Cited by 305Cannabis and Cannabinoid ResearchSubstance Abuse Treatment and OutcomesOpioid Use Disorder Treatment

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Early evidence of the impact of cannabis legalization on cannabis use, cannabis use disorder, and the use of other substances: Findings from state policy evaluations

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Smart, Rosanna, Pacula, Rosalie Liccardo·2019·The American Journal of Drug and Alcohol Abuse

DOI 10.1080/00952990.2019.1669626PMC PMC6934162

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Abstract

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.

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Authors: Smart, R., & Pacula, R. L.
Affiliations: RAND Corporation (US)
University of Southern California (US)
Corresponding author: Smart, Rosanna
ORCID: Smart, Rosanna
Pacula, Rosalie Liccardo
Venue: The American Journal of Drug and Alcohol Abuse
Publisher: Informa UK Limited
Published: 2019-10-11
Volume: 45
Issue: 6
Pages: 644-663
ISSN: 0095-2990 (ISSN-L)
1097-9891
DOI: 10.1080/00952990.2019.1669626
PMC: PMC6934162
OpenAlex: W2980236327
Cited by: 305
References: 116
Citations by year: 2026: 34 · 2025: 36 · 2024: 44 · 2023: 48 · 2022: 62 · 2021: 45 · 2020: 34 · 2019: 2
FWCI: 4.59
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: The American Journal of Drug and Alcohol Abuse (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (2t32hd007545-21)
National Institute on Alcohol Abuse and Alcoholism (R01AA026268)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32-HD007545, P2CHD041022)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords: cannabis legalization, medical cannabis laws, cannabis use, cannabis use disorder, substance use, alcohol consumption, opioid use, tobacco use, adolescent cannabis use
MeSH terms: Marijuana Use, Adolescent, Adult, Age Factors, Alcohol Drinking, Marijuana Abuse, Humans, Legislation, Drug, Opioid-Related Disorders, Public Policy, Substance-Related Disorders, Medical Marijuana, Tobacco Use

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Early evidence of the impact of cannabis legalization on cannabis use, cannabis use disorder, and the use of other substances: Findings from state policy evaluations

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