We
studied
the
effect
of
marijuana
liberalization
policies
on
perinatal
health
with
a
multiperiod
difference-in-differences
estimator
that
exploited
variation
in
effective
dates
medical
laws
(MML)
and
recreational
(RML).We
found
proportion
maternal
hospitalizations
use
disorder
increased
by
23%
(0.3
percentage
points)
first
three
years
after
RML
implementation,
larger
effects
states
authorizing
commercial
sales
marijuana.This
growth
was
accompanied
7%
(0.4
decline
tobacco
hospitalizations,
yielding
net
zero
over
all
substance
hospitalizations.RMLs
were
not
associated
changes
newborn
health.MMLs
had
no
significant
nor
fairly
small
could
be
ruled
out.In
absolute
numbers,
our
findings
implied
modest
or
adverse
array
outcomes
considered.
Addiction,
Journal Year:
2019,
Volume and Issue:
115(8), P. 1411 - 1412
Published: Nov. 20, 2019
Cannabis
use
during
pregnancy
is
associated
with
poor
maternal
and
child
health
outcomes.
However,
its
prevalence
increasing
in
the
United
States
Canada
while
perceived
risk
of
cannabis
appears
to
be
decreasing.
This
may
an
adverse
unintended
consequence
legalization.
Studies
humans
other
species
suggest
that
low
birth
weight
1,
2,
neurodevelopmental
deficits
(e.g.
impaired
memory
reasoning
infants
children)
2
anemia
1.
Determining
extent
cannabis-related
risks
complicated
by
a
lack
longitudinal
studies
representative
samples
control
for
alcohol,
tobacco,
substance
socio-environmental
characteristics.
Nevertheless,
given
current
evidence,
American
College
Obstetricians
Gynecologists,
Academy
Pediatrics
recent
US
Surgeon
General's
advisory
recommend
physicians
screen
counsel
women
on
use,
advise
abstain
3.
these
recommendations
are
being
made
within
context
which
policies
beliefs
about
becoming
increasingly
permissive
available.
explain
trends
among
pregnant
some
countries
4-7.
more
than
doubled
since
2002,
rising
from
estimated
2.4%
4
approximately
5.0%
2016
5.
Among
experiencing
nausea
vomiting
(i.e.
morning
sickness),
even
prevalent,
6.5%
2009
11.1%
7.
In
Canada,
have
increased
slightly,
1.2%
2012
1.8%
2017
6.
A
possible
explanation
prenatal
Thirty-three
states
District
Columbia
(DC)
legalized
medical
8.
Additionally,
6,
Uruguay
9,
11
DC
8
recreational
use.
Laws
allow
appear
been
increases
general
adult
population
10,
as
well
rate
treatment
11.
Furthermore,
biochemically
verified
12
consequences
13
self-reported
reflect
real
increase
number
who
rather
artifact
honest
reporting
post-legalization.
Decreased
perception
also
Legalizing
access
availability
cannabis,
particularly
via
dispensaries.
It
dispensaries
offering
advice
regarding
contrary
public
clinical
14,
leading
believe
safe.
States,
2005
2015
probability
no
regular
13.0%
(from
3.5
16.5%)
were
not
users,
39.6%
25.8
65.4%)
used
past
month
15.
perceive
safe
remedy
sickness,
especially
misinformation
internet
safety
benefits
14.
one
state-wide
study,
majority
was
found
treating
sickness;
likely
retail
make
this
recommendation;
third
all
41.0%
told
callers—who
stated
they
weeks
sickness—that
Economic
gains
legalization
put
profit
motive
at
odds
messages
aiming
prevent
Social
consequences,
similar
those
alcohol
civil
commitment;
mandatory
welfare
agencies)
16,
result
pregnancy.
For
example,
many
consider
abuse
17
punishable
law.
These
laws
disproportionately
affect
low-income,
minority
due
discrimination
17.
Few
criminalize
do
such
onus
fetal
mother,
without
accounting
socioenvironmental
factors
promote
behaviors
laws,
dispensaries,
widespread
cannabis).
Individuals
their
social
environments
inextricably
linked
18.
Therefore,
continue
legalize
identifying
preventing
potential
will
critical.
To
optimal
health,
should
(and
substance)
preconception,
lactation.
Health-care
providers
support
endeavors
respectfully
providing
education
referring
when
needed,
opposed
using
punitive
measures.
part
best
practices,
required
post
warning
signs—similar
16—on
include
work
National
Center
Advancing
Translational
Sciences
(NCATS)
grants
KL2TR003018
(Q.L.B.)
UL1TR003017
awarded
New
Jersey
Alliance
Clinical
Science
-
NCATS
Awards
(CTSA)
Program
hub
Rutgers,
The
State
University
Institute
Drug
Abuse
grant
R01DA048860
(D.S.H.)
