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）在加州成为法律的以来，在了解医用大麻（MM）政策如何影响新兴成年人方面存在着重要的知识差距。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）的身体或心理健康。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，正在洛杉矶（LA）提出一个为期五年的项目，研究年轻MMP，年轻的非医用大麻用户（NMU），MM药房在自然环境中使用定性和定量方法。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。这一特定应用的总体目标是确定洛杉矶的MM政策对新兴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，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模式的药物使用相比，NMU。这一假设得到了目前资助的NIH研究期间在LA收集的关于年轻MMP和NMU的初步数据的支持，这表明这两组之间存在重要差异，以及年轻MMP和慢性病老年MMP之间的差异。拟议研究的基本原理是，年轻的MMP和NMU将受到MM政策的影响比其他成人队列更长，后果未知，而LA的多样化环境-拥有大量的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进行检验：1）确定MMP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MMP状态对新兴成年人药物使用模式的影响，包括大麻使用的强度和滥用酒精，处方药和非法药物。3)描述MMP和NMU在洛杉矶使用大麻的自然历史。该方法是创新的，因为它侧重于一个关键的年轻人群体，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集成到纵向研究设计中。拟议的研究是重要的，因为研究数据可以提供证据为基础的理由，修改病人的健康行为，医生的指导方针，和城市条例。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.