title: A reexamination of medical marijuana policies in relation to suicide risk.
abstract: OBJECTIVE
  Previous research has suggested that medical marijuana policies lead to reductions in suicide rates. In this study, we further investigate the association between these policies and within-state changes in suicide risk.
  
  
  METHODS
  Data on suicide deaths (n=662,993) from the National Vital Statistics System Multiple Cause of Death files were combined with living population data. Fixed-effects regression methods were employed to control for state differences in suicide rates and national and state secular trends. Analyses extended prior research that suggested a protective effect of medical marijuana policies by incorporating newer data and additional covariates.
  
  
  RESULTS
  After adjustment for race/ethnicity, tobacco control policies, and other covariates, we found no association between medical marijuana policy and suicide risk in the population ages 15 and older (OR=1.000; 95% CI: 0.956, 1.045; p=0.98), among men overall (OR=0.996; 95% CI: 0.951, 1.043; p=0.87) or for any other age-by-sex groups.
  
  
  CONCLUSIONS
  We find no statistically significant association between medical marijuana policy and suicide risk. These results contradict prior analyses which did not control for race/ethnicity and certain state characteristics such as tobacco control policies. Failure to control for these factors in future analyses would likely bias estimates of the associations between medical marijuana policy and health outcomes.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: gruczar@psychiatry.wustl.edu.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Grucza
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hur
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Arpana
authors.initials: A
authors.lastname: Agrawal
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Krauss
authors.affiliation: Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Plunk
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Cavazos-Rehg
authors.affiliation: Department of Economics and Health Policy Center, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Chaloupka
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Bierut
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D064086:Medical Marijuana / Q000009:adverse effects*; D008875:Middle Aged; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D064086:Medical Marijuana
keywords: Epidemiology; Marijuana; Medical marijuana; Policy; Suicide