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: 10450840
• 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 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10450840
• 关键词: Accounting; Admission activity; Adopted; Adult; Affect; American; Area; Black Populations; 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 Population; 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; Persons; Policies; Prevalence; Provider; Public Health; Race; Reporting; Research; Role; Sampling; Services; Social outcome; Source; 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：医用大麻法与物质使用障碍治疗之间的多层次关联 医用大麻法 (MML) 在美国越来越多地得到采用； 一半的人生活在允许医疗用途大麻的州，而 MML 与大麻有关。 物质使用障碍 (SUD) 的治疗入院、MML 与 SUD 治疗之间的关系 复杂且动态，并且可能根据具体的大麻药房规定而变化，例如， 与大麻治疗的增加和阿片类药物治疗入院的减少有关。 然而，关于 MML 影响的机制，文献中存在严重的空白。 SUD 治疗的使用和相关结果。拟议的研究采用多学科方法来研究。 了解并隔离 MML 对跨性别和种族/族裔群体的 SUD 治疗的影响， 考虑个人（例如看法）、社区（例如刑事司法）和州一级（例如医疗补助） 估计 MML 等结构性因素对 SUD 治疗使用的影响可能有 重大公共卫生影响，因为 SUD 与各种负面健康后果相关，并且 大多数符合 SUD 标准的人不会接受 SUD 治疗对个体 SUD 的影响。 将使用限制使用国家药物调查的数据来估计治疗需求和看法 从 2004 年起，MML 对刑事司法转介至 SUD 治疗的影响将是。 使用 1992-2014 年治疗事件数据集估计 MML 对健康结果和的影响。 2004 年至 2014 年期间的服务费用将在一群享受 Medicare/Medicaid 的成年人中进行评估。 将测试性别和种族/民族之间的相互作用，以确定 MML 是否 为改变医疗保健差异做出贡献 本 K01 提案中的研究支持国家计划。 药物滥用研究所的目标是“评估与药物滥用相关的联邦、州和系统级政策的影响” 药物使用和物质使用障碍对公共卫生和福祉的影响将是三个具体培训领域。” 纳入研究目标，包括：(a) 造成医疗保健差异的结构性因素 SUD 治疗；(b) 刑事司法、卫生政策和治疗系统之间的动态；以及 (c) 卫生 融资和卫生经济学分析雄心勃勃的培训和研究目标在 5 年内是可行的。 K01 奖获得哥伦比亚大学跨学科导师团队（Drs. Martins、 Metsch、Hasin 和 Muennig）和合作者（Fagan 博士、Crystal 和 Alexandre），最终在 R01 的职业发展计划将支持申请人的目标和轨迹。 独立研究。

项目成果

Racial and Ethnic Differences in Cannabis Use Following Legalization in US States With Medical Cannabis Laws.

美国各州医用大麻法合法化后大麻使用的种族和民族差异。

• 发表时间: 2021
• 影响因子: 13.8
• 作者: Martins, Silvia S;Segura, Luis E;Levy, Natalie S;Mauro, Pia M;Mauro, Christine M;Philbin, Morgan M;Hasin, Deborah S
• 通讯作者: Hasin, Deborah S

Measuring polysubstance use over the life course: implications for multilevel interventions.

测量生命过程中多物质的使用：对多层次干预的影响。

• 发表时间: 2019
• 作者: Philbin, Morgan M;Mauro, Pia M
• 通讯作者: Mauro, Pia M

Gender differences in any alcohol screening and discussions with providers among older adults in the United States, 2015 to 2019.

2015 年至 2019 年美国老年人酒精筛查和与提供者讨论中的性别差异。

• 发表时间: 2021
• 作者: Mauro, Pia M;Askari, Melanie S;Han, Benjamin H
• 通讯作者: Han, Benjamin H

Trends in Racial-Ethnic Disparities in Adult Mental Health Treatment Use From 2005 to 2019.

2005 年至 2019 年成人心理健康治疗使用中种族差异的趋势。

• 发表时间: 2023-05-01
• 作者: Kaur, Navdep;Esie, Precious;Finsaas, Megan C;Mauro, Pia M;Keyes, Katherine M
• 通讯作者: Keyes, Katherine M

Mind The Gap: Differences in Alcohol Use Screening And Discussions Among Adults Comparing Asian American And Other Racial And Ethnic Subgroups in the United States, 2015-2019.

注意差距：2015-2019 年美国亚裔美国人和其他种族和族裔亚群体比较成年人酒精使用筛查和讨论的差异。

• 发表时间: 2023-01-09
• 作者: Mauro, Pia M;Kane, Jeremy C;Askari, Melanie S;Iwamoto, Derek;Martins, Silvia S
• 通讯作者: Martins, Silvia S