Impact of Marijuana Legalization on Opioid Prescribing and Poisonings in Colorado

大麻合法化对科罗拉多州阿片类药物处方和中毒的影响

• 批准号: 9889931
• 负责人: Rosalie Liccardo Pacula
• 金额: $ 47.1万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9889931
• 关键词: Accident and Emergency department; Adoption; Affect; Americas; Area; Attention; Automobile Driving; Back; Code; Colorado; Communities; Country; County; Coupled; Data; Data Aggregation; Data Sources; Databases; Death Rate; Dependence; Diagnosis; Digit structure; Dose; Drug Prescriptions; Drug Utilization; Drug usage; Ecological Bias; Environment; Exposure to; Goals; Growth; Health; Health Insurance; Health Status; Hospitals; Incidence; Individual; Laws; Legal; Light; Link; Location; Marijuana; Measures; Medical; Medical Marijuana; Methods; Opioid; Opioid Rotation; Overdose; Patients; Pharmaceutical Preparations; Pharmacy facility; Poison; Poisoning; Policies; Records; Research; Risk; Role; Sales; Source; Surveys; Symptoms; Taxes; Testing; Therapeutic; Travel; United States; Vital Statistics; Voting; addiction; base; geographic difference; improved; individual response; innovation; insight; marijuana legalization; marijuana use; mortality; nonmedical use; opioid abuse; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use; opioid user; overdose death; prescription opioid; response; time use; trend

PROJECT SUMMARY/ABSTRACT The opioid epidemic is devastating individuals and communities across America. While the opioid epidemic affects all states, Colorado has been particularly hard hit as is evident by a 68% increase in opioid overdose deaths between 2002 and 2014. Several of Colorado's counties have among the highest death rates from opioids in the country. Recent research suggests marijuana could serve as a substitute for opioids, and diminish the harms from opioid misuse. Although Colorado legalized medical marijuana in 2000, dispensaries were not widespread until 2010. Recreational stores, made legal by a popular vote in 2012, started opening in January 2014. Colorado is therefore an excellent environment in which to evaluate whether increasing access to marijuana does in fact reduce opioid abuse. In this study we exploit the increase in access that occurred with the legalization of recreational marijuana to assess the impacts on opioid utilization and opioid related harm (abuse, dependence, poisonings and mortality). While individuals with specific medical conditions had access prior to recreational legalization, that access was not uniform throughout the state as local jurisdictions could choose to ban dispensaries. Similarly, even with legalization, jurisdictions could ban stores. We make use of this geographic variation with respect to bans on medical and recreational marijuana outlets as well as differential access to medical marijuana stores based on underlying health conditions to assess the impact of the policy change and growth in the number of stores on prescription drug use and harm within these markets. By combining information on the number of registered medical and recreational outlets with information on sales tax revenue, we are able to create a new measure of exposure that improves upon prior measures by also reflecting the size of the market. We link this information on marijuana market exposure to prescription drug utilization and harms available in the Colorado All Payers Claims Database (APCD). Difference-in-difference methods allow us to identify the effects of living in exposed and growing markets while controlling for broader state-level trends in opioid prescribing and abuse. Given weaknesses of the APCD, we also evaluate effects using other data, including the National Vital Statistics Survey, Hospital Emergency Department data, Hospital Discharge data, and poison center calls. Our study will be the first to provide a comprehensive assessment of whether increasing access to legal marijuana actually reduces opioid utilization and harm.

项目总结/文摘

项目成果

Impact of cannabis legalization on healthcare utilization for psychosis and schizophrenia in Colorado.

• DOI: 10.1016/j.drugpo.2022.103685
• 发表时间: 2022-06
• 期刊: INTERNATIONAL JOURNAL OF DRUG POLICY
• 影响因子: 4.4
• 作者: Wang, George Sam;Buttorff, Christine;Wilks, Asa;Schwam, Daniel;Tung, Gregory;Pacula, Rosalie Liccardo
• 通讯作者: Pacula, Rosalie Liccardo

Disposition of Oral Cannabidiol-Rich Cannabis Extracts in Children with Epilepsy.

癫痫儿童口服富含大麻二酚的大麻提取物的处置。

• DOI: 10.1007/s40262-020-00869-z
• 发表时间: 2020
• 期刊: Clinical pharmacokinetics
• 影响因子: 4.5
• 作者: Wang,GeorgeSam;Bourne,DavidWA;Klawitter,Jost;Sempio,Cristina;Chapman,Kevin;Knupp,Kelly;Wempe,MichaelF;Borgelt,Laura;Christians,Uwe;Leonard,Jan;Heard,Kennon;Bajaj,Lalit
• 通讯作者: Bajaj,Lalit

Impact of Recreational Cannabis Legalization on Opioid Prescribing and Opioid-Related Hospital Visits in Colorado: an Observational Study.

• DOI: 10.1007/s11606-023-08195-3
• 发表时间: 2023-09
• 期刊: JOURNAL OF GENERAL INTERNAL MEDICINE
• 影响因子: 5.7
• 作者: Buttorff, Christine;Wang, George Sam;Wilks, Asa;Tung, Gregory;Kress, Amii;Schwam, Dan;Pacula, Rosalie Liccardo
• 通讯作者: Pacula, Rosalie Liccardo

Changes in Emergency Department Encounters for Vomiting After Cannabis Legalization in Colorado.

• DOI: 10.1001/jamanetworkopen.2021.25063
• 发表时间: 2021-09-01
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Wang GS;Buttorff C;Wilks A;Schwam D;Tung G;Pacula RL
• 通讯作者: Pacula RL

Another Perspective on Cannabis and Emergency Medicine in Colorado.

科罗拉多州大麻和急诊医学的另一个视角。

• DOI: 10.5811/westjem.2019.8.44882
• 发表时间: 2019
• 期刊: The western journal of emergency medicine
• 作者: Heard,Kennon;Monte,AndrewA;Wang,GeorgeSam
• 通讯作者: Wang,GeorgeSam