Medical Marijuana, Emerging Adults, and Community: Connecting Health and Policy

项目摘要/摘要 合法获得大麻用于医疗和/或娱乐用途的个人人数不断增加 考虑到对公众的潜在影响，可以说是过去20年来毒品政策最深刻的变化 健康。加利福尼亚州是自1996年以来授权大麻用于医疗用途的28个州之一，成为第八个 医用大麻州在成人使用大麻法案通过后将娱乐用途大麻合法化 2016年的《大麻法案》(Auma)。还没有研究过从医疗到医疗的实时转换 自各州开始合法化以来，娱乐环境及其对年轻成年大麻使用者的影响 2012年用于娱乐用途的大麻。此外，还没有研究检查合法化对 18至20岁青少年的娱乐用途--符合医疗用途但被禁止娱乐用途的群体 在所有合法的州。我们更新目前的R01的长期目标是为公共政策提供调查结果 在大麻合法的环境中，年轻人更安全和受控地使用大麻 供娱乐之用。我们的目标是确定大麻合法化对年轻人的影响 使用者(18至30岁)通过继续研究一群年轻人--210名医用大麻 患者(MMP)，156名非患者大麻使用者(NPU)-2014-15年度在加利福尼亚州洛杉矶招募，而 还招募了新的150名18岁至20岁的大麻使用者。我们的中心假设是 娱乐用大麻合法化将导致更多的大麻使用、其他毒品使用和风险 年轻人的行为，但这种增加将因患者状态(MMPvs.NPU)和取向而异 对于大麻的使用，即药用与娱乐。我们建议进行这项研究的理由是 更新当前的R01将提供独特的机会来分析大麻使用、其他药物使用和风险 连续收集前后的一组年轻成年大麻使用者的行为 在加利福尼亚州合法化；并招募新的未成年吸食大麻者队列，用于比较目的。 在当前R01的初步数据的指导下，中心假设将通过追求三个 具体目标：1)确定大麻合法化对大麻使用轨迹的影响，包括 高效形式，例如，在基质金属和NPU(21至30岁)中的涂抹、食用；2)决定 大麻合法化对医疗和娱乐场所其他毒品使用方式和危险行为的影响 使用者(21岁至30岁)；以及3)确定大麻合法化对人们的态度和模式的影响 在新招募的未成年青年(18至20岁)队列中使用大麻。方法是 创新是因为它使用了中断的时间序列设计来研究大麻合法化对 年轻人，包括合法和非合法的娱乐使用者，并包括 在完全合法的情况下娱乐使用者使用大麻。拟议的研究具有重要意义，因为 年轻人娱乐用大麻合法化对公共健康的影响尚不清楚。

PROJECT SUMMARY/ABSTRACT The rising number of individuals with legal access to marijuana for medical and/or recreational use is arguably the most profound change in drug policy in the past 20 years given the potential impact on public health. California, one of 28 states that authorized marijuana for medical use since 1996, became the eighth medical marijuana state to legalize marijuana for recreational use following the passage of the Adult Use of Marijuana Act (AUMA) in 2016. No research has studied the real-time transition from a medical to a recreational environment and its impact on young adult marijuana users since states began legalizing marijuana for recreational use in 2012. Furthermore, no study has examined the impact of legalization for recreational use on 18 to 20 year olds – a group eligible for medical use but prohibited from recreational use in all legal states. Our long-term goal in this renewal of a current R01 is to inform public policy with findings on safer and controlled use of marijuana among young adults in an environment where marijuana is legal for recreational use. Our objective here is to determine the impact of legalization on young adult marijuana users (18 to 30 year olds) by continuing the study of a cohort of young adults – 210 medical marijuana patients (MMP), 156 non-patient marijuana users (NPU) - recruited in Los Angeles, CA in 2014-15 while also enrolling a new cohort of 150 18 to 20 year old marijuana users. Our central hypothesis is that legalizing marijuana for recreational use will result in increased marijuana use, other drug use, and risk behaviors among young adults, but this increase will vary by patient status (MMP vs. NPU) and orientation towards marijuana use, i.e., medicinal vs. recreational. Our rationale for the proposed research is that renewing a current R01 will offer the unique opportunity to: analyze marijuana use, other drug use, and risk behaviors on a cohort of young adult marijuana users continuously collected both before and after legalization in California; and recruit a new underage cohort of marijuana users for comparative purposes. Guided by preliminary data from the current R01, the central hypothesis will be tested by pursuing three specific aims: 1) Determine the impact of marijuana legalization on trajectories of marijuana use, including high-potency forms, e.g., dabs, edibles, among MMP and NPU (aged 21 to 30); 2) Determine the impact of marijuana legalization on patterns of other drug use and risk behaviors among medicinal and recreational users (aged 21 to 30); and 3) Determine the impact of marijuana legalization on attitudes and patterns of marijuana use among a newly recruited cohort of underage young adults (aged 18 to 20). The approach is innovative because it uses an interrupted time series design to study the effects of legalizing marijuana on young adults, includes both legal and non-legal recreational users, and includes medicinal orientation of marijuana use among recreational users in a fully legal context. The proposed research is significant since the public health impact of legalizing marijuana for recreational use among young adults is unknown.