Cannabis legalization and changes in young adult substance use, related health risk behaviors, and risk factors in Washington State: Within-state variation and the role of community-level factors

华盛顿州大麻合法化和年轻人物质使用、相关健康风险行为和风险因素的变化：州内差异和社区层面因素的作用

• 批准号: 10207582
• 负责人: Katarina Guttmannova
• 金额: $ 28.59万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10207582
• 关键词: Adult; Age; Alcohols; Area; Cannabis; Case Study; Cities; Communities; County; Criminal Justice; Data; Data Collection; Databases; Development; Disadvantaged; Disease; District of Columbia; Driving While Intoxicated; Etiology; Evaluation; Funding; Geographic Distribution; Health; Health Surveys; Human; Individual; Intervention; Laws; Legal; Lifestyle-related condition; Link; Longitudinal cohort; Longitudinal cohort study; Municipalities; Outcome; Perception; Personal Satisfaction; Pharmaceutical Preparations; Play; Policies; Prevalence; Prevention; Prevention program; Problem behavior; Public Health; Regulation; Reporting; Research; Resources; Risk Behaviors; Risk Factors; Role; Sales; Shapes; Social Health Services; Social Justice; Spatial Distribution; Statutes and Laws; Surveys; Testing; Time; Variant; Voting; Washington; aged; cohort; density; economic cost; implementation intervention; improved; infancy; intervention program; marijuana legalization; marijuana use; neighborhood disadvantage; nonmedical use; secondary analysis; social; socioeconomic disadvantage; substance use; young adult

ABSTRACT Cannabis use among young adults is widespread and national studies indicate increases in recent years in prevalence of cannabis use, including daily use. As of November 2018, 10 U.S. states and the District of Columbia have legalized cannabis for non-medical (“recreational”) use for adults aged 21 and older. Washington State was on the forefront of these changes, voting to approve legalization in 2012 and effectively implementing the legislation two years later. Although a major argument for legalization was its potential to decrease the human, social, and economic costs related to criminal justice involvement, an un-intended detrimental consequence might involve its impact on cannabis and other substance use (SU). Importantly, the impact of policy implementation may be felt differently across the state. Local jurisdictions in many communities passed ordinances that impose restrictions on the cannabis market. Further, in municipalities where no bans are in place, the geographic distribution of stores is uneven, with cannabis retail stores often concentrating in socio-economically disadvantaged neighborhoods. Research on the evaluation of the effects of legalization on cannabis use is only in its infancy; little is known about the etiology of SU and related health risk behaviors, such as driving while intoxicated, and the role of community- and individual level cannabis- specific risk factors in the context of legalized cannabis. Moreover, it is unclear how relationships among use of different substances may change during the course of implementation or developmentally. The salience of known risk factors may also change during implementation, by context or over the course of young adulthood. This project capitalizes on unique and rich data we collected with funding from the WA State Department of Social and Health Services. The WA State Young Adult Health Survey (YAHS) is an accelerated longitudinal cohort study of young adults ages 18-29 from 2014-2018 with the first data collection occurring before any legal cannabis stores opened and additional cohorts added in each of the four subsequent years. The survey data will be linked with a cannabis policy database that denotes local variation in cannabis context, including regulations and restrictions on sales, and with data on density of stores and neighborhood disadvantage. This project aims to examine effects of cannabis legalization on SU and related health risk behaviors among young adults in WA State. We will also assess within-state variation in SU outcomes as it relates to community-level factors such as city and county policy, cannabis and alcohol retail outlet availability, and neighborhood disadvantage. Moreover, we will examine the trajectories of SU and their interplay over the course of young adulthood and the role of the community-level factors in the etiology of young adult SU and related outcomes in the context of legalized cannabis. Understanding these effects will inform (1) planning of prevention and intervention efforts aimed at improving health outcomes and reducing problem behaviors in the changing cannabis policy context; and (2) regulatory provisions for the existing and new policies related to cannabis.

抽象的 大麻在年轻人中使用大麻是广泛的，国家研究表明近年来有所增加 大麻使用的患病率，包括日常使用。截至2018年11月，美国10个州和地区 哥伦比亚已将21岁及以上成人的非医疗（“娱乐性”）使用大麻合法化。 华盛顿州处于这些变化的最前沿，投票决定在2012年批准合法化，并有效地批准 两年后实施立法。尽管合法化的主要论点是它的潜力 减少与刑事司法参与有关的人类，社会和经济成本 有害后果可能涉及其对大麻和其他物质使用（SU）的影响。重要的是， 在全州，政策实施的影响可能会有所不同。许多地方司法管辖区 社区通过了对大麻市场施加限制的条例。此外，在市政当局 在没有禁令的地方，商店的地理分布不均匀，大麻零售店经常 集中于社会经济处于弱势群体的社区。对影响评估的研究 大麻使用合法化仅在起步阶段；关于SU和相关健康的病因知之甚少 风险行为，例如陶醉时驾驶，以及社区和个人水平的大麻的作用 合法大麻的背景下的特定风险因素。此外，目前尚不清楚如何使用之间的关系 在实施或发展过程中可能会发生不同的物质。显着性 已知的危险因素在实施期间，环境或成年期间也可能发生变化。 该项目利用了我们从西澳州国务院的资金收集的独特而丰富的数据 社会和卫生服务。西澳州年轻成人健康调查（YAHS）是一个加速的纵向 2014 - 2018年18至29岁的年轻人的队列研究，第一个数据收集在任何之前发生 合法的大麻商店开业，随后的四年中的每一个都增加了同类人群。调查 数据将与大麻策略数据库链接，该数据库表示大麻环境中的局部变化 销售的法规和限制，以及有关商店和邻里灾难密度的数据。这 项目旨在检查大麻合法化对SU和相关健康风险行为的影响 西澳大利亚州的成年人。我们还将评估与社区级别相关的SU成果的州内变化 诸如城市和县政策，大麻和酒精零售店的可用性以及邻里等因素 劣势。此外，我们将研究SU及其在年轻人过程中的相互作用的轨迹 成年和社区级因素在年轻成人SU的病因和相关结果中的作用 在合法大麻的背景下。了解这些效果将告知（1）预防计划和 干预工作旨在改善健康状况和减少不断变化的问题行为 大麻政策背景； （2）与大麻有关的现有政策和新政策的监管条款。

项目成果

The association between cannabis use and risk of non-medical pain reliever misuse onset among young adults in a legal cannabis context.

在合法大麻背景下，大麻使用与年轻人非医疗止痛药误用风险之间的关联。

• DOI: 10.1016/j.addbeh.2023.107711
• 发表时间: 2023
• 期刊: Addictive behaviors
• 影响因子: 4.4
• 作者: Rhew,IsaacC;Le,ViT;Ramirez,JasonJ;Fleming,CharlesB;Kilmer,JasonR;Delawalla,MirandaLM;Hultgren,BrittneyA;Lee,ChristineM;Larimer,MaryE;Guttmannova,Katarina
• 通讯作者: Guttmannova,Katarina