Impact of cannabis legalization on healthcare utilization for psychosis and schizophrenia in Colorado.

Autor: Wang GS; University of Colorado Anschutz Medical Campus Children's, Hospital Colorado Department of Pediatrics 13123 East 16th Ave B251 Aurora CO 80045, United States. Electronic address: george.wang@childrenscolorado.org., Buttorff C; RAND Corporation, 1200 S. Hayes St Arlington VA 22202, United States., Wilks A; RAND Corporation, 1776 Main Street Santa Monica, CA 90407, United States., Schwam D; RAND Corporation, 1200 S. Hayes St Arlington VA 22202, United States., Tung G; University of Colorado Anschutz Medical Campus Colorado School of Public Health Department of Health Systems, Management & Policy Program for Injury Prevention, Education and Research (PIPER) Colorado School of Public Health, 13001 E. 17th Place, MS B119, United States., Pacula RL; University of Southern California Sol Price School of Public Policy, Schaeffer Center for Health Policy & Economics 635 Downey Way, VPD 514J, Los Angeles, CA 90089-3333, United States.
Jazyk: angličtina
Zdroj: The International journal on drug policy [Int J Drug Policy] 2022 Jun; Vol. 104, pp. 103685. Date of Electronic Publication: 2022 Apr 22.
DOI: 10.1016/j.drugpo.2022.103685
Abstrakt: Background: 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.
Methods: 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.
Results: 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]).
Conclusions: 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.
Competing Interests: Declarations of Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Wang receives royalties from UptoDate for authorship contributions on related subjects. The remaining authors have no competing interests to declare.
(Copyright © 2022. Published by Elsevier B.V.)
Databáze: MEDLINE
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