Arizona State University, Department of Psychology, Tempe, AZ, United States.
Arizona State University, School of Social and Family Dynamics, Tempe, AZ, United States.
Int J Drug Policy. 2022 Feb;100:103531. doi: 10.1016/j.drugpo.2021.103531. Epub 2021 Nov 21.
There is speculation that enrollment in U.S. state medical cannabis programs differs depending on whether adult recreational cannabis use is legal. If true, this could have implications for public health and policy.
Using medical cannabis registry data from U.S. states with a mandatory registry between 2013 and 2020 (N = 23 states), this study examined time-trends in medical cannabis cardholder enrollment and tested whether enrollment trends differed depending on adult recreational cannabis legalization.
Multilevel models showed that time-trends for registered active medical cardholders differed during years when adult recreational cannabis use was legal versus not legal (time*recreational cannabis law interaction: b = -0.004, p < 0.01, 95% CI = -0.005, -0.003). The population prevalence of registered active medical cardholders increased over time in years when recreational cannabis was not legal (i.e., medical-only years; b = 0.004, p < 0.001, 95% CI = 0.003, 0.004, corresponding to an increase of 380 cardholders per 100,000 people per year), and decreased in years when recreational cannabis was legal (i.e., recreational years; b = -0.001, p < 0.001, 95% CI = -0.002, -0.001, corresponding to a decrease of 100 cardholders per 100,000 people per year). Time-trends were similar for each sex (male, female) and age group (18-30/35, 30/35+), with each cardholder group showing increases in medical-only years and decreases in recreational years. In medical-only years, there were no differences in enrollment time-trends across sex, but older cardholder (30/35+) enrollment increased at a faster rate than younger cardholder enrollment (18-30/35) (F = 16.199, p < 0.001). In recreational years, male cardholder enrollment decreased at a faster rate than female cardholder enrollment (F = 7.347, p < 0.01), but there was no difference in trends across age. Three states, all with medical-only years, provided data on ethnicity/race. Results showed significant increases from 2016 to 2020 in enrollment of White, African-American, and Hispanic individuals.
Findings suggest that recreational cannabis legalization is associated with decreasing enrollment in medical cannabis programs, particularly for males.
有人猜测，美国各州的医疗大麻项目的入组情况可能因成人娱乐用大麻是否合法而有所不同。如果这是真的，那么这可能会对公共卫生和政策产生影响。
本研究使用了美国从 2013 年至 2020 年期间实行强制性登记制度的 23 个州的医疗大麻登记数据，研究了医疗大麻卡持卡人的登记时间趋势，并检验了入组趋势是否因成人娱乐用大麻合法化而有所不同。
多水平模型显示，在成人娱乐用大麻合法和不合法的年份，注册的活跃医疗卡持卡人的时间趋势存在差异（时间*娱乐用大麻法律交互作用：b = -0.004，p < 0.01，95%CI = -0.005，-0.003）。在娱乐用大麻不合法的年份（即医疗专用年），注册的活跃医疗卡持卡人的人群患病率随着时间的推移而增加（b = 0.004，p < 0.001，95%CI = 0.003，0.004，相当于每年每 10 万人增加 380 名持卡人），而在娱乐用大麻合法的年份（即娱乐用年）则减少（b = -0.001，p < 0.001，95%CI = -0.002，-0.001，相当于每年每 10 万人减少 100 名持卡人）。每个性别（男性、女性）和年龄组（18-30/35 岁，30/35 岁以上）的时间趋势都相似，每个持卡人组在医疗专用年的入组人数增加，在娱乐用年的入组人数减少。在医疗专用年，性别之间的入组时间趋势没有差异，但 30/35 岁以上的老年持卡人的入组速度比 18-30/35 岁的年轻持卡人更快（F = 16.199，p < 0.001）。在娱乐用年，男性持卡人的入组速度比女性持卡人更快（F = 7.347，p < 0.01），但年龄之间没有差异。有三个州，都只有医疗专用年，提供了关于族裔/种族的数据。结果显示，从 2016 年到 2020 年，白种人、非裔美国人和西班牙裔人士的入组人数显著增加。
研究结果表明，娱乐用大麻合法化与医疗大麻项目的入组人数减少有关，特别是对男性而言。
