Medical marijuana laws and adolescent marijuana use in the United States: a systematic review and meta-analysis.
Medical marijuana laws and adolescent marijuana use in the United States: a systematic review and meta-analysis.
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DOI：
10.1111/add.14136
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Hasin DS
中科院分区：
文献类型：
--
作者：
Sarvet AL;Wall MM;Fink DS;Greene E;Le A;Boustead AE;Pacula RL;Keyes KM;Cerdá M;Galea S;Hasin DS
对研究进行系统回顾和Meta分析，以估计美国医用大麻法律（MML）对青少年过去一个月大麻使用率的影响。系统筛选了17个文献来源的2999篇文献。从四项正在进行的大型全国调查中开发的11项研究进行了Meta分析。从纳入的研究中获得的MML对过去一个月大麻使用流行率的影响估计值是通过比较MML状态的MML前后变化与可比时间段内非MML状态的变化获得的。对这些估计值进行标准化，并将其输入每项研究的固定效应Meta分析模型。采用综合F检验对国家数据调查的研究估计值之间的异质性进行了检验。对额外的大麻结果，MML规定（如药房）和人口统计学亚组的影响估计进行了抽象和总结。还介绍了主要的方法和建模特点。遵循系统性综述和Meta-分析（PRISMA）指南的首选报告项目。这11项研究中没有一项发现与青少年大麻使用率的非MML状态的同期变化相比，MML前后变化的显著估计值。Meta分析得出的非显著性合并估计值（标准化均值差）为−0.003（95%置信区间= −0.012，+0.007）。四项研究比较了MML与非MML状态在MML前的差异，所有研究都发现MML状态在MML前的过去一个月大麻使用率较高。对特定MML规定、MML对其他大麻结果的影响以及亚组之间的其他测试通常产生不显著的结果，尽管有限的异质性可能需要进一步研究。目前证据的综合并不支持美国医用大麻法律（MML）直到2014年导致青少年大麻使用流行率增加的假设。MML对其他大麻使用模式的影响、特定人群亚组内的影响和特定MML规定的影响的估计之间存在有限的异质性。
To conduct a systematic review and meta‐analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past‐month marijuana use prevalence among adolescents. A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta‐analyzed. Estimates of MML effects on any past‐month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non‐MML states over comparable time‐periods. These estimates were standardized and entered into a meta‐analysis model with fixed‐effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F‐test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. None of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non‐MML states for marijuana use prevalence among adolescents. The meta‐analysis yielded a non‐significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non‐MML states on pre‐MML differences and all found higher rates of past‐month marijuana use in MML states pre‐MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non‐significant results, although limited heterogeneity may warrant further study. Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions.
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