Zongo Arsène, Lee Cerina, El-Mourad Jihane, Dyck Jason R B, Hyshka Elaine, Hanlon John G, Eurich Dean T
Faculty of Pharmacy, 4440Université Laval, Quebec City, Canada.
Population Health and Optimal Health Practices Research Unit, CHU de Québec - Université Laval Research Centre, Quebec City, Canada.
Can J Psychiatry. 2022 Jul;67(7):544-552. doi: 10.1177/07067437211060597. Epub 2021 Nov 20.
Poisoning from psychoactive drugs and substance use disorders (SUD) have been reported among non-medical cannabis users. However, little is known about medical cannabis users and their risk for poisoning and/or development of SUD. This study assessed the risk of emergency department (ED) visits or hospitalization for 1) poisoning by psychoactive drugs and 2) mental/behavioural disorders due to the use of psychoactive drugs and other substances, in medically authorized cannabis patients in Ontario, Canada from 2014-2017.
A cohort study of adult patients authorized for medical cannabis that were matched to population-based controls. ED visit/hospitalization were assessed with a main diagnostic code for: 1) poisoning by psychoactive drugs; 2) mental and behavioural disorder due to psychoactive drugs or other substance use. Conditional Cox proportional hazards regressions were conducted.
18,653 cannabis patients were matched to 51,243 controls. During a median follow-up of 243 days, the incidence rate for poisoning was 4.71 per 1,000 person-years (95%CI: 3.71-5.99) for cases and 1.73 per 1,000 person-years (95% CI: 1.36-2.19) for controls. The adjusted hazard ratio (aHR) was 2.45 (95%CI: 1.56-3.84). For mental/behavioural disorders, the incident rates were 8.89 (95% CI: 7.47-10.57) and 5.01 (95% CI: 4.36-5.76) in the cannabis and the controls group. The aHR was 2.27 (95%CI: 1.66-3.11). No difference was observed between males and females (-value for interaction > 0.05).
Our study observed a short-term increased risk of ED visit/hospitalization for poisoning or for mental/behavioural disorders (from use of psychoactive drugs and other substances)- in medically authorized cannabis patients.
非医用大麻使用者中已报告有精神活性药物中毒和物质使用障碍（SUD）。然而，对于医用大麻使用者及其中毒风险和/或发生物质使用障碍的情况知之甚少。本研究评估了2014年至2017年加拿大安大略省获得医学授权的大麻患者因以下情况前往急诊科（ED）就诊或住院的风险：1）精神活性药物中毒；2）因使用精神活性药物和其他物质导致的精神/行为障碍。
对获得医用大麻授权的成年患者进行队列研究，并与基于人群的对照组进行匹配。通过主要诊断代码评估急诊就诊/住院情况：1）精神活性药物中毒；2）因精神活性药物或其他物质使用导致的精神和行为障碍。进行了条件Cox比例风险回归分析。
18653名大麻患者与51243名对照进行了匹配。在中位随访243天期间，病例组中毒的发病率为每1000人年4.71例（95%置信区间：3.71 - 5.99），对照组为每1000人年1.73例（95%置信区间：1.36 - 2.19）。调整后的风险比（aHR）为2.45（95%置信区间：1.56 - 3.84）。对于精神/行为障碍，大麻组和对照组的发病率分别为8.89（95%置信区间：7.47 - 10.57）和5.01（95%置信区间：4.36 - 5.76）。aHR为2.27（95%置信区间：1.66 - 3.11）。男性和女性之间未观察到差异（交互作用P值>0.05）。
我们的研究观察到，在获得医学授权的大麻患者中，短期内因中毒或精神/行为障碍（因使用精神活性药物和其他物质）前往急诊科就诊或住院的风险增加。
