Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Int Rev Psychiatry. 2020 May;32(3):221-234. doi: 10.1080/09540261.2020.1713056. Epub 2020 Feb 6.
Decriminalization, medicalization, and legalization of cannabis use by a majority of U.S. states over the past 25 years have dramatically shifted societal perceptions and use patterns among Americans. How marijuana policy changes have affected population-wide health of U.S. youth and what the downstream public health implications of marijuana legalization are topics of significant debate. Cannabis remains the most commonly used federally illicit psychoactive drug by U.S. adolescents and is the main drug for which U.S. youth present for substance use treatment. Converging evidence indicates that adolescent-onset cannabis exposure is associated with short- and possibly long-term impairments in cognition, worse academic/vocational outcomes, and increased prevalence of psychotic, mood, and addictive disorders. Odds of negative developmental outcomes are increased in youth with early-onset, persistent, high frequency, and high-potency Δ-9-THC cannabis use, suggesting dose-dependent relationships. Cannabis use disorders are treatable conditions with clear childhood antecedents that respond to targeted prevention and early intervention strategies. This review indicates that marijuana policy changes have had mixed effects on U.S. adolescent health including potential benefits from decriminalization and negative health outcomes evidenced by increases in cannabis-related motor vehicle accidents, emergency department visits, and hospitalizations. Federal and state legislatures should apply a and consider the possible downstream effects of marijuana policy change on paediatric health.
在过去的 25 年里，美国大多数州将大麻的使用非刑罪化、医疗化和合法化，这极大地改变了美国社会对大麻的看法和使用模式。大麻政策的变化如何影响美国青年的全民健康，以及大麻合法化的下游公共卫生影响是什么，这些都是备受争议的话题。大麻仍然是美国青少年中最常被滥用的联邦非法精神活性药物，也是美国青少年接受药物使用治疗的主要药物。越来越多的证据表明，青少年时期接触大麻会导致短期和长期认知能力下降、学业/职业成绩更差，以及精神、情绪和成瘾障碍的发病率增加。在青少年中，大麻的发病年龄早、持续时间长、频率高、Δ-9-THC 含量高，这些因素都与负面的发展结果有关，表明存在剂量依赖性关系。大麻使用障碍是一种可治疗的疾病，有明确的儿童期前因，对有针对性的预防和早期干预策略有反应。这篇综述表明，大麻政策的变化对美国青少年健康有混合影响，包括非刑罪化的潜在好处，以及大麻相关的机动车事故、急诊就诊和住院治疗增加所证明的负面健康结果。联邦和州立法机构应采取全面的方法，并考虑大麻政策变化对儿科健康的可能下游影响。
