Societal Costs and Outcomes of Medical and Recreational Marijuana Policies in the United States: A Systematic Review

Abstract

Significant support exists in the United States for legalization of marijuana/cannabis. As of 2021, 36 states and four territories approved the legalization of medical cannabis via medical marijuana laws (MMLs), and 15 states and District of Columbia (DC) have adopted recreational marijuana laws (RMLs). We performed structured and systematic searches of articles published from 2010 through September 2021. We assess the literature pertaining to adolescent marijuana use; opioid use and opioid-related outcomes; alcohol use; tobacco use; illicit and other drug use; marijuana growing and cultivation; employment, earnings, and other workplace outcomes; academic achievement and performance; criminal activity; perceived harmfulness; traffic and road safety; and suicide and sexual activity. Overall, 113 articles satisfied our inclusion criteria. Except for opioids, studies on use of other substances (illicit drugs, tobacco, and alcohol) were inconclusive. MMLs and RMLs do not generate negative outcomes in the labor market, lead to greater criminal activity, or reduce traffic and road safety.

Bridging Disciplines: Applications of Forensic Science and Industrial Hemp

“…Further exacerbating the problem in the USA is the inconsistency of the laws that govern marijuana. It is currently on the controlled substances list, but it is classified for legal use as medical marijuana in 36 states and recreational use in 15 states as well as the District of Columbia ( French et al, 2022 ). Therefore, as the delineation between legally produced hemp and psychoactive forms of Cannabis becomes clearer, and with the passage of more regulations to improve growth conditions, research will undoubtedly provide unprecedented opportunities to expand forensic advances and promote development of industrial and therapeutic possibilities for emblematic Cannabis products.…”

Developments and Changes in Primary Public Health Outcome Indicators Associated with the Legalization of Non-Medical Cannabis Use and Supply in Canada (2018): A Comprehensive Overview

“…These, for example, include community safety, crime and social cost effects but also the extent to which the elimination of the criminal enforcement and penalties for personal cannabis use and their adverse consequences (e.g., criminal records, educational/employment barriers, social injustice) have impacted on the lives and social welfare of the 5–6 million cannabis users (Callaghan et al, 2021a , 2021b ; Fischer et al, 2020a , 2020b ; Lu et al, 2021 ). Such comprehensive evaluations have yet to be implemented, but may eventually conclude that legalization has been an overall more measured and socially beneficial option for cannabis control in Canada (French et al, 2022 ).…”

Association of Recreational Cannabis Legalization With Alcohol Use Among Adults in the US, 2010 to 2019

“…The association between cannabis policies and adult alcohol use also are unclear. 25 Two studies have found that medical cannabis laws reduced alcohol use, 26 , 27 suggesting that cannabis and alcohol are substitutes. However, 2 other studies found that medical laws increased alcohol use, indicating that the 2 substances were economic complements.…”

“…The association between cannabis policies and adult alcohol use also are unclear . Two studies have found that medical cannabis laws reduced alcohol use, suggesting that cannabis and alcohol are substitutes.…”