Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Eur Addict Res. 2022;28(2):113-121. doi: 10.1159/000519541. Epub 2021 Nov 17.
Amphetamine-type stimulants (ATSs) are the second most commonly used class of illegal substances in Europe. Although concurrent substance use has been subject to research, little is known about associations between concurrent use of cocaine, alcohol, or cannabis and ATS dependence. We expect that the concurrent use of any of the substance, especially cannabis and cocaine, is associated with ATS dependence.
Cross-sectional data were gathered within the European ATTUNE study in 2018/2019. Participants (N = 721) were asked about their consumption patterns and social, psychological, and economic situation. Multivariate logistic regressions were carried out for associations between ATS dependence and use combinations of frequent cocaine, alcohol, or cannabis, with the reference group of no frequent concurrent use (model 1). Model 2 calculated associations for ATS dependence with lifetime methamphetamine use for respective use combinations.
The study population was on average 28.9 years old (SD = 7.7), with the majority being male (63.5%). In model 1, the adjusted odds ratio (aOR) for frequent alcohol use was 0.70 (confidence interval [CI] 0.41-1.20). Similar results were shown for model 2 (aOR 0.82, CI 0.42-1.62). Frequent cannabis use significantly reduced the chance for ATS dependence by 50% in adjusted model 1 (aOR 0.50, CI 0.28-0.89) and by 62% in model 2 (aOR 0.38, CI 0.18-0.82). For frequent cocaine use, models 1 and 2 report an aOR at 1.37 (CI 0.58-3.25) and 2.39 (CI 0.77-7.43), although not statistically significant. Frequent users of all 3 substances had a significant 3-fold chance for ATS dependence (model 1: aOR 2.98, CI 1.16-7.63; model 2: aOR 2.95, CI 1.02-8.58).
Against initial hypotheses, frequent concurrent use of alcohol or cannabis generally decreased chances for ATS dependence. An explanation could be the study population, which consists of many irregular users of ATS, who mainly consume alcohol or cannabis. Cocaine generally increased chances, although results were not significant. The frequent use of all 3 substances together with ATS in the last year was significantly associated with dependence, thus reporting important information for treatment services. Further research is needed for disentangling causal relationships underlying these associations and for pinpointing consequences for relapse prevention and retention success.
苯丙胺类兴奋剂（ATS）是欧洲第二大常用的非法物质类别。尽管同时使用多种物质的情况已经受到研究，但关于可卡因、酒精或大麻同时使用与 ATS 依赖之间的关联知之甚少。我们预计，任何物质的同时使用，特别是大麻和可卡因，都会与 ATS 依赖有关。
2018/2019 年在欧洲 ATTUNE 研究中收集了横断面数据。参与者（N=721）被问及他们的消费模式以及社会、心理和经济状况。多变量逻辑回归用于研究 ATS 依赖与频繁使用可卡因、酒精或大麻的组合之间的关联，无频繁同时使用的参考组（模型 1）。模型 2 计算了在各自的使用组合中终生使用甲基苯丙胺与 ATS 依赖之间的关联。
研究人群的平均年龄为 28.9 岁（SD=7.7），大多数为男性（63.5%）。在模型 1 中，频繁饮酒的调整后比值比（aOR）为 0.70（置信区间 [CI] 0.41-1.20）。模型 2 也显示了类似的结果（aOR 0.82，CI 0.42-1.62）。在调整后的模型 1 中，频繁使用大麻可使 ATS 依赖的可能性降低 50%（aOR 0.50，CI 0.28-0.89），在模型 2 中降低 62%（aOR 0.38，CI 0.18-0.82）。对于频繁使用可卡因，模型 1 和 2 报告的比值比分别为 1.37（CI 0.58-3.25）和 2.39（CI 0.77-7.43），尽管没有统计学意义。所有 3 种物质的频繁使用者对 ATS 依赖的可能性增加了 3 倍（模型 1：aOR 2.98，CI 1.16-7.63；模型 2：aOR 2.95，CI 1.02-8.58）。
与最初的假设相反，酒精或大麻的频繁同时使用通常会降低 ATS 依赖的可能性。一种解释可能是研究人群中，许多不规则使用 ATS 的人主要使用酒精或大麻。可卡因通常会增加这种可能性，尽管结果并不显著。在过去一年中同时频繁使用所有 3 种物质与 ATS 与依赖显著相关，因此为治疗服务提供了重要信息。需要进一步研究以厘清这些关联背后的因果关系，并确定对复发预防和保留成功的影响。
