Assessing the public health impacts of legalizing recreational cannabis use in the USA
Corresponding Author
W Hall
Centre for Youth Substance Abuse Research, University of Queensland, Herston, Australia
Addiction Policy, National Addiction Centre, Kings College, London, UK
Correspondence: W Hall ([email protected])Search for more papers by this authorM Weier
Centre for Youth Substance Abuse Research, University of Queensland, Herston, Australia
Search for more papers by this authorCorresponding Author
W Hall
Centre for Youth Substance Abuse Research, University of Queensland, Herston, Australia
Addiction Policy, National Addiction Centre, Kings College, London, UK
Correspondence: W Hall ([email protected])Search for more papers by this authorM Weier
Centre for Youth Substance Abuse Research, University of Queensland, Herston, Australia
Search for more papers by this authorAbstract
A major challenge in assessing the public health impact of legalizing cannabis use in Colorado and Washington State is the absence of any experience with legal cannabis markets. The Netherlands created a de facto legalized cannabis market for recreational use, but policy analysts disagree about how it has affected rates of cannabis use. Some US states have created de facto legal supply of cannabis for medical use. So far this policy does not appear to have increased cannabis use or cannabis-related harm. Given experience with more liberal alcohol policies, the legalization of recreational cannabis use is likely to increase use among current users. It is also likely that legalization will increase the number of new users among young adults but it remains uncertain how many may be recruited, within what time frame, among which groups within the population, and how many of these new users will become regular users.
References
- 1 Room, R., Fischer, B., Hall, W.D., Lenton, S. & Reuter, P. Cannabis Policy: Moving Beyond Stalemate (Oxford University Press, Oxford, UK, 2010).
- 2 Bewley-Taylor, D., Blickman, T. & Jelsma, M. The rise and decline of cannabis prohibition. The history of cannabis in the UN drug control system and options for reform (Global Drug Policy Observatory/Transnational Institute, Amsterdam/Swansea, 2014). <http://www.tni.org/sites/www.tni.org/files/download/rise_and_decline_web.pdf> Accessed 27 November 2014.
- 3 Pacula, R.L., Chriqui, J. & King, J. Marijuana decriminalization: what does it mean in the United States? Report No. WR-126 (RAND, Santa Monica, 2004). <http://www.rand.org/pubs/working_papers/WR126/> Accessed 27 November 2014.
- 4 Baum, D. Smoke and Mirrors: The War on Drugs and the Politics Of Failure (Back Bay Books, New York, 1996).
- 5 Courtwright, D.T. No Right Turn: Conservative Politics in a Liberal America (Harvard University Press, Cambridge, MA, 2010).
- 6 Caulkins, J., Hawken, A., Kilmer, B. & Kleiman, M. Marijuana Legalization: What Everyone Needs to Know (Oxford University Press, New York, 2012).
- 7 Hall, W.D. & Pacula, R. Cannabis Use and Dependence: Public Health and Public Policy (Cambridge University Press, Cambridge, UK, 2010).
- 8 Single, E., Christie, P. & Ali, R. The impact of cannabis decriminalization in Australia and the United States. J. Public Health Policy 21, 157–186 (2000).
- 9 Donnelly, N., Hall, W.D. & Christie, P. Effects of the Cannabis Expiation Notice Scheme on Levels and Patterns of Cannabis Use in South Australia: Evidence From the National Drug Strategy Household Surveys 1985–1995 (Australian Government Publishing Service, Canberra, 1999).
- 10
MacCoun, R.J. &
Reuter, P. Drug War Heresies: Learning From Other Vices, Times and Places (Cambridge University Press, Cambridge, UK, 2001).
10.1017/CBO9780511754272 Google Scholar
- 11 Greenwald, G. Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies (Cato Institute, Washington, D.C., 2009).
- 12 Hughes, C.E. & Stevens, A. A resounding success or a disastrous failure: re-examining the interpretation of evidence on the Portuguese decriminalization of illicit drugs. Drug Alcohol Rev. 31, 101–113 (2012).
- 13 Donnelly, N., Hall, W.D. & Christie, P. The effects of partial decriminalization on cannabis use in South Australia, 1985 to 1993. Aust. J. Public Health 19, 281–287 (1995).
- 14 Cameron, L. & Williams, J. Cannabis, alcohol and cigarettes: substitutes or complements? Econ. Rec. 77, 19–34 (2001).
- 15 Pacula, R.L., Chriqui, J.F., Reichman, D.A. & Terry-McElrath, Y. State medical marijuana laws: understanding the laws and their limitations. J. Public Health Policy 23, 411–437 (2002).
- 16 Williams, J. The effects of price and policy on marijuana use: what can be learned from the Australian experience? Health Econ. 13, 123–137 (2004).
- 17 Williams, J. & Bretteville-Jensen, A.L. Does liberalizing cannabis laws increase cannabis use? J. Health Econ. 36, 20–32 (2014).
