Quantifying the Clinical Significance of Cannabis Withdrawal 英文参考文献.docVIP

QuantifyingtheClinicalSignificanceofCannabis Withdrawal DavidJ.Allsop1*,JanCopeland1,MelissaM.Norberg1,ShanlinFu2,AnnaMolnar2,JohnLewis2, AlanJ.Budney3 1 National Cannabis Prevention and Information Centre, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia, 2 Centre for Forensic Science, School of Chemistry and Forensic Science, University of Technology Sydney (UTS), New South Wales, Australia,3 Geisel School of Medicine at Dartmouth, Hanover, Lebanon, New Hampshire, United States of America Abstract Background and Aims: Questions over the clinical significance of cannabis withdrawal have hindered its inclusion as a discrete cannabis induced psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). This study aims to quantify functional impairment to normal daily activities from cannabis withdrawal, and looks at the factors predicting functional impairment. In addition the study tests the influence of functional impairment from cannabis withdrawal on cannabis use during and after an abstinence attempt. Methods and Results: A volunteer sample of 49 non-treatment seeking cannabis users who met DSM-IV criteria for dependence provided daily withdrawal-related functional impairment scores during a one-week baseline phase and two weeks of monitored abstinence from cannabis with a one month follow up. Functional impairment from withdrawal symptoms was strongly associated with symptom severity (p = 0.0001). Participants with more severe cannabis dependence before the abstinence attempt reported greater functional impairment from cannabis withdrawal (p = 0.03). Relapse to cannabis use during the abstinence period was associated with greater functional impairment from a subset of withdrawal symptoms in high dependence users. Higher levels