州医用大麻法律、成年人中与心理困扰升高相关的大麻使用和大麻使用障碍。
State medical marijuana laws, cannabis use and cannabis use disorder among adults with elevated psychological distress.
机构信息
RAND Corporation, 20 Park Plz, Boston, MA, 02116, USA.
RAND Corporation, 1776 Main St, Santa Monica, CA, 90407, USA.
出版信息
Drug Alcohol Depend. 2020 Oct 1;215:108191. doi: 10.1016/j.drugalcdep.2020.108191. Epub 2020 Jul 24.
BACKGROUND
Cannabis use and cannabis use disorder are more prevalent in U.S. states with medical marijuana laws (MMLs), as well as among individuals with elevated psychological distress. We investigated whether adults with moderate and serious psychological distress experienced greater levels of cannabis use and/or disorder in states with MMLs compared to states without MMLs.
METHODS
National Survey of Drug Use and Health data (2013-2017) were used to compare past-month cannabis use, daily cannabis use, and cannabis use disorder prevalence among adults with moderate and serious psychological distress in states with versus without MMLs. We executed pooled multivariable logistic regression analyses to test main effects of distress, MMLs and their interaction, after adjustment.
RESULTS
Compared to states without MMLs, states with MMLs had higher adjusted prevalence of past-month use (11.1 % vs. 6.8 %), daily use (4.0 % vs. 2.2 %), and disorder (1.7 % vs. 1.2 %). Adults with moderate and serious psychological distress had greater adjusted odds of any use (AORs of 1.72 and 2.22, respectively) and of disorder (AORs of 2.17 and 2.94, respectively), compared to those with no/mild distress. We did not find evidence of an interaction between MMLs and distress category for any outcome.
CONCLUSIONS
Associations between elevated distress and cannabis use patterns are no greater in states with MML. However, cannabis use is more prevalent in MML states. Thus, higher base rates of cannabis use and disorder among adults with elevated distress are proportionally magnified in these states.
背景
在美国拥有医用大麻法（MML）的州，以及心理困扰程度较高的人群中，大麻使用和大麻使用障碍更为普遍。我们调查了在有 MML 的州和没有 MML 的州，中度和严重心理困扰的成年人在 MML 州的大麻使用和/或障碍程度是否更高。
方法
利用全国毒品使用与健康调查数据（2013-2017 年），比较了 MML 州和没有 MML 州中度和严重心理困扰成年人的过去一个月大麻使用、每日大麻使用和大麻使用障碍的流行率。我们执行了基于人群的多变量逻辑回归分析，以测试在调整后困扰、MML 及其相互作用的主要效应。
结果
与没有 MML 的州相比，有 MML 的州过去一个月使用（11.1%比 6.8%）、每日使用（4.0%比 2.2%）和障碍（1.7%比 1.2%）的调整后流行率更高。与无/轻度困扰的成年人相比，中度和严重心理困扰的成年人更有可能出现任何使用（分别为 AOR 为 1.72 和 2.22）和障碍（分别为 AOR 为 2.17 和 2.94）。我们没有发现 MML 和困扰类别之间任何结果的相互作用的证据。
结论
在有 MML 的州，较高的困扰与大麻使用模式之间没有更强的关联。然而，大麻使用在 MML 州更为普遍。因此，在这些州，有较高困扰的成年人的大麻使用和障碍的基础比率更高，呈比例放大。
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