argumentative research paper marijuana legalization

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Argumentative essay marijuana legalization

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Addiction (Abingdon, England)

To examine briefly the (i) rationales for two policy proposals in the United States to make it mandatory for cigarettes to contain very low levels of nicotine and to legalize cannabis for recreational use by adults; and (ii) possible lessons that participants in each policy debate may learn from each other. We briefly describe the diverging policies towards cannabis and tobacco in the United States, explain and critically analyse their rationales and discuss possible policy lessons. Advocates of cannabis legalization have argued that prohibition has been an ineffective and expensive policy that penalizes ethnic minority users unjustly of a drug that is far less harmful than alcohol. The prohibition of traditional tobacco cigarettes has been advocated as a way to eliminate cigarette smoking. These proposals embody very different attitudes towards the harms of recreational adult drug use. Advocates of nicotine prohibition demand that alternative methods of nicotine delivery must be sh...

If caffeine and other such banalised psychoactive substances are left out of consideration, almost everywhere in Europe today cannabis is one of the 'big three'of psychoactive substances, along with alcohol and tobacco. Although the international drug control system applies continuing pressure against it, cannabis has taken on a semi-legal status in many parts of Europe, at least at the level of the user.

Anna Shahrour

Chloe Mutch

BMJ (Clinical research ed.)

John Strang

The Medical Journal of Australia

David Penington

World Medical & Health Policy

James A Swartz

Frontiers in psychiatry / Frontiers Research Foundation

Sunil Aggarwal

Healthcare Policy | Politiques de Santé

Tom Noseworthy

Rachel A Barry

Summary Points • The US states that have legalized retail marijuana are using US alcohol policies as a model for regulating retail marijuana, which prioritizes business interests over public health. • The history of major multinational corporations using aggressive marketing strategies to increase and sustain tobacco and alcohol use illustrates the risks of corporate domination of a legalized marijuana market. • To protect public health, marijuana should be treated like tobacco, not as the US treats alcohol: legal but subject to a robust demand reduction program modeled on successful evidence-based tobacco control programs. • Because marijuana is illegal in most places, jurisdictions worldwide (including other US states) considering legalization can learn from the US experience to shape regulations that prioritize public health over profits.

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The Impact of Recreational Cannabis Legalization on Cannabis Use and Associated Outcomes: A Systematic Review

Kyra n farrelly.

1 Department of Psychology, York University, Toronto, ON, Canada

2 Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare Hamilton, McMaster University, Hamilton, ON, Canada

Jeffrey D Wardell

3 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada

4 Department of Psychiatry, University of Toronto, Toronto, ON, Canada

Emma Marsden

Molly l scarfe, peter najdzionek, jasmine turna.

5 Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University & St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada

James MacKillop

6 Homewood Research Institute, Guelph, ON, Canada

Background:

Recreational cannabis legalization has become more prevalent over the past decade, increasing the need to understand its impact on downstream health-related outcomes. Although prior reviews have broadly summarized research on cannabis liberalization policies (including decriminalization and medical legalization), directed efforts are needed to synthesize the more recent research that focuses on recreational cannabis legalization specifically. Thus, the current review summarizes existing studies using longitudinal designs to evaluate impacts of recreational cannabis legalization on cannabis use and related outcomes.

A comprehensive bibliographic search strategy revealed 61 studies published from 2016 to 2022 that met criteria for inclusion. The studies were predominantly from the United States (66.2%) and primarily utilized self-report data (for cannabis use and attitudes) or administrative data (for health-related, driving, and crime outcomes).

Five main categories of outcomes were identified through the review: cannabis and other substance use, attitudes toward cannabis, health-care utilization, driving-related outcomes, and crime-related outcomes. The extant literature revealed mixed findings, including some evidence of negative consequences of legalization (such as increased young adult use, cannabis-related healthcare visits, and impaired driving) and some evidence for minimal impacts (such as little change in adolescent cannabis use rates, substance use rates, and mixed evidence for changes in cannabis-related attitudes).

Conclusions:

Overall, the existing literature reveals a number of negative consequences of legalization, although the findings are mixed and generally do not suggest large magnitude short-term impacts. The review highlights the need for more systematic investigation, particularly across a greater diversity of geographic regions.

