Medical Marijuana, Emerging Adults & Community: Connecting Health and Policy

描述（由申请人提供）：自1996年医用大麻在加州合法化以来，在理解医用大麻（MM）政策如何影响新兴成年人方面存在关键的知识缺口。目前尚不清楚MM如何影响新兴成人的药物使用模式，包括酒精、处方药和非法药物。目前尚不清楚MM如何影响年轻医用大麻患者（MMP）的生理或心理健康。目前尚不清楚MM药房如何影响年轻MMP的健康，包括关闭MM药房对获得MM的影响。为了解决这些差距，洛杉矶（LA）提出了一个为期五年的项目，使用定性和定量方法研究年轻MMP，年轻非医用大麻使用者（NMU）和自然环境中的MM药房。这项研究的长期目标是向地方、州和国家官员推荐MM政策，为年轻人和社区带来最积极的健康结果。这个特殊应用程序的总体目标是确定洛杉矶的MM政策对新生成人的身心健康的影响，同时了解医用大麻药房如何影响个人健康。指导本研究的中心假设是，与NMU相比，年轻的MMP，由于获得MM和MM药房提供的患者支持，将报告更好的身心健康和更少的有害药物使用模式。在一项目前资助的NIH研究中，在洛杉矶收集的关于年轻MMP和NMU的初步数据支持了这一假设，该数据表明这两组之间存在重要差异，以及年轻MMP与慢性疾病的老年MMP之间存在差异。该研究的基本原理是，年轻的MMP和NMU受MM政策影响的时间比其他成人队列更长，其后果未知，而洛杉矶的多样化环境-拥有大量MM药房-是研究该队列的最佳地点。在初步数据的指导下，这一假设将通过追求三个具体目标来验证：1)确定MMP状态的基础及其对新兴成人身心健康轨迹的影响。2)确定MMP状态对新兴成人药物使用模式的影响，包括大麻使用强度和酒精、处方药和非法药物的滥用。3)在MMP和NMU之间描述洛杉矶大麻使用的自然历史。该方法具有创新性，因为它关注的是一群关键的年轻人，它建立在非医用大麻研究领域的发现和理论观点的基础上，并将定量和定性研究方法整合到纵向研究设计中。提出的研究是重要的，因为研究数据可以为修改患者健康行为，医生指导方针和城市条例提供基于证据的理由。最终，确定医用大麻对洛杉矶新生成人和社区健康的影响，有可能为地方、州和国家层面的医用大麻政策提供信息。

DESCRIPTION (provided by applicant): A critical knowledge gap exists in the understanding of how medical marijuana (MM) policies have impacted emerging adults since MM became legal in California in 1996. It is unknown how MM has affected patterns of drug use, including alcohol, prescription, and illicit, among emerging adults. It is unknown how MM has impacted physical or psychological health among young medical marijuana patients (MMP). It is unknown how MM dispensaries influence health among young MMP, including the impact of closing MM dispensaries on access to MM. To address these gaps, a five-year project is being proposed in Los Angeles (LA) to study young MMP, young non-medical marijuana users (NMU), and MM dispensaries in natural settings using qualitative and quantitative methods. A long-term goal of the study is to recommend MM policies to local, state, and national officials that result in the most positive health outcomes for young adults and communities. The overall objective of this particular application is to determine the impact of LA's MM policies on emerging adults' physical and psychological health while understanding how medical marijuana dispensaries influence individual health. The central hypothesis guiding this study is that young MMP, as a result of access to MM and patient support offered by MM dispensaries, will report better physical and psychological health and less harmful patterns of drug use compared to NMU. This hypothesis is supported by preliminary data collected in LA on young MMP and NMU during a currently funded NIH study, which suggests important differences between these two groups as well as dissimilarities between young MMP and chronically ill, older MMP. The rationale for the proposed research is that young MMP and NMU will be impacted by MM policy longer than other adult cohorts with unknown consequences, while the diverse setting of LA - with its large number of MM dispensaries - is an optimal location to study this cohort. Guided by preliminary data, this hypothesis will be tested by pursuing three specific aims: 1) Determine the basis for MMP status and its impact on trajectories of physical and psychological health among emerging adults. 2) Determine the impact of MMP status on patterns of drug use among emerging adults, including intensity of marijuana use and misuse of alcohol, prescription drugs, and illicit drugs. 3) Describe the natural history of marijuana use in Los Angeles among MMP and NMU. The approach is innovative because it focuses on a critical cohort of young adults, it builds upon findings and theoretical perspectives from the field of non- medical marijuana research, and it integrates quantitative and qualitative research methodologies into a longitudinal research design. The proposed research is significant since study data can provide evidence- based rationales for modifying patient health behaviors, physician guidelines, and city ordinances. Ultimately, determining the impact of medical marijuana on the health of emerging adults and communities in LA has the potential to inform medical marijuana policy at the local, state, and national levels.