Budney A J, Bickel W K, Amass L
University of Vermont, Department of Psychiatry, S. Burlington 05403, USA.
Addiction. 1998 Apr;93(4):493-503. doi: 10.1046/j.1360-0443.1998.9344935.x.
Information concerning the association between marijuana use and opioid dependence and its treatment is needed to determine effective clinical guidelines for addressing marijuana use among opioid abusers.
Marijuana use was assessed in 107 people enrolled in treatment for opioid dependence.
Univariate comparisons of marijuana users and non-users and multivariate regression analyses were performed to examine associations between marijuana use and socio-demographic, psychosocial, medical and substance-use variables. The relationship between marijuana use and treatment outcome was also explored in a subset of this sample who received treatment that included buprenorphine detoxification and behavior therapy (N = 79).
Sixty-six per cent of participants were current marijuana users and almost all (94%) continued to use during treatment. Users were less likely to be married than non-users, and more likely to report financial difficulties, be involved in drug dealing and engage in sharing of needles (p < 0.05). A unique effect of marijuana use on drug dealing and sharing needles was retained after statistically controlling for the influence of heroin and alcohol use and other socio-demographic variables. No significant adverse relations were observed between marijuana use and treatment outcome.
Pending a more comprehensive understanding of the function and consequences of marijuana use on psychosocial functioning, it appears that progress in treatment for opioid dependence can be made without mandating that patients abstain from marijuana use.
为确定针对阿片类药物滥用者使用大麻问题的有效临床指南,需要有关使用大麻与阿片类药物依赖及其治疗之间关联的信息。
对107名接受阿片类药物依赖治疗的人员进行了大麻使用情况评估。
对大麻使用者和非使用者进行单变量比较,并进行多变量回归分析,以研究大麻使用与社会人口统计学、心理社会、医学和物质使用变量之间的关联。还在该样本中接受包括丁丙诺啡脱毒和行为疗法在内治疗的一个子集中(N = 79),探讨了大麻使用与治疗结果之间的关系。
66%的参与者目前使用大麻,几乎所有(94%)在治疗期间仍继续使用。使用者结婚的可能性低于非使用者,更有可能报告经济困难、参与毒品交易和共用针头(p < 0.05)。在对海洛因和酒精使用以及其他社会人口统计学变量的影响进行统计控制后,大麻使用对毒品交易和共用针头仍有独特影响。未观察到大麻使用与治疗结果之间存在显著的不良关系。
在对大麻使用对心理社会功能的作用和后果有更全面了解之前,似乎在不要求患者戒除大麻使用的情况下,阿片类药物依赖治疗也可以取得进展。