Marijuana Legalization Research Articles

Global Impacts of Legalization and Decriminalization of Marijuana and Cannabis

The purpose of this article is to discuss global public health impacts of legalization and decriminalization of marijuana and cannabis regarding physical and mental health impacts as well as accident and death reports.

The effect of marijuana legalization on crime in Alaska

The effect of marijuana legalization on crime in Alaska

A Study Of Maslahah Al - Mursalah On Efforts To Legalize Marijuana For Medical Needs In Indonesia In The Aspect Of Legal Exceptions

<p class="TableParagraph"><em>In this descriptive qualitative study (library research), al-Maslahah Mursalah looks at legal methodology (usul fiqh) in the context of efforts to make medical marijuana legal in Indonesia. It is normative and looks at legal exceptions. The research findings conclude: First, al-Maslahah Mursalah is one of the Islamic legal methodologies appropriately used as an argument for the legalization of marijuana for medical needs in Indonesia, taking into account: (a). Al-Maslahah Mursalah is a real and general maslahah. (b). Judged by common sense as a true maslahah-really in line with the purpose of shara'. (c). Judged by common sense as the ultimate maslahah and having been in line with the objectives of shara' does not clash with the arguments of shara'. (d). Al-Maslahah Mursalah was practised with the narrow conditions of life. Second, the study of al-Maslahah Mursalah on the aspect of legal exceptions to the legalization of marijuana for medical needs in Indonesia is quite open through (a). The process of study and research by representative institutions to find the content of marijuana as an alternative medicine and therapy; if it becomes the only ingredient contained in cannabis content, then legalization can be categorized as an emergency or an exception to the law. The purpose of rukshah is to maintain benefits and reject kemafsadatan. Therefore, according to the scholars of ushul, the law of using rukhshah is permissible /ibahah. (b). Suppose the results of the study find the content of marijuana as an alternative medicine and therapy. In that case, it becomes the basis for disclosing the value of the legalization of marijuana for medical purposes. The values of benefit will create the fulfilment of basic human needs consisting of the maintenance of religion, the maintenance of reason, the maintenance of property, the maintenance of the soul, and the maintenance of offspring/honour.</em></p>

Dazed and Confused: Difficulties for Law Enforcement During Oregon’s Transition to a Legal Marijuana Market

As more states legalize recreational cannabis, questions remain about the impact of this transition for police who continue to be responsible for enforcing laws governing illicit production and distribution of the drug, use of the substance in prohibited settings, and possession by juveniles. Legalization may also lead to additional responsibilities, including policing homegrown cannabis and licensed businesses involved in cultivating, processing, and selling the drug. Documenting the experience of law enforcement officers in states that have already transitioned to a legal market may provide important insights into the implementation of cannabis policies in other jurisdictions. The present study surveyed 301 law enforcement officers in Oregon three years after the state legalized recreational marijuana. Results indicate that officers perceive increases in many marijuana-related problems following legalization and most officers report that the state’s revised statutes are confusing and difficult to enforce. Implications for public policy are discussed.

The Legalization of Medical Marijuana: A Human Rights Law Perspective

The discourse on legalizing marijuana for medical purposes in Indonesia peaked when legislators discussed the draft law on the narcotics law amendment. Efforts to legalize marijuana for medical purposes have also been pursued by testing the narcotics law. However, through decision number 106/PUU-XVII/2020, the Constitutional Court prohibited medical marijuana as a medical treatment. From the Human Rights perspective, everyone has the right to life and health. Therefore, in society's logic, the prohibition of using marijuana for medical treatment is the same as forbidding sick people to stay alive. It means that the state has failed to guarantee its citizens' lives. But on the other hand, several countries legalized medical marijuana, such as Thailand, Turkey, Lebanon, Netherlands, and Spain. So, why is Indonesia still banning the use of medical marijuana? This research tries to find the legal reasoning of Indonesia's government in the medical marijuana case. These problems were then analyzed using the prescriptive method with a comparative approach to finding new concepts related to legalizing medical marijuana in Indonesia. This study indicates that medical marijuana may be legal in the future of Indonesia's regime. It demonstrates by Indonesian Ulema Council and the Ministry of Health's political wills. The research recommendations are to provide proper education about medical marijuana and the prospect of legalization in the future.

