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Impact of cannabis legalization and commercialization on substance use and mental health outcomes in psychosis

Award Number: K23DA062173
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 12/15/2024
PERIOD OF PERFORMANCE END DATE: 11/30/2028

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Impact of cannabis legalization and commercialization on substance use and mental health outcomes in psychosis - Legalization of cannabis and subsequent expansion of commercial cannabis markets are spreading rapidly across the United States. While many can use cannabis without significant harm, individuals with serious mental illnesses such as schizophrenia and other psychotic disorders are disproportionally likely to experience harms from cannabis use, and cannabis commercialization could worsen outcomes for this population. As an early career psychiatrist and health services researcher with specialty interests in addictions and psychosis, I am proposing to use quasi-experimental difference in difference methods to study the effects of commercialization on cannabis use and mental health outcomes among individuals with psychosis. I am first proposing to analyze the Population Assessment of Tobacco and Health (PATH) study to probe the effects of the opening of commercial cannabis markets on cannabis and other substance use among individuals with psychosis (Aim 1). Next, I will utilize data from an NIH funded consortium of first episode psychosis clinics, the Early Psychosis Intervention Network (Epinet), to assess the effect of commercialization on substance use, psychosis relapse (emergency department visits and psychiatric hospitalizations), and secondary outcomes including criminal legal involvement among youth and young adults with early psychosis (Aim 2). Triple difference methodologies will be utilized in each analysis to measure whether commercialization is linked to differences in outcomes, both between individuals with psychosis and the general population (Aim 1) and between individuals with factors associated with better and poorer outcomes once diagnosed with psychosis (Aim 2). In the proposed training plan, I will develop expertise in: 1) substance use disorder research, policy, and implementation, 2) statistical methods for causal inference including difference in difference designs, and 3) rigorous analysis of differences in health outcomes across populations to inform clinical and policy efforts to improve outcomes for vulnerable populations. The research will take place at the Cambridge Health Alliance, a public sector teaching hospital of Harvard Medical School, within the Health Evaluation Research Lab which has deep experience in health policy research in large datasets. In line with NIDA’s strategic plan, this proposal will study “the effects of local, state, and national drug policies on public health” (Goal 1.3 2022-26) and will lay the foundation for my development into a leading health services and policy researcher straddling clinical and public health realms to develop substance use policies that maximize benefits and minimize harms for vulnerable populations.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $177,065 )
2026	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	2	1/30/2026	NON-COMPETING CONTINUATION	$177,065
														Subtotal = $177,065

Issue Date FY: 2025 ( Subtotal = $177,110 )
2025	2025	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	1	12/10/2024	NEW	$177,110
														Subtotal = $177,110

Grand Total All Awards = $354,175

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Impact of cannabis legalization and commercialization on substance use and mental health outcomes in psychosis

Award Number: K23DA062173

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 12/15/2024

PERIOD OF PERFORMANCE END DATE: 11/30/2028

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