Marijuana Laws Research Articles

The impact of medical and recreational marijuana laws on opioid prescribing in employer-sponsored health insurance.

Using data from Truven Health MarketScan Commercial Claims and Encounters Database between 2009 and 2015, we studied the effects of medical and recreational marijuana laws on opioid prescribing in employer-sponsored health insurance. We used a differences-in-differences (DD) approach and found that the implementation of medical marijuana laws (MMLs) and recreational marijuana laws (RMLs) reduced morphine milligram equivalents per enrollee by 7% and 13%, respectively. The reduction associated with MMLs was predominately in people aged 55-64, whereas the reduction associated with RMLs was largely in people aged 35-44 and aged 45-54. Our findings suggest that both MMLs and RMLs have the potential to reduce opioid prescribing in the privately insured population, especially for the middle-aged population.

Marijuana Legalization and Rates of Crashing Under the Influence of Tetrahydrocannabinol and Alcohol.

To determine if statewide marijuana laws impact upon the detection of drugs and alcohol in victims of motor vehicle collisions (MVC). A retrospective analysis of data collected at trauma centers in Arizona, California, Ohio, Oregon, New Jersey, and Texas between 2006 and 2018 was performed. The percentage of patients testing positive for marijuana tetrahydrocannabinol (THC) was compared to the percentage of patients driving under the influence of alcohol (blood alcohol level >0.08g/dL) that were involved in an MVC. The data were analyzed to evaluate the trends in THC and alcohol use in victims of MVC, related to marijuana legalization. The change in incidence of THC detection (percentage) over the time period where data were available are as follows: Arizona 9.5% (0.4 to 9.9), California 5.4% (20.8 to 26.2), Ohio 5.9% (6.7 to 12.6), Oregon 3% (3.0 to 6.0), New Jersey 2.3% (2.7 to 5.0), and Texas 15.3% (3.0 to 18.3). Alcohol use did not change over time in most states. There did not appear to be a relationship between the legalization of marijuana and the likelihood of finding THC in patients admitted after MVC. In fact, in Texas, where marijuana remains illegal, there was the largest change in detection of THC. There was no apparent increase in the incidence of driving under the influence of marijuana after legalization. In addition, the changes in marijuana legislation did not appear to impact alcohol use.

PROTOCOL: The effects of cannabis liberalization laws on health, safety, and socioeconomic outcomes: An evidence and gap map.

PROTOCOL: The effects of cannabis liberalization laws on health, safety, and socioeconomic outcomes: An evidence and gap map.

How State Reforms Have Mellowed Federal Enforcement of Marijuana Prohibition

Modern state medical marijuana laws date back to 1996, when Californians approved the first statewide medical marijuana legalization law via ballot measure; Colorado and Washington voters passed the first ballot initiatives legalizing marijuana for adult use in 2012. By summer 2021, a total of 36 states and 4 U.S. territories had legalized the medical use of marijuana and 18 states, two territories and the District of Columbia had legalized adult use of marijuana. Over this quarter century of state reforms, blanket federal marijuana prohibition has remained the law of the land. Indeed, though federal marijuana policies have long been criticized, federal prohibition has now been in place and unchanged for the last half century. But while federal marijuana law has remained static amidst state-level reforms, federal marijuana prohibition enforcement has actually changed dramatically. In fact, data from the U.S. Sentencing Commission (USSC) reveals quite remarkable changes in federal enforcement patterns since certain states began fully legalizing marijuana in 2012. This essay seeks to document and examine critically the remarkable decline in the number of federal marijuana sentences imposed over the last decade. While noting that federal sentences imposed for marijuana offenses are down 83% from 2012 to 2020, this essay will also explore how the racial composition of persons sentenced in federal court and has evolved as the caseload has declined. Notably, in 2012, the majority of persons sentenced for marijuana offenses in federal court were Hispanic (66%) followed by white (22%), Black (8%), and other races (3%). But by 2020, though the majority were still Hispanic (62%), the number of persons sentenced for marijuana who were Black had doubled to 18% and white offenders were down to 15% with other races at 5%. These data suggest that whites are benefiting relatively more from fewer federal prosecutions. Reports from the Drug Enforcement Administration indicate that marijuana seizures at the southern US border have dwindled as states have legalized adult use and medicinal use of marijuana, and the reduced trafficking over the southern border likely largely explain the vastly reduced number of federal prosecutions of marijuana offenses. Nonetheless, though still shrinking in relative size, there were still more than one thousand people (and mostly people of color) sentenced in federal court for marijuana trafficking in fiscal year 2020 and over 100 million dollars was committed to the incarceration of these defendants for activities not dissimilar from corporate activity in states in which marijuana has been legalized for various purposes. This essay will reflect upon how state legal reforms have mellowed (but certainly not ended) federal enforcement.

