Office of the Assistant Secretary for Planning & Evaluation, US Department of Health & Human Services, Washington, DC.
Center for Financing, Access and Cost Trends, Agency for Healthcare Research & Quality, US Department of Health & Human Services, Rockville, MD.
Womens Health Issues. 2021 Jan-Feb;31(1):24-30. doi: 10.1016/j.whi.2020.09.003. Epub 2020 Oct 14.
In the context of the opioid epidemic, a limited but growing body of literature has found state medical marijuana laws (MMLs) to be associated with lower levels of opioid prescribing. However, robust evidence linking state MMLs with individual-level opioid-related outcomes is lacking, particularly among women. This finding is especially true for pregnant and parenting women, who have been disproportionately affected by the opioid crisis.
Using data drawn from the 2002-2014 National Survey on Drug Use and Heath, the study uses a difference-in-differences estimation strategy to compare opioid-related outcomes (opioid misuse initiation, opioid misuse in the past month and past year, and opioid use disorder) among all women, pregnant women, and parenting women in states with and without MMLs (before and after implementation). The study also investigates the impact of MMLs on marijuana use and marijuana use disorder.
The findings indicate that MMLs were not associated with opioid misuse, opioid misuse initiation, or opioid use disorder among all women, pregnant women, and parenting women. These laws were, however, positively correlated with marijuana use and marijuana use disorder among all women and women with children. In addition, MMLs were associated with an increase in the frequency of opioid misuse for pregnant women and a decrease in the frequency of opioid misuse for parenting women.
This finding suggests that, although medical marijuana may be viewed by some as a substitute for opioid analgesics, MMLs may not be an effective policy tool to tackle the opioid epidemic among women, especially pregnant and parenting women.
在阿片类药物流行的背景下，有限但不断增加的文献发现州级医用大麻法规（MML）与较低水平的阿片类药物处方有关。然而，缺乏强有力的证据将州级 MML 与个体层面的阿片类药物相关结果联系起来，特别是在女性中。对于怀孕和有子女的女性来说，这一发现尤其如此，她们受到阿片类药物危机的影响不成比例。
本研究使用 2002-2014 年全国毒品使用与健康调查的数据，采用差分差异估计策略，比较有和没有 MML 的州的所有女性、孕妇和有子女的女性的阿片类药物相关结果（阿片类药物滥用开始、过去一个月和过去一年的阿片类药物滥用以及阿片类药物使用障碍）（实施前后）。该研究还调查了 MML 对大麻使用和大麻使用障碍的影响。
研究结果表明，MML 与所有女性、孕妇和有子女的女性的阿片类药物滥用、阿片类药物滥用开始或阿片类药物使用障碍无关。然而，这些法律与所有女性和有子女的女性的大麻使用和大麻使用障碍呈正相关。此外，MML 与孕妇阿片类药物滥用频率增加和有子女的女性阿片类药物滥用频率降低有关。
这一发现表明，尽管医用大麻可能被一些人视为阿片类药物镇痛剂的替代品，但 MML 可能不是解决女性，特别是孕妇和有子女的女性阿片类药物流行的有效政策工具。
