Clearing the haze: the complexities and challenges of research on state marijuana laws

Choo, Esther K.; Emery, Sherry

doi:10.1111/nyas.13093

Cited by 33 publications

(26 citation statements)

References 95 publications

(176 reference statements)

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“…For example, some studies have demonstrated that having or passing an LCL is related to greater prevalence of cannabis use in a state (Cerda, Wall, Keyes, Galea, & Hasin, 2012; Schuermeyer, et al, 2014; Stolzenberg, D’Alessio, & Dariano, 2016; Wen, Hockenberry, & Cummings, 2015) while other studies have demonstrated no effect (Harper, Strumpf, & Kaufman, 2012; Lynne-Landsman, Livingston, & Wagenaar, 2013). The lack of consistent findings may be due in part to the use of dichotomous variables representing the presence or absence of an LCL (Choo & Emery, 2017; Hunt & Miles, 2015; Pacula, Powell, Heaton, & Sevigny, 2015). No two LCL are exactly the same and analytical strategies that rely on yes/no LCL comparisons may obfuscate important underlying policy heterogeneity.…”

Section: Introductionmentioning

confidence: 99%

Legal cannabis laws, home cultivation, and use of edible cannabis products: A growing relationship?

Borodovsky

Budney

2017

International Journal of Drug Policy

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Background Over half of U.S. states have enacted legal cannabis laws (LCL). In parallel, edible cannabis products (i.e., edibles) have presented new regulatory challenges. LCL provisions that dictate access to cannabis (e.g., home cultivation (HC) or dispensaries (DSP)) may impact edible production and use. This study examined relationships among HC and DSP provisions, cannabis cultivation, and edible use. Methods An online cannabis use survey was distributed using Facebook. Data were collected from 1813 cannabis-using adults. U.S. states were classified as states without LCL (Non-LCL) or LCL states that: (1) only permit DSP (LCL DSP-only), (2) only permit HC (LCL HC-only), or (3) permit HC and DSP (LCL HC+DSP). Analyses tested associations among these classifications, cannabis growing, and edible use and procurement. Results Individuals in LCL HC-only and LCL HC+DSP states were more likely to report currently growing cannabis at home (OR: 3.3, 95% CI: 1.7, 6.2; OR: 3.9, 95% CI: 2.4, 6.3, respectively) and past-month edible use (OR: 2.1, 95% CI: 1.4, 3.4; OR: 2.9, 95% CI: 2.2, 3.9, respectively) than individuals in LCL DSP-only states. Regardless of state, those who had grown cannabis were more likely to have made edibles than those who had never grown cannabis (OR: 2.2, 95% CI: 1.8, 2.6). Individuals in LCL HC-only states were more likely to have made edibles in the past month than individuals from Non-LCL (OR: 2.75, 95% CI: 1.5, 5.3) and DSP-only states (OR: 2.1, 95% CI: 1.0, 4.4). Individuals in LCL HC+DSP states were more likely to have purchased edibles in the past month than individuals from Non-LCL (OR: 3.7, 95% CI: 2.4, 5.6) and DSP-only states (OR: 3.2, 95% CI: 1.8, 5.5). Conclusion Specific LCL provisions may differentially affect individuals’ propensity to grow cannabis and make, buy, and use edible cannabis products. Permitting home cultivation contributes to a greater probability of growing cannabis. Those who grow cannabis economize the plant by creating homemade edible cannabis products. Conversely, permitting dispensaries increases the likelihood of purchasing edibles. The psychoactive effects of edibles with unknown and variable cannabinoid content will be unpredictable. Policymakers should carefully consider how specific LCL provisions can affect patterns of cannabis edible product access and quality.

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Section: Introductionmentioning

confidence: 99%

Legal cannabis laws, home cultivation, and use of edible cannabis products: A growing relationship?

