Does the legalization of medical marijuana increase completed suicide?
I need help with this homework assignment. I have attached the requirements and please note that the there is an introductory paragraph and a separate paragraph needed for the thesis statement. I am leaning towards proving in favor of the legalization of marijuana.
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http://informahealthcare.com/ada ISSN: 0095-2990 (print), 1097-9891 (electronic) Am J Drug Alcohol Abuse, 2014; 40(4): 269–273 ! 2014 Informa Healthcare USA, Inc. DOI: 10.3109/00952990.2014.910520 Does the legalization of medical marijuana increase completed suicide? Melanie Rylander, MD 1,2,4 , Carolyn Valdez, MS 3 , and Abraham M. Nussbaum, MD 1,4 1 Departments of Behavioral Health, 2 Departments of Internal Medicine, 3 Departments of Patient Safety and Quality, Denver Health, Denver, Colorado, and 4 Department of Psychiatry, University of Colorado School of Medicine, Colorado, USA Abstract Introduction : Suicide is among the 10 most common causes of death in the United States. Researchers have identified a number of factors associated with completed suicide, including marijuana use, and increased land elevation. Colorado is an ideal state to test the strength of these associations. The state has a completed suicide rate well above the national average and over the past 15 years has permitted first the medical and, as 2014, the recreational use of marijuana. Objectives : To determine if there is a correlation between medical marijuana use, as assessed by the number of medical marijuana registrants and completed suicides per county in Colorado. Methods : The number of medical marijuana registrants was used as a proxy for marijuana use. Analysis variables included total medical marijuana registrants, medical marijuana dispensaries per county, total suicide deaths, mechanism of suicide death, gender, total suicide hospitalizations, total unemployment, and county-level information such as mean elevation and whether the county was urban or rural. Analysis was performed with mixed model Poisson regression using generalized linear modeling techniques. Results : We found no consistent association between the number of marijuana registrants and completed suicide after controlling for multiple known risk factors for completed suicide. Conclusion : The legalization of medical marijuana may not have an adverse impact on suicide rates. Given the concern for the increased use of marijuana after its legalization, our negative findings provide some reassurance. However, this conclusion needs to be examined in light of the limitations of our study and may not be generalizable to those with existing severe mental illness. This finding may have significant public health implications for the presumable increase in marijuana use that may follow legalization. Keywords Altitude, cannabis, legalization of marijuana, medical marijuana, suicide, unemployment History Received 18 November 2013 Revised 19 March 2014 Accepted 23 March 2014 Published online 20 June 2014 Introduction Colorado has received national attention for its approach to marijuana. In 2000, a citizen-initiated amendment to the state constitution allowed for the medical use of marijuana. After the federal government announced in 2009 (1) that it would not routinely prosecute users and distributors, the number of registrants to the state’s medical marijuana registry increased dramatically. By 2011, more than 2% of the state’s population had registered to use marijuana for a medical purpose (2). Concerns have been raised that the criteria to obtain a medical marijuana card is extremely broad, and that many of those on the medical marijuana registry are recreational users who have found a way to obtain the drug legally (2,3). Thus, the population of medical marijuana users may be very similar to general recreational users. In 2012, another citizen-initiated amendment legalized the possession, distribution, and recreational use of one ounce or less of marijuana. Simultaneously, members of the Colorado psychi- atric community have voiced concerns regarding the adverse psychiatric effects of marijuana use, especially with regards to suicide (3). In large cohort studies, the association of marijuana use and suicide has been inconsistent (4–9). Degenhardt et al. examined a series of cohort and cross sectional studies and found a modest association for heavy or problematic cannabis use and depressive symptoms. They also found a modest association between early onset regular cannabis use and later onset depression. No association was found for baseline depression with later onset of cannabis use, arguing against the self-medication hypothesis (4). Lynskey et al. examined same sex twin pairs discordant for cannabis dependence to determine relationships between cannabis use and major depressive disorder, suicidal behavior, and suicidal ideations. Cannabis-dependent individuals had an odds of suicide attempt or ideation that was 2.5–2.9 times higher than their non-cannabis-dependent twin. Those who initiated use prior to age 17 had 3.5 times the rate of subsequent suicide attempts (5). Pedersen et al. also observed increased rates of Address correspondence to Melanie Rylander, MD, Departments of Behavioral Health and Internal Medicine, Denver Health, 777 Bannock Street, MC 0490, Denver, CO 80204-4507, USA. Tel: +1 303 602 6938. Fax: +1 303 602 6930. E-mail: melanie.rylander@dhha.org
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Posted 31 Oct 2017 07:10 AM
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