TITLE: Evaluating the correlation between the density and the perceptions held by various socioeconomic populations of medical marijuana dispensaries and how a combination of those will result in substance abuse.
Investigator: Akhil Rani
Team: Xiomara Smith-Romain
A. SPECIFIC AIMS
This mixed-method research study is being conducted to pinpoint the actual reasons that drive the shift from substance use to abuse; focusing on two specific factors that are the catalyst behind said shift. First, the study will focus on how the density and availability of marijuana in dispensaries can affect the delicate balance between use and abuse. Secondly, the study will focus on the different socioeconomic populations and their corresponding perception of marijuana and how that affects the balance.
The main research question:
How does the density/availability and perceptions of legal medical marijuana dispensaries affect the rate of substance abuse/usage in young adults?
Hypothesis 1:
There will be a direct correlation between the number of dispensaries and the rate of substance abuse in a population.
Hypothesis 2:
Those with the lower socioeconomic status will have a higher rate of consumption and a more lenient view towards marijuana; while the opposite will be true for the people in the higher socioeconomic status. They will have a lower rate of consumption but will have a more stringent view towards marijuana.
B. LITERATURE REVIEW
Marijuana is known as an herb branded a schedule 1 drug because of the several body functions it affects. According to the National Institute of Drug Abuse it is a mixture of seeds, leaves, and oil derived from the plant known as cannabis sativa. It is ingested, smoked, or eaten by a various number of people from multiple backgrounds, ethnicities and socioeconomic statuses (SES) (NIDA, 2018). It is also the most widely used illegal drug in the United States, with an estimated 37.6 million users. (CDC, 2018). Marijuana is popular because of the euphoric feelings users get they describe as “high”. What the users do not know, or care about, is that there are several adverse side effects from using marijuana. Long term use or marijuana abuse can lead to several chronic problems such as irreversible chemical changes in the brain, memory loss, reduction in reaction time, etc. However, people are still constantly using it and in some cases, they become dependent on it. Marijuana is known to decrease dopamine levels of your brain to a level that the user only feels “normal” when they are smoking marijuana. According to the Addiction Center, those who want to quit but for some reason cannot or are unable to do so are considered having a substance abuse problem. (The Addiction Center, 2018). The rate of marijuana related substance abuse has become a serious problem in recent years, especially in regard to marijuana. “The number of such cases per year that required hospitalization… from 17,469 in 2001 to 68,408 in 2015 (>85%)” (Mair, Freisthler, Ponicki, Gaidus, 2015). Pinpointing and preventing the reasons behind the shift from harmless recreational use of marijuana to harmful substance abuse should be one of the top phenomenon to study as a country.
Recently, the legalization of marijuana has been a common, yet painstaking, occurrence across all the states, California being one of the first and most effective implementations. Government regulated marijuana dispensaries are now in charge of the distribution and the growing of marijuana, and they happen to be a steady, and significant, revenue source for the states. According to Forbes, in 2012 alone California made a revenue of $2.75 billion off their legalized marijuana dispensaries. Since that is the case, they state will want to increase the amount of money they bring in by building and regulating more dispensaries across states where it is legal. For example, in California the number of dispensaries went from 0, before it was legalized, to 1,650 within the first two years of legalization (Mair, Freisthler, Ponicki, Gaidus, 2015). This increase of availability and the density of these dispensaries may be directly related to the problem of substance abuse. “It is possible that marijuana dispensaries are more likely to have higher underlying rates of marijuana use and abuse, or that the presence of the dispensaries increases local use, or perhaps both” (Mair, Freisthler, Ponicki, Gaidus, 2015). The rate of substance abuse in the Californian population was calculated to have a 6.8% increase from cases of substance abuse hospitalizations to those after marijuana dispensaries were legalized. (Goodman & Huang, 2002). It is also hypothesized by Shi, Meseck, and Jankowska that the density of marijuana dispensaries is directly correlated to the characteristics of the neighborhood. “Consistent with the observations in Denver, Colorado, marijuana stores throughout the Colorado State were more likely to locate in neighborhoods with high crime rates…” (Shi, Meseck, Jankowska, 2016). This observation plays right into the next factor this study will focus on which is the socioeconomic statuses of a population.
