Abstract
A growing concern in the medical and mental health field is the relationship between marijuana use and further illicit drug abuse. Due to the recent state laws passing in Washington and Colorado, there has been a need for a study to address the accessibility factor in relations to the “gateway hypothesis” to marijuana. The fear is that the increase in accessibility of marijuana will result in an increase of substance abuse and dependency.
Therefore, this study is intended to address the following research question: Is the increased accessibility of marijuana correlated with the increase use of marijuana and other illicit drug use. Additionally, this proposal will address the gap in the literature, sample and instrument used, and the findings.
The Relationship of Marijuana Accessibility & Substance Abuse A growing concern in the medical and mental health field is the association of marijuana use and further illicit drug abuse as well as whether the increase accessibility of marijuana will result in the increase of substance abuse (Yacoubian, 2007).
In the United Sates, researchers and professionals have observed the controversial gateway hypothesis of marijuana for the past 30 years (Hall & Lynskey, 2005).
Hall and Lynskey provide the following operational definition for the gateway hypothesis: “Drugs whose use in some unspecified way is a cause of the use of later drugs in the sequence” (p.1).
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During this time, a variety of studies have been conducted and have discovered empirical support to suggest that marijuana is commonly associated with the use of other illicit drugs (Lessem, 2006).
A
previous study found that 90% of cocaine users had used marijuana prior to cocaine (Fergusson, Boden, & Horwood, 2006).
In another study, researchers discovered that 33% of occasional and 84% of daily marijuana users reported using other illicit drugs (Fergusson, Boden, & Horwood, 2006, p. 2).
Currently, marijuana is a hot topic in the media due to the United States having the worlds largest single market for illicit drugs (Yacoubian, 2007). In addition, research shows that marijuana has been discovered as the most prevalent illicit drug within the American households (Yacoubian).
Out of the estimated 19 million people using illicit drugs in American households, the majority of patients admitted to treatment facilities are adolescents and young adults for marijuana abuse (Lessem, 2006).
This research significantly affects the mental health field due to the high demand of professionals trained and qualified to work with and treat patients with substance abuse and dependency issues. In terms of policy, during the 2012 election the state of Washington and Colorado passed laws that legalized the recreational use of marijuana (Healy, 2012).
To date an estimate of 12 states have decriminalized marijuana and 18 states as well as Washington, DC permit medical marijuana use (Healy).
However, under the Federal law there is no such thing as “medical” marijuana (McCarthy, 2004).
This is due to the Drug Enforcement Administration’s criteria and the Controlled Substance Act which classifies marijuana as a Schedule 1 drug based on the following three factors: (1) its high potential for abuse, (2) having no significant means for medical use, (3) lack of accepted safety for use of the drug (McCarthy).
Additionally, the Department of Justice clearly states that marijuana is illegal under Federal Law despite state policies and acts (McCarthy).
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Yacoubian (2007) addresses the debate between criminalization versus decriminalization by comparing and contrasting drug regulation and policies within the United States and the Netherlands.
Research found that de facto legalization, permitting coffee shops, in the Netherlands led to a significant increase of marijuana use among Dutch youth (Yacoubian).
Yacoubian concluded that research suggests that an increase accessibility of marijuana will result in the increase of drug use. For the purpose of this study, the operational definition of accessibility will align with Yacoubians, which is based on state policies and regulation.
For example, legalization policies suggest a high accessibility of marijuana (Yacoubian).
Specifically, in regards to the present study the following three states define the level accessibility: Colorado’s legalization policies and recreational use (high accessibility), California’s decimalization policies and medical use (limited accessibility), and Virginia’s illegal policies and no permitted use (no accessibility) (Healy, 2012).
Due to the conflict of recent state laws passing and Federal Laws not changing there has been a necessity for further research regarding the illicit drug marijuana and its effects (Healy, 2012).
Researchers have found a significant relationship between regular and early marijuana use and further drug use such as cocaine, heroin, pills, etc. (Hall & Lynskey, 2005).
However, previous studies concluded that there is a gap within the research because there may have been an overestimation of results suggesting the “gateway hypothesis” known as the frequency of marijuana use and later involvement in other illicit drug use (Fergusson, Boden & Horwood, 2006).
