Guttmannova Katarina, Lee Christine M, Kilmer Jason R, Fleming Charles B, Rhew Isaac C, Kosterman Rick, Larimer Mary E
Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington.
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
Alcohol Clin Exp Res. 2016 Jan;40(1):33-46. doi: 10.1111/acer.12942. Epub 2015 Dec 21.
Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in 4 states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol.
The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and nonmedical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic Search Premier, Econlit, Legal Collection, Medline, PsycARTICLES, and PsycINFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined.
The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States.
Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Furthermore, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the margin of alcohol use examined. Design of policy evaluation research requires careful consideration of these issues.
大麻政策正在迅速演变。在美国，4个州现在允许娱乐性使用大麻，23个州允许医用大麻合法化。评估此类政策的研究主要集中在政策如何影响大麻的价格、获取、使用及后果等问题上。由于可能存在溢出效应，研究人员还需要研究大麻政策如何影响酒精的使用及后果。
本文是对评估与大麻合法化、医用大麻合法化以及非医用或娱乐性大麻合法化相关的酒精使用结果的文章的批判性综述。我们通过以下方式识别文章和报告：（1）在线搜索EBSCO主机数据库，包括学术搜索高级版、经济文献数据库、法律文集、医学索引、心理学文摘和心理学数据库，以及PubMed和谷歌学术数据库；（2）查阅通过电子搜索确定的论文中引用的其他文章；（3）针对性搜索州和地方政府关于大麻法律实施的记录。我们从研究的数据来源和样本特征、方法、酒精和大麻使用的幅度、政策变化的时间以及所研究法律的方面等角度对研究进行了综述。
现有文献为美国大麻政策自由化背景下的替代关系（即更宽松的大麻政策与随着大麻成为替代品而减少酒精使用相关）和互补关系（即更宽松的大麻政策与大麻和酒精使用增加相关）都提供了一些证据。
更宽松的大麻政策对酒精使用的影响是复杂的，可能取决于政策实施的具体方面，包括政策实施的时长。此外，对大麻政策对酒精使用影响的评估可能因所研究的年龄组和所考察的酒精使用幅度而异。政策评估研究的设计需要仔细考虑这些问题。
