Assessing the Impact of Cannabis Legalization on Adolescent Cannabis Use and Cannabis-Related Health Conditions

评估大麻合法化对青少年大麻使用和大麻相关健康状况的影响

• 批准号: 10588148
• 负责人: Kelly Corinne Young-Wolff
• 金额: $ 69.01万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588148
• 关键词: Accident and Emergency department; Accidents; Acute; Address; Adolescence; Adolescent; Advertising; American; Anxiety; Area; Brain; California; Cannabinoids; Cannabis; Cannabis policy; Clinical; Communities; Complement; Data; Decision Aid; Decision Making; Development; Diagnosis; Education; Electronic Health Record; Emergency Department Physician; Emergency department visit; Event; Focus Groups; Future; Geographic Information Systems; Health; Health Personnel; Health Policy; Healthcare; Heterogeneity; Home; Individual; Integrated Delivery of Health Care; Integrated Health Care Systems; Interruption; Intervention; Interview; Intoxication; Knowledge; Laws; Legal; Local Government; Location; Low income; Maps; Marijuana Dependence; Marketing; Medical Marijuana; Medicine; Mental Depression; Mental Health; Methods; National Institute of Drug Abuse; Natural experiment; Parents; Patients; Perception; Poisoning; Policies; Population Heterogeneity; Provider; Psychoses; Public Health; Public Health Practice; Quasi-experiment; Recreation; Reporting; Research; Respiratory Disease; Respiratory Signs and Symptoms; Risk; Risk Factors; Sampling; Scheme; Schizophrenia; Series; Shapes; Study models; Subgroup; Suicide; Syndrome; System; Taxes; Teenagers; Testing; Time; US State; Vehicle crash; Withdrawal; Youth; addiction; cigarette smoking; clinical care; clinical practice; contextual factors; design; disorder risk; epidemiology study; health service use; health warning; high risk; illicit drug use; innovation; insight; marijuana legalization; marijuana use; marijuana use disorder; meetings; motor vehicle injury; pediatric department; pediatrician; psychiatric comorbidity; public health priorities; public health relevance; respiratory; screening; standard care; substance use; trend

PROJECT SUMMARY/ABSTRACT Adolescent cannabis use is increasingly recognized as an important public health problem with significant adverse health consequences. Recreational cannabis legalization (RCL) has high potential to increase risk for adolescent cannabis use and cannabis-related health conditions. However, the effects of RCL on adolescents are unknown. With a highly representative sample of nearly 1 million adolescents (N=900,000) regularly screened for cannabis use in Kaiser Permanente Northern California’s large integrated healthcare delivery system from 2015 to 2023, this multi-method study will address the pressing public health questions of whether and how California state RCL and heterogeneity of local regulatory schemes impact the risk of adolescent cannabis use and cannabis-related health conditions. We will use a quasi-experimental interrupted time series design to test whether adolescent cannabis use, cannabis-related health conditions (e.g., cannabis use disorder, other substance use, respiratory symptoms, mental health problems, cannabis-related accidents, acute cannabis intoxication, cannabinoid hyperemesis syndrome), and cannabis-related healthcare use (e.g., emergency department, addiction treatment) and rise post-RCL. We will also examine local RCL policies (retailer bans or caps, product and advertising restrictions, taxes, health warnings) and use geographic information systems methods to map retailer location (e.g., distance from home address to the closest retailer) onto individual-level electronic health record data collected in clinical care to test whether the effects of RCL are stronger among those who live in communities with less restrictive local policies, adjusting for pre-RCL medical cannabis policies. We will conduct hypothesis-driven moderation analyses to identify sub-groups whose risk for cannabis use and cannabis-related health conditions may be greatest following RCL. To gain further clinical insight into our quantitative data and guide next steps, we will conduct focus groups with adolescents and interviews with addiction medicine clinicians, pediatricians, and emergency department physicians to gain insight into how RCL impacts adolescent cannabis use and addiction treatment need from the perspective of both patients and providers. Together, results will have immediate public health and clinical implications, providing urgently needed data to identify potentially actionable areas for future policy adaptations and aid decision making for public health practices to reduce adolescent cannabis use and cannabis-related harms.

项目概要/摘要 青少年吸食大麻越来越被认为是一个重要的公共卫生问题，具有重大影响 不良的健康后果。娱乐性大麻合法化（RCL）极有可能增加大麻风险 青少年大麻使用和与大麻相关的健康状况。然而，RCL 对青少年的影响 未知。定期抽取近 100 万青少年 (N=900,000) 的高度代表性样本 在 Kaiser Permanente 北加州大型综合医疗保健服务中筛查大麻使用情况 系统从 2015 年到 2023 年，这项多方法研究将解决紧迫的公共卫生问题： 以及加利福尼亚州 RCL 和地方监管计划的异质性如何影响青少年的风险 大麻使用和与大麻相关的健康状况。我们将使用准实验中断时间序列 旨在测试青少年是否使用大麻、与大麻相关的健康状况（例如，使用大麻 疾病、其他物质使用、呼吸道症状、心理健康问题、大麻相关事故、 急性大麻中毒、大麻素剧吐综合征）以及与大麻相关的医疗保健用途（例如， 急诊室、成瘾治疗）并在 RCL 后升职。我们还将研究当地的 RCL 政策 （零售商禁令或上限、产品和广告限制、税收、健康警告）并使用地理信息 绘制零售商位置地图的信息系统方法（例如，从家庭住址到最近零售商的距离） 分析在临床护理中收集的个人电子健康记录数据，以测试 RCL 是否有影响 根据 RCL 前的情况进行调整，居住在当地政策限制较少的社区的人们的影响力更强 医用大麻政策。我们将进行假设驱动的调节分析来识别子组 RCL 后，其使用大麻和大麻相关健康状况的风险可能最大。为了获得 为了进一步了解我们的定量数据并指导后续步骤，我们将开展焦点小组讨论 青少年以及对成瘾医学临床医生、儿科医生和急诊科的采访 医生可以深入了解 RCL 如何影响青少年大麻使用和成瘾治疗需求 患者和提供者的观点。总之，结果将立即影响公共卫生和临床 影响，提供迫切需要的数据，以确定未来政策调整的潜在可行领域 并协助公共卫生实践决策，以减少青少年大麻使用和大麻相关问题 危害。