生物与医学2017journals.plos.org
能合法获得医用大麻的患者更可能停用阿片类药物
Patients with Access to Legal Medical Cannabis Are More Likely to Quit Opioids
入门 · 约 45 分钟读完前置知识：医用大麻合法化背景、阿片类药物危机基础
导读
这篇 PLOS ONE 论文研究了获得合法医用大麻是否有助于患者戒除阿片类药物，发现能够合法获取医用大麻的患者更可能停用阿片类药物。不过样本量较小（37 人），且以自我选择的背痛患者为主，作者和评论者都认为需要更大规模、更长期的研究来验证。
HN 关注点：医用大麻能否替代阿片类药物是阿片危机背景下的重要政策议题，HN 读者围绕药物合法化、制药业利益和研究方法学展开了讨论。
HN 评论精选
这几条评论里：支持 1 质疑 1 补充 1 亲历 1
支持认可结论但指出样本量小、样本偏差和长期复吸风险等方法学局限
大麻作为短期减害工具对某些人可能有用，但长期可能有风险——尤其当阿片类药物复吸发生时，过量风险会更高。另外，37 人的样本量、且严重偏向自我选择的背痛患者，令人担忧；生活质量调查似乎也未经标准化。总体上我同意他们的结论，期待更大规模、更长期的研究。
ademup查看英文原文
Canabis as a short term harm reduction tool may be good or useful for some people, but there may be danger in the long term, especially wrt overdosing if/when opioid relapse occurs. Also, the sample size of 37 & heavily weighted toward self selected back-pain sufferers is concerning. Also the quality of life survey does not appear to be one that is normed. Overall I would agree with their conclusion. I'm interested in larger studies, especially longer term. Edit: laRger
亲历以亲身经历说明成瘾者需要的是实际帮助，而现行医疗体系反而制造戒断障碍
我对大麻过敏，但完全支持医用大麻合法化。我曾因病情服用类固醇，类固醇对身体伤害很大。我前两次尝试停药都以重新加药告终，其中一次还进了急诊室并卧床一周。医生从未告诉我要逐渐减量，也没提供其他支持。是网络上的朋友告诉我需要逐渐减量、不能骤停，还建议我服用愈创甘油醚，并帮我弄清仿制药（不含蓝色染料和缓释成分）更适合我。一位朋友甚至手工为我分装药片作为圣诞礼物。这不仅帮我戒掉了类固醇，还在几年间帮我戒掉了多种其他处方药。成瘾者不是缺乏自律的人，而是需要切实帮助才能摆脱药物牢笼的人。我们目前的做法常常反而让戒断变得更难甚至不可能。
Mz查看英文原文
I am allergic to marijuana, but I fully support the legalization of medical marijuana. I was on steroids for my condition. Steroids are really hard on the body. My first two attempts to quit landed me back on additional medication. One involved an ER visit and a week in bed. Doctors never told me I needed to taper off, nor provided other support for helping me get off the steroids. Trying to quit was creating potentially life threatening crises for me. Doctors were not proactively helpful to me in escaping this trap that kept me on the steroids because trying to quit was threatening to kill me. An internet friend told me I needed to taper off, that going cold turkey was too hard on the body. A different internet friend told me to take guaifenesin, the active ingredient in Mucinex. Over time, internet friends helped me sort out that generics were tolerated better by me because they lack the blue dye and the time release stuff. They are also cheaper. One internet friend hand-packed pills for me as a Christmas gift to make sure I could get this drug with zero additives and in a lower dose than you can purchase OTC. This not only helped me get off the steroids, it helped me get off of multiple other prescription drugs over a period of several years. Addicts are not people who lack self discipline. They are people who need practical help to get free of the prison of their drugs. Our current approach frequently helps to actively make it harder or impossible for them to do that. Most doctors completely suck at helping patients effectively get off drugs. They are in the business of prescribing drugs and surgeries and can be shockingly oblivious to relatively cheap, simple solutions that can provide a patient with stepped down intervention so trying to quit isn't akin to hurling yourself off a cliff. And then we blame the addict for failing to get to the other side on their own. We have to stop this.
补充以葡萄牙去罪化为例，主张毒品战争彻底失败
葡萄牙是将所有毒品去罪化的决定性案例和依据。毒品战争的禁令一直是失败的政策，只会让监狱、军火供应商和政客发财，对减少药物滥用收效甚微，还毁掉了数百万人的生活及其家庭。
dailyvijeos查看英文原文
Portugual is the definitive case-study and justification for decriminalizing all drugs. The War on Drugs prohibition is, and always will be, a failure that just makes prisons, arms suppliers and politicians rich while doing little to reduce drug abuse and also destroys the lives of millions of people and their families.
质疑讽刺合法阿片类药物与非法大麻之间的双重标准，抨击制药业
一种药是'合法'的，但必须在实验室里做成药丸；另一种是非法的，但你可以在家里自己种植。猜猜哪个是哪个，以及为什么会这样。大多数制药公司应该被起诉或关闭——它们危害公众，靠虚假专利从公众身上牟取暴利。
monsieurgaufre查看英文原文
One is "legal", but has to be put into pills in labs. The other is illegal, but you can grow it yourself at home. Guess which is which and why. Most pharmaceutical companies should be sued/closed for endangering the public, extremely profiting from bogus patents at the expense of the public and so much more.
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- 2017Hacker News 讨论帖141 分 · 32 评
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