Efficacy and Safety of Medical Marijuana in Migraine Headache: A Systematic Review.

Medical marijuana treatment for migraine is becoming more common, although the legality and societal acceptance of marijuana for medical purposes in the United States have been challenged by the stigma attached to it as a recreational drug. These substances function to reduce nociception and decrease the frequency of migraine by having an impact on the endocannabinoid system.Our study reviewed the clinical response, dosing, and side effects of marijuana in migraine management.Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a literature search in PubMed, Google Scholar, and Science Direct, and nine studies were included in the systematic review. The studies demonstrated that medical marijuana has a significant clinical response by reducing the length and frequency of migraines. No severe adverse effects were noted. Due to its effectiveness and convenience, medical marijuana therapy may be helpful for patients suffering from migraines. However, additional clinical trials and observational studies with longer follow-ups are required to study the efficacy and safety of the drug.

In Case You Haven't Heard…

Now that marijuana is legalized in so many places, guess what's cropping up in those same places? Illegal marijuana shops — in other words, shops that sell what they say is marijuana, but don't have a license, don't pay fees to the state, don't guarantee the safety of their product, and have now aroused the ire of citizens. For example, in Buffalo, New York, local lawmakers just passed a resolution to write rules and regulations for marijuana stores. The state legalized recreational use of the drug, but that leaves cities to work out details. Buffalo legislators have asked the New York Office of Cannabis Management — a state agency paid for by taxpayers — to step in and take action against unregulated stores. The lawmakers in Buffalo — as in many jurisdictions — who look at marijuana stores as a source of revenue, tourism, and part of a hospitality industry, are not opposed to legal marijuana. They just want any store that opens before it has a license to be banned. Meanwhile, how does one know if what they are buying is safe and legal? Questions to answer next year. Maybe.

Marijuana legalization associated with transitions to use

A Population Assessment of Tobacco and Health Study waves 3 and 4 found that among youths, those in states that legalized recreational cannabis were more likely to transition from non‐users to users. There was no evidence that youths in those states transitioned from users to non‐users, or from users to weekly users. There was evidence among adults that legalization was associated with transitions from use to weekly use.

Medical Marijuana Legalization and Opioid- and Pain-Related Outcomes Among Patients Newly Diagnosed With Cancer Receiving Anticancer Treatment

The past decade saw rapid declines in opioids dispensed to patients with active cancer, with a concurrent increase in marijuana use among cancer survivors possibly associated with state medical marijuana legalization. To assess the associations between medical marijuana legalization and opioid-related and pain-related outcomes for adult patients receiving cancer treatment. This cross-sectional study used 2012 to 2017 national commercial claims data and a difference-in-differences design to estimate the associations of interest for patients residing in 34 states without medical marijuana legalization by January 1, 2012. Secondary analysis differentiated between medical marijuana legalization with and without legal allowances for retail dispensaries. Data analysis was conducted between December 2021 and August 2022. Study samples included privately insured patients aged 18 to 64 years who received anticancer treatment during the 6 months after a new breast (in women), colorectal, or lung cancer diagnosis. State medical marijuana legalization that took effect between 2012 and 2017. Having 1 or more days of opioids, 1 or more days of long-acting opioids, total morphine milligram equivalents of any opioid dispensed to patients with 1 or more opioid days, and 1 or more pain-related emergency department visits or hospitalizations (hereafter, hospital events) during the 6 months after a new cancer diagnosis. Interaction terms were included between each policy indicator and an indicator of recent opioids, defined as having 1 or more opioid prescriptions during the 12 months before the new cancer diagnosis. Logistic models were estimated for dichotomous outcomes, and generalized linear models were estimated for morphine milligram equivalents. The analysis included 38 189 patients newly diagnosed with breast cancer (38 189 women [100%]), 12 816 with colorectal cancer (7100 men [55.4%]), and 7190 with lung cancer (3674 women [51.1%]). Medical marijuana legalization was associated with a reduction in the rate of 1 or more opioid days from 90.1% to 84.4% (difference, 5.6 [95% CI, 2.2-9.0] percentage points; P = .001) among patients with breast cancer with recent opioids, from 89.4% to 84.4% (difference, 4.9 [95% CI, 0.5-9.4] percentage points; P = .03) among patients with colorectal cancer with recent opioids, and from 33.8% to 27.2% (difference, 6.5 [95% CI, 1.2-11.9] percentage points; P = .02) among patients with lung cancer without recent opioids. Medical marijuana legalization was associated with a reduction in the rate of 1 or more pain-related hospital events from 19.3% to 13.0% (difference, 6.3 [95% CI, 0.7-12.0] percentage points; P = .03) among patients with lung cancer with recent opioids. Findings of this cross-sectional study suggest that medical marijuana legalization implemented from 2012 to 2017 was associated with a lower rate of opioid dispensing and pain-related hospital events among some adults receiving treatment for newly diagnosed cancer. The nature of these associations and their implications for patient safety and quality of life need to be further investigated.

