Cannabis Relapse: Influence of Tobacco Cessation

大麻复吸：戒烟的影响

基本信息

批准号：
9788370
负责人：
MARGARET HANEY
金额：
$ 54.3万
依托单位：
NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-30 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9788370
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 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 use marijuana use disorder novel smoking cessation tobacco abstinence tobacco smokers

项目摘要

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 17% 接受药物治疗的患者被诊断为大麻使用障碍 (CUD)，但很少有人使用 CUD 住院患者实验室模型，我们已经证明，在每日吸食大麻者：(1) 吸烟者的大麻复吸率明显较高与不使用烟草的人相比（61% vs 15%），与烟草的临床证据相一致和大麻吸烟者的 CUD 治疗结果较差，(2) 那些第一次吸烟草的人与开始戒烟的人相比，16 岁之前戒烟 7 天后吸食大麻的复吸率更高吸烟年龄 > 16 岁（55% 比 21%），尽管其他烟草或大麻严重程度没有差异当我们将本研究中的大麻复发率与我们之前使用的研究进行比较时。与此类似的程序，我们发现对于 16 岁以上开始吸烟的人，7 天戒烟与大麻复吸率的相关性与非吸烟者一样低然而，对于那些较早开始吸烟的人（<16 岁），吸烟 7 天。戒烟似乎没有影响；大麻复吸率与持续吸烟的复吸率相当。因此，第一次吸烟的年龄是大麻复吸的有力预测因素。短期戒烟可能是那些更顽固的大麻吸烟者（那些开始吸烟的人）。早期使用）需要比晚发更长的戒烟时间才能影响大麻复吸在小鼠中，每天服用尼古丁会增强吸烟者与滥用相关的行为。兴奋剂和酒精的影响以及尼古丁戒断 14 天逆转了这些影响。该更新应用程序旨在测试戒除大麻之前戒烟的持续时间和年龄我们将比较戒烟 7 天和 21 天对大麻复吸的影响。日常吸烟中的大麻复发（在实验室和自然生态中进行评估），大麻吸烟者，每组中有一半的参与者很早就开始吸烟（<16 年），另一半（> 16 年）将在研究时收集组蛋白乙酰化的血液测量值。发病后和确认戒烟 14 天后，我们追求 (1) 晚发型烟草。 7 岁后吸烟者的大麻复吸率明显低于早发性吸烟者，但并非如此戒烟 21 天，(2) 组蛋白乙酰化将随着戒烟而降低。对吸食大麻和吸烟者的临床研究已让患者同时戒掉这两种药物，并且据我们所知，没有研究测试在吸食大麻之前戒烟。治疗，但这可能是实现长期大麻戒断的更有效方法。这项研究的结果有可能显着影响 CUD 治疗并减少大麻复发相当大比例的烟草依赖患者寻求 CUD 治疗。