Implementation of Medical Marijuana and its Impact on Health

描述（由申请人提供）：医用大麻法律在美国享有广泛的公众支持。15个州和哥伦比亚特区已经将医用大麻法律写入了法律，还有几个州正在考虑类似的立法。最近的民意调查显示，超过70%的美国人支持州法律允许大麻用于规定的医疗目的（皮尤研究中心2010）。尽管它们很受欢迎，但相对较少的研究考虑了医用大麻政策如何影响娱乐性大麻使用或个人和公共健康结果。关于这一主题的少数已发表的定量研究发现了不同的结果，一些发现的证据与更高的娱乐需求（Pacula et al. 2010）一致，而另一些发现与娱乐使用（Gorman and Huber, 2007）或大麻的感知危害（Khatapoush and Hallfors, 2004）没有关系。我们工作的目标是提供迄今为止最完整的医疗大麻法律的细微特征及其对健康的影响。为此，我们将检查州、县和市三级医用大麻法律的实施情况，并评估与患者医用大麻供应相关的规定是否会影响娱乐用户的获取和使用。我们将进一步考虑这些法律是否以及如何与大麻滥用/滥用造成的危害相关，包括事故、哮喘、急性精神病、酒精依赖、精神分裂症、药物驾驶和犯罪。我们将在所有三个地理水平上分析这些个人和公共卫生结果，使我们能够测试来自任何单一数据源或分析的结果的外部有效性，并更好地了解法律实施的细节是否比广泛的法律本身更重要。通过确定州和地方政策中与个人和公共健康结果最明显相关的方面，我们的工作应有助于改善与医用大麻有关的政策制定。通过将我们对州、县和地方各级医用大麻政策的系统编码提供给其他研究人员，我们也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.