The Efficiency of Marijuana Legalization: Uruguay versus Canada

ABSTRACT The legalization of cannabis has been a trend to be done by countries because it is seen as beneficial in many ways. Marijuana is seen as a drug which has less negative impacts, or can be said “manageable” hence receiving much support from the society to be legalized in a country. Cannabis legalization, either medical or non medical marijuana, is believed to positively impact the welfare of society. Uruguay and Canada are the first and second countries which legalized non medical marijuana through the establishment of a specific marijuana policy to regulate various activities related to marijuana. However, the established marijuana legalization policy has not necessarily proven to give advantages to society. In addition, the impacts of the legalization itself can not only be seen from the fact that the countries have legalized marijuana, rather how the legalization is regulated in the policy. Thus, this research will analyze how marijuana is legalized in the national policy of Uruguay and Canada, and compare the impacts of the policy towards human welfare through the perspective of Social Welfare Theory by Elizabeth Wickenden.

Assessing the prevalence and risk factors of marijuana use in adults with disabilities

BackgroundPublic support for the legalization of marijuana (cannabis) for medical or recreational use by adults has grown rapidly over the past two decades. Given the growing prevalence and concerns about potential harms, a better understanding is needed of disparities in marijuana use among adults by disability status. MethodsUsing 2015–2019 data from the National Survey on Drug Use and Health (NSDUH), we obtained a national sample of 195,130 working-age (18–64 year) adults. Descriptive and multivariable analyses were conducted to assess the prevalence and risk factors associated with marijuana use among adults by disability status and type. ResultsWe found the prevalence of marijuana use was higher among adults with disabilities (16.6% vs 10.9%) compared to those without disabilities, and this disparity widened from 2015 to 2019. Furthermore, the odds of marijuana use varied by disability type. Specifically, adults with vision disability only (OR 1.28; 95% CI 1.14–1.44), cognitive disability only (OR 1.24; 95% CI 1.13–1.35), and those with multiple disabilities (OR 1.22; 95% CI 1.11–1.34) had higher odds of marijuana use compared to adults without any disability. ConclusionsAdults with disabilities have a higher prevalence of marijuana use compared to those without disabilities. Living in a state with legalized medical marijuana also increased the odds of marijuana use. These findings can help to inform policy and public health surveillance of marijuana use in the U.S. Further studies are needed to monitor the rising prevalence of marijuana use and examine how intensity of marijuana use affects health outcomes in adults with and without disabilities.

The kids aren’t alright: The effects of medical marijuana market size on adolescents

We exploit shocks to US federal enforcement policy to assess how legal medical marijuana market size affects youth marijuana use and consequences for youth traffic-related fatalities. Using hand-collected data on state medical marijuana patient rates to develop a novel measure of market size, we find that legal market growth increases youth marijuana use. Likely mechanisms are lower prices and easier access. Youth die more frequently from alcohol-involved car accidents, suggesting complementarities for youths. The consequences of marijuana legalization for youth are not immediate, but depend on how supply-side regulations affect production and prices.

