{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:27:28Z","timestamp":1730870848435,"version":"3.28.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003The U.S. opioid epidemic has been characterized by increases in opioid misuse, overdose deaths, and neonatal opioid withdrawal syndrome. Research suggests that marijuana legalization has contributed to decreased use of opiates, although many studies had methodological weaknesses and failed to address the pregnant population. Implementation of medical cannabis laws has the potential to reduce maternal opioid use and, therefore, neonatal exposure to the drugs. This study aimed to examine the association between Oklahoma's implementation of state medical marijuana laws and the neonatal exposure to opioids.<\/jats:p><jats:p>\n            Study Design\u2003Electronic medical records at two sites (Oklahoma City and Lawton) were searched for results of cord, urine, and meconium screens to detect amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, opiates, phencyclidine, and tetrahydrocannabinol (THC). Two study periods were compared: 19 months before Oklahoma's medical marijuana law took effect and 19 months after legalization began.<\/jats:p><jats:p>\n            Results\u2003A total of 16,804 babies were born alive at the two sites during the study period. The rate of positive THC tests per 1,000 liveborn infants significantly increased from 16.2 per 1,000 during the prelaw period to 22.2 per 1,000 during the postlaw period (p\u2009=\u20090.004). Neonatal opioid exposure incidence showed a nonsignificant decrease from 7.6 positive tests per 1,000 liveborn infants to 6.8 per 1,000 from prelaw to postlaw period (p\u2009=\u20090.542). The number of positive tests for THC and concomitant use of opioids doubled from the prelaw period (n\u2009=\u20094) to postlaw (n\u2009=\u20099), but there were too few cases for statistical significance. Infants at the more rural site had significantly higher rates for amphetamines, benzodiazepines, and THC, with a trend toward higher rates for opiates.<\/jats:p><jats:p>\n            Conclusion\u2003Marijuana legalization was related to significant increases in positive test rates for THC, but no significant change\/association was noted for neonatal exposure to opioids.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1990-8311","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T07:28:11Z","timestamp":1669879691000},"page":"e1069-e1074","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates"],"prefix":"10.1055","volume":"41","author":[{"given":"Lise","family":"DeShea","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanna","family":"Rolfs","sequence":"additional","affiliation":[{"name":"University of Oklahoma College of Medicine, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"McCoy","sequence":"additional","affiliation":[{"name":"OU Health, Comanche County Memorial Hospital, Neonatal Intensive Care Unit, Lawton, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William H.","family":"Beasley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgardo","family":"Szyld","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Makkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"issue":"28","key":"ref4","doi-asserted-by":"crossref","first-page":"897","DOI":"10.15585\/mmwr.mm6928a1","article-title":"Vital signs: prescription opioid pain reliever use during pregnancy - 34 U.S. jurisdictions, 2019","volume":"69","author":"J Y Ko","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40621-019-0213-z","article-title":"State marijuana laws and opioid overdose mortality","volume":"6","author":"S Chihuri","year":"2019","journal-title":"Inj 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of cannabis legalization in the opioid crisis","volume":"178","author":"K P Hill","year":"2018","journal-title":"JAMA Intern Med"},{"issue":"08","key":"ref13","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/s11606-018-4782-2","article-title":"Impact of medical marijuana legalization on opioid use, chronic opioid use, and high-risk opioid use","volume":"34","author":"A Shah","year":"2019","journal-title":"J Gen Intern Med"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.drugalcdep.2018.09.016","article-title":"Recreational marijuana legalization and prescription opioids received by Medicaid enrollees","volume":"194","author":"Y Shi","year":"2019","journal-title":"Drug Alcohol Depend"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.outlook.2017.08.012","article-title":"The use of cannabis in response to the opioid crisis: a review of the literature","volume":"66","author":"M B 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Toxicological findings from two US national samples of drivers","volume":"15","author":"G Li","year":"2020","journal-title":"Subst Abuse Treat Prev Policy"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/ADM.0000000000000405","article-title":"Medical marijuana users are more likely to use prescription drugs medically and nonmedically","volume":"12","author":"T L Caputi","year":"2018","journal-title":"J Addict Med"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1080\/14767058.2020.1765157","article-title":"The impact of state legalization on rates of marijuana use in pregnancy in a universal drug screening population","volume":"35","author":"E Lee","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1055\/s-0039-1696719","article-title":"Impact of marijuana legalization on prevalence of maternal marijuana use and perinatal outcomes","volume":"37","author":"M Gnofam","year":"2020","journal-title":"Am J Perinatol"},{"issue":"25","key":"ref29","doi-asserted-by":"crossref","first-page":"8456","DOI":"10.1080\/14767058.2021.1980532","article-title":"Marijuana use in opioid exposed pregnancy increases risk of preterm birth","volume":"35","author":"D S Shah","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1055\/s-0039-1694793","article-title":"Maternal marijuana exposure and birth weight: an observational study surrounding recreational marijuana legalization","volume":"38","author":"H L Straub","year":"2021","journal-title":"Am J Perinatol"},{"issue":"09","key":"ref31","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/bdr2.1680","article-title":"The association between legalization of recreational marijuana use and birth outcomes in Colorado and Washington state","volume":"112","author":"A M Siega-Riz","year":"2020","journal-title":"Birth Defects Res"},{"issue":"10","key":"ref32","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1002\/pds.1626","article-title":"Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type","volume":"17","author":"L J Paulozzi","year":"2008","journal-title":"Pharmacoepidemiol Drug Saf"},{"volume-title":"Substance-Exposed Infants: State Responses to the Problem","author":"N K Young","key":"ref34"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1990-8311.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:19:57Z","timestamp":1730812797000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1990-8311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":27,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1990-8311","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2022,11,30]]},"published":{"date-parts":[[2022,11,30]]}}}