佛罗里达州 NCI 指定癌症中心癌症诊断后有和无大麻使用史的癌症患者同时使用物质的情况。
Concurrent substance use among cancer patients with and without a history of cannabis use since cancer diagnosis at an NCI-Designated Cancer Center in Florida.
机构信息
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.
出版信息
J Natl Cancer Inst Monogr. 2024 Aug 15;2024(66):224-233. doi: 10.1093/jncimonographs/lgad036.
BACKGROUND
Although substance use may have adverse impacts on cancer outcomes, little is known regarding patterns of concurrent substance use with cannabis among cancer patients. Our objective was to examine predictors of concurrent substance use with cannabis among cancer patients since their cancer diagnosis and explore perceptions of cannabis among these patients.
METHODS
Patients treated at a National Cancer Institute-designated comprehensive cancer center were invited to participate in an electronic survey regarding medical cannabis from August to November 2021. Survey data were linked to internal data resources including electronic health records and patient intake forms to obtain history of substance use (defined as within at least 3 months of cancer diagnosis) of cigarettes, injection drugs, high levels of alcohol, or clinically unsupervised prescription drugs (total n = 1094). Concurrent substance users were defined as those with any reported substance use and cannabis use at the time of cancer diagnosis. We used descriptive statistics (χ2 or exact tests) to compare groups and estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) to identify predictors of substance use among users and nonusers of cannabis.
RESULTS
Approximately 45% (n = 489) of the sample reported cannabis use since their cancer diagnosis. Of patients who reported using cannabis, 20% self-reported concurrent polysubstance use, while 8% of cannabis nonusers reported substance use (P < .001). Among patients who use cannabis, those who reported 2 or more self-reported treatment-related symptoms (eg, pain, fatigue) were more likely to have self-reported concurrent substance use (AOR = 3.15, 95% CI = 1.07 to 9.27) compared with those without any symptoms. Among nonusers, those with lower educational background were more likely to have a history of concurrent substance use (AOR = 3.74, 95% CI = 1.57 to 8.92). Patients who use cannabis with concurrent substance use were more likely to report improved sleep (P = .04), increased appetite (P = .03), and treatment of additional medical conditions (P = .04) as perceived benefits of cannabis use.
CONCLUSIONS
High symptom burden may be associated with concurrent substance use with cannabis among cancer patients.
背景
尽管物质使用可能对癌症结果产生不良影响，但对于癌症患者同时使用大麻的模式知之甚少。我们的目的是研究癌症患者自诊断癌症以来同时使用大麻的预测因素，并探讨这些患者对大麻的看法。
方法
邀请在国立癌症研究所指定的综合癌症中心接受治疗的患者参加 2021 年 8 月至 11 月期间关于医用大麻的电子调查。调查数据与电子健康记录和患者入院表等内部数据资源相关联，以获取患者在癌症诊断后至少 3 个月内的物质使用史（定义为），包括香烟、注射毒品、大量饮酒或未经临床监督的处方药物（共 1094 例）。同时使用物质的患者定义为在癌症诊断时报告有任何物质使用和大麻使用的患者。我们使用描述性统计（χ2 或确切检验）比较组，并估计调整后的优势比（AOR）及其 95%置信区间（CI）以确定大麻使用者和非使用者的物质使用预测因素。
结果
约 45%（n=489）的样本报告自癌症诊断以来使用过大麻。在报告使用大麻的患者中，20%自我报告同时使用多种物质，而 8%的非大麻使用者报告物质使用（P<.001）。在使用大麻的患者中，那些报告有 2 个或更多与治疗相关的症状（例如，疼痛、疲劳）的患者更有可能同时报告使用其他物质（AOR=3.15，95%CI=1.07 至 9.27），而没有任何症状的患者则不然。在非使用者中，教育背景较低的患者更有可能同时使用物质（AOR=3.74，95%CI=1.57 至 8.92）。同时使用大麻和其他物质的患者更有可能报告睡眠改善（P=.04）、食欲增加（P=.03）和治疗其他医疗状况（P=.04），这些是他们认为使用大麻的好处。
结论
高症状负担可能与癌症患者同时使用大麻和其他物质有关。
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