Cannabis use during methadone maintenance treatment for opioid use disorder: a systematic review and meta-analysis.

CMAJ open Pub Date : 2019-10-01 DOI:10.9778/cmajo.20190026
H. McBrien, Candice Luo, N. Sanger, L. Zielinski, Meha Bhatt, Xi Ming Zhu, D. Marsh, L. Thabane, Z. Samaan
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引用次数: 22

Abstract

BACKGROUND Rates of cannabis use among patients receiving methadone maintenance therapy are high, and cannabis use may be associated with outcomes of methadone maintenance therapy. We examined the effect of cannabis use on opioid use in patients receiving methadone maintenance therapy to test the hypothesis that cannabis use is associated with a reduction in opioid use. METHODS In this systematic review, we searched MEDLINE/PubMed, Embase, PsycINFO, CINAHL and ProQuest Dissertations and Theses Global from inception to July 12, 2018. We summarized the effects of cannabis use on opioid use during methadone maintenance therapy and treatment retention. We conducted meta-analyses using a random effects model. RESULTS We included 23 studies in our review. We performed a meta-analysis of 6 studies, with a total number of participants of 3676, examining use of cannabis and opioids during methadone maintenance therapy. Owing to high heterogeneity, we described the studies qualitatively but provide the forest plots as supplemental material. The overall quality of evidence was very low, with a high risk of bias, owing to the nature of observational studies. INTERPRETATION We found no consensus among studies that cannabis use is associated with reduced opioid use or longer treatment retention when used during methadone maintenance therapy in patients with opioid use disorder. PROSPERO Registration: CRD42015029372.
美沙酮维持治疗阿片类药物使用障碍期间使用大麻:系统综述和荟萃分析。
背景接受美沙酮维持治疗的患者中大麻使用率很高,大麻使用可能与美沙酮保持治疗的结果有关。我们研究了接受美沙酮维持治疗的患者使用大麻对阿片类药物使用的影响,以检验大麻使用与阿片类物质使用减少有关的假设。方法在本系统综述中,我们检索了MEDLINE/PubMed、Embase、PsycINFO、CINAHL和ProQuest从成立到2018年7月12日的全球论文和论文。我们总结了在美沙酮维持治疗和治疗保留期间大麻使用对阿片类药物使用的影响。我们使用随机效应模型进行了荟萃分析。结果我们在综述中纳入了23项研究。我们对6项研究进行了荟萃分析,共有3676名参与者,研究了美沙酮维持治疗期间大麻和阿片类药物的使用情况。由于高度异质性,我们对研究进行了定性描述,但提供了森林地块作为补充材料。由于观察性研究的性质,证据的总体质量非常低,存在偏见的风险很高。解释我们发现,在阿片类药物使用障碍患者的美沙酮维持治疗中,大麻的使用与阿片类物质使用减少或治疗持续时间延长有关,这在研究中没有达成共识。PROSPERO注册号:CRD42015023972。
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CiteScore
5.40
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