The Impact of Medical Marijuana in Metropolitan Denver

描述(申请人提供)：过去一个月吸食大麻的人数超过1500万，大麻是美国使用最广泛的非法物质。这一点令人担忧，因为大麻的使用与多种后果有关，如事故、攻击性、导致艾滋病毒的高风险性行为和辍学。然而，大麻也可能有一些治疗效果，14个州已经将医用大麻合法化。科罗拉多州现在估计有10万医用大麻患者，这种广泛的使用引发了人们对大麻滥用、转移和其他使用后果的担忧。不幸的是，很少有数据描述医用大麻合法化的影响。这项拟议的为期5年的R01研究的具体目标和假设是：1.在第一阶段，我们将从消费者、MMC所有者和处方医生的角度确定不断发展的医用大麻行业是如何运作的，并确定药物治疗和保健提供者对医用大麻如何影响他们责任的看法。由于这一阶段旨在收集信息以告知第三阶段，因此不存在假设。2.在第二阶段，我们将对医用大麻的流行病学进行持续评估，包括消费者和MMC数量的变化以及消费者和医生使用医用大麻的原因。假设2：医用大麻可获得性的增加将导致大麻使用的流行率和大麻相关问题的增加。3.在第三阶段，我们将评估医用和非医用大麻使用者中大麻滥用和依赖、转移、其他药物使用、一般保健和保健利用的流行率。假设3a：在基线水平上，有大麻依赖的医用大麻使用者将更少，他们比非医用大麻使用者有更低的其他药物使用和健康问题的比率。假设3b：随着时间的推移，医用大麻使用者的大麻依赖率、其他药物使用和健康问题的增加将比非医用大麻使用者更大。假设3c：在医用大麻使用者中，随着时间的推移，医用大麻的转用将会增加。4.同样在第三阶段，我们将评估医用和非医用大麻使用者中与艾滋病毒相关的性行为风险行为。假设4a：在基线情况下，医用大麻使用者报告的HIV性相关危险行为比非医用大麻使用者要少。假设4b：随着时间的推移，医用大麻使用者会比非医用大麻使用者更多地参与与艾滋病毒相关的性相关危险行为。 与公共卫生相关：2009年，科罗拉多州医用大麻使用者的数量增加了2000%。这一增长引发了人们对滥用大麻、转移大麻和其他健康后果的担忧。这项研究旨在及时提供有关医用大麻系统及其公共健康影响的信息，以便政策制定者和医疗提供者能够有效地解决医用大麻的使用问题。

DESCRIPTION (provided by applicant): With over 15 million past month users, marijuana is the most widely used illicit substance in the United States. This is concerning because marijuana use is associated with multiple outcomes such as accidents, aggression, risky sex that leads to HIV and school dropout. However, marijuana may also have some therapeutic effects and fourteen states have legalized medical marijuana. Colorado now has an estimated 100,000 medical marijuana patients, and this widespread use raises concerns about marijuana abuse, diversion and other consequences of use. Unfortunately, there are few data describing the impact of medical marijuana legalization. The Specific Aims and hypotheses of this proposed 5-year R01 study are: 1. During Phase I we will determine how the evolving medical marijuana industry operates from the perspective of consumers, MMC owners and prescribing physicians, as well as ascertain the views of drug treatment and health care providers concerning how medical marijuana impacts their responsibilities. As this Phase is designed to gather information to inform Phase III, there are no hypotheses. 2. In Phase II we will conduct an ongoing assessment of the epidemiology of medical marijuana, including change in the number of consumers and MMCs and consumers' and physicians' reasons for medical marijuana. Hypothesis 2: The increase in medical marijuana availability will lead to an increase in the prevalence of marijuana use and marijuana-related problems. 3. In Phase III we will assess the prevalence of marijuana abuse and dependence, diversion, other drug use, general health and health care utilization among medical and non-medical marijuana users. Hypothesis 3a: At baseline, there will be fewer medical marijuana users with cannabis dependence and they will have lower rates of other drug use and health problems than non-medical marijuana users. Hypothesis 3b: Over time, increase in rates of cannabis dependence, other drug use and health problems will be greater for medical marijuana users than non-medical marijuana users. Hypothesis 3c: Among medical marijuana users, there will be an increase in the diversion of medical marijuana over time. 4. Also in Phase III we will assess HIV-related sex risk behaviors among medical and non-medical marijuana users. Hypothesis 4a: At baseline, fewer medical marijuana users will report HIV sex-related risk behaviors than non-medical marijuana users. Hypothesis 4b: Over time, medical marijuana users will increase their engagement in HIV related sex-related risk behaviors more than non-medical marijuana users. PUBLIC HEALTH RELEVANCE: The number of medical marijuana users in Colorado increased 2000% in 2009. This increase raises concerns about abuse, diversion and other health consequences of marijuana use. This study seeks to provide timely information on the medical marijuana system and its public health impact so that policy makers and medical providers can effectively address medical marijuana use.