Borodovsky

Budney

2017

International Journal of Drug Policy

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“…However, as was shown in some of the reviewed evidence (e.g. [57]), and discussed in greater detail elsewhere [100][101][102], the passage of a law to legalise cannabis use does not necessarily indicate an open cannabis market. Studies that measure access to cannabis through other means (e.g.…”

Section: Discussionmentioning

confidence: 95%

Guidelines for public health and safety metrics to evaluate the potential harms and benefits of cannabis regulation in Canada

Lake

Werb

Haines‐Saah

et al. 2019

Drug and Alcohol Review

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Issues Canada recently introduced a public health‐based regulatory framework for non‐medical cannabis. This review sought to identify a comprehensive set of indicators to evaluate the public health and safety impact of cannabis regulation in Canada, and to explore the ways in which these indicators may be expected to change in the era of legal non‐medical cannabis. Approach Five scientific databases were searched to compile a list of cannabis‐related issues of interest to public health and safety. A set of indicators was developed based on topics and themes that emerged. Preliminary evidence from other jurisdictions in the USA and Canada that have legalised medical and/or non‐medical cannabis (e.g. Colorado, Washington) was summarised for each indicator, wherever possible. Key Findings In total, 28 indicators were identified under five broad themes: public safety; cannabis use trends; other substance use trends; cardiovascular and respiratory health; and mental health and cognition. Preliminary trends from other legalised jurisdictions reveal little consensus regarding the effect of cannabis legalisation on public health and safety harms and an emerging body of evidence to support potential benefits (e.g. reductions in opioid use and overdose). Implications In addition to indicators of commonly discussed challenges (e.g. cannabis‐related hospitalisations, cannabis‐impaired driving), this review led to the recommendation of several indicators to monitor for possible public health and safety improvements. Conclusion In preparing a comprehensive public health and safety monitoring and evaluation system for cannabis regulation, this review underscores the importance of not only measuring the possible risks but also the potential benefits.

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“…Relationships between cannabis use and the use of alcohol, tobacco and opioids will substantially affect the public health impacts of cannabis legalization 38,40,42 . The public health burdens of these drugs could be reduced if cannabis becomes a substitute, while their impact could be amplified if there is more concurrent use of cannabis and these drugs 38,40 .…”

Section: What Adverse Health Effects May Increase After Cannabis Legamentioning

confidence: 99%

“…It has taken time to produce dependable supplies of cannabis within states that have legalized, and there are a limited number of retail outlets available in a relatively small number of locations in these states 1 . For these reasons, evaluations of the first five or so years after legalization may provide a poor indication of the impacts of cannabis use on public health when the industry develops over a decade or more 42,77 .…”

Section: Health Effects Of Legalizing Recreational Cannabis Use In Thmentioning

confidence: 99%

“…We need more rigorous evaluations of the public health impacts of cannabis legalization 42 . Comparisons of differences between states in time series data on various causes of hospitalization and death are of limited value because they are not able to test alternative explanations of state level differences 77 .…”

Section: Monitoring the Future Public Health Impact Of Cannabis Legalmentioning

confidence: 99%

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Assessing the public health impacts of legalizing recreational cannabis use: the US experience

2020

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The sale of cannabis for adult recreational use has been made legal in nine US states since 2012, and nationally in Uruguay in 2013 and Canada in 2018. We review US research on the effects of legalization on cannabis use among adults and adolescents and on cannabis‐related harms; the impact of legalizing adult recreational use on cannabis price, availability, potency and use; and regulatory policies that may increase or limit adverse effects of legalization. The legalization of recreational cannabis use in the US has substantially reduced the price of cannabis, increased its potency, and made cannabis more available to adult users. It appears to have increased the frequency of cannabis use among adults, but not so far among youth. It has also increased emergency department attendances and hospitalizations for some cannabis‐related harms. The relatively modest effects on cannabis use to date probably reflect restrictions on the number and locations of retail cannabis outlets and the constraints on commercialization under a continued federal prohibition of cannabis. Future evaluations of legalization should monitor: cannabis sales volumes, prices and content of tetrahydrocannabinol; prevalence and frequency of cannabis use among adolescents and adults in household and high school surveys; car crash fatalities and injuries involving drivers who are cannabis‐impaired; emergency department presentations related to cannabis; the demand for treatment of cannabis use disorders; and the prevalence of regular cannabis use among vulnerable young people in mental health services, schools and the criminal justice system. Governments that propose to legalize and regulate cannabis use need to fund research to monitor the impacts of these policy changes on public health, and take advantage of this research to develop ways of regulating cannabis use that minimize adverse effects on public health.

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Clearing the haze: the complexities and challenges of research on state marijuana laws

Cited by 33 publications

References 95 publications

Legal cannabis laws, home cultivation, and use of edible cannabis products: A growing relationship?

Legal cannabis laws, home cultivation, and use of edible cannabis products: A growing relationship?

Guidelines for public health and safety metrics to evaluate the potential harms and benefits of cannabis regulation in Canada

Assessing the public health impacts of legalizing recreational cannabis use: the US experience

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