AminiLari Mahmood, Busse Jason W, Turna Jasmine, MacKillop James
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Canada.
Cannabis Cannabinoid Res. 2023 Dec;8(6):1133-1139. doi: 10.1089/can.2021.0128. Epub 2022 Mar 23.
To examine the proportion of individuals using cannabis for medical purposes who reported nonmedical use of cannabis after it became legal to do so. We acquired data from the Population Assessment for Tomorrow's Health, the Cannabis Legalization Surveillance Study on a subpopulation of participants residing in Hamilton, Ontario, Canada, who reported using cannabis for medical purposes. Specifically, we acquired data 6 months before, and again 6 months after, legalization of cannabis for nonmedical purposes. We constructed a logistic regression model to explore the association between potential explanatory factors and endorsing exclusively nonmedical use after legalization and reported associations as odds ratios and 95% confidence intervals. Our sample included 254 respondents (mean age 33±13; 61% female), of which 208 (82%) reported both medical and nonmedical use of cannabis (dual motives) before legalization for nonmedical purposes, and 46 (18%) reported cannabis use exclusively for medical purposes. Twenty-five percent (=63) indicated they had medical authorization to use medical cannabis, of which 37 (59%) also endorsed nonmedical use. After legalization of nonmedical cannabis, ∼1 in 4 previously exclusive cannabis users for medical purposes declared dual use (medical and nonmedical), and ∼1 in 4 previously dual users declared exclusively nonmedical use of cannabis. No individual with medical authorization reported a change to exclusively nonmedical use after legalization. Our adjusted regression analysis found that younger age, male sex, and lacking authorization for cannabis use were associated with declaring exclusively nonmedical use of cannabis after legalization. Anxiety, depression, impaired sleep, pain, and headaches were among the most common complaints for which respondents used cannabis therapeutically. Most respondents reported using cannabis as a substitute for prescription medication at least some of the time, and approximately half reported using cannabis as a substitute for alcohol at least some of the time. In a community sample of Canadian adults reporting use of cannabis for medical purposes, legalization of nonmedical cannabis was associated with a substantial proportion changing to either dual use (using cannabis for both medical and nonmedical purposes) or exclusively nonmedical use. Younger men without medical authorization for cannabis use were more likely to declare exclusively nonmedical use after legalization.
为了调查在大麻用于医疗目的合法化后，报告有非医疗用途大麻使用情况的个人比例。我们从“明日健康人口评估”以及“大麻合法化监测研究”中获取数据，该研究针对居住在加拿大安大略省汉密尔顿的一个参与子群体，这些参与者报告使用过大麻用于医疗目的。具体而言，我们获取了非医疗用途大麻合法化前6个月以及合法化后6个月的数据。我们构建了一个逻辑回归模型，以探讨潜在解释因素与合法化后仅认可非医疗用途之间的关联，并将报告的关联表示为比值比和95%置信区间。我们的样本包括254名受访者（平均年龄33±13岁；61%为女性），其中208人（82%）在非医疗用途大麻合法化之前报告了医疗和非医疗用途大麻的使用（双重动机），46人（18%）报告仅将大麻用于医疗目的。25%（=63人）表示他们有使用医用大麻的医疗授权，其中37人（59%）也认可非医疗用途。在非医疗用途大麻合法化后，约四分之一之前仅将大麻用于医疗目的的使用者声明有双重用途（医疗和非医疗），约四分之一之前有双重用途的使用者声明仅将大麻用于非医疗目的。没有获得医疗授权的个人在合法化后报告转变为仅非医疗用途。我们的调整回归分析发现，年龄较小、男性以及缺乏大麻使用授权与合法化后声明仅将大麻用于非医疗用途有关。焦虑、抑郁、睡眠障碍、疼痛和头痛是受访者使用大麻进行治疗的最常见病症。大多数受访者报告至少在某些时候将大麻用作处方药的替代品，约一半受访者报告至少在某些时候将大麻用作酒精的替代品。在一个报告使用大麻用于医疗目的的加拿大成年人社区样本中，非医疗用途大麻合法化与相当比例的人转变为双重用途（将大麻用于医疗和非医疗目的）或仅非医疗用途有关。没有获得大麻使用医疗授权的年轻男性在合法化后更有可能声明仅非医疗用途。
