Public Health Effects of Medical Marijuana Legalization in Colorado. 2016

Jonathan M Davis, and Bruce Mendelson, and Jay J Berkes, and Katie Suleta, and Karen F Corsi, and Robert E Booth
Project Safe, Department of Psychiatry, School of Medicine, University of Colorado Denver, Denver, Colorado. Electronic address: jonathan.davis@ucdenver.edu.

BACKGROUND The public health consequences of the legalization of marijuana, whether for medical or recreational purposes, are little understood. Despite this, numerous states are considering medical or recreational legalization. In the context of abrupt changes in marijuana policy in 2009 in Colorado, the authors sought to investigate corresponding changes in marijuana-related public health indicators. METHODS This observational, ecologic study used an interrupted time-series analysis to identify changes in public health indicators potentially related to broad policy changes that occurred in 2009. This was records-based research from the state of Colorado and Denver metropolitan area. Data were collected to examine frequency and trends of marijuana-related outcomes in hospital discharges and poison center calls between time periods before and after 2009 and adjusted for population. Analyses were conducted in 2014. RESULTS Hospital discharges coded as marijuana-dependent increased 1% per month (95% CI=0.8, 1.1, p<0.001) from 2007 to 2013. A change in trend was detected in poison center calls mentioning marijuana (p<0.01). After 2009, poison center calls increased 0.8% per month (95% CI=0.2, 1.4, p<0.01). Poison center calls also increased 56% (95% CI=49%, 63%, p<0.001) in the period following the policy change. Further, there was one hospital discharge coded as dependent for every 3,159 (95% CI=2465, 3853, p<0.001) medical marijuana registrant applications. CONCLUSIONS The abrupt nature of these changes suggests public health effects related to broad policy changes associated with marijuana. This report may be used to assist in policy decisions regarding the short-term public health effects of marijuana legalization.

UI MeSH Term Description Entries
D007880 Legislation, Drug Laws concerned with manufacturing, dispensing, and marketing of drugs. Drug Laws,Food, Drug and Cosmetic Act,Narcotic Laws,Drug Legislation,Drug Law,Law, Drug,Law, Narcotic,Laws, Drug,Laws, Narcotic,Narcotic Law
D008385 Marijuana Smoking Inhaling and exhaling SMOKE from CANNABIS. Cannabis Smoking,Hashish Smoking,Marihuana Smoking,Smoking Blunts,Smoking, Blunts,Blunt, Smoking,Blunts Smoking,Blunts Smokings,Blunts, Smoking,Smoking Blunt,Smoking, Cannabis,Smoking, Hashish,Smoking, Marihuana,Smoking, Marijuana,Smokings, Blunts
D010351 Patient Discharge The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities. Discharge Planning,Discharge Plannings,Discharge, Patient,Discharges, Patient,Patient Discharges,Planning, Discharge,Plannings, Discharge
D011634 Public Health Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. Community Health,Environment, Preventive Medicine & Public Health,Environment, Preventive Medicine and Public Health,Health, Community,Health, Public
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D002189 Marijuana Abuse Use of marijuana associated with abnormal psychological, social, and or occupational functioning. Cannabis Abuse,Cannabis Dependence,Cannabis-Related Disorder,Hashish Abuse,Marijuana Dependence,Marihuana Abuse,Abuse, Cannabis,Abuse, Hashish,Abuse, Marihuana,Abuse, Marijuana,Cannabis Related Disorder,Dependence, Cannabis,Dependence, Marijuana,Disorder, Cannabis-Related
D003120 Colorado State bounded on the north by Wyoming and Nebraska, on the east by Kansas and Nebraska, on the south by New Mexico and Oklahoma, and on the west by Utah.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015277 Hotlines A direct communication system, usually telephone, established for instant contact. It is designed to provide special information and assistance through trained personnel and is used for counseling, referrals, and emergencies such as poisonings and threatened suicides. Telephone Hotlines,Hotline,Telephone Hotline

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