Drug Consumption and Disease Mortality: Population-level Analyses

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DESCRIPTION (provided by applicant): The principal aim of this exploratory/developmental project is to examine the relationship between drug consumption and disease at the population level. This project will significantly advance our knowledge of such a relationship with a series of retrospective analyses using a unique recently-discovered and extraordinarily rich and reliable dataset on the consumption of opiates and cannabinoids, collected at a time when the consumption of these substances was legal, in conjunction with contemporaneous data on the prevalence and intensity of a variety of infectious diseases and conditions (including but not restricted to cholera, smallpox, plague, and diarrhea and dysentery) as well as a rich set of possible epidemiologic correlates. The substantive aims include separate tests for and/or analyses of (i) the relationship of the consumption of the above substances with mortality from the above diseases and conditions using legal and reliable population-level data on drug consumption and mortality, (ii) the differences between opium, marijuana, and alcohol and combinations of them in their association with variations in mortality, (iii) the differences between the diseases in their propensity to differentially affect populations of intense and non-intense drug consuming populations, and (iv) the interactions between various other epidemiologically salient factors and drug consumption in exposing populations to diseases. This study will involve the application of statistical and econometric methods to the analysis of data on marijuana and opium consumption, diseases, and other variables in British India. Tests for (i) - (iv) above will be conducted using empirical methods for the analysis of count-based dependent variables (mortality, for example) with a spatial component, necessitating the use of the Poisson or negative binomial model specifications. In addition, multivariate or conditional Granger causality tests will be used to determine if there is evidence for temporal precedence of one phenomenon (drug consumption, for example) in relation to another phenomenon (mortality, for example). PUBLIC HEALTH RELEVANCE: NIDA defines its role in terms of reducing the harm caused by drug abuse. In order to achieve this goal, it is necessary to understand the mechanisms by which drug abuse is linked to negative health outcomes such as infectious disease at both the individual and population levels. This project is relevant in that it aims to significantly advance our knowledge of these relationships with a series of analyses using a unique recently-discovered and extraordinarily rich and reliable dataset on the consumption, at the population level, of opiates and cannabinoids in conjunction with contemporaneous data on mortality from a variety of diseases. The body of knowledge generated by these analyses will contribute to the knowledge base of drug abuse by complementing, for the first time, the existing laboratory- and clinic-based evidence on the drug-disease relationship with population-wide evidence.