Using Existing Data to Advance Knowledge About Adolescent and Emerging Adult Marijuana Use in the Context of Changes in Marijuana Policies (original) (raw)
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Impact of Medical Marijuana Laws on State-Level Marijuana Use by Age and Gender, 2004-2013
Prevention science : the official journal of the Society for Prevention Research, 2017
In states that have passed medical marijuana laws (MMLs), marijuana use (MU) increased after MML enactment among people ages 26 and older, but not among ages 12-25. We examined whether the age-specific impact of MMLs on MU varied by gender. Data were obtained from the 2004-2013 restricted-use National Survey on Drug Use and Health, aggregated at the state level. The exposure was a time-varying indicator of state-level MML (0 = No Law, 1 = Before Law, 2 = After Law). Outcomes included past-month MU prevalence, daily MU prevalence among past-year users (i.e., 300+ days/year), and past-year marijuana use disorder (MUD) prevalence. Linear models tested the state-level MML effect on outcomes by age (12-17, 18-25, 26+) and gender. Models included a state-level random intercept and controlled for time- and state-level covariates. Past-month MU did not increase after enactment of MML in men or women ages 12-25. Among people 26+, past-month MU increased for men from 7.0% before to 8.7% after...
The Impact of State Medical Marijuana Legislation on Adolescent Marijuana Use
A B S T R A C T Purpose: The state-level legalization of medical marijuana has raised concerns about increased accessibility and appeal of the drug to youth. The objective of this study was to assess the impact of medical marijuana legalization across the United States by comparing trends in adolescent marijuana use between states with and without legalization of medical marijuana. Methods: The study utilized data from the Youth Risk Behavioral Surveillance Survey between 1991 and 2011. States with a medical marijuana law for which at least two cycles of Youth Risk Behavioral Surveillance data were available before and after the implementation of the law were selected for analysis. Each of these states was paired with a state in geographic proximity that had not implemented the law. Chi-squared analysis was used to compare characteristics between states with and without medical marijuana use policies. A difference-indifference regression was performed to control for time-invariant factors relating to drug use in each state, isolating the policy effect, and then calculated the marginal probabilities of policy change on the binary dependent variable. Results: The estimation sample was 11,703,100 students. Across years and states, past-month marijuana use was common (20.9%, 95% confidence interval 20.3e21.4). There were no statistically significant differences in marijuana use before and after policy change for any state pairing. In the regression analysis, we did not find an overall increased probability of marijuana use related to the policy change (marginal probability .007, 95% confidence interval À.007, .02). Conclusions: This study did not find increases in adolescent marijuana use related to legalization of medical marijuana.
The International journal on drug policy, 2016
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 a...
Substance abuse, 2017
To assess associations between enactment of state medical marijuana laws (MMLs), MML restrictiveness, and past-30-day youth alcohol use overall, and in relation to marijuana use. This quasi-experimental difference-in-difference designed study used state-level Youth Risk Behavior Survey data of 9th-12th grade students in 45 states from 1991-2011 (N = 715,014). We conducted bivariate (unadjusted) and multivariable (adjusted for state, year, individual characteristics) logistic regression analyses to examine the effect of MML enactment (yes/no) and less restrictive vs. more restrictive MMLs on five varying measures of past 30-day alcohol use (i.e., any use or binge) and alcohol and marijuana use behaviors. In the final adjusted analyses, MML enactment was associated with lower odds of adolescent past 30-day (1) alcohol use (OR = 0.92, [0.87, 0.97], p < .01) and (2) use of both alcohol and marijuana (OR = 0.93, [0.87, 0.99], p < .05). States with less restrictive MMLs had lower od...
Retrospective cross-sectional analysis of the changes in marijuana use in the USA, 2005–2018
BMJ Open, 2020
ObjectivesUnderstanding trends of marijuana use in the USA throughout a period of particularly high adoption of marijuana-legalisation, and understanding demographics most at risk of use, is important in evolving healthcare policy and intervention. This study analyses the demographic-specific changes in the prevalence of marijuana use in the USA between 2005 and 2018.Design, setting and participantsA 14-year retrospective cross-sectional analysis of the National Health and Nutrition Examination Survey database, a publicly available biennially collected national survey, weighted to represent the entire US population. A total of 35 212 adults between 18 and 69 years old participated in the seven-cycles of surveys analysed (2005–2018).Primary outcome measuredLifetime use, first use before 18 years old, and past-year use of marijuana.ResultsThe majority of adults reported ever using marijuana. While the overall prevalence of lifetime marijuana use remained stable (p=0.53), past-year use...
