Abstract
BACKGROUND: Cannabis use has been causally linked to violent behaviors in experimental and case studies, but its association with homicide victimization has not been rigorously assessed through epidemiologic research. METHODS: We performed a case-control analysis using two national data systems. Cases were homicide victims from the National Violent Death Reporting System (NVDRS), and controls were participants from the National Survey on Drug Use and Health (NSDUH). While the NVDRS contained toxicological testing data on cannabis use, the NSDUH only collected self-reported data, and thus the potential misclassification in the self-reported data needed to be corrected. We took a data fusion approach by concatenating the NSDUH with a third data system, the National Roadside Survey of Alcohol and Drug Use by Drivers (NRS), which collected toxicological testing and self-reported data on cannabis use for drivers. The data fusion approach provided multiple imputations (MIs) of toxicological testing results on cannabis use for the participants in the NSDUH, which were then used in the case-control analysis. Bootstrap was used to obtain valid statistical inference. RESULTS: The analyses revealed that cannabis use was associated with 3.55-fold (95% CI: 2.75-4.35) increased odds of homicide victimization. Alcohol use, being Black, male, aged 21-34 years, and having less than a high school education were also significantly associated with increased odds of homicide victimization. CONCLUSIONS: Cannabis use is a major risk factor for homicide victimization. The data fusion with MI method is useful in integrative data analysis for harmonizing measures between different data sources.