- 18Working Party of the Royal College of Psychiatrists and the Royal College of Physicians. Drugs: Dilemmas and Choices (Gaskell, London, 2000).
- 19 Grund, J.P. & Breekesma, J. Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands (Global Drug Policy Program, Open Society Foundation, New York, 2013).
- 20 Korf, D.J. Dutch coffee shops and trends in cannabis use. Addict. Behav. 27, 851–866 (2002).
- 21INCB. Report of the International Narcotics Control Board for 2013 (United Nations, New York, 2014). <http://www.incb.org/documents/Publications/AnnualReports/AR2013/English/AR_2013_E.pdf> Accessed 14 August 2014.
- 22 MacCoun, R.J. & Reuter, P. Interpreting Dutch cannabis policy: reasoning by analogy in the legalization debate. Science 278, 47–52 (1997).
- 23 Abraham, M.D., Cohen, P.D.A. & Beukenhorst, D.J. Comparative cannabis use data. Br. J. Psychiatry 179, 175–176 (2001).
- 24 MacCoun, R.J. What can we learn from the Dutch cannabis coffeeshop system? Addiction 106, 1899–1910 (2011).
- 25 Annas, G.J. Medical marijuana, physicians, and state law. N. Engl. J. Med. 371, 983–985 (2014).
- 26 Sevigny, E.L., Pacula, R.L. & Heaton, P. The effects of medical marijuana laws on potency. Int. J. Drug Policy 25, 308–319 (2014).
- 27 O'Connell, T.J. & Bou-Matar, C.B. Long term marijuana users seeking medical cannabis in California (2001–2007): demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants. Harm Reduct. J. 4, 16 (2007).
- 28 Ryan-Ibarra, S., Induni, M. & Ewing, D. Prevalence of medical marijuana use in California, 2012. Drug Alcohol Rev. (2014).
- 29 Bostwick, J.M. Blurred boundaries: the therapeutics and politics of medical marijuana. Mayo Clin. Proc. 87, 172–186 (2012).
- 30 Cohen, P.J. Medical marijuana 2010: it's time to fix the regulatory vacuum. J. Law. Med. Ethics 38, 654–666 (2010).
- 31 Regan, T. Joint Ventures: Inside America's Almost Legal Marijuana Industry (Wiley, New York, 2011).
- 32 Reinarman, C., Nunberg, H., Lanthier, F. & Heddleston, T. Who are medical marijuana patients? Population characteristics from nine California assessment clinics. J. Psychoactive Drugs 43, 128–135 (2011).
- 33 Cerda, M., Wall, M., Keyes, K.M., Galea, S. & Hasin, D. Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug Alcohol Depend. 120, 22–27 (2012).
- 34 Lynne-Landsman, S.D., Livingston, M.D. & Wagenaar, A.C. Effects of state medical marijuana laws on adolescent marijuana use. Am. J. Public Health 103, 1500–1506 (2013).
- 35 Wall, M.M., Poh, E., Cerda, M., Keyes, K.M., Galea, S. & Hasin, D.S. Adolescent marijuana use from 2002 to 2008: higher in states with medical marijuana laws, cause still unclear. Ann. Epidemiol. 21, 714–716 (2011).
- 36 Harper, S., Strumpf, E.C. & Kaufman, J.S. Do medical marijuana laws increase marijuana use? Replication study and extension. Ann. Epidemiol. 22, 207–212 (2012).
- 37 Choo, E.K., Benz, M., Zaller, N., Warren, O., Rising, K.L. & McConnell, K.J. The impact of state medical marijuana legislation on adolescent marijuana use. J. Adolesc. Health 55, 160–166 (2014).
- 38 Schuermeyer, J. et al. Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003-11. Drug Alcohol Depend. 140, 145–155 (2014).
- 39 Pacula, R.L., Powell, D., Heaton, P. & Sevigny, E.L. Assessing the effects of medical marijuana laws on marijuana use: the devil is in the details. J. Policy Anal. Manage. 34, 7–31 (2015).
- 40 Hall, W.D. What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction 110, 19–35 (2015).
- 41 Masten, S.V. & Guenzburger, G.V. Changes in driver cannabinoid prevalence in 12 U.S. states after implementing medical marijuana laws. J. Safety Res. 50, 35–52 (2014).
- 42 Anderson, D.M., Hansen, B. & Rees, D.I. Medical marijuana laws, traffic fatalities, and alcohol consumption. J. Law Econ. 56, 333–369 (2013).
- 43 Anderson, D.M., Rees, D.I. & Sabia, J.J. Medical marijuana laws and suicides by gender and age. Am. J. Public Health 104, 2369–2376 (2014).
- 44 Bachhuber, M.A., Saloner, B., Cunningham, C.O. & Barry, C.L. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999–2010. JAMA Internal Med. 174, 1668–1673 (2014).
- 45 Hayes, M.J. & Brown, M.S. Legalization of medical marijuana and incidence of opioid mortality. JAMA Internal Med. 174, 1673–1674 (2014).