Introduction

Cannabis is one of the most widely used substances globally, with nearly 2.5% of the world population reporting past year cannabis use. 1 Cannabis use rates are particularly high in North America. In the U.S., 45% of individuals reported ever using cannabis and 18% reported using at least once annually in 2019. 2 , 3 In Canada, approximately 21% of people reported cannabis use in the past year use in 2019. 4 In terms of cannabis use disorder (CUD), a psychiatric disorder defined by clinically significant impairment in daily life due to cannabis use, 5 ~5.1% of the U.S. population ages 12+ years met criteria in 2020, with ~13.5% of individuals ages 18 to 25 years meeting criteria. 6

Overall, rates of cannabis use have shown long-term increasing trends among several age groups in North America. 7 - 9 Moreover, research has revealed recent cannabis use increases in at risk populations, such as individuals with depression and pregnant women. 10 , 11 Parallel to increased cannabis use over time, rates of cannabis-related consequences have also increased across Canada and the U.S., including cannabis dependence and CUD, 8 , 12 crime rates (eg, increased possession charges), 8 and cannabis-impaired driving (and, lower perception of impairment and risk from cannabis use). 11 , 13 , 14 Further, cannabis use poses a risk for early-onset or use during adolescence as there is evidence that cannabis use in adolescence is linked with poorer cognitive performance, psychotic disorders, and increased risk of mood and addictive disorders. 15 With the rates of negative consequences from cannabis use increasing, particularly in North America where cannabis has become legal in many parts of the US and all of Canada, understanding the role of cannabis legalization in these changes is crucial to inform ongoing changes in cannabis policies worldwide.

The legal status of cannabis varies widely across countries and regions. Although cannabis is largely illegal at the global level, policies surrounding cannabis use are becoming steadily liberalized. Decriminalization (reduced penalties for self-use but not distribution) is more widespread worldwide, including in the Netherlands, Portugal, and parts of Australia. Medical legalization is also seen in Peru, Germany, New Zealand, the Netherlands and across many U.S. states. To date, Canada, Uruguay, and Malta are the only 3 countries to legalize recreational cannabis use at the national level. Further, individual U.S. states began legalizing recreational cannabis in 2012, with nearly half of U.S. states having legalized recreational cannabis by 2023. As national and subnational recreational legalization continues to gain support and take effect, understanding the consequences of such major regulatory changes is crucial to informing ongoing policy changes.

There are arguments both for and against recreational cannabis legalization (RCL). Common pro-legalization arguments involve increasing regulatory control over product distribution, weakening organized crime, reducing burden and inequality in the criminal justice system, and generating economic benefits such as tax revenues and commercial activity. 16 Furthermore, as cannabis obtained from illicit markets is of varying and unknown potency, 17 cannabis legalization may help better regulate the potency and quality of cannabis products. 18 On the other hand, there are anti-legalization arguments such as the possibility of legalization leading to increased use among youth and increased cannabis-impaired driving. 16 A nationally representative survey in the U.S. found that pro-legalization arguments were perceived to be more persuasive than public health anti-legalization arguments in a U.S. nationally representative survey, 19 suggesting policymaker concerns regarding RCL do not seem to hold as much weight in the general public. However, while research may be increasing surrounding the impacts of RCL, the general consensus of if RCL leads to more positive or negative consequences is unclear.

With RCL becoming more prevalent globally, the impacts it may have on a variety of health-related outcomes are of critical importance. Prevalence of cannabis use is of course a relevant issue, with many concerned that RCL will cause significant spikes in rates of cannabis use for a variety of groups, including youth. However, current studies have revealed mixed evidence in the U.S., 20 , 21 thus there is a need to synthesize the extant literature to better understand the balance of evidence and potential impacts of RCL across different samples and more diverse geographic areas. Another common question about RCL is whether it will result in changes in attitudes toward cannabis. These changes are of interest as they might forecast changes in consumption or adverse consequences. Similarly, there are concerns surrounding RCL and potential spill-over effects that may influence rates of alcohol and other substance use. 22 Thus, there remains a need to examine any changes in use of other substance use when studying effects of RCL.

