Passage Of Medical Marijuana Laws Research Articles

What We Still Need to Know About the Impacts of Medical Marijuana Laws in the United States?

Past-month marijuana use among adolescents does not increase after the passage of medical marijuana laws in the U.S. It is crucial for future research to explore causal mechanisms affecting different types of marijuana users to bring a deeper understanding of behavioral responses to marijuana polices.

Sex, Drugs, and Baby Booms: Can Behavior Overcome Biology?

We study the behavioral changes due to marijuana consumption on fertility and its key mechanisms, as opposed to physiological changes. We can employ several large proprietary data sets, including the 1997 National Longitudinal Survey of Youth, Nielsen Retail Scanner database, as well as the Vital Statistics Natality files and apply a differences-in-differences approach by exploiting the timing of the introduction of medical marijuana laws among states. We first replicate the earlier literature by showing that marijuana use increases after the passage of medical marijuana laws. Our novel results reveal that birth rates increased after the passage of a law corresponding to increased frequency of sexual intercourse, decreased purchase of condoms and suggestive evidence on decreased condom use during sex. More sex and less contraceptive use may be attributed to behavioral responses such as increased attention to the immediate hedonic effects of sexual contact, delayed discounting and ignoring costs associated with risky sex. These findings are consistent with a large observational literature linking marijuana use with increased sexual activity and multiple partners. Our findings are robust to a broad set of tests.

Psychiatrists Cross Borders for Collaborative Learning

Back to table of contents Previous article Next article International NewsFull AccessPsychiatrists Cross Borders for Collaborative LearningAaron LevinAaron LevinSearch for more papers by this authorPublished Online:29 Aug 2017https://doi.org/10.1176/appi.pn.2017.8a1AbstractSharing knowledge and developing collegial friendships know no boundaries.Some people want to build walls along the border between the United States and Mexico, while other people want to build bridges and roads to link them closer together.Transnational cooperation was evident at a joint conference convened by Mexican and U.S. psychiatric associations and held on both sides of the border.A few weeks after APA’s 2017 Annual Meeting in San Diego, members of the San Diego Psychiatric Society met with their counterparts from Mexico. Sessions were held in both San Diego and Tijuana, just a short drive away. The theme was “Psychiatry Without Borders” and featured presenters from both Mexico and the United States, said Bernardo Ng, M.D., chair of APA’s Council on International Psychiatry and vice president of La Asociación Psiquiátrica Mexicana (APM). Former APA President Michelle Riba, M.D., of the University of Michigan, offered the opening remarks in Tijuana, while Enrique Chavez, M.D., the president of the APM, closed the event with a talk in San Diego.The collaborative meeting was conceived by Ng, who practices at Sun Valley Behavioral Health in Imperial, Calif., about 100 miles east of San Diego, near the Mexican border, and Steve Koh, M.D., M.P.H., M.B.A., a professor at the University of California, San Diego, and former president of the San Diego Psychiatric Society. One benefit of the program: all attendees could receive CME credits from their respective societies.“For the first time, we had a meeting that was held concurrently in English and Spanish, where psychiatrists and researchers from both countries attended and presented lectures and symposia,” said Ng.For instance, a symposium on neuromodulation was presented by two experts on ECT, Maria Lapid, M.D., of the Mayo Clinic and Sergio Galvan, M.D., of Mexico’s Hospital Angeles. The segment on transcranial magnetic stimulation was delivered by Simon Kung, M.D., of Mayo and two psychiatrists from the Clinic STIM in Guadalajara, Mexico, Thelma Sanchez, M.D., and Marisela Duran, M.D. A symposium on eating disorders matched Walter Kaye, M.D., of the University of California, San Diego, with Eva Trujillo, M.D., of Volver a Empezar in Mexico. “We are also trying to coordinate training opportunities between U.S. and Mexican institutions to permit rotations in both directions,” said Ng.Drugs—legal and illegal—present questions for both psychiatric societies. Americans often head south to buy drugs, including antipsychotics, which are available in Mexico without prescription. That raises questions about monitoring patients once they return home, said Riba. Meanwhile, the passage of medical marijuana laws in California has resulted in increased smuggling of the weed into Mexico, a reversal of the historical norm, said Ng.The border region extends about 25 miles on either side of the formal boundary and has a very mixed culture, said Ng. The area is so used to free exchange of visitors that it has more in common within the region than with the rest of each country.“If people move elsewhere, it’s like they’re going to another country,” said Ng. “I get one new patient a month who is a college student returning home with psychosis or depression because of culture shock.”Even in a moment of political distancing, he said, commerce, collaboration, and scientific exchange will continue, he said. “We were able to do real-time comparisons in both countries, and we found that there were more similarities than differences. This connection is not going to stop.” ■ ISSUES NewArchived

State-level medical marijuana laws, marijuana use and perceived availability of marijuana among the general U.S. population

