State medical marijuana laws and NSDUH marijuana use and consequences since 2004

自 2004 年以来各州医用大麻法和 NSDUH 大麻使用及其后果

• 批准号: 8744452
• 负责人: Silvia Saboia Martins
• 金额: $ 38.52万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8744452
• 关键词: Accident and Emergency department; Address; Adolescent; Adult; Affect; Age; Alcohol or Other Drugs use; Alcohols; Asians; Biometry; Censuses; Cocaine; Data; Data Files; Disease; Drug Prescriptions; Drug usage; Elderly; Ethnic Origin; Funding; Future; Geographic state; Health; Heroin; High Prevalence; Hispanics; Imprisonment; Individual; Investigation; Knowledge; Laws; Lead; Legal; Marijuana; Marijuana Smoking; Marketing; Medical; Medical Marijuana; Minority Groups; Modeling; Monitor; National Institute of Drug Abuse; Not Hispanic or Latino; Outcome; Patients; Pattern; Pharmaceutical Preparations; Policy Maker; Population; Prevalence; Price; Public Health; Race; Relative (related person); Research; Resources; Respondent; Risk; Scientist; Statutes and Laws; Surveys; Testing; Time; Variant; Visit; Youth; age related; aged; data portal; design; experience; innovation; member; prescription opioid; public health relevance; racial and ethnic; racial and ethnic disparities; residence; substance abuse epidemiology; trend; young adult

DESCRIPTION (provided by applicant): Since 1996, 20 states and DC passed laws legalizing medical use of marijuana (40% of all states), and other states are considering such laws. Whether these fast-changing laws lead to increases in marijuana use (MU) is now largely a matter of opinion and debate. Responding to NIDA PA 11-230, we propose to investigate the relationship between MML and MU, MU disorders and consequences of MU in both adolescents and adults, using an outstanding resource, the restricted access data files from the National Survey on Drug Use and Health (NSDUH), 2004 and onwards, that we are authorized to access through SAMHSA's new NSDUH Restricted Use Files Data Portal. These data files include important variables not included in the public use files, including state of residence, exact respondent age, and detailed race/ethnicity information. We will also incorporate state-level data external to NSDUH (e.g., Census demographic data, state arrest rates, emergency department visits, MML variation) as potential confounders and outcomes in our models comparing states with and without MML. The proposed study is a comprehensive, timely, and innovative investigation of these issues, designed to provide much-needed, important information to health scientists, policy-makers and the public. Primary aims are to: 1a) Examine individual-level MU and MU disorder from 2004 to 2014 as a function of state-level MML; 1b) Using data from the US states that approved MML after 2004, examine the effects of different time lags (e.g., 1-, 2-years) before and after passage of the laws on individual-level MU and MU disorder. 2) Explore whether state-level variations in MML or specific aspects of MML (e.g., variations of amounts allowed per patient, registration rules, permitted medical conditions) are associated with the prevalence of MU, how individuals acquire marijuana, and how much they pay for it. 3) Investigate whether passage of state MML is followed by change in individual risk for (a) other substances (alcohol, nonmedical prescription opioid, cocaine, heroin use), relative to trends in the US states without MML (increase, per the gateway hypothesis; or decrease, per the substitution hypothesis); (b) consequences related to marijuana use (i.e., arrests, incarceration, legal problems), relative to any change in the risk for these consequences in states without MML. 4) Investigate whether racial/ethnic (non-Hispanic White, non-Hispanic Black, Asian, and Hispanic) and age (i.e., adolescents, young adults, and older adults) differences in past-year and past-month prevalence of MU and MU disorders and potential consequences of MU change as a function of the passage of state-level MML. Our research team includes experts in substance abuse epidemiology and biostatistics as well as an expert with extensive expertise in marijuana laws and marijuana markets. Our analyses will employ multilevel regression modeling. This study will address questions of major public health significance, adding important knowledge about fast-changing marijuana laws and their effects on MU among adults and adolescents, contributing to general knowledge about the relationship of legislation to substance use.

描述（由申请人提供）：自 1996 年以来，20 个州和华盛顿特区通过了大麻医疗用途合法化的法律（占所有州的 40%），其他州正在考虑此类法律。这些快速变化的法律是否会导致大麻使用（MU）的增加现在很大程度上是一个观点和争论的问题。为了响应 NIDA PA 11-230，我们建议利用来自国家药物使用和健康调查的受限访问数据文件这一优秀资源，调查 MML 与 MU 之间的关系、MU 疾病以及 MU 在青少年和成人中的后果(NSDUH)，2004 年及以后，我们有权通过 SAMHSA 的新 NSDUH 限制使用文件数据门户进行访问。这些数据文件包括公共使用文件中未包含的重要变量，包括居住州、确切的受访者年龄和详细的种族/民族信息。我们还将纳入 NSDUH 外部的州级数据（例如人口普查人口数据、州逮捕率、急诊科就诊、MML 变化）作为我们模型中潜在的混杂因素和结果，比较有和没有 MML 的州。拟议的研究是对这些问题进行全面、及时和创新的调查，旨在为卫生科学家、政策制定者和公众提供急需的重要信息。主要目标是： 1a) 检查 2004 年至 2014 年个人层面的 MU 和 MU 紊乱作为州层面 MML 的函数； 1b) 使用 2004 年之后批准 MML 的美国各州的数据，检查法律通过前后不同时滞（例如 1 年、2 年）对个人层面 MU 和 MU 障碍的影响。 2) 探索 MML 的州级变化或 MML 的特定方面（例如，每位患者允许的金额、登记规则、允许的医疗条件的变化）是否与 MU 的流行、个人获取大麻的方式以及支付的金额相关为了它。 3) 调查州 MML 的通过后是否会导致 (a) 其他物质（酒精、非医疗处方阿片类药物、可卡因、海洛因使用）的个人风险发生变化，相对于没有 MML 的美国各州的趋势（根据网关假设增加） ；或根据替代假设减少）； (b) 与吸食大麻相关的后果（即逮捕、监禁、法律问题），以及在没有 MML 的州中这些后果的风险变化。 4) 调查过去一年和过去一个月的 MU 患病率是否存在种族/族裔（非西班牙裔白人、非西班牙裔黑人、亚洲人和西班牙裔）和年龄（即青少年、年轻人和老年人）差异MU 疾病和 MU 变化的潜在后果作为州级 MML 的通过的函数。我们的研究团队包括药物滥用流行病学和生物统计学专家以及在大麻法律和大麻市场方面拥有丰富专业知识的专家。我们的分析将采用多级回归模型。这项研究将解决具有重大公共卫生意义的问题，增加有关快速变化的大麻法律及其对成人和青少年 MU 影响的重要知识，有助于增进有关立法与药物使用关系的一般知识。