Objective:

Given changes in U.S. marijuana laws, attitudes, and use patterns, individuals with pain may be an emerging group at risk for nonmedical cannabis use and cannabis use disorder. The authors examined differences in the prevalence of nonmedical cannabis use and cannabis use disorder among U.S. adults with and without pain, as well as whether these differences widened over time.

Methods:

Data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001–2002; N=43,093) and NESARC-III (2012–2013; N=36,309) were analyzed using logistic regression. Risk differences of past-year nonmedical cannabis use, frequent (at least three times a week) nonmedical use, and DSM-IV cannabis use disorder were estimated for groups with and without moderate to severe pain, and these risk differences were tested for change over time.

Results:

Any nonmedical cannabis use was more prevalent in respondents with than without pain (2001–2002: 5.15% compared with 3.74%; 2012–2013: 12.42% compared with 9.02%), a risk difference significantly greater in the 2012–2013 data than in the 2001–2002 data. The prevalence of frequent nonmedical cannabis use did not differ by pain status in the 2001–2002 survey, but was significantly more prevalent in those with than without pain in the 2012–2013 survey (5.03% compared with 3.45%). Cannabis use disorder was more prevalent in respondents with than without pain (2001–2002: 1.77% compared with 1.35%; 2012–2013: 4.18% compared with 2.74%), a significantly greater risk difference in the data from 2012–2013 than from 2001–2002.

Conclusions:

The results suggest that adults with pain are a group increasingly vulnerable to adverse cannabis use outcomes, warranting clinical and public health attention to this risk. Psychiatrists and other health care providers treating patients with pain should monitor such patients for signs and symptoms of cannabis use disorder.

中文翻译：

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美国成年人疼痛，这一群体越来越容易受到非医疗性大麻使用和大麻使用障碍的困扰：2001-2002年和2012-2013年。

目的：

鉴于美国大麻法律，态度和使用方式的变化，患有疼痛的人可能是新兴群体，面临着非医疗用大麻和大麻使用障碍的风险。作者研究了有疼痛和无疼痛的美国成年人中非医学用大麻和大麻使用障碍的患病率差异，以及这些差异是否随着时间的推移而扩大。

方法：

使用Logistic回归分析了来自全国酒精和相关疾病流行病学调查（NESARC，2001–2002； N = 43,093）和NESARC-III（2012–2013； N = 36,309）的数据。对于有或没有中度至重度疼痛的组，估计了过去一年非医疗大麻使用，频繁（每周至少三次）和DSM-IV大麻使用障碍的风险差异，并测试了这些风险差异的变化时间。

结果：

有疼痛者比没有疼痛者更普遍使用非医疗大麻（2001-2002年：5.15％，相比之下，则为3.74％； 2012-2013年：12.42％，相比，9.02％），2012-2013年数据中的风险差异明显大于2001-2002年的数据。在2001–2002年的调查中，经常使用非医用大麻的患病率因疼痛状况而无差异，但在2012–2013年的调查中，有痛者的患病率比无痛者的患病率要高得多（5.03％，而3.45％）。大麻使用障碍在没有疼痛的受访者中更普遍（2001–2002：1.77％，相比于1.35％； 2012–2013：4.18％，相比于2.74％），2012–2013年数据的风险差异明显大于2001–2002。

结论：

结果表明，患有疼痛的成年人越来越容易受到不利的大麻使用后果的影响，因此有必要在临床和公共卫生方面关注这一风险。治疗疼痛患者的精神科医生和其他医疗保健提供者应监视此类患者的大麻使用障碍的体征和症状。