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: 8926931
• 负责人: Silvia Saboia Martins
• 金额: $ 40.11万
• 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/8926931
• 关键词: Address; Adolescent; Adolescent marijuana use; Adult; Affect; Age; Alcohol or Other Drugs use; Alcohols; Asians; Biometry; Censuses; Cocaine; Data; Data Files; Disease; Drug Prescriptions; Drug usage; Elderly; Emergency department visit; Ethnic Origin; Funding; Future; Geographic state; Health; Heroin; High Prevalence; Hispanics; Imprisonment; Individual; Investigation; Knowledge; Laws; Lead; Legal; Marijuana; 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; Youth; age related; aged; data portal; design; experience; innovation; marijuana use; marijuana use disorder; member; prescription opioid; 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（由申请人提供）：自1996年以来，20个州和华盛顿特区通过了大麻医疗使用合法化的法律（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（MU）的增加，现在主要是一个意见和辩论的问题。响应NIDA PA 11-230，我们建议调查MML和MU之间的关系，MU障碍和MU在青少年和成人的后果，使用一个优秀的资源，从全国药物使用和健康调查（NSDUH），2004年及以后的限制访问数据文件，我们被授权通过SAMHSA的新NSDUH限制使用文件数据门户网站访问。这些数据文件包括公共使用文件中未包含的重要变量，包括居住国、确切的受访者年龄和详细的种族/民族信息。我们还将合并NSDUH外部的州级数据（例如，人口普查数据，州逮捕率，急诊室就诊，MML变异）作为潜在的混杂因素和结果，在我们的模型中比较有和没有MML的州。这项研究是对这些问题的全面、及时和创新的调查，旨在为卫生科学家、政策制定者和公众提供急需的重要信息。主要目标是：1a）检查2004年至2014年个人水平的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，检查不同时滞的影响（例如，1年，2年）之前和之后通过的法律对个人层面的MU和MU障碍。2)探索MML中的状态级变化或MML的特定方面（例如，每个病人允许的量的变化，登记规则，允许的医疗条件）与MU的流行，个人如何获得大麻，以及他们为它支付多少钱有关。3）调查MML状态的通过是否伴随着（a）其他物质的个人风险的变化（酒精、非医疗处方阿片类药物、可卡因、海洛因使用），相对于无MML的美国各州的趋势（增加，根据网关假设;或减少，根据替代假设）;（B）与大麻使用相关的后果（即，逮捕、监禁、法律的问题），相对于没有MML的州中这些后果的风险的任何变化。4)调查种族/民族（非西班牙裔白色、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疾病患病率的差异以及MU变化的潜在后果作为州一级MML通过的函数。我们的研究团队包括药物滥用流行病学和生物统计学专家，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级回归模型。这项研究将解决重大公共卫生意义的问题，增加有关快速变化的大麻法律及其对成年人和青少年的影响的重要知识，有助于了解立法与物质使用的关系。