Socioeconomic status (SES), and their respective perceptions, also have a factor to play in the role of marijuana and substance abuse in society. Socioeconomic status is defined by three factors; wealth, family income, and parental education. (Patrick, Wightman, Schoeni, 2012). Contrary to popular belief, it is actually the high SES population that is at the highest risk for abusing drugs for anxiety and depression (Patrick, Wightman, Schoeni, 2012). Those with a lower SES usually have a more lenient and tolerant attitude towards marijuana use and therefore are misappropriated to being the scapegoats of substance abuse (Goodman & Huang, 2002). According to Luthar, citizens in affluent families are more prone to depression and anxiety because they have a greater pressure to achieve great accomplishments to impress people, combined with the isolation from their parents who they themselves have demanding careers. (Luthar and Latendresse, 2015). “We hypothesized that, among teenagers, substance use would be associated with SES in a graded, linear fashion and that increased depressive symptoms would be an intermediary factor in the pathway towards substance abusive behaviors.” (Karrike-Jaffe, 2015). The aspect of parental education is a significant contributor to substance abuse, having an “… inverse linear relationship, while all other relationships between SES level and substance abuse was linear, as hypothesized.” (Goodman & Huang, 2002). Since this is the case, the corresponding perceptions of marijuana are quite different in the various levels of SES, and consequently the rate of substance abuse in those respective populations will reflect their believed notions. In a low SES population, “Both monthly drug use measures included a majority of respondents who reported using the substance on a weekly basis or more,” (Karrike-Jaffe, 2015). This was the outcome because of the different perceptions they hold towards marijuana and their lenient attitudes, but it turned out to be the opposite for those in a high SES level. Recently, when given a survey to answer, residents of Colorado showed that the “all three age groups were significantly less likely to perceive ‘great-risk’ for all years studied…” (Schuermeyer et al. 2014).
There have been numerous studies done about the significant rate of marijuana related substance abuse between the number of dispensaries and socioeconomic status, individually. Extensive articles and studies have been done about each aspect and have realized that each of them are significant factors that cause or lead towards substance abuse. The purpose of this study is to fill the gap in the literature in regard to what instigates substance abuse and its contributing factors; the different socioeconomic perceptions of marijuana and the density and availability of marijuana dispensaries.
C. RESEARCH DESIGN AND METHODS
1. Rationale/Overview: This study will utilize a correlational, mixed-method design to derive a comprehensive answer in regard to the relationship between substance abuse and the various perceptions of marijuana and respective dispensaries. There will be two separate types of data collection, targeting both ends of the socioeconomic spectrum who partake in smoking marijuana and their corresponding point of view of it. The first will be a face-to-face interview pinpointing their perception and the implications of marijuana in their daily life, starting with but not limited to; their personal reason for starting smoking (if they do), their opinions on their consumption rate or their relatives’, their personal opinion of legalized marijuana, etc. The other pillar of this design will be a questionnaire answering a multitude of questions about their daily smoking habits, their consumption rate, the closest dispensary to them, how much they purchase in one visit, and if they believe if they are using or abusing marijuana.
2. Sampling:
a. Research Site: The city of Denver in Colorado, one of the first states that legalized and implemented marijuana dispensaries throughout the city. Breaking down incomes statistics of the socioeconomic populations, the research design parameters defined the high socioeconomic status as any citizen that fell within the 60th to the 95th percentile ($72,000-$233,100). and defined the low status as anyone who fell within the median income to the 20th percentile ($56,300-$22,800). The other aspect of this study is to see the density of dispensaries that sell marijuana. In the city of Denver there are 169 recreational dispensaries and 195 medical dispensaries, bringing the total to 364 in a city of 704,621 people.
b. Study Sample: For this project, to get the most effective interviewees convenience sampling will be the way to collect information for this project. Volunteers from the University of Denver will be monitoring various dispensaries and will ask the customers if they want to participate and provide us with their data. Along with asking average citizens in the Denver population, whether or not they smoke, to get a full range of answers and different viewpoints. Those who agree will be asked to fill out a questionnaire about their individual rate of consumption, the amount of times they purchase marijuana in a month, the quantity they purchase, and if they believe they are using or abusing marijuana. Then they will have to sit down for an interview about their personal opinions and corresponding perceptions of marijuana. All participants will be given the full information about the two parts of the project and their answers will remain completely anonymous, so no judgement occurs. Every answer from every participant will be included in the data analysis and will be used to answer both hypotheses posed.
c. Screening: All participants’ answer and views will be included in the results and data collection.
Inclusion Criteria:
1. Must smoke marijuana constantly and legally.
2. They must fall within the stated socioeconomic spectrum.
Exclusion Criteria:
1. Anyone who indulges in any schedule 1 drug that is not marijuana. (Heroin, cocaine, oxycodone).
3. Procedure:
a. Data Collection: Residents of Denver, Colorado who were approached at their respective marijuana dispensaries were asked, several times, if they wanted to participate in this study. Those who understood what the study and gave informed consent will be asked to participate in the study that will help the research further progress in pinpointing the shift between substance use and abuse. The participant will partake in two separate data collection methods; first will be a questionnaire and second will be a face-to-face interview. The questionnaire will focus on the logistical data that will help find correlations in other data received. It will be comprised of a series of questions such as, but not limited to; personal smoking habits, their daily, weekly, monthly consumption rate, the closest dispensary to them, how much they purchase in one visit (and monthly), and the last question will be an opinionated question probing for an honest answer about if they are using or abusing marijuana. The second part, the face-to-face interview will comprise of a non-scripted series of questions from one of the research members and a participant. The questions will be probing for the different perceptions of marijuana and their reason for starting smoking, their opinions on their individual or relative’s consumption rate, their personal opinion of legalized marijuana. Every participant will have the option to opt out at any time and they always have the option of doing only part of the study.
b. Data Analysis: All the compiled data will be taken and be analyzed using a correlational and inferential statistics. In using the correlational method, the study can see if there is in fact a direct, a negative, or even no correlation to the number of dispensaries and the percentage of substance abuse in that population. The inferential statistics will help the volunteers discover the importance perceptions and personal beliefs hold in certain populations and infer the abundance of substance abuse. The quantitative data will be shown on a graph and a correlational scatterplot to emphasize the relationship between the two factors. The qualitative data will be released as an article so people can read and understand it themselves, however all the participant’s personal information will remain anonymous.
