美国娱乐用大麻合法化与大麻和酒精同时使用的流行率。
Cannabis Recreational Legalization and Prevalence of Simultaneous Cannabis and Alcohol Use in the United States.
机构信息
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St Room 509, New York, NY, 10032, USA.
School of Government & Public Policy, University of Arizona, Tucson, USA.
出版信息
J Gen Intern Med. 2023 May;38(6):1493-1500. doi: 10.1007/s11606-022-07948-w. Epub 2022 Nov 30.
BACKGROUND
Simultaneous cannabis/alcohol use, using both substances within a short time interval so that their effects overlap, has a greater risk of potential negative consequences than single-substance use and is more common in younger age. Relationships between recreational cannabis laws (RCLs) and changes in simultaneous cannabis/alcohol use prevalence remain untested.
OBJECTIVE
To examine trends in simultaneous cannabis/alcohol use from 2008 to 2019, and investigate associations between implementation of RCLs (i.e., presence of active legal dispensaries or legal home cultivation) and simultaneous cannabis/alcohol use in the United States (U.S.).
DESIGN
Repeated cross-sectional samples from the 2008-2019 U.S. National Survey on Drug Use and Health (NSDUH).
PARTICIPANTS
Respondents (51% female) aged 12 and older.
INTERVENTIONS
Changes in simultaneous cannabis/alcohol use before and after RCL implementation (controlling for medical cannabis law implementation) were compared in different age groups (12-20, 21-30, 31-40, 41-50, 51+), using adjusted multi-level logistic regression with state random intercepts and an RCL/age group interaction.
MEASUREMENTS
Self-reported simultaneous cannabis/alcohol use.
RESULTS
From 2008 to 2019, the overall prevalence of simultaneous cannabis/alcohol use declined among those aged 12-20 but increased in adults aged 21+. Model-based simultaneous cannabis/alcohol use prevalence increased after RCL implementation among respondents aged 21-30 years (+1.2%; aOR= 1.15 [95%CI = 1.04-1.27]), 31-40 years (+1.0; 1.15 [1.04-1.27]), and 41-50 years (+1.75; 1.63 [1.34-1.98]), but not in individuals aged <21 or 51+ years.
CONCLUSIONS
Implementation of recreational cannabis policies resulted in increased simultaneous use of cannabis and alcohol, supporting the complementarity hypothesis, but only among adults aged 21+. Efforts to minimize harms related to simultaneous cannabis/alcohol use are critical, especially in states with RCLs. Future studies should investigate cultural norms, perceived harm, and motives related to simultaneous use.
背景
同时使用大麻和酒精，即在短时间内同时使用两种物质，其效果会重叠，比单独使用一种物质的潜在负面影响风险更大，并且在年轻人群中更为常见。娱乐用大麻法规（RCLs）与同时使用大麻和酒精流行率变化之间的关系尚未得到验证。
目的
本研究旨在调查 2008 年至 2019 年期间同时使用大麻和酒精的趋势，并研究美国（U.S.）实施 RCLs（即存在活跃的合法药房或合法家庭种植）与同时使用大麻和酒精之间的关联。
设计
重复的横截面样本来自 2008 年至 2019 年美国国家毒品使用和健康调查（NSDUH）。
参与者
年龄在 12 岁及以上的应答者（51%为女性）。
干预措施
在控制医用大麻法实施的情况下，比较 RCL 实施前后不同年龄组（12-20 岁、21-30 岁、31-40 岁、41-50 岁、51 岁及以上）同时使用大麻和酒精的变化，使用具有州随机截距和 RCL/年龄组交互作用的调整后的多级逻辑回归。
测量
自我报告的同时使用大麻和酒精。
结果
从 2008 年至 2019 年，12-20 岁人群的同时使用大麻和酒精的总体流行率下降，但 21 岁及以上成年人的流行率上升。RCL 实施后，21-30 岁（+1.2%；优势比[aOR]=1.15[95%置信区间（CI）=1.04-1.27]）、31-40 岁（+1.0%；1.15[1.04-1.27]）和 41-50 岁（+1.75%；1.63[1.34-1.98]）应答者的基于模型的同时使用大麻和酒精的流行率增加，但 21 岁以下或 51 岁及以上的应答者则不然。
结论
娱乐用大麻政策的实施导致大麻和酒精同时使用增加，支持互补假说，但仅在 21 岁及以上的成年人中如此。努力减少与同时使用大麻和酒精相关的危害至关重要，尤其是在有 RCL 的州。未来的研究应调查与同时使用相关的文化规范、感知危害和动机。
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