SHORE & Whariki Research Centre, College of Health, Massey University, PO Box 6137, Victoria Street West, Auckland, 1142, New Zealand.
Harm Reduct J. 2024 Nov 5;21(1):192. doi: 10.1186/s12954-024-01111-w.
The substitution of cannabis for alcohol and other drugs has been conceptualised in a harm reduction framework as where cannabis is used to reduce the negative side-effects, addiction potential, and social stigma of other drugs. There is currently mixed evidence with recent reviews suggesting cannabis co-use patterns may vary by age and ethnicity. Yet few studies have had large enough samples to examine this demographic variation in detail.
To explore the co-use of cannabis with alcohol and other drugs within demographic subgroups of a large sample of people who use cannabis. Specifically: (1) whether cannabis is being substituted for other drugs, and (2), whether cannabis use leads to more, less or the same level of other drug use.
Online convenience survey promoted via Facebook™ completed by 23,500 New Zealand respondents. Those who had used cannabis and any of eight other substances in the same six-month period were asked if their use of cannabis had any impact on their use of each other substance ("a lot more", "little more", "no impact/same", "little less", "a lot less"). Frequency and quantity used of each other drug was compared by co-use group. Generalised logistic regression models were developed to predict co-use categories.
Significant proportions reported cannabis use led to "less" alcohol (60%), synthetic cannabinoid (60%), morphine (44%) and methamphetamine (40%) use. Those who reported using "less" had lower frequency and amount used of other drugs. Approximately seven-out-ten reported cannabis use had "no impact" on LSD, MDMA, and cocaine use. One-in-five reported using cannabis led to "more" tobacco use. Young adults (21-35-years) were more likely to report cannabis use led to "less" drinking and methamphetamine use. Adolescent co-users (16-20 years) reported mixed impacts. Māori were more likely to report cannabis use resulted in "less" alcohol, tobacco, methamphetamine, and LSD use. Students and those living in cities were less likely to report cannabis use lowering use of other substances.
Cannabis and other drug co-use patterns are moderated by life stages, lifestyles, cultural perspectives, and urbanicity. Harm reduction initiatives and policy reforms should take account of these moderating factors.
在减少伤害框架中，大麻替代酒精和其他药物的概念是指大麻被用于减少其他药物的负面副作用、成瘾潜力和社会耻辱感。最近的评论表明，大麻的共同使用模式可能因年龄和种族而异，目前证据存在分歧。然而，很少有研究有足够大的样本来详细研究这种人口统计学上的差异。
在大麻使用者的大样本中，探索大麻在人口统计学亚组中的共同使用情况，具体包括：（1）大麻是否被替代其他药物，以及（2）大麻使用是否导致其他药物使用增加、减少或相同。
通过 Facebook™ 在线便利调查，对 23500 名新西兰受访者进行了调查。那些在过去六个月内同时使用大麻和其他八种物质的人被问到他们使用大麻是否对他们使用其他物质有任何影响（“多得多”、“少得多”、“没有影响/相同”、“少一些”、“多一些”）。按共同使用组比较每种其他药物的使用频率和数量。开发了广义逻辑回归模型来预测共同使用类别。
相当大的比例报告说，大麻的使用导致“更少”的酒精（60%）、合成大麻素（60%）、吗啡（44%）和甲基苯丙胺（40%）的使用。那些报告使用“少”的人使用其他药物的频率和数量较低。大约十分之七的人报告说，大麻的使用对 LSD、MDMA 和可卡因的使用没有影响。五分之一的人报告说，大麻的使用导致“更多”的烟草使用。年轻人（21-35 岁）更有可能报告说，大麻的使用导致“更少”的饮酒和甲基苯丙胺的使用。青少年共同使用者（16-20 岁）报告了混合影响。毛利人更有可能报告说，大麻的使用导致“更少”的酒精、烟草、甲基苯丙胺和 LSD 的使用。学生和居住在城市的人不太可能报告说，大麻的使用降低了其他物质的使用。
大麻和其他药物的共同使用模式受到生命阶段、生活方式、文化视角和城市化的调节。减少伤害的倡议和政策改革应考虑到这些调节因素。
