Rylander Melanie, Valdez Carolyn, Nussbaum Abraham M
Departments of Behavioral Health .
Am J Drug Alcohol Abuse. 2014 Jul;40(4):269-73. doi: 10.3109/00952990.2014.910520. Epub 2014 Jun 20.
Suicide is among the 10 most common causes of death in the United States. Researchers have identified a number of factors associated with completed suicide, including marijuana use, and increased land elevation. Colorado is an ideal state to test the strength of these associations. The state has a completed suicide rate well above the national average and over the past 15 years has permitted first the medical and, as 2014, the recreational use of marijuana.
To determine if there is a correlation between medical marijuana use, as assessed by the number of medical marijuana registrants and completed suicides per county in Colorado.
The number of medical marijuana registrants was used as a proxy for marijuana use. Analysis variables included total medical marijuana registrants, medical marijuana dispensaries per county, total suicide deaths, mechanism of suicide death, gender, total suicide hospitalizations, total unemployment, and county-level information such as mean elevation and whether the county was urban or rural. Analysis was performed with mixed model Poisson regression using generalized linear modeling techniques.
We found no consistent association between the number of marijuana registrants and completed suicide after controlling for multiple known risk factors for completed suicide.
The legalization of medical marijuana may not have an adverse impact on suicide rates. Given the concern for the increased use of marijuana after its legalization, our negative findings provide some reassurance. However, this conclusion needs to be examined in light of the limitations of our study and may not be generalizable to those with existing severe mental illness. This finding may have significant public health implications for the presumable increase in marijuana use that may follow legalization.
自杀是美国十大常见死因之一。研究人员已经确定了一些与自杀死亡相关的因素,包括大麻使用和海拔升高。科罗拉多州是检验这些关联强度的理想之州。该州的自杀死亡率远高于全国平均水平,并且在过去15年里,先是允许医用大麻,到2014年,又允许娱乐用大麻。
根据科罗拉多州各县医用大麻登记人数和自杀死亡人数,确定医用大麻使用与自杀死亡之间是否存在关联。
将医用大麻登记人数用作大麻使用的替代指标。分析变量包括医用大麻登记总人数、各县医用大麻药房数量、自杀死亡总数、自杀死亡机制、性别、自杀住院总数、总失业率以及县级信息,如平均海拔和该县是城市还是农村。采用广义线性建模技术,通过混合模型泊松回归进行分析。
在控制了多个已知的自杀死亡风险因素后,我们发现大麻登记人数与自杀死亡之间没有一致的关联。
医用大麻合法化可能不会对自杀率产生不利影响。鉴于对大麻合法化后使用增加的担忧,我们的阴性结果提供了一些慰藉。然而,鉴于我们研究的局限性,这一结论需要进一步审视,可能不适用于那些已有严重精神疾病的人群。这一发现可能对大麻合法化后可能出现的大麻使用增加具有重大的公共卫生意义。