Joshi Spruha, Snyder Kyle M, Thurstone Christian, Rivera Bianca D, Feldman Justin, Cerdá Magdalena, Krawczyk Noa
Department of Population Health, New York University Grossman School of Medicine, USA; University of Colorado School of Medicine, USA.
Department of Population Health, New York University Grossman School of Medicine, USA; Denver Health and Hospital Authority, USA; University of Colorado School of Medicine, USA.
Drug Alcohol Depend. 2025 Aug 1;273:112719. doi: 10.1016/j.drugalcdep.2025.112719. Epub 2025 May 23.
An increasing number of U.S. states have legalized cannabis, but the effect on adolescent and young adult psychosis-related hospitalizations remains under-studied. Using data from Denver Health between 2005 and 2020, we examined associations between implementation of the Ogden Memo (expanding use of medical cannabis in Colorado, October 2009) and Amendment 64 (legalizing adult-use cannabis in Colorado, November 2012) and trends in psychosis-related emergency department and hospital visits with and without cannabis use disorder (CUD) among youth aged 10-29. Patients with psychosis hospitalizations were predominately male (68 %), white (53 %), and Medicaid recipients (59 %). Significant increases (p < 0.05) were observed in the monthly average rate of psychosis hospitalizations between pre-Ogden memo (21.9 per 100,000) and post-Ogden memo pre-legalization (28.0 per 100,000) and post-legalization (32.3 per 100,000). Similarly, significant increases (p < 0.05) were observed in the monthly average rate of psychosis hospitalizations involving CUD between pre-Ogden memo (2.0 per 100,000), post-Ogden memo and pre-legalization (3.4 per 100,000), and post-legalization (8.5 per 100,000). Interrupted time series modeling found a significant difference in the trends for psychosis hospitalizations involving CUD following recreational legalization (change in average monthly rate went from 0.02/100,000 (95 % CI -0.02, 0.06) to 0.11/100,000 (95 % CI 0.09, 0.13), (difference (0.09 (95 %CI 0.05, 0.14)). Findings suggest an increase in overall hospital encounters for psychosis among youth after the legalization of recreational cannabis. Given the adoption of increasingly permissive cannabis laws, there is a need to plan effective public health responses that could mitigate unintended consequences related to cannabis use.
美国越来越多的州已将大麻合法化，但大麻合法化对青少年和青年与精神病相关的住院治疗的影响仍未得到充分研究。利用丹佛健康中心2005年至2020年的数据，我们研究了《奥格登备忘录》（2009年10月在科罗拉多州扩大医用大麻的使用）和第64号修正案（2012年11月使科罗拉多州成人使用大麻合法化）的实施与10至29岁青少年中有无大麻使用障碍（CUD）的与精神病相关的急诊科就诊和住院趋势之间的关联。因精神病住院的患者主要为男性（68%）、白人（53%）以及医疗补助接受者（59%）。在《奥格登备忘录》之前（每10万人中21.9例）、《奥格登备忘录》之后且合法化之前（每10万人中28.0例）以及合法化之后（每10万人中32.3例），精神病住院的月平均发生率均出现显著上升（p<0.05）。同样，在涉及CUD的精神病住院月平均发生率方面，在《奥格登备忘录》之前（每10万人中2.0例）、《奥格登备忘录》之后且合法化之前（每10万人中3.4例）以及合法化之后（每10万人中8.5例）也观察到显著上升（p<0.05）。中断时间序列模型发现，娱乐性大麻合法化后，涉及CUD的精神病住院趋势存在显著差异（月平均发生率变化从0.02/10万（95%CI -0.02，0.06）变为0.11/10万（95%CI 0.09，0.13），差异为（0.09（95%CI 0.05，0.14））。研究结果表明，娱乐性大麻合法化后，青少年因精神病住院的总体情况有所增加。鉴于越来越宽松的大麻法律的采用，有必要制定有效的公共卫生应对措施，以减轻与大麻使用相关的意外后果。
