Jayani Jayawardhana
Dr. Jayani Jayawardhana is a health economist and an Associate Professor in the Department of Health Management and Policy in the College of Public Health at the University of Kentucky (UK). She is also jointly appointed as Associate Professor in the Department of Pharmacy Practice and Science in the College of Pharmacy at UK. She earned her Ph.D. in economics from the University of Virginia. Her research focuses on the intersection of public policy and substance use research. Her work has been funded by the National Institute on Drug Abuse, the National Cancer Institute, and a variety of research foundations including the Robert Wood Johnson Foundation. Dr. Jayawardhana’s research work contributes to advancing the scientific knowledge and informing policy makers on the effectiveness of public policies in achieving better substance use related health outcomes. Her research has been published in JAMA Psychiatry, Health Services Research, Medical Care, and American Journal of Public Health.
Session
Background: As state implementation of cannabis laws is rapidly changing, whether increased access to cannabis results in increased cannabis use disorder (CUD) is a concern. This is even a bigger concern for the older adult population since cannabis use has significantly increased in this population in recent years. This study examines the impact of medical and recreational cannabis laws (RCLs) on CUD, and differential impacts by age, race/ethnicity, and sex.
Methods: Using a 5% random sample of Medicare inpatient claims data from 2012-2021 from all 50 states and the District of Columbia, we examine how different types of cannabis laws are affecting CUD diagnoses in Medicare inpatient population using a staggered difference-in-differences approach.
Results: States with RCLs and home cultivation of medical cannabis (HC-MCs) experienced 113.7% (P<0.001) and 61.7% (P<0.05) increase in CUD among Medicare enrollees compared with states without these laws, respectively. The effects of RCLs were largest among the age group 75 and older with a 155% (P<0.01) increase in CUD while it was a 100.8% (P<0.001) increase for age group 65-74. The RCLs were associated with a 181.8% (P<0.01) and an 82.5% (P<0.001) increase in CUD among females and males, respectively. HC-MCs was associated with an 82.4% (P<0.001) increase in CUD among males while no significant effect was observed for females. The RCLs were associated with a 113.15% (P<0.001) and a 77.39% (P<0.05) increase in CUD among White and Black populations, respectively. HC-MCs was associated with a 64.95% (P<0.01) increase in CUD among White population while no significant association was observed for Black population.
Conclusions & Implications: Although states have passed different types of cannabis laws, only RCLs and HC-MCs were associated with increased CUD diagnoses in Medicare population. Since there is no accepted pharmacological treatment available for CUD, healthcare systems, clinicians, and policy makers should prepare and plan for strategies for responding to increases in CUD diagnoses.