Beyond changes in cannabis and other substance use and attitudes, health-related impacts of RCL are important to consider as there are links between cannabis use and adverse physical and mental health consequences (eg, respiratory and cardiovascular diseases, psychosis). 23 Additionally, emergency service utilization associated with cannabis consumption is a frequent concern associated with RCL, particularly due to the spikes in admissions following RCL in Colorado. 24 However, the rates of cannabis-related emergency service admissions more globally (eg, in legal countries like Canada and Uruguay) have not been fully integrated into summaries of the current literature. Finally, another health-related consequence of RCL is potential impacts on opioid use. While opioid-related outcomes can fall into substance use, they are considered health-related for this review as much of the discussion surrounding RCL and opioids involve cannabis substituting opioid use for medicinal reasons or using cannabis as an alternate to prescription opioids in the healthcare system. The current opioid crisis is a global public health problem with serious consequences. While there is evidence that medicinal cannabis may reduce prescription opioid use 25 and that cannabis may be a substitute for opioid use, 26 the role of recreational cannabis legalization should also be examined as the 2 forms of cannabis use are not interchangable 27 and have shown unique associations with prescription drug use. 28 Thus, there is a need to better understand how and if RCL has protective or negative consequences on opioid-related outcomes.

Due to the impairing effects of cannabis on driving abilities and the relationship with motor vehicle accidents, 29 another important question surrounding RCL is how these policy changes could result in adverse driving-related outcomes. An understanding of how RCL could influence impaired driving prevalence is needed to give insight into how much emphasis jurisdictions should put on impaired driving rates when considering RCL implementation. A final consequence of RCL that is often debated but requires a deeper understanding is how it impacts cannabis-related arrest rates. Cannabis-related arrests currently pose a significant burden on the U.S. and Canadian justice system. 30 , 31 Theoretically, RCL may ease the strain seen on the justice system and have positive trickle-down effects on criminal-related infrastructure. However, the overall implications of RCL on arrest rates is not well understood and requires a systematic evaluation. With the large number of RCL associated outcomes there remains a need to synthesize the current evidence surrounding how RCL can impact cannabis use and other relevant outcomes

Present review

Currently, no reviews have systematically evaluated how RCL is associated with cannabis-use changes across a variety of age groups as well as implications on other person- or health-related outcomes. The present review aims to fill an important gap in the literature by summarizing the burgeoning research examining a broad range of consequences of RCL across the various jurisdictions that have implemented RCL to date. Although previous reviews have considered the implications of RCL, 32 , 33 there has recently been a dramatic increase in studies in response to more recent changes in recreational cannabis use policies, requiring additional efforts to synthesize the latest research. Further, many reviews focus on specific outcomes (eg, parenting, 34 adolescent use 35 ). There remains a need to systematically summarize how RCL has impacted a variety of health-related outcomes to develop a more comprehensive understanding of the more negative and positive outcomes of RCL. While a few reviews have examined a broad range of outcomes such as cannabis use, related problems, and public health implications, 32 , 33 some reviews have been limited to studies from a single country or published in a narrow time window. 32 Thus, a broader review is necessary to examine multiple types of outcomes from studies in various geographic regions. Additionally, a substantial amount of the current literature examining the impact of RCL relies on cross-sectional designs (eg, comparing across jurisdictions with vs without recreational legalization) which severely limit any conclusions about causal associations. Thus, given its breadth, the current systematic review is more methodologically selective by including only studies with more rigorous designs (such as longitudinal cohort studies), which provide stronger evidence regarding the effects of RCL. In sum, the aim of the current review was to characterize the health-related impacts of RCL, including changes in these outcomes in either a positive or negative direction.