York
Psychiatric
(D.S.H.).
Journal of Addiction Medicine,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Nov. 15, 2024
Objectives
Assessment
and
counseling
are
recommended
for
individuals
with
prenatal
cannabis
use.
We
examined
characteristics
that
predict
substance
use
assessment
among
who
screened
positive
in
settings.
Methods
Electronic
health
record
data
from
Kaiser
Permanente
Northern
California’s
Early
Start
perinatal
screening,
assessment,
program
was
used
to
identify
≥1
pregnancies
Outcomes
included
completion
of
a
those
assessed,
attendance
only
or
Addiction
Medicine
Recovery
Services
(AMRS)
treatment.
Predictors
demographics
past-year
psychiatric
disorder
diagnoses
evaluated
GEE
multinomial
logistic
regression.
Results
The
sample
17,782
20,398
(1/2011–12/2021).
Most
(80.3%)
had
an
assessment.
Individuals
Medicaid,
anxiety,
depression
tobacco
disorders,
compared
without,
higher
odds
greater
parity,
older
age
(≥35)
later
trimesters,
lower
Among
64%
(n
=
10,469)
needing
intervention
based
on
most
(88%)
attended
AMRS
(with
without
Start).
Greater
parity
trimester
associated
odds,
while
Medicaid
counseling.
Nearly
all
diagnosed
disorders
were
Conclusions
A
comprehensive
engaged
pregnant
Opportunities
improve
care
gaps
remain.
Addiction,
Journal Year:
2019,
Volume and Issue:
115(1), P. 188 - 189
Published: Nov. 13, 2019
Sir:
Meinhofer
et
al.
1
analyzes
administrative
data
from
state
medical
marijuana
laws
and
substance
use
treatment
admissions
in
an
ecological
study
design
to
show
that
are
associated
with
state-level
increases
marijuana,
alcohol
cocaine
among
pregnant
women.
While
these
findings
provocative,
the
utility
of
analyses
assessing
effects
is
severely
limited
this
study's
results
could
reflect
bias,
rather
than
individual-level
effect.
Ecological
studies
susceptible
a
bias
commonly
referred
as
‘ecological
fallacy’—the
(often
implied)
assumption
correlations
occurring
at
population-level
parallel
individual
level
2.
This
sometimes
true,
but
not
always;
indeed,
exist
when
analysing
may
or
even
be
reversed
data.
Researchers
must
reliably
discern
effect
use,
exposure.
Concern
over
fallacy
correlating
have
been
expressed
several
times
research
literature
3-7,
invokes
same
concern.
As
using
data,
should
used
evidence
individual's
correlated
increased
likelihood
enters
treatment.
Why,
then,
still
regularly
published?
First,
all
inappropriate.
For
example,
exposure
universally
affects
population
interest
(e.g.
almost
cigarette
smokers
affected
by
tax
increases),
capture
risk.
generally
case
for
marijuana;
only
approximately
2.5%
adults
states
actually
rest
unlikely
experience
significant
health
benefits
consequences
legalization
8.
The
present
focus
on
strengthen
reliability
its
results,
users
probably
disproportionately
marijuana-related
laws;
however,
far
universal.
Further,
some
argue
act
preliminary
provoke
further
investigation.
However,
researchers
cognizant
(a)
lay
people
equipped
conclusive
peer-reviewed
(b)
advocates
both
sides
debate
often
disseminate
headlines
support
their
viewpoint
(regardless
rigour
usually
omitting
any
limitations).
Consequently,
take
care
clearly
communicate
limitations
work
or,
failing
that,
choose
publish
such
results.
In
case,
researchers,
policymakers
public
well
informed
correlation
observed
between
admission
fallacy,
use.
T.L.C.
reports
conducting
paid
analytics
Smart
Approaches
Marijuana
(SAM),
501(c)
(3)
educational
non-profit
organization.
manuscript
was
funded
SAM,
SAM
holds
no
control
what
publishes.
We
studied
the
effect
of
marijuana
liberalization
policies
on
perinatal
health
with
a
multiperiod
difference-in-differences
estimator
that
exploited
variation
in
effective
dates
medical
laws
(MML)
and
recreational
(RML).We
found
proportion
maternal
hospitalizations
use
disorder
increased
by
23%
(0.3
percentage
points)
first
three
years
after
RML
implementation,
larger
effects
states
authorizing
commercial
sales
marijuana.This
growth
was
accompanied
7%
(0.4
decline
tobacco
hospitalizations,
yielding
net
zero
over
all
substance
hospitalizations.RMLs
were
not
associated
changes
newborn
health.MMLs
had
no
significant
nor
fairly
small
could
be
ruled
out.In
absolute
numbers,
our
findings
implied
modest
or
adverse
array
outcomes
considered.