As Pennsylvania lawmakers continue a long-standing debate over legalizing medicinal marijuana, one University of Pittsburgh study shows officials shouldn't overlook the importance of where those future clinics could crop up.
Researchers at the University of Pittsburgh examined the effect of California’s medical marijuana law on in-patient treatment from 2001 to 2012. The study, which appears in the September issue of the journal Drug and Alcohol Dependence, found a greater number of marijuana-related hospitalizations in areas with a higher density of dispensaries.
Overall, hospitalizations rose from about 17,000 in 2001 to 68,000 in 2012, data shows.
"And there were some neighborhood characteristics associated with a greater likelihood of having a marijuana abuse or dependence hospitalization,” said lead author Christina Mair, assistant professor in Pitt's public health department.
A greater number of dispensaries were found in city neighborhoods, Mair said, often with lower household incomes and lower educational attainment. Mair said the study could provide good guidance to Pennsylvania policymakers.
“We really have to think carefully about zoning regulations and laws governing how many of these dispensaries we can have (and) where they can be sited,” she said.
Passed in 1996, California law requires patients obtain both a doctor's recommendation and state approved identification. Hospitalizations recognized abuse as defined by clinicians and recorded through hospital discharges bearing codes for marijuana dependence or abuse with at least one overnight stay.
The dependence wasn’t on par with cocaine or heroin addiction, she said. About 99.2 percent were hospitalized for something other than marijuana. Other factors brought them in, she said.
"They’re sort of seeing marijuana as a contributing factor to some set of problems with each person that comes through the door,” Mair said.
Mair recognized the possibility that patients already receiving medicinal marijuana could, by virtue of their recognized, medical need, be more prone to hospitalizations in general, but the data doesn't support that, she said.
The answer lies somewhere between use and abuse, she said. In Pitt's sample, about 15 percent had a dependence code; many more were labeled abuse.
"So it’s not, ‘Do you use marijuana, yes or no?’ And it’s not, ‘Do you have a dependence problem, yes or no?’ But, 'Are there problems in your everyday life that are coming through your use of marijuana?'”
Twenty-three states and Washington, D.C. have already legalized medicinal marijuana; four legalized recreational marijuana use.
A Robert Morris University poll indicated in March that the number of Pennsylvanians in favor of legalizing medical marijuana continues to grow. Legislation to that effect is creeping through the state General Assembly.
Senate Bill 3 calls for licensing 65 growers, 65 processors and 130 dispensaries. It passed the chamber in May, but stalled in the House rules committee in June. House Bill 1432, which would limit growth, processing and distribution to just five organizations, is still awaiting consideration.
Mair said further study and monitoring is needed to determine the effects on dispensary-dense areas. The project was funded by the National Institutes of Health.
