Rubin-Kahana Dafna Sara, Hassan Ahmed Nabeel, Sanches Marcos, Le Foll Bernard
Child, Youth, and Family Services, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Front Psychiatry. 2022 Apr 1;13:836908. doi: 10.3389/fpsyt.2022.836908. eCollection 2022.
With the increasing number of cannabis users and more jurisdictions allowing medical cannabis, more evidence-based knowledge about the prevalence of cannabis use disorder (CUD) among medical users is greatly needed.
To examine and compare the prevalence and severity of CUD and the prevalence of different CUD criteria among two groups: those who combine recreational and medical use vs. those who exclusively use cannabis recreationally. To examine the association between CUD and sociodemographic characteristics, medical conditions, and psychiatric comorbidities between these two groups.
The National Epidemiological Survey on Alcohol and Related Conditions III data were used, a US nationally representative in-person interview of 36,309 adults aged ≥18 years collected in 2012-2013. The statistical examination included proportion comparison hypothesis testing and linear regressions, all using complex survey design analysis procedures.
Recreational users who used cannabis also for medical purposes had a higher prevalence of CUD in general, as well as mild and moderate CUD than users who used cannabis only for recreational purposes. CUD is more prevalent in recreational, medical users with the following characteristics: young, male, non-white, living in the Midwest, using a greater amount of cannabis, having a concurrent mental disorder, and had CUD before the past year.
Recreational, medical cannabis users have a higher likelihood of having CUD. Although the results should be taken with caution, given the lack of established validity of CUD among medical users, health care professionals who prescribe or recommend the use of cannabis for medical purposes should take this into consideration while evaluating the risks/benefits ratio of cannabis. They need to assess patients' recreational cannabis use, screen for CUD, and educate users about the possible complications caused by cannabis use.
随着大麻使用者数量的增加以及越来越多的司法管辖区允许医用大麻，对于医用大麻使用者中大麻使用障碍（CUD）患病率的循证知识的需求大幅增加。
检查并比较两组人群中CUD的患病率和严重程度以及不同CUD标准的患病率：同时进行娱乐性和医用大麻使用的人群与仅进行娱乐性大麻使用的人群。检查这两组人群中CUD与社会人口学特征、医疗状况和精神共病之间的关联。
使用了全国酒精及相关状况第三次流行病学调查的数据，该调查是2012 - 2013年对36309名年龄≥18岁的成年人进行的具有全国代表性的面对面访谈。统计检验包括比例比较假设检验和线性回归，均采用复杂抽样设计分析程序。
同时将大麻用于医疗目的的娱乐性使用者总体上CUD的患病率以及轻度和中度CUD的患病率高于仅将大麻用于娱乐目的的使用者。CUD在具有以下特征的娱乐性医用大麻使用者中更为普遍：年轻、男性、非白人、居住在中西部、使用大麻量更大、患有并发精神障碍以及在过去一年之前就患有CUD。
娱乐性医用大麻使用者患CUD的可能性更高。尽管鉴于医用大麻使用者中CUD的有效性尚未确立，这些结果应谨慎看待，但开具或推荐将大麻用于医疗目的的医疗保健专业人员在评估大麻的风险/效益比时应考虑到这一点。他们需要评估患者的娱乐性大麻使用情况，筛查CUD，并向使用者宣传大麻使用可能导致的并发症。