- 46 Garvey, T. & Yeh, B.T. State legalization of recreational marijuana: selected legal issues (Congressional Research Office, Washington, D.C., 2014).
- 47Washington State Liquor Control Board. I-502 Implementation, <http://www.liq.wa.gov/marijuana/I-502> (2014). Accessed 27 November 2014.
- 48Colorado Department of Public Health and Environment. Retail marijuana <https://www.colorado.gov/pacific/cdphe/retail-marijuana> (2014). Accessed 27 November 2014.
- 49 Pardo, B. Cannabis policy reforms in the Americas: a comparative analysis of Colorado, Washington, and Uruguay. Int. J. Drug Policy 25, 727–735 (2014).
- 50Washington State Department of Revenue. Marijuana: taxes due on recreational marijuana <http://dor.wa.gov/Content/FindTaxesAndRates/marijuana/Default.aspx> (2014). Accessed 27 November 2014.
- 51 Wallach, P.A. & Hudak, J. Legal marijuana: comparing Washington and Colorado (2014) <http://www.brookings.edu/blogs/fixgov/posts/2014/07/08-washington-colorado-legal-marijuana-comparison-wallach-hudak>.
- 52Editorial Board. Repeal Prohibition, again. New York Times (2014, July 27).
- 53
Babor, T. et al. Alcohol: No Ordinary Commodity: Research and Public Policy 2nd ed. (Oxford University Press, Oxford, UK, 2010).
10.1093/acprof:oso/9780199551149.001.0001 Google Scholar
- 54 Room, R. Legalizing a market for cannabis for pleasure: Colorado, Washington, Uruguay and beyond. Addiction 109, 345–351 (2014).
- 55 Barry, R.A., Hiilamo, H. & Glantz, S.A. Waiting for the opportune moment: the tobacco industry and marijuana legalization. Milbank Q. 92, 207–242 (2014).
- 56 Wyatt, K. Merry marijuana: pot sellers woo holiday shoppers. (2014). <http://www.stltoday.com/news/local/merry-marijuana-pot-sellers-woo-holiday-shoppers/article_5c2e45d1-ab9e-5928-9dd5-aab43058f34e.html>.
- 57 Kilmer, B., Caulkins, J.P., Pacula, R.L., MacCoun, R.L. & Reuter, P.H. Altered state? Assessing how marijuana legalization in California could influence marijuana consumption and public budgets (RAND Drug Policy Research Center, Santa Monica, 2010). <www.rand.org/content/dam/rand/pubs/occasional_papers/2010/RAND_OP315.pdf> Accessed 27 November 2014.
- 58 Pacula, R.L., Kilmer, B., Wagenaar, A.C., Chaloupka, F.J. & Caulkins, J.P. Developing public health regulations for marijuana: lessons from alcohol and tobacco. Am. J. Public Health 104, 1021–1028 (2014).
- 59Transform Drug Policy Foundation. How to regulate cannabis: a practical guide (Transform Drug Policy Foundation, Bristol, 2014). <http://www.tdpf.org.uk/resources/publications/how-regulate-cannabis-practical-guide> Accessed 30 September 2014.
- 60 Wagenaar, A.C., Salois, M.J. & Komro, K.A. Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies. Addiction 104, 179–190 (2009).
- 61 Hall, W.D. What are the policy lessons of National Alcohol Prohibition in the United States, 1920–1933? (Addiction history). Addiction 105, 1164–1173 (2010).
- 62
Warburton, C. The Economic Results of Prohibition (Columbia University Press, New York, 1932).
10.7312/warb93378 Google Scholar
- 63 Warburton, C. Prohibition, in Encyclopaedia of the Social Sciences (ed. Seligman, E.) 499–510 (Macmillan, Detroit, 1934).
- 64 Cole, J.M. Memorandum for all United States Attorneys: guidance regarding marijuana enforcement (US Department of Justice, Washington, D.C., 2013). <http://www.justice.gov/iso/opa/resources/3052013829132756857467.pdf> Accessed 17 November 2014.
- 65 Roxburgh, A. et al. The epidemiology of cannabis use and cannabis-related harm in Australia 1993–2007. Addiction 105, 1071–1079 (2010).
- 66 Johnston, L.D., O'Malley, P.M. & Bachman, J.G. National Survey Results on Drug Use From the Monitoring the Future Study, 1975–1993. College Students and Young Adults (National Institute on Drug Abuse, Rockville, MD, 1994).
- 67 Johnston, L.D., O'Malley, P.M. & Bachman, J.G. National Survey Results on Drug Use From the Monitoring the Future Study, 1975–1993. Secondary School Students (National Institute on Drug Abuse, Rockville, MD, 1994).
- 68 Room, R., Greenfield, T. & Weisner, C. “People who might have liked you to drink less”: changing responses to drinking by U. S. family members and friends, 1979–1990. Contemp. Drug Probl. 18, 573–595 (1991).