State medical marijuana laws and NSDUH marijuana use and consequences since 2004

自 2004 年以来各州医用大麻法和 NSDUH 大麻使用及其后果

• 批准号: 8744452
• 负责人: Silvia Saboia Martins
• 金额: $ 38.52万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8744452
• 关键词: Accident and Emergency department; Address; Adolescent; Adult; Affect; Age; Alcohol or Other Drugs use; Alcohols; Asians; Biometry; Censuses; Cocaine; Data; Data Files; Disease; Drug Prescriptions; Drug usage; Elderly; Ethnic Origin; Funding; Future; Geographic state; Health; Heroin; High Prevalence; Hispanics; Imprisonment; Individual; Investigation; Knowledge; Laws; Lead; Legal; Marijuana; Marijuana Smoking; Marketing; Medical; Medical Marijuana; Minority Groups; Modeling; Monitor; National Institute of Drug Abuse; Not Hispanic or Latino; Outcome; Patients; Pattern; Pharmaceutical Preparations; Policy Maker; Population; Prevalence; Price; Public Health; Race; Relative (related person); Research; Resources; Respondent; Risk; Scientist; Statutes and Laws; Surveys; Testing; Time; Variant; Visit; Youth; age related; aged; data portal; design; experience; innovation; member; prescription opioid; public health relevance; racial and ethnic; racial and ethnic disparities; residence; substance abuse epidemiology; trend; young adult

DESCRIPTION (provided by applicant): Since 1996, 20 states and DC passed laws legalizing medical use of marijuana (40% of all states), and other states are considering such laws. Whether these fast-changing laws lead to increases in marijuana use (MU) is now largely a matter of opinion and debate. Responding to NIDA PA 11-230, we propose to investigate the relationship between MML and MU, MU disorders and consequences of MU in both adolescents and adults, using an outstanding resource, the restricted access data files from the National Survey on Drug Use and Health (NSDUH), 2004 and onwards, that we are authorized to access through SAMHSA's new NSDUH Restricted Use Files Data Portal. These data files include important variables not included in the public use files, including state of residence, exact respondent age, and detailed race/ethnicity information. We will also incorporate state-level data external to NSDUH (e.g., Census demographic data, state arrest rates, emergency department visits, MML variation) as potential confounders and outcomes in our models comparing states with and without MML. The proposed study is a comprehensive, timely, and innovative investigation of these issues, designed to provide much-needed, important information to health scientists, policy-makers and the public. Primary aims are to: 1a) Examine individual-level MU and MU disorder from 2004 to 2014 as a function of state-level MML; 1b) Using data from the US states that approved MML after 2004, examine the effects of different time lags (e.g., 1-, 2-years) before and after passage of the laws on individual-level MU and MU disorder. 2) Explore whether state-level variations in MML or specific aspects of MML (e.g., variations of amounts allowed per patient, registration rules, permitted medical conditions) are associated with the prevalence of MU, how individuals acquire marijuana, and how much they pay for it. 3) Investigate whether passage of state MML is followed by change in individual risk for (a) other substances (alcohol, nonmedical prescription opioid, cocaine, heroin use), relative to trends in the US states without MML (increase, per the gateway hypothesis; or decrease, per the substitution hypothesis); (b) consequences related to marijuana use (i.e., arrests, incarceration, legal problems), relative to any change in the risk for these consequences in states without MML. 4) Investigate whether racial/ethnic (non-Hispanic White, non-Hispanic Black, Asian, and Hispanic) and age (i.e., adolescents, young adults, and older adults) differences in past-year and past-month prevalence of MU and MU disorders and potential consequences of MU change as a function of the passage of state-level MML. Our research team includes experts in substance abuse epidemiology and biostatistics as well as an expert with extensive expertise in marijuana laws and marijuana markets. Our analyses will employ multilevel regression modeling. This study will address questions of major public health significance, adding important knowledge about fast-changing marijuana laws and their effects on MU among adults and adolescents, contributing to general knowledge about the relationship of legislation to substance use.

描述(申请人提供)：自1996年以来，20个州和华盛顿特区通过了使医用大麻合法化的法律(占所有州的40%)，其他州正在考虑这样的法律。这些快速变化的法律是否会导致大麻使用量(MU)的增加，现在在很大程度上是一个观点和辩论的问题。作为对NIDA PA 11-230的回应，我们建议调查MML和MU之间的关系、MU障碍和MU在青少年和成人中的后果，使用一个杰出的资源，来自2004年及以后的全国药物使用和健康调查(NSDUH)的受限访问数据文件，我们被授权通过SAMHSA新的NSDUH限制使用文件数据门户访问。这些数据文件包括公共用途文件中没有包括的重要变量，包括居住状况、被调查者的确切年龄以及详细的种族/族裔信息。我们还将纳入NSDUH之外的州一级数据(例如，人口普查数据、州逮捕率、急诊科就诊次数、MML变异)，作为潜在的混杂因素和结果，在我们的模型中比较使用和不使用MML的州。拟议的研究是对这些问题的全面、及时和创新的调查，旨在向卫生科学家、政策制定者和公众提供急需的重要信息。主要目的是：1a)检查2004至2014年间个人MU和MU障碍作为州一级MML的函数；1b)使用2004年后批准MML的美国各州的数据，检查关于个人MU和MU障碍的法律通过之前和之后的不同时间滞后(例如1年、2年)的影响。2)探讨MML的州一级差异或MML的特定方面(例如，每个患者允许的数量、登记规则、允许的医疗条件)是否与MU的流行、个人如何获得大麻以及他们为其支付多少费用有关。3)调查在通过MML之后，个人风险是否发生了变化：(A)其他物质(酒精、非医疗处方阿片类药物、可卡因、海洛因的使用)相对于没有MML的州的趋势(根据门户假说增加；或者根据替代假说减少)；(B)与大麻使用相关的后果(即逮捕、监禁、法律问题)，相对于没有MML的州这些后果的风险的任何变化。4)调查种族/民族(非西班牙裔白人、非西班牙裔黑人、亚洲人和西班牙裔)和年龄(即青少年、年轻人和老年人)过去一年和过去一个月MU和MU障碍患病率的差异，以及MU变化作为州一级MML通过的函数的潜在后果。我们的研究小组包括药物滥用、流行病学和生物统计学方面的专家，以及在大麻法律和大麻市场方面具有广泛专业知识的专家。我们的分析将采用多水平回归建模。这项研究将解决具有重大公共卫生意义的问题，增加关于快速变化的大麻法律及其对成人和青少年MU的影响的重要知识，有助于了解立法与药物使用的关系。