Recreational Marijuana Laws and the Use of Opioids: Evidence from Nsduh Microdata

Recent studies have concluded that state laws legalizing medical marijuana can reduce deaths from opioid overdoses. Using data from the National Survey on Drug Use and Health, a survey uniquely suited to assessing drug misuse, we examine the relationship between recreational marijuana laws (RMLs) and the use of opioids. Standard difference-in-differences (DD) regression estimates indicate that RMLs do not affect the likelihood of misusing prescription pain relievers such as OxyContin, Percocet, and Vicodin. Although DD regression estimates provide evidence that state laws legalizing recreational marijuana can reduce the frequency of misusing prescription pain relievers, event-study estimates are noisy and suggest that any effect on the frequency of misuse is likely transitory.

Targeted Marijuana Law Enforcement in Los Angeles, 1914-1950

Marijuana was illegal to possess or sell in California for 103 years. The state first banned it in 1913, grouping it with opiates and cocaine on a list of prohibited vice drugs adopted six years earlier, meaning that it was subject to the same penalties as these other, far more dangerous, drugs until 1961. Initially framed as a “Mexican” drug, marijuana prohibition enforcement began on the periphery of Los Angeles in older Latino neighborhoods as well as in agricultural outposts where immigrants lived, worked, and gardened. Later this policing turned toward the city center, targeting the segregated section of Central Avenue with its jazz musicians and its multiracial nightlife, as well as actors and musicians in nearby Hollywood. By 1950, Los Angeles-area police were arresting more people for the possession or sale of marijuana than for heroin, other opiates, and cocaine combined. Mexican, Mexican American, and Black citizens were the targets of this enforcement in sharp disproportion to their presence there.

Does Marijuana Legalization Affect Work Capacity? Evidence from Workers’ Compensation Benefits

We study the effect of state recreational marijuana laws (RMLs) on workers’ compensation (WC) benefit receipt among adults 40-62 years. We find that WC receipt declines in response to RML adoption both in terms of the propensity to receive benefits and benefit amount. We estimate complementary declines in non-traumatic workplace injury rates and the incidence of work-limiting disabilities. We offer evidence that the primary driver of these reductions is an improvement in work capacity, likely due to access to an additional form of pain management therapy. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Fair Lending for Cannabis Banking Justice

This Comment offers a fair lending solution to promote racial equity in cannabis banking reform: amend the Equal Credit Opportunity Act to ensure individuals previously arrested, charged, or convicted for selling, cultivating, or possessing marijuana will not therefore be precluded from loans to start legal cannabis businesses. Given disparities in the criminal enforcement of marijuana laws, this amendment would provide racial justice benefits, while also encouraging entrepreneurship. As a market-based social justice effort, this amendment offers a bipartisan approach to one of the most vexing and contentious issues in marijuana banking reform. Part II of this Comment briefly surveys the federal statutes that have led to an under-banked cannabis industry and discusses the costs of cash for marijuana businesses. It then examines prior reforms proposed by academics, executive-branch officials, and legislators. Part III explores the racial equity concerns that these proposals fail to address, while Part IV offers a fair lending approach for justice in marijuana banking reform.

Direct democracy, policy diffusion, and medicalized marijuana

AbstractVirtually all studies of policy diffusion are based on statutory enactments by state legislatures. But a substantial number of medicalized marijuana laws were initiated through citizen initiatives and ratified by referenda (I&R). This case study suggests that the diffusion of laws adopted by I&R requires two modifications to the conventional model of policy diffusion. First, early policy adoptions must occur through direct democracy so that horizontal diffusion results when those past adoptions by the I&R process lead to future adoptions. Second, the necessity of bypassing institutions of representative government must be operationalized as an interaction between the availability of direct democracy and the precise political variable that blocks legislative enactments.

Is Recreational Marijuana a Gateway to Harder Drug Use and Crime?

Recreational marijuana laws (RMLs), which legalize the possession of small quantities of marijuana for recreational use, have been adopted by 18 states and the District of Columbia. Opponents argue that RML-induced increases in marijuana consumption will serve as a “gateway” to harder drug use and crime. Using data covering the period 2000-2019 from a variety of national sources (the National Survey of Drug Use and Health, the Uniform Crime Reports, the National Vital Statistics System, and the Treatment Episode Data Set) this study is the first to comprehensively examine the effects of legalizing recreational marijuana on hard drug use, arrests, drug overdose deaths, suicides, and treatment admissions. Our analyses show that RMLs increase adult marijuana use and reduce drug-related arrests over an average post-legalization window of three to four years. There is little evidence to suggest that RML-induced increases in marijuana consumption encourage the use of harder substances or violent criminal activity, and some evidence that RMLs may aid in reducing opioid-related mortality.

