After Party
Increasing Trends in United States Alcohol Related Mortality
Alexandra Matarazzo et al.
American Journal of Medicine, forthcoming
Methods: Publicly available US Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) and the underlying cause of death file from CDC WONDER using ICD-10 codes.
Results: In 1999, there were 19,356 alcohol-related deaths, a mortality rate of 10.7 per 100,000. By 2020, deaths increased to 48,870 or 21.6 per 100,000. Overall, the mortality rate ratio (MRR) was significantly increased by about 2.0-fold. There were significant increases in all 10-year age groups with the largest 3.8-fold in those 25 to 34. Women experienced a 2.5-fold increase; Asians and Pacific Islanders had the largest increase of 2.4-fold; and the Midwest showed the largest regional increase of 2.5-fold.
Online Retailer Nonadherence to Age Verification, Shipping, and Flavor Restrictions on E-Cigarettes
Raquel Harati et al.
Journal of the American Medical Association, 24 December 2024, Pages 2113-2114
"To curtail youth access to vaping products, the 2020 Preventing Online Sales of E-Cigarettes to Children Act implemented a ban on the use of the United States Postal Service (USPS) to ship vaping products and mandated identification (ID)-scan authentication of age on delivery...Throughout October 2023, 16 buyers made attempts to purchase flavored nicotine vaping products...Among the 105 deliveries, only 1.0% of buyers had their ID scanned by delivery personnel as required by law...Among the 99 completed deliveries with packaging, 80.8% arrived via USPS."
High Returns: The Effects of Legalizing Recreational Marijuana on Local Economic Activity and Household Finance
John Barrios, Jared Jennings & Jung Min Kim
Washington University in St. Louis Working Paper, October 2024
Abstract:
We examine the impact of recreational marijuana legalization and distribution on local economic activity, household finance, and personal creditworthiness across eight U.S. states from 2001 to 2019. Utilizing a staggered difference-indifference model at the county level, we observe significant improvements in local economies and household finances following the opening of marijuana dispensaries. These improvements are reflected in increased population growth, GDP, personal income, and housing prices. Additionally, personal creditworthiness also improves, as evidenced by a reduction in derogatory accounts and a rise in credit scores. Importantly, the benefits of legalization are more pronounced in underprivileged counties, underscoring a potential social equity dimension in the economic gains arising from recreational marijuana legalization. Our findings offer valuable insights to the ongoing debate over the economic implications of marijuana legalization, particularly concerning its role in promoting financial stability and reducing economic disparities.
Psychosis Spectrum Symptoms Before and After Adolescent Cannabis Use Initiation
Juston Osborne et al.
JAMA Psychiatry, forthcoming
Importance: Adolescent cannabis use has been consistently posited to contribute to the onset and progression of psychosis. However, alternative causal models may account for observed associations between cannabis use and psychosis risk, including shared vulnerability for both cannabis use and psychosis or efforts to self-medicate distress from psychosis spectrum symptomology.
Design, Setting, and Participants: This cohort study used data from 5 waves across 4 years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. The ABCD study is an ongoing large-scale, longitudinal study of brain development and mental and physical health of children in the US launched in June 2016. Data are collected from 21 research sites. The study included data from 11 868 adolescents aged 9 to 10 years at baseline. Three participants were excluded from the present analysis owing to missing data. Data analysis was performed from September 2023 to July 2024.
Results: Among the 11 858 participants at wave 1, the mean (SD) age was 9.5 (0.5) years; 6182 (52%) participants were male. Consistent with a shared vulnerability hypothesis, adolescents who used cannabis at any point during the study period reported a greater number of psychosis spectrum symptoms (B, 0.86; 95% CI, 0.68-1.04) and more distress (B, 1.17; 95% CI, 0.96-1.39) from psychosis spectrum symptoms relative to those who never used cannabis. Additionally, consistent with a self-medication hypothesis, the number of psychosis spectrum symptoms (B, 0.16; 95% CI, 0.12-0.20) and distress (B, 0.23; 95% CI, 0.21-0.26) from psychosis spectrum symptoms increased in the time leading up to cannabis initiation. We observed mixed evidence for an increase in psychosis symptoms after cannabis initiation (ie, contributing risk hypothesis).
The addition of cannabis to prescription drug monitoring programs and medication fills in Medicaid
Shelby Steuart
Health Economics, forthcoming
Abstract:
To date, there is considerable evidence of the medical applications of cannabis, however concerns regarding the safety of cannabis are also mounting. To improve the safety of cannabis, nine states have added medical cannabis to their state PDMPs, helping providers to take patient cannabis use into consideration when making prescribing decisions. Across a variety of models using Medicaid State Drug Utilization claims data, I find statistically significant reductions in severely and moderately contraindicated medication fills across two outcomes. In my main specification, adding cannabis to a state PDMP is associated with a 14.4% (p < 0.01) and 7.74% (p < 0.001) decrease in the units per prescription, for severely and moderately contraindicated medications, respectively, as compared to states with legal medical cannabis dispensaries open. An interesting spillover effect of adding cannabis to PDMPs is an apparent decrease in the prescribing of scheduled narcotics, with Schedule II medications seeing a moderately significant decrease and Schedule IV medications seeing a 11.4% decrease (p < 0.01) in the prescribing rate and a 16.2% decrease (p < 0.001) in the units per prescription. The main analysis was conducted using the Borusyak et al. (2023) Imputation Estimator with a robustness check using the Callaway and Sant’Anna (2021) difference-in-difference. This work presents evidence that adding cannabis to a state PDMP impacts provider prescribing decisions involving medications that are contraindicated for use with cannabis as well as controlled substances. This paper demonstrates that adding cannabis to PDMPs influences prescribing and thus has the potential to make medical cannabis use safer. Conversely, this work indicates providers may have bias against patients who use cannabis and deny them life-improving medications (like controlled ADHD medication or opioids) on the basis of medical cannabis use. This paper also contributes to the literature comparing DD outcomes estimated using Borusyak, Jaravel, and Spiess' (2023) Imputation Estimator and Callaway and Sant’Anna's (2021) DD Estimator.