Implementation of Medical Marijuana and its Impact on Health

描述（由申请人提供）：医用大麻法在美国享有广泛的公众支持。十五个州和哥伦比亚特区已制定了医用大麻法，还有几个州正在考虑制定类似的立法。最近的民意调查显示，超过 70% 的美国人赞成允许将大麻用于处方医疗目的的州法律（皮尤研究中心，2010 年）。 尽管医用大麻很受欢迎，但很少有研究考虑医用大麻政策如何影响娱乐性大麻的使用或个人和公共卫生结果。少数发表的关于该主题的定量研究发现了不同的结果，其中一些发现证据与较高的娱乐需求一致（Pacula 等人，2010），而另一些则发现与娱乐用途（Gorman 和 Huber，2007）或大麻的感知危害没有关系（Khatapoush 和 Hallfors，2004）。 我们工作的目标是提供迄今为止最完整的说明，说明医用大麻法律的细微差别及其对健康的影响。为此，我们将审查州、县和市各级医用大麻法律的实施情况，并评估与向患者供应医用大麻相关的规定是否影响娱乐使用者的获取和使用。我们将进一步考虑这些法律是否以及如何涉及大麻误用/滥用造成的伤害，包括事故、哮喘、急性精神病、酒精依赖、精神分裂症、药后驾驶和犯罪。我们将在所有三个地理层面上分析这些个人和公共卫生结果，使我们能够测试任何单一数据源或分析结果的外部有效性，并更好地了解法律实施方式的细节是否比广泛的法律本身更重要。 我们的工作应通过确定与个人和公共卫生结果最明显相关的州和地方政策的维度，有助于改善与医用大麻相关的政策制定。通过向其他研究人员提供我们对州、县和地方各级医用大麻政策的系统编码，我们还将为该领域的未来工作奠定基础。

DESCRIPTION (provided by applicant): Medical marijuana laws enjoy broad public support in the United States. Fifteen states and the District of Columbia have medical marijuana laws on the books and several states are contemplating similar legislation. Recent polls indicate that over 70 percent of Americans favor state laws allowing marijuana use for prescribed medical purposes (The Pew Research Center 2010). Despite their popularity, relatively few studies have considered how medical marijuana policies affect recreational marijuana use or individual and public health outcomes. The few published quantitative studies on the topic find disparate results, with some finding evidence consistent with higher recreational demand (Pacula et al. 2010) and others finding no relationship to recreational use (Gorman and Huber, 2007) or perceived harm of marijuana (Khatapoush and Hallfors, 2004). The goal of our work is to provide the most complete accounting to date of the nuanced features of medical marijuana laws and their implications for health. To do this we will examine the implementation of medical marijuana laws at the state, county and city level and assess whether provisions related to the supply of medical marijuana for patients influence access and use among recreational users. We will further consider whether and how these laws relate to harms caused by marijuana misuse/abuse including accidents, asthma, acute psychoses, alcohol dependence, schizophrenia, drugged driving, and crime. We will analyze these individual and public health outcomes at all three geographic levels allowing us to test the external validity of findings from any single data source or analysis as well as better understand whether the specifics of how laws get implemented is more important than the broad law itself. Our work should contribute to improved policymaking relating to medical marijuana by identifying the dimensions of state and local policy that are most clearly linked to individual and public health outcomes. By making our systematic coding of medical marijuana policies at the state, county and local levels available to other researchers, we will also lay the groundwork for future work in this area.