D. HUMAN SUBJECTS RESEARCH PRTOTECTION FROM RISK
1. Risk to Subjects: It is the belief of the research team that this study will not pose a physical or psychological risk to the participants. This study has no invasive section so there is no chance of any physical harm happening to any of the participants. The questionnaire is not anticipated to pose a risk to anyone filling it out. The face-to-face interview is also not anticipated to pose a risk but just in case people realize they are in fact abusing marijuana and have a negative reaction, the researchers took a precaution in bringing along a few qualified counselors until they can see a professional. There is an extremely low chance of that happening, but the researchers want to make the participants as comfortable as possible.
2. Adequacy of Protection Against Risks: The team is fully prepared to handle those who are under the influence of marijuana during the study, however it is unlikely they will cause a problem. The data will all be completely anonymous and all names will be redacted or removed immediately. The information itself is the property of the study so we can release them when the team decides that the results have yielded important information, however everything will be completely anonymous. There are no other foreseeable risks to anticipate.
3. Potential Benefits of Proposed Research to the Subjects and Others: The team anticipates several benefits from this study. The participants will benefit from the answers they give for the two tests because in the end, if they truly believe they are abusing marijuana this can be an intervention of sorts to wane them off, or at the least propose they have a problem. The main problem we aim to address and solve is sheer percentage of people suffering from substance abuse and to do so we need to see the people’s opinions and problems and see how substance abuse is even occurring. With the knowledge gained from the answers from all the participants we aim to isolate the factor(s) and eventually teach people avoid them to lower the number of those who are suffering. This study will also benefit future studies regarding substance abuse and marijuana because they will be able to use the information gained as evidence-based to further progress their own study.
4. Importance of the Knowledge to be Gained: The knowledge gained from this study could be the change needed by the people to avoid substance abuse as a whole. This study’s aim is to definitively pinpoint the leading factors that drive the shift from use to abuse; in doing so, we can implement this information into a preemptive strike in schools and colleges through programs like the Drug Abuse Resistance Education (D.A.R.E.) and other similar programs. This study can also point out the various perceptions held by people from different socioeconomic statuses. These perceptions can help deter those who use marijuana but are on the border of substance abuse.
Reference Page:
Freisthler, B., & Gruenewald, P. J. (2014). Examining the relationship between the physical availability of medical marijuana and marijuana use across fifty California cities. Drug and alcohol dependence, 143, 244-250.
Goodman, E., & Huang, B. (2002). Socioeconomic status, depressive symptoms, and adolescent substance use. Archives of pediatrics & adolescent medicine, 156(5), 448-453.
Hopfer, C. (2014). Implications of Marijuana Legalization for Adolescent Substance Use. Substance Abuse: Official Publication of the Association for Medical Education and Research in Substance Abuse, 35(4), 331–335. http://doi.org/10.1080/08897077.2014.943386
Karriker-Jaffe, K. J. (2013). Neighborhood socioeconomic status and substance use by US adults. Drug and alcohol dependence, 133(1), 212-221.
Luthar, S. S., & Latendresse, S. J. (2005). Children of the affluent: Chal- lenges to well-being. Current Directions in Psychological Science, 14, 49–53.
Mair, C., Freisthler, B., Ponicki, W. R., & Gaidus, A. (2015). The impacts of marijuana dispensary density and neighborhood ecology on marijuana abuse and dependence. Drug and alcohol dependence, 154, 111-116.
Marijuana Addiction and Abuse – Understanding Marijuana Abuse. (n.d.). Retrieved November 13, 2018, from https://www.addictioncenter.com/drugs/marijuana/
Marijuana and Public Health | CDC. (2018, February 26). Retrieved November 11, 2018, from https://www.cdc.gov/marijuana/
National Institute on Drug Abuse. (n.d.). What are marijuana's long-term effects on the brain? Retrieved November 11, 2018, from https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-marijuanas-long-term-effects-brain
Patrick, M. E., Wightman, P., Schoeni, R. F., & Schulenberg, J. E. (2013). Socioeconomic status and substance use among young adults: a comparison across constructs and drugs. Journal of studies on alcohol and drugs, 73(5), 772-782.
Schuermeyer, J., Salomonsen-Sautel, S., Price, R. K., & Balan, U. (2014). Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003–11, 140(1), 145-155. https://www.sciencedirect.com/science/article/pii/S0376871614008424
Yuyan, S., Meseck, K., & M., M. (2016). Availability of Medical and Recreational Marijuana Stores and Neighborhood Characteristics in Colorado, 20(16), 233.
http://dx.doi.org/10.1155/2016/7193740