Lessem (2006) mentioned some of the limitations to research were the inability to measure drug dependency as well as the issues of causality. In addition, most current research studies are out dated and prior to the recent laws.
This research study was designed to fill the specific gap portrayed within the current research. According to Fergusson, Boden, and Horwood (2006) their study resulted in overestimation of date; therefore, this specific study was formatted to ensure the data is precisely and accurately analyzed to prevent complications of overestimations.
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Additionally, this study uses a valid and reliable assessment to measure drug abuse and dependency, which satisfies the limitations previously mentioned in Lessem’s (2006) research study. It is a concern that as marijuana becomes more accessible, there will be an increase in substance abuse and dependency across the nation (Hall& Lynckey, 2005).
This study is intended to address the following research question: Is the increase accessibility of marijuana correlated with the increase of marijuana use and substance abuse and dependency. Therefore, the research hypothesis for this study is that with the increase of accessibility there will an increase in substance abuse and dependency.
The overall purpose of this research study is to cover several presenting factors. First, it is to increase awareness of the epidemic of marijuana use and further drug abuse within our nation. Second, it is to educate the public on the significance of the relationship between marijuana and drug abuse. Lastly, this research proposal is designed to gather and analyze data from states in which recent laws were passed permitting increase in accessibility and use of marijuana. Method
Participants
The sample for this study consisted of 450 subjects from the states of California, Colorado, and Virginia. A sample size of 150 was used from each of these states, 75 participants were students from state universities and another 75 participants were patients at rehabilitation and drug treatment centers.
The mean average age of participants within in the sample was 22.23. Among the total sample size, 64% (n=288) were male subjects and 36% (n=162) were female subjects. In terms of ethnicity, 42% (n=189) of participants identified as white, 22% (n=99) as African American, 20% (n=90) as Hispanic, 16% (n=72) as Asian, and 4% (n=18) as other.
The sample was first divided into the following three pre-existing groups according to state accessibility of marijuana: California participants (decriminalized marijuana/limited accessibility), Colorado participants (legalized marijuana/high accessibility), and Virginia participants (illegal marijuana/no permitted accessibility).
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Participants were then separated into one of the three subgroups based on their drug use and abuse. The participant’s score on the Drug Abuse Screening Test assessment determined their placement in one of the following three subgroups: non-existing/mild, moderate, and severe. Instrument
The Drug Abuse Screening Test (DAST) was the instrument used to assess the sample in this specific study. The DAST is a 20-item psychometric instrument that is purposed to measure an individual’s drug use and abuse (Corcoran, & Fischer, 2007).
The manual indicates that a higher total score suggests an index of problem severity (Corcoran, & Fischer).
The DAST is scored by the total sum of all 20 items with range of scores being from 0 to 28 (Corcoran, & Fischer).
For the purpose of this study, participants scores are estimated by mild (scores: 0-6), moderate (scores: 7-13), severe (scores: 14-20).
Refer to Appendix A for a sample of the full instrument presenting all 20 items.
The DAST indicates that psychometric instrument has both excellent reliability and validity (Corcoran, & Fischer, 2007).
The estimated internal consistency reliability was calculated with an alpha of .92; however, the manual does not provide any data of test-retest reliability (Corcoran, & Fischer).
The DAST manual shows both a good discriminant and concurrent validity for the instrument.
In terms of discriminant validity, the instrument’s total score accurately and significantly distinguished between the groups with mainly alcohol-related problems from the groups with drug problems (Corcoran, & Fischer).
The DAST concurrent validity was examined by its significant correlation of the DAST’s background variables, frequency of drug use within a 12-month time frame, and indices psychopathology (Corcoran, & Fischer).
Procedure
The participants of this study were recruited by two different approaches based on their institutional setting. At state universities, the psychology departments recruited participants through a research database that required all students in a PSYC 101 course to participate in at least 3 studies in which this study was an option. Additionally, faculty and staff at state university counseling centers recruited students whom were receiving counseling services. At the substance abuse rehabilitation and treatment centers, staff recruited current and new patients to participate in the study at their consent.
