Abstract：
BACKGROUND: Older adults are increasingly using medical cannabis (MC). It is unclear if therapeutic effects increase problematic use patterns. The current study addresses this issue by examining symptom trajectories across the day and using trajectories to predict problematic use.
METHODS: One-hundred six older adults (age range 55-74) who endorsed medical conditions approved for treatment using MC were recruited online. Participants received six text messages/day to assess momentary symptoms for 15 days.
RESULTS: Participants provided 5,156 momentary assessments across 1,106 use days. Symptom trajectories were examined across the day. There was a decline in all symptoms following use. Negative affect, pain, and nausea evinced momentary negative reinforcement associations with cannabis intoxication. Momentary negative reinforcement was associated with adverse cannabis outcomes. Declines in post-use trauma symptoms and momentary negative reinforcement effects for negative affect were both associated with cannabis use disorder symptoms.
CONCLUSIONS: These data suggest that MC may be effective in reducing common symptom clusters. However, the negative reinforcing effect (i.e., the link between use and symptom relief at the event level) may complicate the therapeutic nature (i.e., symptom reduction). Identifying interventions to maximize benefits while minimizing costs may increase the efficacy and safety of MC in older adults.
METHODS: One-hundred six older adults (age range 55-74) who endorsed medical conditions approved for treatment using MC were recruited online. Participants received six text messages/day to assess momentary symptoms for 15 days.
RESULTS: Participants provided 5,156 momentary assessments across 1,106 use days. Symptom trajectories were examined across the day. There was a decline in all symptoms following use. Negative affect, pain, and nausea evinced momentary negative reinforcement associations with cannabis intoxication. Momentary negative reinforcement was associated with adverse cannabis outcomes. Declines in post-use trauma symptoms and momentary negative reinforcement effects for negative affect were both associated with cannabis use disorder symptoms.
CONCLUSIONS: These data suggest that MC may be effective in reducing common symptom clusters. However, the negative reinforcing effect (i.e., the link between use and symptom relief at the event level) may complicate the therapeutic nature (i.e., symptom reduction). Identifying interventions to maximize benefits while minimizing costs may increase the efficacy and safety of MC in older adults.
摘要：
背景：老年人越来越多地使用医用大麻（MC）。目前尚不清楚治疗效果是否会增加有问题的使用模式。当前的研究通过检查一天中的症状轨迹并使用轨迹来预测有问题的使用来解决这个问题。
方法：在网上招募了106名老年人（年龄范围55-74岁），他们认可了使用MC治疗的医疗条件。参与者每天收到6条短信，以评估15天的瞬时症状。
结果：参与者在1,106个使用日中提供了5,156个瞬时评估。全天检查症状轨迹。使用后所有症状都有所下降。负面影响，疼痛,和恶心表明与大麻中毒的瞬时负强化关联。瞬时负强化与不良大麻结局相关。使用后创伤症状的下降和负面影响的瞬时负面强化效应都与大麻使用障碍症状有关。
结论：这些数据表明MC可能有效减少常见症状群。然而,负增强效应(即，在事件级别使用和症状缓解之间的联系)可能会使治疗性质复杂化(即，症状减轻)。确定干预措施以最大化收益，同时最小化成本可能会增加老年人MC的疗效和安全性。
方法：在网上招募了106名老年人（年龄范围55-74岁），他们认可了使用MC治疗的医疗条件。参与者每天收到6条短信，以评估15天的瞬时症状。
结果：参与者在1,106个使用日中提供了5,156个瞬时评估。全天检查症状轨迹。使用后所有症状都有所下降。负面影响，疼痛,和恶心表明与大麻中毒的瞬时负强化关联。瞬时负强化与不良大麻结局相关。使用后创伤症状的下降和负面影响的瞬时负面强化效应都与大麻使用障碍症状有关。
结论：这些数据表明MC可能有效减少常见症状群。然而,负增强效应(即，在事件级别使用和症状缓解之间的联系)可能会使治疗性质复杂化(即，症状减轻)。确定干预措施以最大化收益，同时最小化成本可能会增加老年人MC的疗效和安全性。