The review is compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 36 ). Full-text extraction was initiated immediately following article search, therefore the protocol was not registered with PROSPERO. Relevant articles on cannabis legalization were principally identified using the Boolean search terms (“cannabis” OR “marijuana” OR “THC” OR “marihuana”) AND “legalization” AND (“recreational” OR “non-medical” OR “nonmedical”) AND (“longitudinal” OR “pre-post” OR “prospective” OR “timeseries” OR “cohort”). The search was conducted using PubMed/MEDLINE, EMBASE, and PsycINFO through November 2022. Relevant studies identified through secondary means (eg, prior knowledge of a relevant publication, articles brought to the authors’ attention) were also included for screening. Titles and abstracts resulting from the initial search were screened in Covidence (Veritas Health Innovation Inc) by 2 reviewers for suitability for full-text review and final inclusion. Conflicts were discussed by both reviewers and a final decision was made by consensus. Following screening, reviewers read and extracted relevant data. To be included, an article was required to meet the following criteria: (i) an original empirical research article published in a peer-reviewed journal; (ii) written in (or available in) English; (iii) RCL serves as an independent variable; (iv) quantitative study design that clearly permitted the evaluation of the role of RCL with a more rigorous non-cross-sectional study design (eg, pre- vs post-legalization, longitudinal, cohort, interrupted time series, etc.); and (v) reports on health-related outcomes (ie, changes in consumption or attitudes, as opposed to changes in price or potency).

RCL related outcomes that were considered were those specifically involving the behavior, perceptions, and health of individuals. Population-level outcomes (eg, health-care utilization or impaired driving) were considered eligible for inclusion as they involve the impacts that legalization has on individual behavior. Thus, economic- or product-level outcomes that do not involve individual behavior (eg, cannabis prices over time, changes in cannabis strain potency) were considered out of scope. The outcome groups were not decided ahead of time and instead 5 main themes in outcomes emerged from our search and were organized into categories for ease of presentation due to the large number of studies included.

Studies that examined medicinal cannabis legalization or decriminalization without recreational legalization, and studies using exclusively a cross-sectional design were excluded as they were outside the scope of the current review. The study also excluded articles that classified RCL as the passing of legal sales rather than implementation of RCL itself as RCL is often distinct from introduction of legal sales, or commercialization. Thus, we excluded studies examining commercialization as they were outside the scope of the current review.

Characteristics of the literature

The search revealed 65 relevant articles examining RCL and related outcomes (see Figure 1 ). There were 5 main themes established: cannabis use and other substance use behaviors ( k  = 28), attitudes toward cannabis ( k  = 9), health-related outcomes ( k  = 33), driving related impacts ( k  = 6), and crime-related outcomes ( k  = 3). Studies with overlapping themes were included in all appropriate sections. Most studies (66.2%) involved a U.S. sample, 32.3% examined outcomes in Canada, and 1.5% came from Uruguay. Regarding study design, the majority (46.2%) utilized archival administrative data (ie, hospital/health information across multiple time points in one jurisdiction) followed by cohort studies (18.5%). The use of administrative data was primarily used in studies examining health-related outcomes, such as emergency department utilization. Studies examining cannabis use or attitudes over time predominantly used survey data. Finally, both driving and crime related outcome studies primarily reported findings with administrative data.

Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) study flow diagram.

Changes in cannabis and other substance use

Cannabis and other substance use changes represented the second largest number of studies, with 28 articles identified. Studies examining changes in cannabis use behaviors were divided by subpopulation (ie, adolescents, young adults, general population adults, clinical populations, and maternal use; see Table 1 ). Finally, we separately summarized studies reporting changes in concurrent use of other substances, and routes of cannabis administration.

Studies investigating the role of recreational cannabis legalization on cannabis and other substance consumption.

Author, author of article; Year, publication year of article; Location, jurisdiction article data was collected in; Date of Legalization, year legalization was enacted in jurisdiction; Sample, total N of article sample; RCL, Recreational Cannabis Legalization.

Cannabis use changes in adolescents (~12-17)

