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Neuroth LM, Benedetti MH, Brooks-Russell A, Li L, Zhu M. Associations between Adolescent Marijuana Use, Driving after Marijuana Use and Recreational Retail Sale in Colorado, USA. Subst Use Misuse 2023; 59:235-242. [PMID: 37877210 DOI: 10.1080/10826084.2023.2267123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
OBJECTIVE We investigated associations between the retail distribution of recreational marijuana in Colorado and (i) past 30-day marijuana use and (ii) driving after marijuana use (DAMU) among a representative sample of public high school students using four waves of data from a state surveillance system. METHODS Past 30-day marijuana use was assessed among all sampled students (n = 85,336). DAMU was assessed among students 15 years or older who indicated driving (n = 47,518). Modified Poisson regression with robust variance estimates was used to estimate prevalence ratios (PR) comparing the pre-distribution (2013) and post-distribution (2015, 2017, 2019) periods for marijuana-related behaviors. Frequency of behavioral engagement was assessed using a multinomial approach. RESULTS An estimated 20.3% of students engaged in past 30-day marijuana use and 10.5% of student drivers engaged in DAMU. Retail distribution of recreational marijuana was not significantly associated with the prevalence of any marijuana use or DAMU. However, it was associated with 1.16 (95% CI: 1.04-1.29) times the prevalence of using marijuana one or two times in the last 30 days, 1.27 (1.03, 1.55) times the prevalence of DAMU one time, and 0.82 (0.69, 0.98) times the prevalence of DAMU six or more times. No significant associations were observed for the remaining frequency categories. CONCLUSIONS Approximately 1 in 10 students who drive reported DAMU. Varying prevalence in the frequency of past 30-day marijuana use and DAMU was observed following the retail distribution of recreational marijuana in Colorado. Care should be taken to properly educate adolescent drivers regarding the dangers of DAMU.
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Affiliation(s)
- Lucas M Neuroth
- The Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marco H Benedetti
- The Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ashley Brooks-Russell
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Li Li
- Department of Epidemiology and Health Statistics, Xiangya College of Public Health, Central South University, Changsha, Hunan, China
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Motao Zhu
- The Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Sevigny EL, Greathouse J, Medhin DN. Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1362. [PMID: 37915420 PMCID: PMC10616541 DOI: 10.1002/cl2.1362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Background Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy-relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms. Objectives This evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps. Search Methods We comprehensively searched for eligible English-language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020. Selection Criteria The conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population-level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer-term consequences (health, safety, and socioeconomic outcomes) of these laws. Data Collection and Analysis Both dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2. Main Results The EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws-including CBDLs, IHLs, and DCLs-are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid-related harms (3), and alcohol-related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality. Authors’ Conclusions More primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer-term-and arguably more salient-health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions.
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Affiliation(s)
- Eric L. Sevigny
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Jared Greathouse
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Danye N. Medhin
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
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Barbalat G, Liu S. Long-Term Impact of Medical Marijuana Laws on the Burden of Cannabis Use Disorders in US Male and Female Adolescents and Young Adults. Community Ment Health J 2023; 59:391-399. [PMID: 36036345 DOI: 10.1007/s10597-022-01018-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/06/2022] [Indexed: 01/25/2023]
Abstract
Deregulation of cannabis use has raised concerns regarding its potential effects on health, particularly in adolescents and young adults. Here, we extracted data from the Global Burden of Disease database to estimate the long-term effect (> 5 years) of medical marijuana laws (MML) on 2019 cannabis use disorders Disability Adjusted Life Years (2019 CUD DALYs) in US male and female adolescents (15-19 years old) and young adults (20-24 years old). Socio-cultural, demographic and economic characteristics were used as baseline covariates. To improve the robustness of estimation, we took advantage of machine learning techniques. We found no significant effect of MML on 2019 CUD DALYS in each of our four age/sex groups. Estimates from a marginal structural model taking into account age and sex strata in the same model were also non-significant. Our findings suggest that MML may have a negligible effect (if any) on cannabis use disorders in this population group.
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Affiliation(s)
- Guillaume Barbalat
- Centre ressource de réhabilitation psychosociale et de remédiation cognitive, Hôpital Le Vinatier, Pôle Centre rive gauche, Université de Lyon, CNRS & Université Lyon, UMR, 5229, France.
- Department of Population Health Sciences, Weill Cornell Medicine, 1300 York Ave, 10065, New York, NY, USA.
| | - Sze Liu
- Department of Population Health Sciences, Weill Cornell Medicine, 1300 York Ave, 10065, New York, NY, USA
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Perez LG, Tucker JS, Pedersen ER, Troxel WM, Rodriguez A, Firth CL, Seelam R, Shih RA, D'Amico EJ. Neighborhood social environment change in late adolescence predicts substance use in emerging adulthood. Health Place 2022; 75:102807. [PMID: 35512503 PMCID: PMC10519144 DOI: 10.1016/j.healthplace.2022.102807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/31/2022] [Accepted: 04/11/2022] [Indexed: 11/04/2022]
Abstract
This study examines associations of changes in perceived and objective (census-based) neighborhood social environment variables during adolescence with alcohol and marijuana outcomes in emerging adulthood using two waves of data (2013-14 and 2019-20) from a cohort in Southern California (n = 1249). Increasing perceived disorganization predicted greater alcohol consequences and socialization with peers using marijuana. Decreasing objective neighborhood SES predicted fewer alcohol consequences and greater socialization with peers drinking alcohol. Unexpectedly, both decreasing and increasing perceived social cohesion predicted fewer alcohol consequences. Increasing perceived social cohesion predicted lower solitary alcohol use. Findings identify potential environmental targets to prevent substance use during the transition to emerging adulthood, but more research is warranted to understand the complex findings for alcohol consequences.
