Multi-level associations between medical marijuana laws and substance use disorder treatment

医用大麻法与物质使用障碍治疗之间的多层次关联

• 批准号: 10221660
• 负责人: Pia M. Mauro
• 金额: $ 17.2万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10221660
• 关键词: Accounting; Admission activity; Adopted; Adult; Affect; American; Area; Communities; Complex; Crime; Criminal Justice; Crystallization; Data; Data Set; Data Sources; Development; Development Plans; Disadvantaged; Disease; District of Columbia; Drug usage; Ethnic Origin; Ethnic group; Freedom; Gender; Goals; Health; Health Care Reform; Health Policy; Health financing; Healthcare; Individual; Inpatients; Insurance; Latino; Laws; Lead; Light; Literature; Low income; Marijuana; Medicaid; Medical; Medical Marijuana; Medicare/Medicaid; Mentored Research Scientist Development Award; Mentorship; National Institute of Drug Abuse; Opioid; Outcome; Perception; Personal Satisfaction; Policies; Prevalence; Provider; Public Health; Race; Reporting; Research; Role; Sampling; Services; Social outcome; Source; Structure; Substance Use Disorder; Surveys; System; Testing; Time; Training; United States; Universities; Visit; Woman; base; behavioral health; care providers; career development; cohort; cost; economic evaluation; health care disparity; health economics; improved; improved outcome; interdisciplinary approach; low socioeconomic status; male; marijuana use; marijuana use disorder; men; opioid epidemic; opioid use; public health priorities; racial and ethnic; racial disparity; screening; service utilization; social stigma; substance use; substance use treatment; uptake

TITLE: Multi-level associations between medical marijuana laws and substance use disorder treatment Medical marijuana laws (MMLs) have been increasingly adopted throughout the United States; more than half of people live in states that permit medical use of marijuana. While MMLs have been associated with treatment admissions for substance use disorders (SUDs), the relationship between MML and SUD treatment is complex and dynamic and can vary based on specific MML provisions. Marijuana dispensaries, for example, have been associated with increases in marijuana treatment and decreases in opioid treatment admissions. However, there are critical gaps in the literature regarding the mechanisms through which MMLs can affect SUD treatment use and related outcomes. The proposed research takes a multidisciplinary approach to understand and isolate the effects of MML on SUD treatment across gender and racial/ethnic groups, accounting for individual- (e.g., perceptions), community- (e.g., criminal justice), and state-level (e.g., Medicaid expansion) factors. Estimating the effect of structural factors such as MMLs on SUD treatment use could have significant public health impact, as SUDs are associated with a variety of negative health consequences, and the majority of people who meet SUD criteria do not receive SUD treatment. MML effects on individual SUD treatment need and perceptions will be estimated using data from the restricted use National Survey on Drug Use and Health from 2004 onwards. MML effects on criminal justice referrals to SUD treatment will be estimated using the 1992-2014 Treatment Episodes Data Set. The effects of MMLs on health outcomes and service costs between 2004 and 2014 will be assessed in a cohort of adults with Medicare/Medicaid. Interactions between gender and race/ethnicity will be tested in order to determine whether MMLs are contributing to changes in health care disparities. The research in this K01 proposal supports the National Institute on Drug Abuse objective to “assess the impact of federal, state-, and systems-level policies related to drug use and substance use disorders on public health and well-being.” Three specific training areas will be incorporated to carry out the research aims, including: (a) structural contributors to health care disparities in SUD treatment; (b) dynamics between criminal justice, health policy, and treatment systems; and (c) health financing and health economics analysis. The ambitious training and research aims are feasible in the 5-year K01 award with the support of the interdisciplinary mentorship team at Columbia University (Drs. Martins, Metsch, Hasin, and Muennig) and collaborators (Dr. Fagan, Crystal and Alexandre), culminating in the development of an R01. The career development plan will support the applicant’s goals and trajectory towards research independence.

标题：医用大麻法与药物使用障碍治疗之间的多层次关联 在美国，医用大麻法（MML）越来越多地采用；多于 一半的人居住在允许大麻医学使用的州。虽然MML与 药物使用障碍的治疗入院（SUD），MML和SUD治疗之间的关系 是复杂而动态的，可以根据特定的MML规定而变化。例如，大麻药房 与大麻治疗的增加和阿片类药物治疗的减少有关。 但是，文献中存在有关MML可能影响的机制的危险差距 SUD治疗使用及相关结果。拟议的研究采用了多学科的方法 了解和隔离MML对性别和种族/种族跨性别和种族群体SUD治疗的影响， 为个人（例如，感知），社区 - （例如刑事司法）和州级（例如Medicaid）会计 扩展）因素。估计结构因素（例如MMLS对SUD治疗使用）的影响可能具有 由于SUD与各种负面健康后果有关，并且 符合SUD标准的大多数人都不会接受SUD治疗。 MML对单个SUD的影响 治疗需求和看法将使用限制性使用全国药物调查的数据估算 从2004年开始使用和健康。 MML对刑事司法介绍SUD治疗的影响将是 使用1992 - 2014年治疗发作数据集估计。 MML对健康结果和 在2004年至2014年之间的服务成本将在成年人的Medicare/Medicaid组成的队列中进行评估。 性别与种族/种族之间的相互作用将进行测试，以确定MML是否是 促进医疗保健分销的变化。这项K01提案中的研究支持国家 药物滥用研究所“评估联邦，州和系统级别的政策的影响 在公共卫生和福祉方面的吸毒和药物使用障碍。 纳入研究目的，包括：（a）医疗保健分配的结构性贡献者 SUD治疗； （b）刑事司法，卫生政策和治疗系统之间的动态； （c）健康 融资和健康经济学分析。雄心勃勃的培训和研究目标在5年中是可行的 在哥伦比亚大学跨学科心态团队的支持下，K01奖（Martins博士， Metsch，Hasin和Muennig）和合作者（Fagan博士，Crystal和Alexandre），最终达到 R01的开发。职业发展计划将支持申请人的目标和轨迹 研究独立性。