Legalizing cannabis
人们越来越普遍认为大麻是自然的，因此无害使用。实际上，许多沉迷于阿片类药物的人认为使用大麻是美沙酮的替代品，可以帮助他们控制阿片类药物的戒断症状。此外，越来越多的研究提倡使用大麻而不是阿片类药物来慢性疼痛。大麻对每个人所声称的无害吗？使大麻合法并最终更容易获得伤害或好处？
Criminalization of cannabis has been ineffective in reducing its use, generating larger societal costs with minimal effect on public health. Canada is moving towards legalization of cannabis, and therefore it is important for the public to be aware of potential risks of cannabis on people, especially people with opioid addiction in the current opioid epidemic before cannabis becomes widely available.
公众对大麻的看法是，它是一种无害的物质，主要是因为它不太可能导致过量导致死亡。虽然没有记录在大麻中致命过量服药的报道，但已经注意到其他不利后果，包括认知障碍，呼吸道问题和精神病症状。弱势群体，例如现有成瘾的人群，正面临这些不利事件的更大风险。
Opioid addiction
Opioid addiction (or阿片类药物use disorder) has skyrocketed around the globe, and is especially pervasive in Canada where it was declared a public health crisis. Deaths from opioid overdoses have become commonplace in Canada; the urgent need for adequate treatment options for those with opioid addictions has been emphasized by clinicians and the public.
大麻是一种广泛使用的物质，是美沙酮治疗中最常用的药物（男性60％和44％的女性）。
美沙酮维持治疗目前是阿片类药物成瘾的最古老，最广泛使用的药理治疗方法。接受治疗的人每天接受美沙酮（一种长效的合成阿片类药物），以减少渴望和缓解戒断症状，而不会产生其他阿片类药物的欣快作用。
尽管美沙酮治疗对许多患者有效，但其他有些人在治疗期间继续使用非法阿片类药物，这对过量和死亡构成了严重的健康风险。大麻是一种广泛使用的物质，是美沙酮治疗中最常用的药物（男性60％和44％的女性）。它的使用率比一般人群高得多，这导致了大麻对该人群的影响的问题。
当前的研究
In our study recently published in性别差异的生物学，we investigated the association between cannabis use and methadone treatment outcomes, in particular, concurrent illicit opioid use.Previous researchhas found differences in clinical profile and treatment outcomes between men and women, and therefore our study aimed to explore sex differences in cannabis use.
我们包括777名参与者（414名男性和363名女性）。大约60％的男性和44％的女性报告使用大麻。在控制年龄，美沙酮剂量和治疗时间长度之后，我们发现，如果是大麻使用者，则在美沙酮治疗时使用非法阿片类药物的可能性高82％。
我们发现，如果是大麻使用者，则在美沙酮治疗时使用非法阿片类药物的可能性也高82％。
Women in methadone treatment also have significantly worse physical and psychological functioning and higher rates of comorbid psychiatric disorders.最近的研究found the motivation for using cannabis varied between men and women, whereby women tended to report the primary purpose for using it was for self-medication, whereas men more often reported using cannabis was for recreational purposes. However what we see in this study is that women who use cannabis are not fairing well compared to men. Cannabis has not helped women and was associated with worse health outcomes for them.
接下来我们要去哪里？
Historically, addiction was a male-dominated problem, and thus past research and subsequently clinical practices are largely male-centric. Addiction treatment programs should adopt a more gender-informed approach to treatment to address the unique needs of men and women. The first step towards doing this may be to systematically screen for cannabis use in women on MMT, and aim to address their underlying physical and psychological symptoms in addition to the opioid addiction in order to improve treatment outcomes.
注释