Levels and in-unit stability of 11-nor-9-carboxy-9-tetrahydrocannabinol (9-carboxy-THC) in donor platelets and whole blood: is enough present to have an impact on recipients?

Abstract Objective The safety of the United States donor blood supply has been questioned in the context of recreational marijuana legalization in Colorado and other states nationwide. It is unclear whether cannabis use by donors presents a danger to recipients, either through direct toxicity or socioeconomic ramifications. Our objectives are to both determine if the active metabolite of tetrahydrocannabinol (THC), 11-nor-9-carboxy-9-tetrahydrocannabinol (9-carboxy-THC), is present in donated units in a dosage high enough to impact the recipient and to assess for in-unit metabolism or degradation. Methods We will quantify the amount of 9-carboxy-THC in platelet units donated by self-reported cannabis users through liquid chromatography with tandem mass spectrometry (LC-MS/MS) testing and correlate the assay data with donor survey responses. To gain insight into in-unit metabolite stability, we also will test whole blood units at several time points throughout storage, collected from participants who self-report taking a known oral dose of THC prior to donation. Results Institutional review board approval for a study evaluating marijuana at a children’s hospital presented a challenge, requiring the addition of an organizational risk review and an update to the hospital transfusion consent for approval. Thus, the projected timeline of this study has been extended. Study recruitment flyers and an email screening survey have generated interest from volunteer donors. The email survey was sent to 9,208 donors who had previously donated at least once, from which we received 372 responses (4.04% response rate). Of the respondents, 49 individuals reported daily marijuana use, 33 reported marijuana usage 4-6 times per week, 32 reported usage 1-3 times/week, 30 reported usage 1-3 times/month, 52 reported rare usage, and 167 reported never using marijuana. Overall, out of the survey respondents, over 50% reported at least some marijuana usage, and 31% reported at least weekly marijuana usage. Although this number is small, our prior study found that many were repeat donors. Research visits are currently being scheduled for interested participants. Conclusions This study highlights the challenges of performing marijuana research at a children’s hospital and illustrates why there is a lack of published data evaluating the effects of recreational marijuana legalization. Although completion of this project investigating this controversial topic has been delayed, persistent advocation for this area of interest is opening doors for future studies and will hopefully pave the way to fill our knowledge gaps. The results of this research study will inform decisions regarding donor eligibility and safety of the national blood supply as well as address associated socioeconomic implications.

Abstract 11890: Association Between State Marijuana Legalization Policies and Marijuana Use Reasoning Among Adults With Cardiovascular Disease, 2017-2020

Introduction: The rapid adoption of marijuana legalization policies in states has forced clinicians to evaluate the health effects of marijuana due to increased availability; however, little is known about changes in marijuana use among adults with CVD after legalization (medical, recreational, dual) in the US. Methods: Using a sample of 298,651 adults from 2017-2020 survey data from the Behavioral Risk Factor and Surveillance System (BRFSS), we estimated the prevalence of recent (past-month) marijuana use in eleven states among adults with and without CVD by marijuana legalization (ML) status of a state. Multivariate logistic regression models were conducted to examine factors associated with marijuana use by self-reported CVD status. Results: Recent marijuana use was higher among adults with CVD in ML states compared to non-ML states (10.7% vs. 6.4%). The mean days of marijuana use in the CVD cohort in ML-states were 17.2±15.5, and 16.1±13.7 days in non-ML-states. Medical use among CVD adults decreased from 57.4% in 2017 to 47% in 2020. In contrast, dual-use increased from 14.4% in 2017 to 30.9% in 2020. However, trends were different in ML vs non-ML states(Figure). Adults with CVD in ML-states had higher (OR=1.75, p<.001), while in non-ML states had lower (OR=0.81, p<0.05), odds of marijuana use compared to those without CVD in non-ML states (reference group). Among CVD adults who used marijuana, odds of medical use were 85% higher in ML-states (OR=1.85, p<0.05), while more than two-fold for recreational (OR=2.10, p<0.05) and 2.5-fold for dual-use (OR=2.53, p<0.05), than non-ML states. Conclusions: We found a higher prevalence and likelihood of marijuana use in adults with CVD living in legalized vs. non-legalized states, which was not unexpected. However, marginal decline in use for medical reasons in ML states with the increasing prevalence of recreational and dual-use in the CVD population requires greater attention to the risk/benefits of individual preferences.

