Medical marijuana: Longitudinal trajectories in use, pain and functioning

描述（由申请人提供）：Maritime是美国最常用的药物，与许多负面结果有关。然而，许多人也认为大麻对治疗慢性疼痛有益。尽管大麻长期镇痛作用的证据仍处于初步阶段，但已有15个州将大麻使用合法化 大麻用于医疗目的，包括缓解疼痛。迄今为止，甚至缺乏关于使用医用大麻的人的特征以及获得医用大麻后物质使用和物质使用相关问题如何变化的基本数据。同样，获得医用大麻可能会影响个人的疼痛体验，艾滋病毒风险状况，功能和卫生服务使用。随着美国正在进行的政策辩论和医用大麻计划的日益普及，了解医用大麻的潜在影响至关重要。 这项拟议中的研究将筛选在密歇根州南部四家医用大麻诊所之一寻求获得医用大麻的个人。根据对这一筛选的回应，拟议的项目将确定一个800人（400名男性和400名女性）的队列，他们首次因与疼痛有关的原因寻求医用大麻。该队列将在2年内每6个月进行一次重新评估，以充分衡量身心功能、就业和法律的功能以及卫生服务使用结局水平的长期变化。初步分析将利用筛选数据来检查首次寻求医用大麻卡的人和寻求更新医用大麻卡的人之间在物质使用，疼痛，艾滋病毒风险状况，功能和服务使用方面的基线差异。随后的分析将模拟物质使用（大麻和其他药物使用），疼痛（疼痛水平和行为疼痛耐受性），艾滋病毒风险状况，功能（精神，身体，就业和法律的功能），以及医疗服务（专业疼痛治疗，成瘾治疗和一般医疗保健）在首次访问医用大麻诊所进行疼痛治疗后2年内的利用率。我们 还将确定预测物质使用，疼痛，功能和健康服务使用的长期轨迹的因素。作为次要目标，我们将研究医用大麻转移的范围以及随着时间的推移从事医用大麻转移的参与者的特征。该项目将提供有关寻求医用大麻进行疼痛管理的个人的关键数据，以及这些人如何随着时间的推移而变化。由此产生的数据将为围绕医用大麻使用的辩论提供信息，并有助于制定识别和干预与药物使用相关问题风险的个人的策略。

DESCRIPTION (provided by applicant): Marijuana is the most frequently used drug in the United States and has been linked to numerous negative outcomes. However, many individuals also perceive marijuana to be beneficial for the treatment of chronic pain. Although evidence for the long-term analgesic effects of marijuana is still preliminary, 15 states have legalized the use of marijuana for medical purposes, including pain relief. To date, even basic data are lacking on the characteristics of those who use medical marijuana and how substance use and substance use-related problems change after obtaining medical marijuana. Similarly, access to medical marijuana may influence an individual's experience of pain, HIV risk profile, functioning, and health service use. With the ongoing policy debate and growing popularity of medical marijuana programs in the United States, it is essential to understand the potential ramifications of medical marijuana use for individuals who seek access to it. The proposed study will screen individuals seeking to obtain medical marijuana at one of four medical marijuana clinics in Southern Michigan. Based on responses to this screen, the proposed project will identify a cohort of 800 individuals (400 men and 400 women) who are seeking medical marijuana for the first time for reasons related to pain. This cohort will be re-assessed at 6-month intervals for 2 years in order to adequately measure the longer-term changes in levels of mental and physical functioning, employment and legal functioning, and health service use outcomes. Initial analyses will utilize the screening data to examine baseline differences in substance use, pain, HIV risk profile, functioning, and service use between those seeking a medical marijuana card for the first time and those seeking to renew their medical marijuana card. Subsequent analyses will model substance use (marijuana and other drug use), pain (pain level and behavioral pain tolerance), HIV risk profile, functioning (mental, physical, employment, and legal functioning), and health service (specialty pain treatment, addictions treatment, and general medical care) utilization over the course of 2 years after a first visit to a medical marijuana clinic for pain treatment. We will also identify factors that predict longer-term trajectories of substance use, pain, functionin, and health service use. As a secondary objective, we will examine the scope of medical marijuana diversion and the characteristics of participants who engage in medical marijuana diversion over time. This project will provide crucial data on individuals seeking medical marijuana for pain management and how these individuals change over time. The resulting data will inform the debate surrounding medical marijuana use and could help shape strategies to identify and intervene with individuals at risk for problems related to substance use.