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

描述(由申请人提供)：自1996年医用大麻(MM)在加利福尼亚州合法化以来，在理解医用大麻(MM)政策如何影响新兴成年人方面存在着关键的知识差距。目前尚不清楚MM如何影响新兴成年人的药物使用模式，包括酒精、处方和非法药物。目前尚不清楚MM如何影响年轻医用大麻患者的身体或心理健康。目前尚不清楚MM药房如何影响年轻的MM的健康，包括关闭MM药房对MM获取的影响。为了解决这些差距，洛杉矶正在提议一个为期五年的项目，用定性和定量的方法研究自然环境中的年轻MM、年轻的非医用大麻使用者(NMU)和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。这一特殊应用的总体目标是确定洛杉矶MM政策对初出茅庐的成年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。指导这项研究的中心假设是，由于获得MM的机会和MM药房提供的患者支持，年轻的MM将报告比NMU更好的身心健康和更少的有害药物使用模式。这一假设得到了洛杉矶在目前资助的一项NIH研究中收集的关于年轻MMP和NMU的初步数据的支持，该数据表明了这两组之间的重要差异，以及年轻MMP和慢性病、老年MMP之间的不同。建议进行这项研究的理由是，年轻的MM和NMU将比其他成人队列受MM政策影响的时间更长，后果未知，而洛杉矶多样化的环境-其大量的MM药房-是研究这一队列的最佳地点。在初步数据的指导下，这一假说将通过追求三个具体目标来检验：1)确定基质金属蛋白酶状态的基础及其对新兴成年人身心健康轨迹的影响。2)确定基质金属蛋白酶状态对新兴成年人药物使用模式的影响，包括大麻的使用强度和酒精、处方药和非法药物的滥用。3)描述在MMPs和NMU中在洛杉矶使用大麻的自然历史。这种方法是创新的，因为它侧重于关键的年轻人队列，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纳入纵向研究设计。这项拟议的研究意义重大，因为研究数据可以为修改患者的健康行为、医生指南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兴成年人和社区健康的影响可能会为地方、州和国家各级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.