Ten studies examined changes in cannabis use among adolescents and found that changes in the rates of use were inconsistent following RCL. Gunadi et al 37 found an association between RCL and more pronounced transition from non-use to cannabis use when compared to states with no legalization and those with medical cannabis legalization ( P  ⩽ .001) combined, but not when compared to states with medical cannabis legalization only. Another study found that in states with RCL adolescents who never used cannabis but used e-cigarettes were more likely to use cannabis at follow-up than those living in states without RCL (aOR = 18.39, 95% CI: 4.25-79.68vs aOR = 5.09, 95% CI: 2.86-9.07, respectively) suggesting a risk of cannabis initiation among legal states. 38 Among adolescents reporting recent alcohol and cannabis co-use, one study found a significant increase in the frequency of past 30-day cannabis use following RCL ( b  = 0.36, SE = 0.07, P  ⩽ .001). 39 In a Canadian study using a repeated cross-sectional design as well as a longitudinal design to examine changes in cannabis use, results revealed that adolescents had increased odds of ever using cannabis in the year following RCL in the cross-sectional data ( P  = .009). 40 However, the longitudinal sample revealed no significant differences in the odds of ever use, current use, and regular use of cannabis post-legalization. There is also evidence of RCL impacts on adolescent cannabis use consequences, as a Washington study found a significant indirect effect of RCL on cannabis consequences through perceived risk as a mediator ( B  = 0.37, P  ⩽ .001). 41

On top of the above evidence, there were multiple studies examining cannabis use changes over time among adolescents in Washington and Oregon that found higher rates of cannabis use associated with cohorts examined during RCL compared to non-legal cohorts, 42 - 44 although the differences across legal cohorts were not significant in all cases. 42 Furthermore, in another study, RCL did not impact initiation of use, but for current users the RCL group had significantly greater increased rates of cannabis use compared to the pre-RCL group (RR = 1.26, 95% CI = 1.10, 1.45). 43 For the final study, cannabis use increased in the post-RCL group but patterns of use (frequency; daily vs weekly use) were similar across groups. 44 Overall, the preceding 8 studies reveal some evidence that RCL was associated with increasing rates of cannabis use in adolescent. However, 5 studies point to some inconsistent associations of RCL and cannabis use and suggest that overall relationship of RCL and adolescent cannabis as mixed.

Three studies add to these inconsistent findings and point to lack of an association between RCL and changes in cannabis use among adolescents. Two studies found no significant increase in the frequency of or prevalence of cannabis use following RCL. 41 , 45 Finally, a study examining trends of adolescent cannabis use and associations with period effects (ie, external world events that could influence use) suggests laws and regulations associated with RCL were not associated with cannabis use changes. 46 The current research reveals conflicting evidence about the role of RCL on adolescent cannabis use.

Cannabis use changes in young adults (~18-25)

Young adulthood, typically defined as ages 18 to 25 and also known as emerging adulthood, is commonly associated with decreased parental supervision, increased availability of substances, and greater substance experimentation making it a key developmental period for the onset of cannabis use. 47 Four studies examined the impact of RCL on cannabis use among young adults, 2 of which found significant associations between RCL and increased cannabis use in college students. 47 , 48 Barker and Moreno 48 found the rate of students ever using cannabis did not change. However, in those who had used cannabis prior to RCL, the proportion of students using in the past 28-days increased faster following RCL in Washington (legal-state) when compared with the rate of increase in Wisconsin (non-legal state; P  ⩽ .001). 48 Further, in college students from Oregon, rates of cannabis use increased significantly from before to after RCL ( P  = .0002). 47 Another study looked at changes in cannabis use in a sample of young adults from the U.S. who had never vaped cannabis at the time of recruitment. 49 Results revealed that cannabis use in the past year did not differ in states with or without RCL, although, those living in states with RCL did show a larger increase in rates of cannabis vaping across time, compared to those in non-RCL states. Finally, in a sample of youth from Oregon and Washington, RCL predicted a higher likelihood of past-year cannabis use ( P  = .001). 50 In contrast to the adolescent literature, studies examining cannabis use in young adult samples fairly consistently point to an association between RCL and increasing rates of cannabis use.

