Motor vehicle crash fatalaties and undercompensated care associated with legalization of marijuana
Motor vehicle crash fatalaties and undercompensated care associated with legalization of marijuana
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DOI：
10.1097/ta.0000000000001983
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发表时间：
2018-09-01
影响因子：
3.4
通讯作者：
Biffl, Walter
中科院分区：
文献类型：
--
作者：
Steinemann, Susan;Galanis, Daniel;Biffl, Walter
背景：美国一半的州已经将医用大麻合法化，有些州允许娱乐用途。这些政策的经济和公共卫生影响仍在评估之中。我们假设，大麻合法化是与大麻阳性司机的机动车碰撞死亡的比例增加，大麻的使用是与高风险的行为和不良的保险states.METHODS：夏威夷合法化大麻在2000年。死亡分析报告系统的数据分析之前（1993-2000年）和之后（2001-2015年）的合法化。大麻（THC），甲基苯丙胺和酒精在致命受伤的司机的存在进行了比较。从1997年到2013年，该州最高级别创伤中心的数据被审查为THC状态。从2011年至2015年国家创伤登记数据进行了审查，以评估大麻，头盔/安全带的使用，和payor mix.Results之间的关联：THC积极驾驶死亡人数增加，因为合法化，从1993-2000年增加了三倍，2001-2015年。甲基苯丙胺仍然是非法的，酒精阳性在2000年前后没有显著差异。THC阳性死亡人数更年轻，更可能是单车事故，夜间撞车和超速。他们不太可能使用安全带或头盔。在我们最高级别的创伤中心测试的所有受伤患者中，THC阳性率从合法化前的11%增加到20%。从2011年到2015年，THC阳性患者佩戴安全带或头盔的可能性显着降低（33%对56%）。他们的两倍可能有医疗补助保险（28%对14%）。结论：大麻合法化以来，MVC死亡中的THC阳性率在全州范围内增加了两倍，在最高级别创伤中心就诊的患者中THC阳性率增加了一倍。THC阳性患者不太可能使用保护性设备，更可能依赖于医疗保险。这些发现对全国都有影响，并强调需要进一步研究和制定政策，以解决大麻相关创伤的公共健康影响和成本。版权所有（C）2018威科医疗集团All rights reserved.
BACKGROUND: Half of the US states have legalized medical cannabis (marijuana), some allow recreational use. The economic and public health effects of these policies are still being evaluated. We hypothesized that cannabis legalization was associated with an increase in the proportion of motor vehicle crash fatalities involving cannabis-positive drivers, and that cannabis use is associated with high-risk behavior and poor insurance status.METHODS: Hawaii legalized cannabis in 2000. Fatality Analysis Reporting System data were analyzed before (1993-2000) and after (2001-2015) legalization. The presence of cannabis (THC), methamphetamine, and alcohol in fatally injured drivers was compared. Data from the state's highest level trauma center were reviewed for THC status from 1997 to 2013. State Trauma Registry data from 2011 to 2015 were reviewed to evaluate association between cannabis, helmet/seatbelt use, and payor mix.RESULTS: THC positivity among driver fatalities increased since legalization, with a threefold increase from 1993-2000 to 2001-2015. Methamphetamine, which has remained illegal, and alcohol positivity were not significantly different before versus after 2000. THC-positive fatalities were younger, and more likely, single-vehicle accidents, nighttime crashes, and speeding. They were less likely to have used a seatbelt or helmet. THC positivity among all injured patients tested at our highest level trauma center increased from 11% before to 20% after legalization. From 2011 to 2015, THC-positive patients were significantly less likely to wear a seatbelt or helmet (33% vs 56%). They were twice as likely to have Medicaid insurance (28% vs 14%).CONCLUSION: Since the legalization of cannabis, THC positivity among MVC fatalities has tripled statewide, and THC positivity among patients presenting to the highest level trauma center has doubled. THC-positive patients are less likely to use protective devices and more likely to rely on publically funded medical insurance. These findings have implications nationally and underscore the need for further research and policy development to address the public health effects and the costs of cannabis-related trauma. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.