Dynamics of Cannabis Market Environment Changes and Public Health Effects after Legalization: The Role of Local-Level Regulation Beyond the Short-Term in the Pacific Northwest

项目摘要/摘要 我们的研究将有助于证明毒品非刑事化政策的效果， 通过评估俄勒冈州2020年11月投票的实施情况和结果 主动措施110：吸毒成瘾治疗和康复法(M-110)。这 这项措施使持有少量毒品合法化，并减少了犯罪 对更严重罪行的惩罚。拥有少量毒品将不再是 犯罪，但结果是民事处罚，100美元的罚款可以免除 参加通过M-110提供的健康评估-建立的区域 成瘾康复中心(ARCS)。这是第一次通过这样的政策 美国。 这项拟议的行政补充文件的目的将建立在家长研究的基础上 评估物质使用政策执行情况的数据和方法 结果，以及地方政策的可变性如何与不同的结果相关联， 包括在农村和城市社区环境中以及在不同人口之间 组。第一个目标是系统地描述行为健康的趋势。 执行M-110规定后的系统容量，包括时变 为行为健康、治疗服务的可用性和健康提供地方一级的资金 已交付评估。第二个目标将评估公共付费服务的交付趋势 物质使用依赖治疗服务。第三个目标将评估毒品的趋势- 相关住院和急诊科就诊。目标2和目标3将 描述俄勒冈州的趋势，评估不同地区的趋势是否存在差异 社区类型(例如，城市/农村)或针对不同的个人群体(例如，通过 种族/民族、年龄、性别和收入)，以及变异性是否由 社区层面行为健康能力的差异。 我们将使用我们母公司开发的准实验方法来解决这些目标 研究，它利用了州内和跨时间变化的地方政策。公众 这项研究的健康监测数据来自父母拨款，包括 住院和急诊数据以及公共付费治疗(医疗补助费用)数据。 这项研究的发现将对理解药物的作用至关重要。 非刑事化政策，以及对卫生公平的潜在贡献。

PROJECT SUMMARY/ABSTRACT Our study will contribute to the evidence about effects of drug decriminalization policy, by assessing implementation and outcomes from Oregon’s November 2020 ballot initiative Measure 110: Drug Addiction Treatment and Recovery Act (M-110). This measure decriminalizes possession of small amounts of drugs and reduces criminal penalties for greater offenses. Possession of small amounts of drugs would no longer be a crime, but instead result in a civil penalty, with a $100 fine that can be waived by participating in a health assessment provided through M-110-established regional Addiction Recovery Centers (ARCs). This is the first such policy to be passed in the United States. The aims of this proposed administrative supplement would build on the parent study’s data and approaches to assess implementation of substance use policies and associated outcomes, and how variability in local policies is associated with different outcomes, including in rural and urban community settings and among different population groups. The first aim will provide a systematic description of trends in behavioral health system capacity following implementation of M-110 provisions, including time-varying local-level funding for behavioral health, availability of treatment services, and health assessments delivered. The second aim will assess trends in delivery of public-paid substance use dependence treatment services. The third aim will assess trends in drug- related hospitalizations and emergency department (ED) visits. Aims 2 and 3 will describe Oregon trends, assess whether there are differences in trends for different community types (e.g., urban/rural) or for different groups of individuals (e.g., by race/ethnicity, age, gender, and income), and whether variability is explained by differences in community-level behavioral health capacity. We will address these aims using quasi-experimental methods developed in our parent study, which exploit within-state and across-time variation in local policies. Public health surveillance data for the study are in-hand from the parent grant, including hospitalization and ED data and public-paid treatment (Medicaid charge) data. Findings from this study will be critical for understanding the effects of drug decriminalization policy, and potential contribution to health equity.