Cannabis use changes in general population adults

Five studies examined changes in cannabis use in adults (without further age subclassification) associated with RCL. Four of these studies suggested higher rates of cannabis use in adults for RCL jurisdictions compared to non-legal states post-RCL, or increased use following RCL. 37 , 45 , 51 , 52 Past 30-day cannabis use increased significantly 1-month post-RCL and remained elevated 6-months post-RCL (ps = 0.01) in a sample of adults from California. 51 Another study found an association between RCL and transition from non-users to cannabis users and non-users to weekly users when compared to states with no medical legalization or RCL ( P  ⩽ .001) and states with no legalization combined with those with medical cannabis legalization ( P  ⩽ .001). 37 Meanwhile, in Canada, a significant increase in prevalence of cannabis use was observed following RCL. 45 Additionally, in those reporting no cannabis use prior to RCL in Canada, there were significant increases in cannabis use frequency, quantity of cannabis used, and severity of cannabis misuse following RCL. 52 The opposite pattern was seen for those reporting cannabis use prior to RCL, with significant decreases in frequency of use, quantity, and misuse. 52 However, not all studies found RCL was associated with increased cannabis use. For instance, a repeated cross-sectional study of adult in the U.S. found no association between RCL and frequency of cannabis use. 53

A benefit of the extant literature examining general population cannabis use is that it covers a variety of jurisdictions and study designs, albeit with some heterogeneity and mixed findings. On balance, the evidence within the current literature, generally suggests an increase in cannabis use for adults in the general population following RCL with 80% of the reviewed studies supporting this conclusion.

Maternal use

Three studies examined whether rates of cannabis use during pregnancy have increased following RCL. Two studies suggested increased cannabis use during pregnancy associated with RCL. In one study urine screen-detected cannabis use during pregnancy increased from 6% to 11% following RCL in California ( P  = .05). 54 Another study in a sample of women participating in an intensive case management program for heavy alcohol and/or drug use during pregnancy, examined cannabis use among those exiting from the program before versus after RCL. Findings revealed women exiting after RCL were more likely to report using cannabis in the 30 days prior to exit compared to those pre-RCL (OR = 2.1, P  ⩽ .0001). 55 One study revealed no significant difference in cannabis or alcohol use associated with RCL in women living with HIV during pregnancy or the postpartum period. 56 Overall, the evidence from these three studies suggests there may be increases in perinatal cannabis use following RCL, but the small number of studies and unique features of the samples suggests a need for more research.

Clinical populations use

Six studies examined cannabis use in clinical populations. One study investigated use and trauma admissions for adults and pediatric patients in California. 57 Results showed an increase in adult trauma patients with THC+ urine tests from pre- to post-RCL (9.4% to 11.0%; P  = .001), but no difference for pediatric trauma patients. A study based in Colorado and Washington, found that cannabis use rates in inflammatory bowel disease patients significantly increased from 107 users to 413 ( P  ⩽ .001) pre to post-RCL. 58 A Canada-based study of women with moderate-to-severe pelvic pain found an increase in the prevalence of current cannabis use following RCL (13.3% to 21.5%; P  ⩽ .001). 59 Another Canadian study showed an increase in the prevalence of current cannabis use after RCL among cancer patients (23.1% to 29.1%; P  ⩽ .01). 60 Finally, two studies examined changes in cannabis use among individuals receiving treatment for a substance use disorder. In a sample of Canadian youth in an outpatient addictions treatment program, there was no change in the rate of cannabis use following RCL. 61 Further, in a sample of individuals receiving treatment for opioid use disorder, cannabis use was compared for those recruited 6 months before or after RCL with no significant changes in the prevalence or frequency of self-reported ( P  = .348 and P  = .896, respectively) or urine screen-detected ( P  = .087 and P  = .638, respectively) cannabis use following RCL. 62 Although these studies only represent a small number of observations, their findings do reveal associations between RCL and increasing cannabis use within some clinical samples.

Changes in polysubstance and other substance use

One study examined simultaneous cannabis and alcohol use among 7th, 9th, and 11th grade students in the U.S. 39 This study found that RCL was associated with a 6% increase in the odds of past 30-day alcohol and cannabis co-use. The association was even stronger in students with past 30-day alcohol use and heavy drinking. However, among past 30-day cannabis users, RCL was associated with a 24% reduction in co-use. This study suggests at least a modest association between RCL and concurrent cannabis and alcohol use among adolescents.

