Older, Less Regulated Medical Marijuana Programs Have Much Greater Enrollment Rates Than Newer 'Medicalized' Programs
Older, Less Regulated Medical Marijuana Programs Have Much Greater Enrollment Rates Than Newer 'Medicalized' Programs
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DOI：
10.1377/hlthaff.2015.0528
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发表时间：
2016-03-01
期刊：
影响因子：
9.7
通讯作者：
Kleber, Herbert D.
中科院分区：
文献类型：
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作者：
Williams, Arthur Robin;Olfson, Mark;Kleber, Herbert D.
23个州以及哥伦比亚特区已经通过法律实施医用大麻计划。截至2014年10月，正在运行的19个计划总共有超过100万名参与者。所有有医用大麻法律的州（包括哥伦比亚特区）都要求医生直接或间接地自行决定授权使用大麻，然而对于医用大麻计划在遵循医疗实践基本原则以及相关注册率方面有何差异，人们知之甚少。为了探究这一点，我们根据传统医疗护理和药品监管的七个组成部分对大麻计划进行了分析。然后我们在控制可能造成混淆的州的特征的同时，研究了注册率。我们发现，24个计划中有14个是非医疗性质的，在全国范围内共吸纳了99.4%的参与者，其注册率是被视为“医疗化”的计划的20倍。实施或修订医用大麻计划的政策制定者应该考虑监管较少与注册人数较多之间的紧密关系。研究人员在评估计划对人群层面的影响时应该考虑计划之间的差异。
Twenty-three states and the District of Columbia have passed laws implementing medical marijuana programs. The nineteen programs that were in operation as of October 2014 collectively had over one million participants. All states (including D.C.) with medical marijuana laws require physicians directly or indirectly to authorize the use of marijuana at their discretion, yet little is known about how medical marijuana programs vary regarding adherence to basic principles of medical practice and associated rates of enrollment. To explore this, we analyzed marijuana programs according to seven components of traditional medical care and pharmaceutical regulation. We then examined enrollment rates, while controlling for potentially confounding state characteristics. We found that fourteen of the twenty-four programs were nonmedical and collectively enrolled 99.4 percent of participants nationwide, with enrollment rates twenty times greater than programs deemed to be "medicalized." Policy makers implementing or amending medical marijuana programs should consider the powerful relationship between less regulation and greater enrollment. Researchers should consider variations across programs when assessing programs' population-level effects.