“那些瘾君子”——德国大麻使用者中感知到的外部污名和自我污名：患病率及其与社会人口统计学、大麻使用模式和心理困扰的关联
"Those pot heads" - perceived external stigma and self-stigma among cannabis users in Germany: prevalence and associations with socio-demographics, cannabis use patterns and psychological distress.
作者信息
Rosenkranz Moritz, Schranz Anna, Verthein Uwe, Schomerus Georg, Speerforck Sven, Manthey Jakob
机构信息
Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany.
出版信息
J Cannabis Res. 2025 Sep 17;7(1):66. doi: 10.1186/s42238-025-00328-1.
BACKGROUND
Cannabis users have been stigmatized in the course of the long-standing prohibition. A recent law change in Germany made cannabis possession and cultivation legal for recreational use, potentially impacting stigmatization. This article aims to quantify the experience of perceived and self-stigma related to cannabis use before the law change and to explore associations with sociodemographic-, cannabis use pattern- and psychological distress-related items.
METHODS
Participants were recruited in 2023 from ISO-certified online access panels. A subsample of n = 684 regular (at least monthly) cannabis users was selected through quota-sampling based on age, gender, education, and federal state to reflect the demographic composition of the German population aged 18-64. A standardized online-questionnaire covering sociodemographics, health-related variables, cannabis use (frequency, purpose) as well as experiences of external and self-stigmatization was employed. Descriptive data analyses were performed utilizing the stigma-related items as outcome variables.
RESULTS
External Stigmatization was perceived by 30.6%, while 22.1% reported self-stigma concerning their cannabis use. Higher education, high psychological distress, medical use, and cannabis use disorder (CUD) were significantly associated with both external stigmatization and self-stigma. Respondents speaking publicly about their cannabis use show higher shares of external and self-stigma. Having been in trouble with the police regarding cannabis was positively associated with both types of stigmatization.
CONCLUSION
German residents who use cannabis at least monthly perceived external stigmatization and self-stigma related to cannabis consumption at a relevant level. As medical users and those with CUD are particularly affected, healthcare providers should be sensitized to the issue of stigmatization.
背景
在长期的大麻禁令期间，大麻使用者一直受到污名化。德国最近的一项法律变革使持有和种植用于娱乐用途的大麻合法化，这可能会影响污名化情况。本文旨在量化法律变革之前与大麻使用相关的感知污名和自我污名经历，并探讨其与社会人口统计学、大麻使用模式及心理困扰相关因素之间的关联。
方法
2023年从通过ISO认证的在线访问小组中招募参与者。通过基于年龄、性别、教育程度和联邦州的配额抽样，选取了n = 684名经常（至少每月一次）使用大麻的使用者作为子样本，以反映18 - 64岁德国人口的人口构成。采用了一份标准化的在线问卷，涵盖社会人口统计学、健康相关变量、大麻使用情况（频率、目的）以及外部和自我污名化经历。利用与污名相关的项目作为结果变量进行描述性数据分析。
结果
30.6%的人感知到外部污名，而22.1%的人报告称对自己的大麻使用存在自我污名。高等教育、高度心理困扰、医疗用途和大麻使用障碍（CUD）与外部污名和自我污名都显著相关。公开谈论自己大麻使用情况的受访者中，外部污名和自我污名的比例更高。因大麻问题与警方有过麻烦的人与两种污名化类型均呈正相关。
结论
至少每月使用一次大麻的德国居民在一定程度上感知到与大麻消费相关的外部污名和自我污名。由于医疗使用者和患有CUD的人受到的影响尤为严重，医疗保健提供者应提高对污名化问题的敏感度。
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