Numerous studies examined changes of alcohol and other substance use pre to post RCL. With regard to alcohol, one study from Colorado and Washington found a decrease in alcohol consumption among adolescents following RCL, 42 whereas another Washington study found RCL predicted a higher likelihood of alcohol use among youth. 50 A Canadian study also found no significant effect of RCL on rates of alcohol or illicit drug use among youth. 61 Finally, in a sample of trauma patients in California the findings around changes in substance use were mixed. 57 In adult patients, the rates of positive screens for alcohol, opiates, methamphetamine, benzodiazepine/barbiturate, and MDMA did not change following RCL, but there was an increase in positive screens for cocaine. In pediatric patients, increases were seen in positive screens for benzodiazepine/barbiturate, but positive screens for alcohol, opiates, methamphetamine, and cocaine did not change. 57 The current evidence is divided on whether RCL is associated with increased alcohol and other substance use, with 40% of studies finding an association and 60% not observing one or finding mixed results.

In the case of cigarettes, Mason et al 42 did find significant cohort effects, where the post-RCL cohort was less likely to consume cigarettes compared to the pre-RCL one (Coefficient: − 2.16, P  ⩽ .01). However, these findings were not echoed in more recent studies. Lack of an effect for cigarette use is supported by an Oregon study that found RCL was not associated with college student’s cigarette use. 47 Similarly, RCL was not significantly associated with past-year cigarette use in a sample of young adults from Oregon and Washington. 50 On balance, there is little evidence that RCL is linked with changes in cigarette smoking.

Route of administration

The increase in smoke-free alternative routes of cannabis administration (eg, vaping and oral ingestion of edibles) 63 , 64 make method of cannabis consumption an important topic to understand in the context of RCL. Two studies examined differences in route of cannabis consumption as a function of cannabis policy. One study examined changes in the number of different modes of cannabis use reported by high school students in Canada. 65 Results showed that from pre-to-post RCL 31.3% of students maintained a single mode of use, 14.3% continued to use cannabis in multiple forms, while 42.3% expanded from a single mode to multiple modes of administration and 12.1% reduced the number of modes they used. Another study found that smoking, vaping, and edibles (in that order) were the most frequent modes of cannabis use pre- and post-RCL in California, suggesting minimal impact of RCL on mode of cannabis use. 51 However, the least common mode of cannabis use was blunts, which did decline following RCL (13.5%-4.3%). 51 Overall, the evidence suggests RCL may be associated with changes in modes of cannabis consumption, but as the evidence is only from two studies there still remains a need for more studies examining RCL and cannabis route of administration.

Nine studies examined RCL and cannabis attitudes (see Table 2 ). Regarding cannabis use intentions, one U.S. study found that for both a non-RCL state and a state that underwent RCL, intention to use in young adults significantly increased post-RCL, suggesting a lack of RCL specific effect, 48 and that aside from the very first time point, there were no significant differences between the states in intention to use. Further, attitudes and willingness to use cannabis, between the RCL and non-RCL state remained similar overtime ( P s ⩾ .05), although both states reported significantly more positive attitudes toward cannabis following RCL ( P  ⩽ .001). 48 However, another study U.S. from found differences in adolescent use intentions across RCL, whereby those in the RCL cohort in jurisdictions that allowed sales were less likely to increase intent to use cannabis ( P  = .04), but the RCL cohort without sales were more likely to increase intent to use ( P  = .02). 43 The pre-RCL cohort in communities that opted out of sales were also less likely to increase willingness to use compared to the cohort with legal sales ( P  = .02). 43 Both studies reveal contrasting findings surrounding RCL’s relationship with cannabis use intentions and willingness to use.

Studies examining recreational cannabis legalization and attitudes surrounding cannabis.

Looking at cannabis use motives, one study found a non-significant increase in recreational motives for cannabis use post-RCL. 60 Similarly following RCL in Canada, 24% of individuals previously reporting cannabis use exclusively for medical purposes declared using for both medical and non-medical purposes following RCL, and 24% declared use for non-medical purposes only, 66 suggesting RCL can influence recreational/nonmedicinal motivations for cannabis use among those who previously only used for medical reasons.

