Impact of cannabis legalization on healthcare utilization for psychosis and schizophrenia in Colorado.
Impact of cannabis legalization on healthcare utilization for psychosis and schizophrenia in Colorado.
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DOI：
10.1016/j.drugpo.2022.103685
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发表时间：
2022-06
影响因子：
4.4
通讯作者：
Pacula, Rosalie Liccardo
中科院分区：
文献类型：
--
作者：
Wang, George Sam;Buttorff, Christine;Wilks, Asa;Schwam, Daniel;Tung, Gregory;Pacula, Rosalie Liccardo
关键词：
在过去的十年中，涉及精神病和精神分裂症的急诊科（艾德）就诊率的增长速度超过了美国人口的增长速度。研究表明，长期使用高效大麻与出现精神病症状的几率之间存在强烈的剂量反应关系。本研究的目的是评估大麻合法化对精神病和精神分裂症相关的艾德访问科罗拉多的影响。使用科罗拉多医院协会（CHA）关于2013年1月1日至2018年12月31日期间县级季度艾德就诊的行政数据，我们应用差异分析来研究2014年后新接触娱乐性大麻药房如何不同地影响精神病和精神分裂症的艾德就诊率，将以前没有医疗大麻药房暴露的县与医疗药房暴露程度低或高的县进行比较。随着每万名居民中娱乐性药房的增加，人均精神分裂症艾德就诊率（发病率比或IRR：0.95，95% CI [0.69，1.30]）无显著相关性，而精神病就诊率增加了24%（IRR：1.24，95% CI [1.02，1.49]）。以前没有医疗诊所的县精神分裂症艾德就诊率比已经接触到低水平医疗诊所的县有更大的增加，但这种影响并不显著。基线医疗暴露低的县精神病就诊率的增加低于基线医疗暴露高的县（IRR 0.83，95% CI [0.69，0.99]）。在科罗拉多所有县，大麻药房的数量和精神病艾德就诊率之间存在正相关。虽然目前还不清楚是否是获得产品，或者可能推动这种关联的产品类型，但我们的研究结果表明，大麻合法化后观察到的当地人口的心理健康可能会受到影响。
Emergency department (ED) visits involving psychosis and schizophrenia have increased at a rate exceeding population growth in the United States over the past decade. Research shows a strong dose-response relationship between chronic use of high-potency cannabis and odds of developing symptoms of psychosis. The aim of this study was to evaluate the impact of cannabis legalization on psychosis and schizophrenia-related ED visits in Colorado. Using administrative data from Colorado Hospital Association (CHA) on county-level quarterly ED visits between January 1, 2013, and December 31, 2018, we applied a difference-in-difference analysis to examine how new exposure to recreational cannabis dispensaries after 2014 differentially influenced the rate of ED visits for psychosis and schizophrenia, comparing counties with no prior medical cannabis dispensary exposure to counties with low or high medical dispensary exposure. As recreational dispensaries per 10,000 residents increased, there was no significant association with the rate of schizophrenia ED visits per capita (incidence rate ratio or IRR: 0.95, 95% CI [0.69, 1.30]) while the rate of psychosis visits increased 24% (IRR: 1.24, 95% CI [1.02, 1.49]). Counties with no previous medical dispensaries experienced larger increases in schizophrenia ED visits than counties already exposed to a low level of medical dispensaries, but this effect was not significant. Counties with low baseline medical exposure had lower increases in rates of psychosis visits than counties with high baseline medical exposure (IRR 0.83, 95% CI [0.69, 0.99]). There was a positive association between the number of cannabis dispensaries and rates of psychosis ED visits across all counties in Colorado. Although it is unclear whether it is access to products, or the types of products that may be driving this association, our findings suggest there is a potential impact on the mental health of the local population that is observed after cannabis legalization.
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DOI：
10.1016/s2215-0366(19)30048-3
发表时间：
2019-05
期刊：
The lancet. Psychiatry
影响因子：
--
作者：
Di Forti M;Quattrone D;Freeman TP;Tripoli G;Gayer-Anderson C;Quigley H;Rodriguez V;Jongsma HE;Ferraro L;La Cascia C;La Barbera D;Tarricone I;Berardi D;Szöke A;Arango C;Tortelli A;Velthorst E;Bernardo M;Del-Ben CM;Menezes PR;Selten JP;Jones PB;Kirkbride JB;Rutten BP;de Haan L;Sham PC;van Os J;Lewis CM;Lynskey M;Morgan C;Murray RM;EU-GEI WP2 Group
通讯作者：
EU-GEI WP2 Group
DOI：
10.1056/nejmra1402309
发表时间：
2014-06-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Volkow ND;Baler RD;Compton WM;Weiss SR
通讯作者：
Weiss SR
影响因子：
3.1
作者：
Goncalves-Pinho, Manuel;Braganca, Miguel;Freitas, Alberto
通讯作者：
Freitas, Alberto
影响因子：
1.5
作者：
Hooker, Edmond A.;Mallow, Peter J.;Oglesby, Michelle M.
通讯作者：
Oglesby, Michelle M.
影响因子：
3.3
作者：
Shelton, Shelby K.;Mills, Eleanor;Monte, Andrew A.
通讯作者：
Monte, Andrew A.