The authors sought to determine whether cannabis use is associated with a change in the risk of incident nonmedical prescription opioid use and opioid use disorder at 3-year follow-up.

The authors used logistic regression models to assess prospective associations between cannabis use at wave 1 (2001–2002) and nonmedical prescription opioid use and prescription opioid use disorder at wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Corresponding analyses were performed among adults with moderate or more severe pain and with nonmedical opioid use at wave 1. Cannabis and prescription opioid use were measured with a structured interview (the Alcohol Use Disorder and Associated Disabilities Interview Schedule–DSM-IV version). Other covariates included age, sex, race/ethnicity, anxiety or mood disorders, family history of drug, alcohol, and behavioral problems, and, in opioid use disorder analyses, nonmedical opioid use.

In logistic regression models, cannabis use at wave 1 was associated with increased incident nonmedical prescription opioid use (odds ratio=5.78, 95% CI=4.23–7.90) and opioid use disorder (odds ratio=7.76, 95% CI=4.95–12.16) at wave 2. These associations remained significant after adjustment for background characteristics (nonmedical opioid use: adjusted odds ratio=2.62, 95% CI=1.86–3.69; opioid use disorder: adjusted odds ratio=2.18, 95% CI=1.14–4.14). Among adults with pain at wave 1, cannabis use was also associated with increased incident nonmedical opioid use (adjusted odds ratio=2.99, 95% CI=1.63–5.47) at wave 2; it was also associated with increased incident prescription opioid use disorder, although the association fell short of significance (adjusted odds ratio=2.14, 95% CI=0.95–4.83). Among adults with nonmedical opioid use at wave 1, cannabis use was also associated with an increase in nonmedical opioid use (adjusted odds ratio=3.13, 95% CI=1.19–8.23).

Cannabis use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder.

作者试图确定在三年的随访中，大麻的使用是否与非医学处方阿片类药物使用和阿片类药物使用障碍的风险变化相关。

作者使用逻辑回归模型评估了第一波（2001-2002年）的大麻使用与国家酒精和相关疾病流行病学调查第二波（2004-2005年）的非医学处方阿片类药物使用和处方阿片类药物使用障碍之间的前瞻性关联。在中度或重度疼痛且在第一波使用非医学类阿片类药物的成人中进行了相应的分析，并通过结构化访谈（酒精使用障碍和相关残疾访谈时间表–DSM-IV版）对大麻和处方类阿片类药物的使用进行了测量。其他协变量包括年龄，性别，种族/民族，焦虑或情绪障碍，药物家族史，饮酒和行为问题，以及在阿片类药物使用障碍分析中，非医学类阿片药物使用。

在Logistic回归模型中，第1波的大麻使用与非医疗处方阿片类药物事件的使用增加（几率= 5.78，95％CI = 4.23-7.90）和阿片类药物使用障碍（几率= 7.76，95％CI = 4.95-12.16）有关）在第2波。调整背景特征后，这些关联仍然很显着（非医学类阿片使用：调整后的优势比= 2.62，95％CI = 1.86–3.69；阿片类药物使用障碍：调整后的优势比= 2.18，95％CI = 1.14-4.14 ）。在第1浪中有疼痛的成年人中，在第2浪中，大麻的使用也与非医疗类鸦片药物的使用增加有关（调整比值比= 2.99，95％CI = 1.63–5.47）。尽管相关性不显着（校正比值比= 2.14，95％CI = 0.95–4.83），但它也与事件处方阿片类药物使用障碍增加有关。在第1浪中使用非医疗类阿片类药物的成年人中

大麻的使用似乎会增加而不是降低发展非医学处方阿片类药物使用和阿片类药物使用障碍的风险。