Cannabis Relapse: Influence of Tobacco Cessation

大麻复吸：戒烟的影响

• 批准号: 10425259
• 负责人: MARGARET HANEY
• 金额: $ 55.56万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10425259
• 关键词: 16 year old; Abstinence; Adolescence; Adolescent; Age; Alcohols; Behavioral; Blood; Cannabis; Characteristics; Cigarette; Cigarette Smoker; Clinical; Clinical Markers; Clinical Research; Cohort Studies; Corpus striatum structure; Data; Diagnosis; Ecology; Funding; Goals; Histone Acetylation; Human; Individual; Inpatients; Laboratories; Length; Marijuana Smoking; Measures; Mediating; Modeling; Mus; Nicotine; Outcome Study; Participant; Patients; Pharmaceutical Preparations; Pharmacotherapy; Procedures; Public Health; Relapse; Severities; Smoker; Smoking; Stimulant; Substance Use Disorder; Testing; Time; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco smoke; Tobacco smoking behavior; Tobacco use; Treatment outcome; base; cannabis cessation; cannabis withdrawal; cigarette smoking; drug reward; early onset; human study; improved; marijuana smoker; marijuana use; marijuana use disorder; novel; smoking cessation; tobacco abstinence; tobacco smokers

Currently, ∼17% of patients entering drug treatment has a diagnosis of Cannabis Use Disorder (CUD), yet few achieve sustained abstinence. Using an inpatient human laboratory model of CUD, we have shown that among daily cannabis smokers: (1) tobacco cigarette smokers have markedly higher rates of cannabis relapse in the laboratory relative to those who do not use tobacco (61% vs 15%), paralleling clinical evidence that tobacco and cannabis smokers have poorer CUD treatment outcome, (2) those who had their first tobacco cigarette prior to age 16 had higher rates of cannabis relapse after 7-days of tobacco cessation relative to those starting cigarettes at > 16 years (55% vs 21%), despite no differences in other tobacco- or cannabis-severity characteristics. When we compare cannabis relapse rates in this study as compared to our earlier study using closely similar procedures, we find that for those who started smoking cigarettes at > 16 years of age, 7 days of tobacco cessation was associated with rates of cannabis relapse as low as those seen in non-cigarette smokers. Yet for those who started smoking tobacco cigarettes earlier (<16 years of age), 7 days of tobacco cessation appeared to have no impact; cannabis relapse rates matched those seen in ongoing cigarette smokers. Thus, the age of first tobacco cigarette is a robust predictor of cannabis relapse following short-term tobacco cessation. It may be that the more intractable cannabis smokers (those initiating tobacco use early) require a longer period of tobacco cessation to impact cannabis relapse than later-onset tobacco/cannabis smokers. In mice, daily nicotine administration enhanced the abuse-related behavioral effects of stimulants and alcohol, and nicotine abstinence for 14 days reversed these effects. The objective of this renewal application is to test both the duration of smoking cessation prior to cannabis abstinence and age of tobacco onset on cannabis relapse. We will compare the effects of 7- and 21-days of tobacco cessation on cannabis relapse (assessed both in the laboratory and the natural ecology) in daily cigarette-smoking, cannabis smokers, with half the participants in each group initiating tobacco cigarette smoking early (<16 years) and the other half later (>16 years). Blood measures of histone acetylation will be collected at study onset and following 14 days of confirmed tobacco abstinence. We hypothesize that (1) later-onset tobacco smokers will have significantly lower cannabis relapse rates than early-onset tobacco smokers after 7- but not 21 days of tobacco cessation, (2) histone acetylation will decrease as a function of tobacco cessation. To date, clinical studies with cannabis and tobacco smokers have had patients quit both drugs concurrently, and have not reduced cannabis relapse. No studies to our knowledge have tested tobacco cessation prior to cannabis treatment, yet this may be a more effective approach to achieving long-term cannabis abstinence. The outcome of this study has the potential to significantly impact CUD treatment and reduce cannabis relapse in the sizable proportion of tobacco-dependent patients seeking treatment for CUD.

目前，约有17％的进入药物治疗的患者患有大麻使用障碍（CUD），但很少 实现持续的禁欲。使用住院的人类实验室模型，我们已经表明 每日吸烟者：（1）烟草吸烟者的大麻减轻速度明显更高 实验室相对于那些不使用烟草的人（61％vs 15％），与烟草的临床证据并行 大麻吸烟者的CUD治疗结果较差，（2）那些有第一批烟草的人 16岁之前的大麻退休率较高，相对于开始的烟草戒烟7天 > 16年的香烟（55％vs 21％），dospite在其他烟草或大麻中没有差异 特征。当我们比较本研究中的大麻继电器率与我们先前的研究相比 非常相似的程序，我们发现对于那些在16岁以上开始抽烟的人来说 烟草戒烟与与非二烟中的大麻继电器速率相关 吸烟者。然而，对于那些开始吸烟的人（<16岁），7天的烟草 停止似乎没有影响。大麻中继率与正在进行的香烟中看到的率相匹配 吸烟者。那，第一烟烟的年龄是大麻继电器的强大预测指标 短期烟草戒烟。可能是吸烟者更棘手的大麻（那些发起烟草的人 尽早使用）需要更长的烟草戒烟才能影响大麻继电器 烟草/大麻吸烟者。在小鼠中，每日尼古丁管理增强了与滥用相关的行为 兴奋剂和酒精以及戒酒的影响14天反转了这些影响。目的 这种更新的应用是在大麻戒酒和年龄之前测试戒烟的持续时间 大麻继电器上的烟草发作。我们将比较7天和21天的烟草戒烟对 每天抽烟的大麻继电器（在实验室和自然生态学中评估）， 大麻吸烟者，每个小组的一半参与者提早发射烟草香烟（<16 年），另一半之后（> 16年）。在研究中将收集组蛋白乙酰化的血液测量 发病并在经过14天的确认烟草禁欲。我们假设（1）以后发作的烟草 吸烟者的大麻继电器速率将比早期发作的烟草在7-但不降低 21天的烟草戒烟，（2）Hisstone乙酰化将随着烟草戒烟的作用而减少。迄今为止， 大麻和烟草吸烟者的临床研究使患者同时退出两种药物，并且 不会减少大麻继电器。据我们所知，没有研究大麻之前测试了烟草戒烟 治疗，但这可能是实现长期大麻节制的一种更有效的方法。 这项研究的结果有可能显着影响CUD治疗并减少大麻退休 寻求CUD治疗的烟草依赖性患者的相当比例。