Mills Llewellyn, Arnold Jonathon C, Mcgregor Iain S, Lintzeris Nicholas
Drug and Alcohol Services, South Eastern Sydney Local Health District, New South Wales, Australia.
Specialty of Addiction Medicine, Faculty Medicine and Health, University of Sydney, New South Wales, Australia.
Drug Alcohol Depend Rep. 2025 Jul 19;16:100362. doi: 10.1016/j.dadr.2025.100362. eCollection 2025 Sep.
People who use cannabis medically do so more frequently than those who use nonmedically, potentially placing them at higher risk of cannabis use disorder (CUD). Prescription involves receiving guidance from doctors how best to administer medication; however, it remains unknown whether prescribed medical cannabis is associated with reduced incidence of CUD compared to illicit.
Data came from a 2022-23 online anonymous cross-sectional survey of Australians who had used medical cannabis. We examined differences between respondents who use Prescribed medical cannabis and respondents who use Illicit medical cannabis in demographic characteristics, patterns of use, and odds of meeting DSM-5 criteria for Any-CUD (≥2/11 criteria) and Moderate-Severe-CUD (≥4/11). Bayesian penalised regression models were used to identify the most important factors associated with CUD.
Of 1796 respondents, 43 % met Any- and 17 % Moderate-Severe CUD criteria. In bivariate analyses, respondents who sourced illicit medical cannabis were more likely to meet criteria for Any CUD (53 % vs 41 %, OR=1.6 [CI: 1.3, 2.0]) and Moderate-Severe CUD (25 % vs 15 %, OR=2.0 [CI: 1.5, 2.6]) than those who were prescribed; however, with other factors controlled for, age, frequency-of-use, mental health, THC content, route of administration, and proportion of medical vs nonmedical cannabis use were more important correlates than whether medical cannabis was prescribed or illicitly sourced.
CUD is common amongst people who use medical cannabis. While CUD was less prevalent among people who obtained it on prescription than those who obtained it illicitly, other factors such as the concomitant use of cannabis for nonmedical reasons were a more important correlate with CUD.
医用大麻使用者的使用频率高于非医用大麻使用者，这可能使他们面临更高的大麻使用障碍（CUD）风险。开具处方意味着从医生那里获得关于如何最佳用药的指导；然而，与非法获取的医用大麻相比，开具处方的医用大麻是否与降低CUD发病率相关尚不清楚。
数据来自2022 - 2023年对使用过医用大麻的澳大利亚人的在线匿名横断面调查。我们研究了使用开具处方的医用大麻的受访者与使用非法获取的医用大麻的受访者在人口统计学特征、使用模式以及符合《精神疾病诊断与统计手册》第五版（DSM - 5）中任何CUD（≥2/11项标准）和中重度CUD（≥4/11项标准）标准的几率方面的差异。使用贝叶斯惩罚回归模型来确定与CUD相关的最重要因素。
在1796名受访者中，43%符合任何CUD标准，17%符合中重度CUD标准。在双变量分析中，获取非法医用大麻的受访者比开具处方者更有可能符合任何CUD标准（53%对41%，比值比[OR]=1.6[置信区间：1.3, 2.0]）和中重度CUD标准（25%对15%，OR = 2.0[置信区间：1.5, 2.6]）；然而，在控制了其他因素后，年龄、使用频率、心理健康状况、四氢大麻酚（THC）含量、给药途径以及医用大麻与非医用大麻使用的比例等因素比医用大麻是开具处方获取还是非法获取更能显著影响CUD。
CUD在使用医用大麻的人群中很常见。虽然通过处方获取医用大麻的人群中CUD的患病率低于非法获取者，但其他因素，如出于非医疗原因同时使用大麻，与CUD的关联更为重要。