The effects of medical marijuana laws on birth outcomes: Evidence from early adopting U.S. states

This paper examines the effects of state-level medical marijuana laws (MMLs) in the U.S. on birth outcomes, including birth weight, length of gestation, and Apgar scores. Using individual-level natality data from the National Center for Health Statistics from 1990 to 2013, we take advantage of the geographic and temporal variation in the implementation of MMLs in a difference-in-differences estimation framework with state and year fixed effects and state-specific time trends. Overall, we find that MMLs have no impact on gestation period or Apgar scores. While MMLs lead to a statistically significant increase in birth weight by 4.4 g (0.13%), this effect is practically small. Furthermore, we find little variation in the effects of MMLs on birth outcomes across different socioeconomic subgroups and observe no lagged negative effects of MMLs on birth outcomes of children born in the MML states in the years following the legalization of medical marijuana.

Impact of state-level cannabis legalization on poly use of alcohol and cannabis in the United States, 2004–2017

BackgroundCannabis policy has shifted toward legalization in many parts of the United States (US). While attention has been focused on whether legalization will lead to changes in cannabis use, it is conceivable that legalization will also affect use of substances that individuals frequently use with cannabis. This study assessed whether cannabis legalization impacted the prevalence of poly use of cannabis and alcohol from 2004 to 2017 and estimated the prevalence of cannabis and alcohol poly use in 2017. MethodsPublic and restricted-use data from the US 2004–2017 National Survey on Drug Use and Health were analyzed. Data on past-month cannabis and alcohol use were assessed each year. Cannabis legalization was determined by the presence or absence of medical marijuana laws (MML) and recreational marijuana laws (RML) in each state. Difference-in-difference approach was used to estimate the association of MML and RML on cannabis and alcohol use overall and by sociodemographic subgroups (e.g., age, income, education). ResultsBetween 2004 and 2017, poly use of cannabis and alcohol increased while alcohol-only use decreased. MML were associated with increases in poly use only among adults over age 50 and among those with higher annual incomes and higher education, while RML were associated with increases in poly use broadly among adults across sociodemographic groups. ConclusionsLegalization of cannabis was associated with increases in cannabis-alcohol poly use in the US. RML were associated with increases across demographics, while the impact of MML was more limited to certain sociodemographic groups.

Medical Marijuana Laws, Marijuana Use, and Opioid-Related Outcomes among Women in the United States.

In the context of the opioid epidemic, a limited but growing body of literature has found state medical marijuana laws (MMLs) to be associated with lower levels of opioid prescribing. However, robust evidence linking state MMLs with individual-level opioid-related outcomes is lacking, particularly among women. This finding is especially true for pregnant and parenting women, who have been disproportionately affected by the opioid crisis. Using data drawn from the 2002-2014 National Survey on Drug Use and Heath, the study uses a difference-in-differences estimation strategy to compare opioid-related outcomes (opioid misuse initiation, opioid misuse in the past month and past year, and opioid use disorder) among all women, pregnant women, and parenting women in states with and without MMLs (before and after implementation). The study also investigates the impact of MMLs on marijuana use and marijuana use disorder. The findings indicate that MMLs were not associated with opioid misuse, opioid misuse initiation, or opioid use disorder among all women, pregnant women, and parenting women. These laws were, however, positively correlated with marijuana use and marijuana use disorder among all women and women with children. In addition, MMLs were associated with an increase in the frequency of opioid misuse for pregnant women and a decrease in the frequency of opioid misuse for parenting women. This finding suggests that, although medical marijuana may be viewed by some as a substitute for opioid analgesics, MMLs may not be an effective policy tool to tackle the opioid epidemic among women, especially pregnant and parenting women.

Impact of recreational marijuana legalization on crime: Evidence from Oregon

The legalization of recreational marijuana is a pivotal policy change, and its social consequences remain largely unknown. Central to the public concern is its impact on crime, about which competing views exist and empirical studies have yielded mixed results. Based on Uniform (UCR) data from 2007 to 2017, this study used Difference in Differences (DID) analysis to examine the impact of recreational marijuana legalization on the rates of a variety of serious crimes in Oregon, which passed its recreational marijuana law (RML) in late 2014. Results provide some evidence demonstrating a crime-exacerbating effect of recreational marijuana legalization, as reflected by substantial increases in the rates of multiple types of serious crimes as measured by the UCR in Oregon relative to non-legalized states following legalization, including property and violent crime overall, as well as other crimes such as burglary, motor vehicle theft, larceny, and aggravated assault.

