Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Ave, New York, NY, 10065, USA.
Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Ave, New York, NY, 10065, USA.
Drug Alcohol Depend. 2021 Sep 1;226:108834. doi: 10.1016/j.drugalcdep.2021.108834. Epub 2021 Jun 24.
Persons with severe opioid or cocaine use disorders are particularly vulnerable to morbidity and mortality. Heaviest use of mu-opioid receptor agonists and cocaine typically commences in early adulthood and is preceded by substantial adolescent exposure to cannabis and/or alcohol. Little information exists on the age trajectories of exposure to cannabis or alcohol in persons diagnosed with severe opioid or cocaine use disorders, compared to persons diagnosed with other substance use disorders (unrelated to opioids or cocaine).
This observational study had n = 854 volunteers (male = 581, female = 273; ≥18 years of age at the time of interview) and examined the ages of onset of heaviest use of cannabis and alcohol in persons diagnosed by DSM-IV criteria with opioid dependence (OD), both opioid and cocaine dependence (OD + CD) and cocaine dependence (CD). These age trajectory measures were compared to persons with other substance use disorders (primarily cannabis and alcohol use disorders, termed "Any Other Diagnoses").
Unadjusted survival analyses showed persons diagnosed with either OD + CD or CD had earlier onset of heaviest use of cannabis (mean ages of 16.2 and 17.8, respectively) compared to the "Any Other Diagnoses" reference group (mean age = 19.5). A multivariate logistic regression showed that later onset of heaviest use of cannabis was associated with lower odds of being in the OD + CD or CD groups, when compared to the reference group.
Persons diagnosed with severe cocaine use disorders or dual opioid and cocaine use disorders exhibit a pattern of heavy and especially early adolescent exposure to cannabis, compared to persons with other substance use disorders.
患有严重阿片类或可卡因使用障碍的人特别容易出现发病和死亡。μ-阿片受体激动剂和可卡因的重度使用通常始于成年早期，在此之前，大量青少年接触大麻和/或酒精。与诊断为其他物质使用障碍（与阿片类或可卡因无关）的人相比，患有严重阿片类或可卡因使用障碍的人接触大麻或酒精的年龄轨迹信息较少。
这项观察性研究有 854 名志愿者（男性 581 名，女性 273 名；在接受访谈时年龄均≥18 岁），并检查了根据 DSM-IV 标准诊断为阿片类药物依赖（OD）、阿片类和可卡因依赖（OD + CD）以及可卡因依赖（CD）的人接触大麻和酒精的最重使用年龄。将这些年龄轨迹测量值与患有其他物质使用障碍（主要是大麻和酒精使用障碍，称为“其他任何诊断”）的人进行比较。
未调整的生存分析显示，与“其他任何诊断”参考组（平均年龄为 19.5 岁）相比，被诊断为 OD + CD 或 CD 的人接触大麻的最重使用年龄更早（分别为 16.2 岁和 17.8 岁）。多变量逻辑回归显示，与参考组相比，接触大麻的最重使用年龄较晚与 OD + CD 或 CD 组的可能性降低相关。
与其他物质使用障碍的人相比，患有严重可卡因使用障碍或双重阿片类和可卡因使用障碍的人表现出大量且尤其在青少年早期接触大麻的模式。