Abstract 13921: Substance Use Disorders and Prevalence of Stroke Amongst the US Population

Introduction: Globally, stroke is one of the top five leading causes of death. Although it was being mostly reported in the elderly population, recently a significant number of young adults are being diagnosed with stroke. The increasing prevalence of comorbidities like diabetes, & hypertension, along with a rise in substance use disorders (SUDs) could be attributed to increased stroke diagnosis among young adults. Aims & Objectives: The aims of the study include an evaluation of the prevalence of stroke in the US population & prevalence of SUDs amongst patients with a history of Stroke. Methods: Our population was obtained from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. We identified respondents who were diagnosed with stroke & SUDs based on the questionnaire. We performed univariate analysis using chi-square & Mann-Whitney tests using SAS software (Version 9.4). A p-value of <0.05 was considered statistically significant. Results: 264,740 respondents were included in this study, of which 10435 (3.94%) had a history of stroke. Respondents with history of stroke were older (median age: 68 years) & more prevalent among males (3.98% vs 3.90% females), non-Hispanic Blacks (5.07% vs 4.76% non-Hispanic Whites vs 2.92% other Hispanics), population, & those belonging to lower annual household income (6.76% $0-$25,000 vs 1.50% >$100,000).(p<0.0001). Consumption of cocaine [89.91% vs 95.56%], marijuana/hashish [63.72% vs 52.97%], methamphetamine [45.81% vs 39.71%], alcohol use disorder-heavy drinking [36.44% vs 47.21%], heroin [23.43% vs 15.21%], e-cigarettes [12.71% vs 17.09%], & injectable drugs [4.21% vs 2.49%] were prevalent amongst people had stroke in comparison to without stroke history. Conclusions: The use of marijuana was most prevalent among respondents with a history of stroke followed by the use of methamphetamine & heroin. With the legalization of marijuana in 19 states for recreational use, the government should plan appropriate policies to lessen the stroke burden among the population with SUDs in the USA. Recall bias & geographic variations in response rate by participants of the study were the limitations of our survey-based study.

Local Prohibitions on Marijuana Businesses With On-Site Consumption: Evidence from New York State

As several US states have legalized recreational marijuana over the past decade, local approval of commercial marijuana activities has faced opposition in a non-negligible share of communities. A common provision in state laws often grants local governments the authority to prohibit marijuana businesses from locating within their jurisdictions. This paper analyzed determinants of local government policies in New York State following the legalization of recreational marijuana in 2021. A key feature of New York’s law authorized municipal governments to pass an “opt-out” ordinance prohibiting marijuana retail stores, on-site consumption establishments, or both. Based on results from multilevel logistic regression models, the likelihood of allowing commercial marijuana activities was higher for local governments representing communities with larger Black populations, fewer evangelical Protestants, and lower levels of household income. While slightly more municipalities prohibited on-site consumption, determinants of opt-out decisions were similar for both retail and consumption businesses.

Recreational marijuana legalization and drug-related offenses in Washington State: an interrupted time series analysis with a combination of synthetic controls

Recreational marijuana legalization and drug-related offenses in Washington State: an interrupted time series analysis with a combination of synthetic controls

Crime in a Time of Cannabis: Estimating the Effect of Legalizing Marijuana on Crime Rates in Colorado and Washington Using the Synthetic Control Method

The legalization of marijuana for recreational use continues to expand across America. Colorado and Washington were the first states to legalize marijuana in 2012. A primary concern regarding legalization is how these policy changes affect crime rates. Researchers have begun to estimate the effect marijuana legalization has had on crime rates. We extend this literature by using a different analytical approach. State level data covering years 2000–2019 were analyzed using the synthetic control method to find that legalizing marijuana for recreational use in Colorado and Washington was generally not associated with variations in index crime rates. These findings substantiate prior research. Increased crime rates should not be a primary concern as more states move to adopt recreational marijuana use legislation. Instead, the benefits to states via harm reduction, increased tax revenue, and a more efficient allocation of policing resources ought to be more of a consideration for states when passing recreational marijuana legislation.

