Impact of Medical and Recreational Marijuana Laws On Cannabis, Opioids And Psychiatric Medications: National Study of VA Patients, 2000 - 2024

医用和娱乐大麻法对大麻、阿片类药物和精神药物的影响：2000 年至 2024 年退伍军人事务部患者的全国研究

• 批准号: 10612385
• 负责人: DEBORAH S HASIN
• 金额: $ 74.64万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10612385
• 关键词: Address; Adult; Affect; Age; Alcohol consumption; Alcohols; Anti-Anxiety Agents; Antidepressive Agents; Anxiety; Anxiety Disorders; Area; Attention; Behavior; Cannabis; Cannabis policy; Caring; Cessation of life; Characteristics; Computerized Medical Record; Data; Data Set; Depressive disorder; Diagnosis; Disease; Drug Prescriptions; Economic Factors; Epidemiology; Ethnic Origin; General Population; Health; Health Professional; Healthcare Systems; Impairment; Individual; Internal Medicine; Justice; Knowledge; Laws; Left; Link; Literature; Low income; Medical; Medical Marijuana; Medicare; Mental Depression; Mental disorders; Methods; Modeling; Modification; National Institute of Drug Abuse; Opioid; Outcome; Outcome Study; Overdose; Pain; Patients; Pharmaceutical Preparations; Policies; Policy Maker; Population; Post-Traumatic Stress Disorders; Prevalence; Public Health; Race; Recreation; Research; Research Personnel; Resources; Risk Factors; Symptoms; Testing; Text; Time; Tobacco; Tobacco use; United States Department of Veterans Affairs; Variant; Veterans Health Administration; Vulnerable Populations; addiction; adverse outcome; chronic pain; chronic painful condition; clinical practice; clinical risk; demographics; design; effective therapy; federal policy; high risk; human old age (65+); hypnotic; indexing; male; marijuana use; marijuana use disorder; medical examination; multilevel analysis; opioid epidemic; opioid policy; opioid use; opioid use disorder; overdose death; prescription opioid; public health priorities; sedative; sex; trend

Thirty states now have medical marijuana laws (MML), 9 have recreational marijuana laws (RML), and many more states are considering such laws. The health effects of cannabis laws are controversial; understanding them is a major public health and NIDA priority (PA-17-135). Thus far, only 3 studies of adults (2 of them ours; Hasin et al., 2017, Martins et al., 2016) used multi-level modeling to examine MML effects on cannabis outcomes with individual data. These studies suggested post-MML increases in cannabis use and Cannabis Use Disorder (CUD). However, they left many questions unanswered, including whether MML have stronger effects in those with key vulnerability factors (chronic pain, psychiatric disorders). In addition, soaring rates of opioid prescriptions and overdoses have led to calls for MML as part of the solution to the US opioid crisis, but most MML-opioid studies are ecological (a weak design to study individual behavior), and results from individual-level studies leave the evidence unclear. Ecological studies also suggest that through cannabis substitution, MML reduce medication prescriptions for common psychiatric disorders (e.g., PTSD, depression), but no individual-level studies of this have been conducted. Importantly, RML effects are almost entirely unknown, a major gap in knowledge. In Veterans Administration (VA) patients, CUD prevalence has doubled since 2002, and in those age ≥35, is 2-6 times higher than in the general population. VA patients also have high rates of opioid prescriptions, overdoses, and of chronic pain and psychiatric disorders that may increase their vulnerability to adverse MML and RML effects. They thus are a large, vulnerable population in whom MML and RML effects are unknown. We will investigate MML and RML effects utilizing a major resource, the individual data from the VA Electronic Medical Record, available since 2000 from the ~5,000,000 patients served each year by the VA healthcare system. We will create yearly EMR datasets, and merge this with National Death Index data, Medicare data (for those age ≥65) and state-year MML and RML variables that we will create. Using multi-level models and difference-in-difference tests, we will examine MML and RML effects on three main outcomes: cannabis (use, CUD), opioids (prescriptions, fatal and non-fatal overdoses, opioid use disorders), and psychotropic medication prescriptions (antidepressants, anxiolytics, sedatives/hypnotics). Importantly, we will determine if pain, psychiatric disorders or demographics (sex, age, race/ethnicity) modify MML/RML effects. We will also examine specific MML/RML provisions, time lags, and breakpoints in trends reflecting federal policy changes. Analyses will incorporate individual- and state-level confounders, e.g., state norms, economic factors. We will also explore alcohol and tobacco outcomes. The research team includes substance epidemiology/policy experts and VA addiction and internal medicine experts. Findings will be disseminated to clinicians and policy-makers. Determining MML/RML effects in VA patients will make a major contribution to the limited adult literature on MML/RML, contributing to knowledge that will inform policy and the care of individuals with vulnerability factors.

现在有30个州有医用大麻法（MML）， 9个州有娱乐性大麻法（RML），还有很多

项目成果

Correction to Lancet Psychiatry 10: 877-86.

《柳叶刀精神病学》10 更正：877-86。

• DOI: 10.1016/s2215-0366(23)00362-0
• 发表时间: 2023
• 期刊: The lancet. Psychiatry

Prevalence and Correlates of Cannabis Use and Cannabis Use Disorder Among U.S. Veterans: Results From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III).

• DOI: 10.1176/appi.ajp.2021.20081202
• 发表时间: 2022-01
• 期刊: The American journal of psychiatry
• 作者: Browne KC;Stohl M;Bohnert KM;Saxon AJ;Fink DS;Olfson M;Cerda M;Sherman S;Gradus JL;Martins SS;Hasin DS
• 通讯作者: Hasin DS

Substance, use in relation to COVID-19: A scoping review.

物质，与COVID-19的使用：范围审查。

• DOI: 10.1016/j.addbeh.2021.107213
• 发表时间: 2022-04
• 期刊: Addictive behaviors
• 影响因子: 4.4
• 作者: Kumar N;Janmohamed K;Nyhan K;Martins SS;Cerda M;Hasin D;Scott J;Sarpong Frimpong A;Pates R;Ghandour LA;Wazaify M;Khoshnood K
• 通讯作者: Khoshnood K

Trends over time in adult cannabis use: A review of recent findings.

• DOI: 10.1016/j.copsyc.2021.03.005
• 发表时间: 2021-04
• 期刊: Current opinion in psychology
• 影响因子: 5.9
• 作者: Hasin D;Walsh C
• 通讯作者: Walsh C

Implications of Medical and Recreational Marijuana Laws for Neuroscience Research: a Review.

• DOI: 10.1007/s40473-020-00222-5
• 发表时间: 2020-12
• 期刊: Current behavioral neuroscience reports
• 影响因子: 1.7
• 作者: Hasin DS;Aharonovich E
• 通讯作者: Aharonovich E