Cannabis Is Risky During Pregnancy

Consistent with the national liberalization of marijuana laws, cannabis use by pregnant women doubled from 2002 to 2017. To assess the risks of this

Recreational marijuana laws and junk food consumption

We use retail scanner data on purchases of high calorie food to study the causal relationship between recreational marijuana laws (RMLs) and consumption of high calorie food. To do this we exploit differences in the timing of introduction of recreational marijuana laws among states and find that they are complements. Specifically, in counties located in RML states monthly sales of high calorie food increased by 3.2 percent when measured by sales and 4.5 percent when measured by volume when using our preferred identification strategy. Results are robust to including placebo effective dates for RMLs in treated states and products as well as when using Synthetic Control Methods as an alternative methodology.

Cannabis and Small Business: Issues to Consider Regarding Organizational Behavior and Workplace Changes

Thirty-three states have legalized some form of cannabis in the USA, including 11 states with expansive laws legalizing recreational marijuana. These new legislative changes pose challenges for small businesses from an organizational behavior perspective. A survey of 17 small businesses was conducted to examine current challenges small businesses face regarding the new cannabis using workforce. The paper examines challenges, along with current marijuana laws affecting small business today. Recommendations are provided regarding necessary company drug policy changes, and workforce issues arising from the legalization of marijuana. Descriptive statistics and a thorough discussion are provided.

To CBD or not to CBD?: What pharmacists need to know

To CBD or not to CBD?: What pharmacists need to know

State Medical Marijuana Laws and Associated Marijuana Use, Attitudes, and Perceived Social Norms among Adolescents in the U.S

ABSTRACT Statewide medical marijuana laws (MMLs) in the U.S. may be associated with adolescent marijuana use behavior, attitudes toward marijuana use, and social norms. This study used data from the National Study on Drug Use and Health (2013–2016) to examine the associations of state MML with marijuana use, use frequency, and attitudes and perceived peer and parental social norms toward using marijuana. Propensity-score matching was used to reduce selection bias between states with and without MML (matched N = 50,000). Results showed that adolescents residing in states with MML had higher odds of using marijuana in the past month and past year (OR = 1.45 and 1.49; ps < .001), higher marijuana use frequencies in the past month (β = 0.12, p < .001), relatively more neutral attitudes toward marijuana use (β = − 0.06, p < .001), and weaker perception of peer and parental disapproval of marijuana use (β = − 0.04 and −0.02, ps < .001). Our findings suggested that for the states that have implemented MML, special efforts should be strengthened to prevent and reduce adolescent marijuana use. For the states that have not yet implemented MML, the associations between MML and adolescent marijuana use attitudes and perceived norms should be taken into account when legislating medical marijuana and designing prevention and intervention efforts.

State medical marijuana laws, cannabis use and cannabis use disorder among adults with elevated psychological distress

BackgroundCannabis use and cannabis use disorder are more prevalent in U.S. states with medical marijuana laws (MMLs), as well as among individuals with elevated psychological distress. We investigated whether adults with moderate and serious psychological distress experienced greater levels of cannabis use and/or disorder in states with MMLs compared to states without MMLs. MethodsNational Survey of Drug Use and Health data (2013–2017) were used to compare past-month cannabis use, daily cannabis use, and cannabis use disorder prevalence among adults with moderate and serious psychological distress in states with versus without MMLs. We executed pooled multivariable logistic regression analyses to test main effects of distress, MMLs and their interaction, after adjustment. ResultsCompared to states without MMLs, states with MMLs had higher adjusted prevalence of past-month use (11.1 % vs. 6.8 %), daily use (4.0 % vs. 2.2 %), and disorder (1.7 % vs. 1.2 %). Adults with moderate and serious psychological distress had greater adjusted odds of any use (AORs of 1.72 and 2.22, respectively) and of disorder (AORs of 2.17 and 2.94, respectively), compared to those with no/mild distress. We did not find evidence of an interaction between MMLs and distress category for any outcome. ConclusionsAssociations between elevated distress and cannabis use patterns are no greater in states with MML. However, cannabis use is more prevalent in MML states. Thus, higher base rates of cannabis use and disorder among adults with elevated distress are proportionally magnified in these states.