US Adult Illicit Cannabis Use, Cannabis Use Disorder, and Medical Marijuana Laws
JAMA Psychiatry, 2017
IMPORTANCE Over the last 25 years, illicit cannabis use and cannabis use disorders have increased among US adults, and 28 states have passed medical marijuana laws (MML). Little is known about MML and adult illicit cannabis use or cannabis use disorders considered over time. OBJECTIVE To present national data on state MML and degree of change in the prevalence of cannabis use and disorders. DESIGN, PARTICIPANTS, AND SETTING Differences in the degree of change between those living in MML states and other states were examined using 3 cross-sectional US adult surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES; 1991-1992), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002), and the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013). Early-MML states passed MML between NLAES and NESARC ("earlier period"). Late-MML states passed MML between NESARC and NESARC-III ("later period"). MAIN OUTCOMES AND MEASURES Past-year illicit cannabis use and DSM-IV cannabis use disorder.
DOSE OF REALITY: POST MARIJUANA LEGALIZATION IMPACT IN MARIJUANA LEGAL STATES.
Marijuana is one of the most abused drugs in the United States. In recent years, it has become one of the most discussed topics with massive media coverage. The principal reason for its nationwide coverage is a constant debate over its legalization. At present, nine states and Washington, D.C. have legalized recreational marijuana. It has been around six years since marijuana was legalized in Colorado and Washington. Also, medical marijuana is legal in thirty states. However, there is a big divide between people?s beliefs on the matter of marijuana legalization. Proponents of marijuana legalization argue that it would allow people to use a relatively safe substance without the threat of arrest, raise new revenue from marijuana sales, and redirect resources to fund new programs. Opponents of marijuana legalization argue that it is too dangerous to use, lacks FDA approval, and has adverse health consequences, and increased societal costs. The goal of this study is to offer an up-to-date overview of the existing information available on the impact of marijuana legalization on the society in marijuana-legal states. An accurate view of this subject would contribute to increased knowledge and improved awareness among people towards marijuana. However, the nationwide effect of legalizing marijuana remains an open question requiring further research and studies.
JAMA psychiatry, 2017
Over the last 25 years, illicit cannabis use and cannabis use disorders have increased among US adults, and 28 states have passed medical marijuana laws (MML). Little is known about MML and adult illicit cannabis use or cannabis use disorders considered over time. To present national data on state MML and degree of change in the prevalence of cannabis use and disorders. Differences in the degree of change between those living in MML states and other states were examined using 3 cross-sectional US adult surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES; 1991-1992), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002), and the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013). Early-MML states passed MML between NLAES and NESARC ("earlier period"). Late-MML states passed MML between NESARC and NESARC-III ("later period"). Past-year illicit cannabis use and DSM-IV canna...
The American Journal of Drug and Alcohol Abuse
Background: The past decade has seen unprecedented shifts in the cannabis policy environment, and the public health impacts of these changes will hinge on how they affect patterns of cannabis use and the use and harms associated with other substances. Objectives: To review existing research on how state cannabis policy impacts substance use, emphasizing studies using methods for causal inference and highlighting gaps in our understanding of policy impacts on evolving cannabis markets. Methods: Narrative review of quasi-experimental studies for how medical cannabis laws (MCLs) and recreational cannabis laws (RCLs) affect cannabis use and use disorders, as well as the use of or harms from alcohol, opioids, and tobacco. Results: Research suggests MCLs increase adult but not adolescent cannabis use, and provisions of the laws associated with less regulated supply may increase adult cannabis use disorders. These laws may reduce some opioid-related harms, while their impacts on alcohol and tobacco use remain uncertain. Research on RCLs is just emerging, but findings suggest little impact on the prevalence of adolescent cannabis use, potential increases in college student use, and unknown effects on other substance use. Conclusions: Research on how MCLs influence cannabis use has advanced our understanding of the importance of heterogeneity in policies, populations, and market dynamics, but studies of how MCLs relate to other substance use often ignore these factors. Understanding effects of cannabis laws requires greater attention to differences in short-versus long-term effects of the laws, nuances of policies and patterns of consumption, and careful consideration of appropriate control groups.