A new study reviews evidence legalization of recreational and/or medical marijuana at the state level may be associated with higher prevalence of cannabis use disorders (CUDs) among residents. The authors identified three “risk factor” areas: Pharmacology of drug effects, access/availability of cannabis, and environmental influences. As cannabis legalization spreads, the potency of cannabis products may increase, as manufacturers create edibles and other products with high THC concentrations, as well as new delivery methods. This could lead to earlier initiation of cannabis use among youth, a risk factor for future CUD. Access/availability of cannabis may also be related to incidence of CUD: As the number of retail/medicinal marijuana outlets increases, the unit price of cannabis products is likely to decrease and residents’ frequencies of cannabis use and CUD-related hospitalizations may rise. Additionally, home cultivation of cannabis can be difficult to regulate and more research is needed to develop effective marijuana taxation policies. Environmental influences on CUDs include marketing of cannabis products (which is not tightly regulated in some states) and social norms. As acceptability of marijuana use increases, individuals may perceive cannabis as less harmful, thus leading to increased marijuana use and risk of CUDs.
Take away: Cannabis legalization may increase the prevalence of cannabis use disorders, because it is associated with stronger products, increased availability, greater social acceptance of marijuana use, and aggressive marketing. States should consider implementing public health policies similar to those regulating alcohol and tobacco to minimize these risks.
Citation: Budney AJ & Borodovsky JT. (2017). The potential impact of cannabis legalization on the development of cannabis use disorders [published online ahead of print June 29 2017], Preventive Medicine doi: 10.1016/j.ypmed.2017.06.034