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After participants were recruited through their institutional setting and consent, they received two separate emails from the researcher of the present study. The first email was a confirmation email for the individual’s participation. The second email contained a testing packet for the research studying which included the following three components: study consent form, personal questionnaire (age, race, gender, and institutional setting), and the Drug Abuse Screening Test (DAST).
Participants were asked to complete the entire testing packet and return by email to the research of the study within a week time frame.
Once the researcher received the completed testing packets from participants via email, the packets were examined and separated by pre-existing groups based on state accessibility. For example, all participants from the state of Virginia were separated into the no accessibility group. Participants were then additionally divided in to one of the 3 subgroups based on their score on the DAST.
The three subgroups were determined based of the following range of scores on the DAST and the individual’s degree of drug use and abuse: mild (scores: 0-7), moderate (scores: 7-14), and serve (scores: 14-20).
For the purpose of this study the data was converted to nominal with mild=1, moderate=2, and severe= 3. Once the data was collected and converted, it was inputted into the IBM SPSS® 20.0 software to analyze the statistical relationship between marijuana accessibility and drug use/dependency. Results
The statistical analysis conducted was a coefficient of contingency in order to analyze the correlation and statistical significance of marijuana accessibility and drug use/dependency. The coefficient of contingency was conducted two separate times examining the statistical significance between no marijuana accessibility (Virginia) to limited marijuana accessibility (California) and then again no accessibility (Virginia) to high accessibility (Colorado).
Additionally, analyzing the relationship between each accessibility level and drug use/dependency. Before running the statistical analysis, a frequency table was made to organize the data. The table portrayed how many participants scored in one of the three subgroups (mild, moderate, severe) under each state.
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Therefore, it was discovered that in the state of Virginia 47 participants fell in the mild, 61 in moderate, and 32 in the severe subgroups. The state of California had 37 participants were in the mild, 66 in the moderate, and 47 in the severe subgroups. Lastly, in the state of Colorado 29 participants were in the mild, 62 in the moderate, and 56 in the severe subgroups. The coefficient of contingency was calculated after the frequency table was formed. The first statistical analysis of Virginia and Colorado computed a contingency coefficient of .716 and statistical significance of .00. The second analysis of Virginia and California computed a contingency coefficient of .775 and a statistical significance of .00. Discussion
In conclusion, the results of this study can be interpreted as supporting the researchers purpose and design for this specific study. The frequency table demonstrates that in the state of Virginia which has no permitted accessibility to marijuana that there were more participants who fell in the mild subgroup and fewer participants within the moderate and severe subgroup compare to the two other states. In the state of California, limited accessibility, there were more participants in the moderate subgroup and fewer participants in the mild and severe subgroups.
Lastly, in the state of Colorado, high accessibility, there were more participants in the severe subgroup and fewer participants in the mild and moderate. The two statistical analyses results conveyed additional statistical support for the hypothesis of this study. It was hypothesize that there this a relationship between marijuana accessibility and drug use and dependency, which translates that with an increase in accessibility there will be an increase in use or dependency. Therefore, the statistical analysis of Virginia and Colorado portrayed that there was a .716 correlation that was statistically significant by .00.
The analysis of Virginia and California found that there was a .775 correlation that was also statistically significant by .00. Concluding that the null hypothesis was rejected and the research hypothesis was statistically significantly supported. Several suggestions can be made for future research due to the limitations of the present study. First, future studies should attempt to acquire interval data to run a more robust statistical analysis of the collected data. Second, it is suggested that future research studies use multiple assessments to measure both accessibility and drug use.
Specially, the researchers recommend the Adult Substance Abuse Subtle Screening Test-3 (SASSI-3) that measures an individual’s probability to abuse or depend on substances. Lastly, a significant gap in the research conveys that there is a need for longitudinal case studies with individuals from states where policies permit recreational use of marijuana in order to accurately discovered whether these individuals are likely to use and/or abuse substances.
Appendix A
References
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Measures for clinical practice: A sourcebook (4th ed., Vol. 2).
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Voters Ease Marijuana Laws in 2 States, but Legal Questions Remain. The New York Times.
Retrieved from http://www,nytimes.com Lessem, J. K. (2006).
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Conversations about Medical Marijuana between Physicians and Their Patients. Journal Of Legal Medicine, 25(3), 333-349. Yacoubian, G. S. (2007).
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