Institute for Implementation Science in Population Health, The City University of New York, New York, NY, USA.
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Drug Alcohol Depend. 2021 Jan 1;218:108364. doi: 10.1016/j.drugalcdep.2020.108364. Epub 2020 Oct 18.
Cannabis policy has shifted toward legalization in many parts of the United States (US). While attention has been focused on whether legalization will lead to changes in cannabis use, it is conceivable that legalization will also affect use of substances that individuals frequently use with cannabis. This study assessed whether cannabis legalization impacted the prevalence of poly use of cannabis and alcohol from 2004 to 2017 and estimated the prevalence of cannabis and alcohol poly use in 2017.
Public and restricted-use data from the US 2004-2017 National Survey on Drug Use and Health were analyzed. Data on past-month cannabis and alcohol use were assessed each year. Cannabis legalization was determined by the presence or absence of medical marijuana laws (MML) and recreational marijuana laws (RML) in each state. Difference-in-difference approach was used to estimate the association of MML and RML on cannabis and alcohol use overall and by sociodemographic subgroups (e.g., age, income, education).
Between 2004 and 2017, poly use of cannabis and alcohol increased while alcohol-only use decreased. MML were associated with increases in poly use only among adults over age 50 and among those with higher annual incomes and higher education, while RML were associated with increases in poly use broadly among adults across sociodemographic groups.
Legalization of cannabis was associated with increases in cannabis-alcohol poly use in the US. RML were associated with increases across demographics, while the impact of MML was more limited to certain sociodemographic groups.
在美国（US）的许多地区，大麻政策已经向合法化转变。虽然人们一直关注合法化是否会导致大麻使用的变化，但可以想象，合法化也会影响到个人经常与大麻一起使用的物质的使用。本研究评估了从 2004 年到 2017 年大麻合法化是否影响了大麻和酒精的混合使用的流行率，并估计了 2017 年大麻和酒精混合使用的流行率。
分析了来自美国 2004-2017 年全国毒品使用与健康调查的公开和受限使用数据。每年都评估了过去一个月大麻和酒精的使用情况。大麻合法化是通过每个州是否存在医用大麻法（MML）和娱乐大麻法（RML）来确定的。采用差分法来估计 MML 和 RML 对总体大麻和酒精使用以及按社会人口统计学分组（例如，年龄、收入、教育）的关联。
在 2004 年至 2017 年期间，大麻和酒精的混合使用增加，而仅使用酒精的情况减少。MML 仅与 50 岁以上的成年人以及年收入较高和受教育程度较高的成年人的混合使用增加有关，而 RML 则与各社会人口统计学群体中成年人的混合使用增加有关。
大麻的合法化与美国大麻-酒精混合使用的增加有关。RML 与所有人群的增加有关，而 MML 的影响则更为局限于某些社会人口统计学群体。