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Affiliation(s)
- Lilian G Perez
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, 2250 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Wendy M Troxel
- RAND Corporation, 4570 Fifth Avenue, Pittsburgh, PA, 15213, USA
| | | | - Caislin L Firth
- Psychiatry and Behavioral Sciences Department, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - Regina A Shih
- RAND Corporation, 1200 South Hayes Street, Arlington, VA, 22202, USA
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Adzrago D, Wong SW, Wilkerson JM. Effect Modification of Illicit Drug Use on Symptoms of a Major Depressive Episode to Better Understand Binge Drinking by Adolescents and Adults in the United States. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00770-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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French MT, Zukerberg J, Lewandowski TE, Piccolo KB, Mortensen K. Societal Costs and Outcomes of Medical and Recreational Marijuana Policies in the United States: A Systematic Review. Med Care Res Rev 2022; 79:743-771. [PMID: 35068253 DOI: 10.1177/10775587211067315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Significant support exists in the United States for legalization of marijuana/cannabis. As of 2021, 36 states and four territories approved the legalization of medical cannabis via medical marijuana laws (MMLs), and 15 states and District of Columbia (DC) have adopted recreational marijuana laws (RMLs). We performed structured and systematic searches of articles published from 2010 through September 2021. We assess the literature pertaining to adolescent marijuana use; opioid use and opioid-related outcomes; alcohol use; tobacco use; illicit and other drug use; marijuana growing and cultivation; employment, earnings, and other workplace outcomes; academic achievement and performance; criminal activity; perceived harmfulness; traffic and road safety; and suicide and sexual activity. Overall, 113 articles satisfied our inclusion criteria. Except for opioids, studies on use of other substances (illicit drugs, tobacco, and alcohol) were inconclusive. MMLs and RMLs do not generate negative outcomes in the labor market, lead to greater criminal activity, or reduce traffic and road safety.
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Wong CF, Mendez SEA, Conn BM, Iverson E, Lankenau SE. Attitudes and beliefs about recreational cannabis legalization among cannabis-using young adults in Los Angeles: Impact on concurrent cannabis practices and problematic cannabis use. Drug Alcohol Depend 2021; 228:109053. [PMID: 34610520 PMCID: PMC11104431 DOI: 10.1016/j.drugalcdep.2021.109053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study investigated differences in attitudes and beliefs about recreational cannabis legalization (RCL) among cannabis-using young adults comprised of medical cannabis patients (MCP) and non-patient users (NPU). We further investigated whether these variations are associated with concurrent cannabis practices and problematic use. METHOD Cannabis-using young adults (N = 301) were interviewed between 2017 and 2018 - after RCL and through the early months after storefront sales began. Latent class analysis empirically derived groups based on participants' attitudes/beliefs about the impact of RCL. Socio-demographic factors, patient status, medicinal and/or recreational use, and social norms differentiated latent class memberships, while concurrent cannabis practices and problematic use served as distal outcomes. The manual Bolck, Croon, and Hagenaars (BCH) three-step process modeled all covariates and distal outcomes simultaneously in the final LCA solution. RESULTS Three patterns emerged: Impacted (RCL had broad impact on attitudes/beliefs) (n = 113), Partially-Impacted (RCL had some impact on attitudes/beliefs) (n = 131) and Neutral (RCL had no/limited impact) (n = 57). MCP were more likely to be Neutral than Partially-Impacted users while those who reported recreational cannabis use were more likely to be Impacted than Neutral users. Class membership predicted cannabis practices and problematic use with Impacted individuals reporting the greatest recent days of use, number of hits per day, and highest scores in problematic cannabis use compared to Partially-Impacted and Neutral users. CONCLUSION Variability in attitudes/beliefs about RCL served as strong drivers of concurrent cannabis practices and problematic use. Findings provide an important baseline for tracking attitudes/beliefs' long-term health and substance use impact as retail cannabis sales evolve.
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Affiliation(s)
- Carolyn F Wong
- Children's Hospital Los Angeles, Division of Adolescent and Young Adult Medicine, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027, USA; University of Southern California, Keck School of Medicine, Department of Pediatrics, 4650 Sunset Blvd., MS #71, Los Angeles, CA 90027, USA.
| | - Stephanie E A Mendez
- USC University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, 4650 Sunset Blvd., MS#53, Los Angeles, CA 90027, USA
| | - Bridgid M Conn
- Children's Hospital Los Angeles, Division of Adolescent and Young Adult Medicine, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027, USA; University of Southern California, Keck School of Medicine, Department of Pediatrics, 4650 Sunset Blvd., MS #71, Los Angeles, CA 90027, USA
| | - Ellen Iverson
- Children's Hospital Los Angeles, Division of Adolescent and Young Adult Medicine, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027, USA; University of Southern California, Keck School of Medicine, Department of Pediatrics, 4650 Sunset Blvd., MS #71, Los Angeles, CA 90027, USA
| | - Stephen E Lankenau
- Drexel University, Dornsife School of Public Health, Department of Community Health and Prevention, 3215 Market Street, Philadelphia, PA 19104, USA
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