Impact of Marijuana Policies on Alcohol Use and Alcohol-Related Mortality

大麻政策对饮酒和酒精相关死亡率的影响

• 批准号: 9769603
• 负责人: Timothy Simonds Naimi
• 金额: $ 69.43万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9769603
• 关键词: AODR mortality; Accounting; Address; Adolescent Risk Behavior; Adopted; Adult; Affect; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Cessation of life; Data Set; Data Sources; Development; Dimensions; Disease; Drug usage; Environment; Health; Heavy Drinking; Heterogeneity; Homicide; Individual; Injury; Marijuana; Measures; Medical; Medical Marijuana; Methods; Nature; Outcome; Policies; Policy Developments; Policy Making; Public Health; Reporting; Research; Risk; Risk Factors; Series; Suicide; Surveys; System; Testing; Time; Update; Variant; Violence; Work; Youth; addiction; alcohol effect; alcohol involvement; alcohol measurement; base; binge drinking; experience; improved; innovation; interest; marijuana use; mortality; population based; public policy on alcohol; underage drinking

Alcohol use by youth and excessive alcohol use by adults are associated with multiple consequences. In terms of associations with alcohol, marijuana use is a risk factor for youth drinking, binge drinking, and crash fatalities involving alcohol. Therefore, the liberalization of marijuana policy among U.S. states may impact alcohol use, alcohol-related mortality, and the concurrent use of alcohol and marijuana. However, existing research about the impact of marijuana policies on alcohol use and related outcomes is limited and inconsistent, and has not accounted for the heterogeneity of marijuana policies, or fully accounted for the effect of alcohol policies. The objective of this proposal is to assess the impact of the liberalization of marijuana policies on individual-level alcohol use, concurrent and simultaneous use of alcohol and marijuana, and alcohol-related crash fatalities, suicides and homicides. We will address past research limitations by developing and testing a series of state- level marijuana policy measures that incorporate aspects of multiple marijuana policy domains (decriminalization, medical use, recreational use), and the policies and provisions within those domains. We will then select measures based on their ability to explain variance in marijuana use outcomes. The methods to develop marijuana policy measures will be similar to those used by our research team to successfully develop the `Alcohol Policy Scales'. The scales, which generated more valid predictions (based on goodness-of-fit) of alcohol-related outcomes compared with simpler measures, will be used in conjunction with the marijuana policy measures to fully account for both groups of policies in analyses. Our specific aims are to: Aim 1: a) Develop comprehensive measures of marijuana policies, and b) determine their relationships with marijuana use among youth and adults. Aim 2: a) Determine relationships between alcohol and marijuana policies across and within states over time; and b) assess how accounting for alcohol policies influences marijuana policy- marijuana use relationships. Aim 3: Determine relationships of marijuana policies with alcohol use measures and alcohol-related crash fatalities, suicide and homicide among youth and adults, while accounting for alcohol policies. We will examine: a) the independent effects of marijuana policies; and b) whether marijuana policies modify the relationships between alcohol policies and alcohol use and mortality outcomes. Aim 4: Assess how both alcohol and marijuana policies relate to the concurrent and simultaneous use of alcohol and marijuana, concurrent use disorder, treatment for concurrent use disorder, and crash fatalities involving both substances among youth and adults. Although we are interested in the effects of state-level policies, we will be examining individual-level outcomes with large population-based data sources including NSDUH, YRBS, FARS, and NVDRS from 1999-2018. The development of more comprehensive measures of the marijuana policy environment for use in conjunction with our measures of the alcohol policy environment is innovative, will overcome limitations of existing research, and will inform policy development and improve public health.

青年饮酒和成人过度使用饮酒与多种后果有关。用 在与酒精的关联中，大麻使用是青年饮酒，暴饮暴食和崩溃死亡的危险因素 涉及酒精。因此，美国各州之间大麻政策的自由化可能会影响饮酒， 与酒精有关的死亡率以及同时使用酒精和大麻。但是，现有的研究 大麻政策对酒精使用和相关结果的影响有限且不一致，尚未 解释了大麻政策的异质性，或完全解释了酒精政策的影响。这 该提议的目的是评估大麻政策对个人级别的自由化的影响 酒精使用，同时使用酒精和大麻，以及与酒精有关的坠机死亡， 自杀和凶杀。我们将通过开发和测试一系列国家 - 水平大麻政策措施，结合了多个大麻政策领域的各个方面 （非刑事化，医疗用途，娱乐用途）以及这些领域内的政策和规定。我们 然后，将根据其解释大麻使用结果方差的能力来选择措施。方法 制定大麻政策措施将与我们的研究团队成功开发的政策措施相似 “酒精政策规模”。量表产生了更有效的预测（基于拟合优点） 与更简单的措施相比，与酒精有关的结果将与大麻一起使用 政策措施可以充分说明分析中的两组政策。我们的具体目的是：目标1：a） 制定大麻政策的全面措施，b）确定其与大麻的关系 在青年和成人中使用。目标2：a）确定酒精与大麻政策之间的关系 随着时间的流逝，在州内； b）评估酒精政策的会计如何影响大麻政策 - 大麻使用关系。目标3：确定大麻政策与酒精使用措施的关系 以及与酒精有关的坠机死亡，年轻人和成人的自杀和杀人罪 政策。我们将研究：a）大麻政策的独立影响； b）大麻政策是否 修改酒精政策与酒精使用和死亡率之间的关系。目标4：评估如何 酒精和大麻政策都涉及并发和同时使用酒精和大麻， 并发使用障碍，并发使用障碍的治疗以及涉及这两种物质的崩溃死亡 在青年和成人中。尽管我们对国家级政策的影响感兴趣，但我们将研究 具有大量基于人群的数据源的个人级别结果，包括NSDUH，YRB，FARS和 NVDR从1999 - 2018年开始。制定大麻政策的更全面措施 与我们对酒精政策环境的措施一起使用的环境是创新的，将会 克服现有研究的局限性，并将为政策制定提供依据并改善公共卫生。