BackgroundLittle is known on how perceived availability of marijuana is associated with medical marijuana laws. We examined the relationship between medical marijuana laws (MML) and the prevalence of past-month marijuana use, with perceived availability of marijuana. MethodsData were from respondents included in the National Survey of Drug Use and Health restricted use data portal 2004–2013. Multilevel logistic regression of individual-level data was used to test differences between MML and non-MML states and changes in prevalence of past-month marijuana use and perceived availability from before to after passage of MML among adolescents, young adults and older adults controlling for demographics. ResultsAmong adults 26+, past-month prevalence of marijuana use increased from 5.87% to 7.15% after MML passage (Adjusted Odds Ratio (AOR): 1.24 [1.16–1.31]), but no change in prevalence of use was found for 12–17 or 18–25 year-olds. Perceived availability of marijuana increased after MML was enacted among those 26+ but not in younger groups. Among all age groups, prevalence of marijuana use and perception of it being easily available was higher in states that would eventually pass MML by 2013 compared to those that had not. Perceived availability was significantly associated with increased risk of past-month marijuana use in all age groups. ConclusionEvidence suggests perceived availability as a driver of change in use of marijuana due to MML. To date, this has only occurred in adults 26+ and different scenarios that could explain this change need to be further explored.

How does state marijuana policy affect US youth? Medical marijuana laws, marijuana use and perceived harmfulness: 1991-2014.

To test, among US students: (1) whether perceived harmfulness of marijuana has changed over time, (2) whether perceived harmfulness of marijuana changed post-passage of state medical marijuana laws (MML) compared with pre-passage; and (3) whether perceived harmfulness of marijuana statistically mediates and/or modifies the relation between MML and marijuana use as a function of grade level. Cross-sectional nationally representative surveys of US students, conducted annually, 1991-2014, in the Monitoring the Future study. Surveys conducted in schools in all coterminous states; 21 states passed MML between 1996 and 2014. The sample included 1 134 734 adolescents in 8th, 10th and 12th grades. State passage of MML; perceived harmfulness of marijuana use (perceiving great or moderate risk to health from smoking marijuana occasionally versus slight or no risk); and marijuana use (prior 30days). Data were analyzed using time-varying multi-level regression modeling. The perceived harmfulness of marijuana has decreased significantly since 1991 (from an estimated 84.0% in 1991 to 53.8% in 2014, P<0.01) and, across time, perceived harmfulness was lower in states that passed MML [odds ratio (OR)=0.86, 95% confidence interval (CI)=0.75-0.97]. In states with MML, perceived harmfulness of marijuana increased among 8th graders after MML passage (OR=1.21, 95% CI=1.08-1.36), while marijuana use decreased (OR=0.81, 95% CI=0.72-0.92). Results were null for other grades, and for all grades combined. Increases in perceived harmfulness among 8th graders after MML passage was associated with ~33% of the decrease in use. When adolescents were stratified by perceived harmfulness, use in 8th graders decreased to a greater extent among those who perceived marijuana as harmful. While perceived harmfulness of marijuana use appears to be decreasing nationally among adolescents in the United States, the passage of medical marijuana laws (MML) is associated with increases in perceived harmfulness among young adolescents and marijuana use has decreased among those who perceive marijuana to be harmful after passage of MML.

Prevalence of marijuana use does not differentially increase among youth after states pass medical marijuana laws: Commentary on and reanalysis of US National Survey on Drug Use in Households data 2002–2011

There is considerable interest in the effects of medical marijuana laws (MML) on marijuana use in the USA, particularly among youth. The article by Stolzenberg et al. (2015) “The effect of medical cannabis laws on juvenile cannabis use” concludes that “implementation of medical cannabis laws increase juvenile cannabis use”. This result is opposite to the findings of other studies that analysed the same US National Survey on Drug Use in Households data as well as opposite to studies analysing other national data which show no increase or even a decrease in youth marijuana use after the passage of MML. We provide a replication of the Stolzenberg et al. results and demonstrate how the comparison they are making is actually driven by differences between states with and without MML rather than being driven by pre and post-MML changes within states. We show that Stolzenberg et al. do not properly control for the fact that states that pass MML during 2002–2011 tend to already have higher past-month marijuana use before passing the MML in the first place. We further show that when within-state changes are properly considered and pre-MML prevalence is properly controlled, there is no evidence of a differential increase in past-month marijuana use in youth that can be attributed to state MML.

Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: results from annual, repeated cross-sectional surveys

Adolescent use of marijuana is associated with adverse later effects, so the identification of factors underlying adolescent use is of substantial public health importance. The relationship between US state laws that permit marijuana for medical purposes and adolescent marijuana use has been controversial. Such laws could convey a message about marijuana acceptability that increases its use soon after passage, even if implementation is delayed or the law narrowly restricts its use. We used 24 years of national data from the USA to examine the relationship between state medical marijuana laws and adolescent use of marijuana. Using a multistage, random-sampling design with replacement, the Monitoring the Future study conducts annual national surveys of 8th, 10th, and 12th-grade students (modal ages 13-14, 15-16, and 17-18 years, respectively), in around 400 schools per year. Students complete self-administered questionnaires that include questions on marijuana use. We analysed data from 1 098 270 adolescents surveyed between 1991 and 2014. The primary outcome of this analysis was any marijuana use in the previous 30 days. We used multilevel regression modelling with adolescents nested within states to examine two questions. The first was whether marijuana use was higher overall in states that ever passed a medical marijuana law up to 2014. The second was whether the risk of marijuana use changed after passage of medical marijuana laws. Control covariates included individual, school, and state-level characteristics. Marijuana use was more prevalent in states that passed a medical marijuana law any time up to 2014 than in other states (adjusted prevalence 15·87% vs 13·27%; adjusted odds ratio [OR] 1·27, 95% CI 1·07-1·51; p=0·0057). However, the risk of marijuana use in states before passing medical marijuana laws did not differ significantly from the risk after medical marijuana laws were passed (adjusted prevalence 16·25% vs 15·45%; adjusted OR 0·92, 95% CI 0·82-1·04; p=0·185). Results were generally robust across sensitivity analyses, including redefining marijuana use as any use in the previous year or frequency of use, and reanalysing medical marijuana laws for delayed effects or for variation in provisions for dispensaries. Our findings, consistent with previous evidence, suggest that passage of state medical marijuana laws does not increase adolescent use of marijuana. However, overall, adolescent use is higher in states that ever passed such a law than in other states. State-level risk factors other than medical marijuana laws could contribute to both marijuana use and the passage of medical marijuana laws, and such factors warrant investigation. US National Institute on Drug Abuse, Columbia University Mailman School of Public Health, New York State Psychiatric Institute.

The effects of medical marijuana laws on illegal marijuana use

More and more states have passed laws that allow individuals to use marijuana for medical purposes. There is an ongoing, heated policy debate over whether these laws have increased marijuana use among non-patients. In this paper, I address that question empirically by studying marijuana possession arrests in cities from 1988 to 2008. I estimate fixed effects models with city-specific time trends that can condition on unobserved heterogeneities across cities in both their levels and trends. I find that these laws increase marijuana arrests among adult males by about 15–20%. These results are further validated by findings from data on treatment admissions to rehabilitation facilities: marijuana treatments among adult males increased by 10–20% after the passage of medical marijuana laws.

Medical Marijuana Laws and Illegal Marijuana Use

More and more states have passed laws that allow individuals to use marijuana for medical purposes.There is an ongoing, heated policy debate over whether these laws have increased marijuana use amongnon-patients. In this paper, I address that question empirically by studying marijuana possession arrests incities from 1988 to 2008. I estimate fixed effects models with city-specific time trends that can conditionon unobserved heterogeneities across cities in both their levels and trends. I find that these laws increasemarijuana arrests among adult males by about 15–20%. These results are further validated by findingsfrom data on treatment admissions to rehabilitation facilities: marijuana treatments among adult malesincreased by 10–20% after the passage of medical marijuana laws.

Exploring the Impact of Medical Marijuana Laws on the Validity of Self-Reported Marijuana Use Among Juvenile Arrestees Over Time

Past studies have found that underreporting of marijuana use is particularly high. The present study extends previous research that examined the temporal validity of self-reported marijuana use among juvenile arrestees. Furthermore, the present study explores whether the passage of medical marijuana laws in some states have affected the validity of self-reported marijuana use among juvenile arrestees. Using existing juvenile offender interview and urinalysis data from the Arrestee Drug Abuse Monitoring Program (ADAM) for the years 1998 to 2002, we find that the validity of self-reported marijuana use was low, but quite stable, over time even after the threshold for a positive test was changed. However, study sites in states that had passed medical marijuana laws had significantly higher validity levels than states that had not, suggesting that the passage of medical marijuana laws may affect validity of self-reported marijuana use.

Medical marijuana: a survey of teenagers and their parents.

Parents and their teenage children were questioned about medical marijuana and whether they believed that passage of medical marijuana laws in their states would increase teenage use of marijuana for non-medical purposes. A 24-question written survey was distributed separately to teenager/parent pairs who visited 1 of 2 suburban general pediatric offices located in Vienna, Virginia or Mason, Ohio. Completed surveys were collected from 393 parent-teen pairs. Only 13% of the teenagers admitted to ever smoking marijuana while 6% admitted smoking it in the past 30 days. There was good agreement between parents and teens (81% of parents and 76% of their teenagers who responded to the survey) that regular use of marijuana causes harm to many or most users, not just "potheads." Although there was close agreement in the range of opinions about medical marijuana (i.e., from liberal use to no use) by parents as a group and the teens as a group, agreement between the answers of parents matched with their own children was poor based on K-coefficient analysis (K = 0.20). Twenty-eight percent of the parent group and 55% of the teenagers believed that passage of state laws for medical marijuana would make it easier for teens to smoke marijuana for medical purposes.