Perception and Utilization of Cannabinoids in Patients Undergoing Radiation Treatment: Our Patients are Curious

<h3>Purpose/Objective(s)</h3> There has been growing interest in the use of cannabinoid products as medical treatments, particularly for cancer care. With the legalization of marijuana for recreational use in many states in the United States, patients are increasingly using these substances at their own discretion. Limited studies have described the utilization of cannabinoids among cancer patients. This study aimed to characterize utilization patterns and perceptions of cannabinoid use for treatment-related side effects among patients receiving radiation treatment. <h3>Materials/Methods</h3> This was a single-institution study conducted at a comprehensive cancer center in a state with legalized medical and recreational use of cannabinoids. An anonymous survey was administered using a tablet and distributed to patients who were undergoing or recently completed radiation treatment. Patient demographics were recorded, including age, gender, race and ethnicity, marital status, education, household income, and cancer diagnosis. Two surveys were designed, one for those who used or are using cannabinoids during treatment and one for those who were not. The survey also included Likert-scale items regarding perceived effects of cannabinoids. Survey results were calculated using descriptive summary statistics. <h3>Results</h3> Of the 165 respondents, 45 (27.7%) patients reported cannabinoid use since their original cancer diagnosis. Of those who reported use, the majority (66.7%) experienced improvement of symptoms with cannabinoids. Much of this subset (66.7%) had better relief of symptoms from cannabinoid than from prescription medications, and 46.7% lowered the amount of pain medications required after using cannabinoid. More than half of cannabinoid users reported some degree of effectiveness of cannabinoid in managing pain (64.4%), sleep (62.2%), and anxiety/stress (57.8%), with more patients citing benefits while undergoing chemo- or immunotherapy (35.6%) than while undergoing radiation treatment (17.8%). Additionally, 44.4% of patients who reported cannabinoid use wanted more discussions with their doctors regarding their cannabinoid use. For patients who did not report cannabinoid use, a large majority (89.2%) never had discussions with their doctors regarding using cannabinoid as part of their cancer care, and 43.4% would like to learn about cannabinoids from their doctors. <h3>Conclusion</h3> About one in four cancer patients reported cannabinoid use since their cancer diagnosis. A majority had subjective alleviation of symptoms associated with cancer treatments, and some reported improved symptom relief from cannabinoid compared to prescription medications. A large proportion of patients, regardless of their cannabinoid use, were interested in discussing cannabinoid use with their radiation oncologists during their treatment. Guidelines are needed to assist radiation oncologists on how cannabinoid may play a role in their patients' care.

State Marijuana Laws and Marijuana Use Among Sexual and Gender Minority Youth in the United States.

Purpose: The purpose of this study was to explore the association between state-level marijuana policies and marijuana use among sexual and gender minority (SGM) adolescents. Methods: A secondary analysis was conducted using a nonprobability sample, the 2017 LGBTQ National Teen Survey, based on 10,027 youth who reported their marijuana use behaviors and state of residence. Random intercept multilevel models were estimated to account for between- and within-state variability. Results: State marijuana possession laws were not associated with lifetime use; however, the odds of current marijuana use were 50% greater among youth living in states with legalized marijuana possession for recreational use (adjusted odds ratio [aOR] = 1.50; 95% confidence interval [CI]: 1.21-1.86) compared with states that prohibit any possession. Lesbian, gay, bisexual, transgender, and queer victimization was associated with greater odds of lifetime (aOR = 1.98; 95% CI: 1.78-2.20) and current (aOR = 1.99; 95% CI: 1.74-2.27) marijuana use. Conclusions: State-level policies governing recreational marijuana possession are associated with current marijuana use among SGM youth. Public health approaches to control underage access to legal marijuana and mitigate substance use-related health disparities are needed.