Introduction: Amphetamine-type stimulants (ATSs) are the second most commonly used class of illegal substances in Europe. Although concurrent substance use has been subject to research, little is known about associations between concurrent use of cocaine, alcohol, or cannabis and ATS dependence. We expect that the concurrent use of any of the substance, especially cannabis and cocaine, is associated with ATS dependence. Methods: Cross-sectional data were gathered within the European ATTUNE study in 2018/2019. Participants (N = 721) were asked about their consumption patterns and social, psychological, and economic situation. Multivariate logistic regressions were carried out for associations between ATS dependence and use combinations of frequent cocaine, alcohol, or cannabis, with the reference group of no frequent concurrent use (model 1). Model 2 calculated associations for ATS dependence with lifetime methamphetamine use for respective use combinations. Results: The study population was on average 28.9 years old (SD = 7.7), with the majority being male (63.5%). In model 1, the adjusted odds ratio (aOR) for frequent alcohol use was 0.70 (confidence interval [CI] 0.41–1.20). Similar results were shown for model 2 (aOR 0.82, CI 0.42–1.62). Frequent cannabis use significantly reduced the chance for ATS dependence by 50% in adjusted model 1 (aOR 0.50, CI 0.28–0.89) and by 62% in model 2 (aOR 0.38, CI 0.18–0.82). For frequent cocaine use, models 1 and 2 report an aOR at 1.37 (CI 0.58–3.25) and 2.39 (CI 0.77–7.43), although not statistically significant. Frequent users of all 3 substances had a significant 3-fold chance for ATS dependence (model 1: aOR 2.98, CI 1.16–7.63; model 2: aOR 2.95, CI 1.02–8.58). Discussion: Against initial hypotheses, frequent concurrent use of alcohol or cannabis generally decreased chances for ATS dependence. An explanation could be the study population, which consists of many irregular users of ATS, who mainly consume alcohol or cannabis. Cocaine generally increased chances, although results were not significant. The frequent use of all 3 substances together with ATS in the last year was significantly associated with dependence, thus reporting important information for treatment services. Further research is needed for disentangling causal relationships underlying these associations and for pinpointing consequences for relapse prevention and retention success.
Eur Addict Res

中文翻译：

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安非他明类兴奋剂依赖与同时使用可卡因、酒精和大麻的关联：一项横断面研究

简介：苯丙胺类兴奋剂 (ATS) 是欧洲第二大最常用的非法物质类别。尽管同时使用药物已受到研究，但关于同时使用可卡因、酒精或大麻与 ATS 依赖之间的关联知之甚少。我们预计同时使用任何物质，尤其是大麻和可卡因，都与 ATS 依赖有关。方法：横断面数据是在 2018/2019 年欧洲 ATTUNE 研究中收集的。参与者（ N= 721) 被问及他们的消费模式和社会、心理和经济状况。对 ATS 依赖与频繁使用可卡因、酒精或大麻的组合之间的关联进行了多变量逻辑回归，参考组不经常同时使用（模型 1）。模型 2 计算了 ATS 依赖性与终生甲基苯丙胺使用的相关性，用于各自的使用组合。结果：研究人群平均为 28.9 岁（SD = 7.7），其中大多数为男性（63.5%）。在模型 1 中，频繁饮酒的调整优势比 (aOR) 为 0.70（置信区间 [CI] 0.41–1.20）。模型 2 显示了类似的结果（aOR 0.82，CI 0.42–1.62）。在调整后的模型 1（aOR 0.50，CI 0.28-0.89）和模型 2 中，频繁使用大麻显着降低了 50% 的 ATS 依赖机会（aOR 0.38，CI 0.18-0.82）。对于频繁使用可卡因，模型 1 和 2 报告的 aOR 分别为 1.37 (CI 0.58–3.25) 和 2.39 (CI 0.77–7.43)，尽管没有统计学意义。所有 3 种物质的频繁使用者对 ATS 依赖的几率是显着的 3 倍（模型 1：aOR 2.98，CI 1.16–7.63；模型 2：aOR 2.95，CI 1.02–8.58）。讨论：与最初的假设相反，经常同时使用酒精或大麻通常会降低 ATS 依赖的机会。一个解释可能是研究人群，其中包括许多非正常使用 ATS 的人，他们主要消费酒精或大麻。可卡因通常会增加机会，尽管结果并不显着。去年所有 3 种物质连同 ATS 的频繁使用与依赖显着相关，因此报告了治疗服务的重要信息。需要进一步的研究来解开这些关联背后的因果关系，并确定复发预防和保留成功的后果。
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