University of Colorado Anschutz Medical Campus Children's, Hospital Colorado Department of Pediatrics 13123 East 16th Ave B251 Aurora CO 80045, United States.
RAND Corporation, 1200 S. Hayes St Arlington VA 22202, United States.
Int J Drug Policy. 2022 Jun;104:103685. doi: 10.1016/j.drugpo.2022.103685. Epub 2022 Apr 22.
Emergency department (ED) visits involving psychosis and schizophrenia have increased at a rate exceeding population growth in the United States over the past decade. Research shows a strong dose-response relationship between chronic use of high-potency cannabis and odds of developing symptoms of psychosis. The aim of this study was to evaluate the impact of cannabis legalization on psychosis and schizophrenia-related ED visits in Colorado.
Using administrative data from Colorado Hospital Association (CHA) on county-level quarterly ED visits between January 1, 2013, and December 31, 2018, we applied a difference-in-difference analysis to examine how new exposure to recreational cannabis dispensaries after 2014 differentially influenced the rate of ED visits for psychosis and schizophrenia, comparing counties with no prior medical cannabis dispensary exposure to counties with low or high medical dispensary exposure.
As recreational dispensaries per 10,000 residents increased, there was no significant association with the rate of schizophrenia ED visits per capita (incidence rate ratio or IRR: 0.95, 95% CI [0.69, 1.30]) while the rate of psychosis visits increased 24% (IRR: 1.24, 95% CI [1.02, 1.49]). Counties with no previous medical dispensaries experienced larger increases in schizophrenia ED visits than counties already exposed to a low level of medical dispensaries, but this effect was not significant. Counties with low baseline medical exposure had lower increases in rates of psychosis visits than counties with high baseline medical exposure (IRR 0.83, 95% CI [0.69, 0.99]).
There was a positive association between the number of cannabis dispensaries and rates of psychosis ED visits across all counties in Colorado. Although it is unclear whether it is access to products, or the types of products that may be driving this association, our findings suggest there is a potential impact on the mental health of the local population that is observed after cannabis legalization.
在过去十年中，涉及精神病和精神分裂症的急诊（ED）就诊量在美国以超过人口增长率的速度增加。研究表明，慢性使用高浓度大麻与出现精神病症状的几率之间存在很强的剂量反应关系。本研究旨在评估科罗拉多州大麻合法化对精神病和精神分裂症相关 ED 就诊的影响。
使用科罗拉多州医院协会（CHA）的行政数据，我们对 2013 年 1 月 1 日至 2018 年 12 月 31 日期间按县季度进行的 ED 就诊情况进行了分析，应用差异分析法，比较无前期医用大麻药房暴露的县与低或高医用药房暴露的县，观察 2014 年后新接触娱乐性大麻药房如何对精神病和精神分裂症的 ED 就诊率产生差异影响。
随着每 10000 名居民中娱乐性大麻药房数量的增加，人均精神分裂症 ED 就诊率没有显著相关性（发病率比或 IRR：0.95，95%CI [0.69，1.30]），而精神病就诊率增加了 24%（IRR：1.24，95%CI [1.02，1.49]）。无前期医用药房的县比已经暴露于低水平医用药房的县经历了更大的精神分裂症 ED 就诊率的增加，但这种影响并不显著。基线医用暴露水平低的县的精神病就诊率增加幅度低于基线医用暴露水平高的县（IRR 0.83，95%CI [0.69，0.99]）。
科罗拉多州所有县的大麻药房数量与精神病 ED 就诊率之间呈正相关。虽然尚不清楚是产品的可及性还是产品的类型导致了这种关联，但我们的研究结果表明，大麻合法化后可能会对当地人口的心理健康产生影响。
