与非使用者相比，大麻使用者使用每种物质的可能性更高，除了抗抑郁药外，调整后的优势比范围从 1.3（安定）到 3.6（非法药物）。与非医用大麻使用者相比，医用大麻使用者同时使用镇静剂、安定和处方止痛药的可能性高 2-2.5 倍，但狂饮和大量饮酒的可能性较低。
大麻使用者，特别是医用大麻使用者，更有可能同时使用处方精神药物或止痛药。医疗保健专业人员应评估有精神疾病的老年人群中是否存在多药物使用和潜在的不良反应。