In studies examining perceived risk and perceptions of cannabis use, one U.S. study found an indirect effect between RCL and increased consequences of use in adolescents through higher perceived risk ( P  ⩽ .001), but no association with frequency of use. 41 Another U.S. study revealed mixed results and found that RCL was not associated with perceived harm of use in youth. 50 Further, youth in one study did not report differences in perceptions of safety of cannabis, ease of accessing cannabis use or on concealing their use from authority, 61 which contrasts with another study finding increased reports of problems accessing cannabis post-RCL ( P  ⩽ .01). 60 Regarding health perceptions, a California study found that cannabis use was perceived as more beneficial for mental health, physical health, and wellbeing in adults at 6 months post-RCL compared to pre-RCL and 1-month post-RCL ( P  = .02). 51 Mental health perceptions of cannabis use increased from being perceived as “slightly harmful” pre-RCL to perceived as “slightly beneficial” at 6 months post-RCL. 51 However, in a sample of treatment seeking individuals with an opioid use disorder, the vast majority of participants reported beliefs that RCL would not impact their cannabis use, with no difference in beliefs pre- to post-RCL (85.9% reported belief it would have no impact pre-RCL and 85.7%, post-RCL). 62 The combined results of the studies suggest potential associations of RCL with risk and benefit perceptions of cannabis use, however as 55% of studies suggest a lack of or inconsistent association with RCL, on balance the literature on RCL’s impact on cannabis attitudes is mixed.

Health-related outcomes

We identified 33 articles that examined various health-related outcomes associated with RCL (see Table 3 ). The largest number involved hospital utilization (ie, seeking emergency services for cannabis-related problems such as unintentional exposure, CUD, and other harms). Other health-care outcomes included opioid-related harms, mental health variables, and adverse birth outcomes.

Studies investigating the relationship of recreational cannabis legalization and health-related outcomes.

Author, Author of article; Year, Publication year of article; Location, Jurisdiction article data was collected in; Date of Legalization, Year legalization was enacted in jurisdiction; Sample, Total N of article sample; CDC, Center for Disease Prevention; WONDER, Wide-Ranging Online Data for Epidemiologic Research; RCL, Recreational Cannabis Legalization.

Emergency service utilization

Seventeen studies examined the association between RCL and use of emergency services related to cannabis (eg, hospital visits, calls to regional poison centers). Regarding emergency service rates in youth, a Colorado study found the rate of pediatric cannabis-related emergency visits increased pre- to post-RCL ( P  ⩽ .0001). 67 Similarly, cannabis-related visits requiring further evaluation in youth also increased. 67 This increasing need for emergency service related to cannabis exposure in youth following RCL was supported in 4 other U.S. studies. 68 - 71 A Canadian study supported the U.S. studies, finding a 2.6 increase in children admissions for cannabis poisonings post-RCL. 72 In contrast, overall pediatric emergency department visits did not change from pre- to post-RCL in Alberta, Canada, 73 but there was a non-significant increase of the rate and proportion of children under 12 presenting to the emergency department. However, unintentional cannabis ingestion did increase post-RCL for children under 12 (95% CI: 1.05-1.47) and older adolescents (1.48, 95% CI: 1.21-1.81). 74 Taken together, these studies do suggest a risk for increasing cannabis-related emergency visits in youth following RCL, with 75% of studies finding an association between RCL and increasing emergency service rates in youth.

There is also evidence of increased hospital utilization in adults following RCL. Five studies found evidence of increased emergency service utilization or poison control calls from cannabis exposure associated with RCL in the U.S. and Canada. 24 , 69 , 74 - 76 Finally, a Colorado study saw an increase in cannabis involved pregnancy-related hospital admissions from 2011 to 2018, with notable spikes after 2012 and 2014, timeframes associated with state RCL. 77

However, some evidence points to a lack of association between RCL and emergency service utilization. A chart review in Ontario, Canada found no difference in number of overall cannabis emergency room visits pre- versus post-RCL ( P  = .27). 78 When broken down by age group, visits only increased for those 18 to 29 ( P  = .03). This study also found increases in patients only needing observation ( P  = .002) and fewer needing bloodwork or imaging services (both P s ⩽.05). 78 Further in a California study that found overall cannabis exposure rates were increasing, when breaking these rates down by age there was no significant change in calls for those aged 13 and up, only for those 12 and under. 69 An additional Canadian study found that rates of cannabis related visits were already increasing pre-RCL. 79 Following RCL, although there was a non-significant immediate increase in in cannabis-related emergency visits post-RCL this was followed a significant drop off in the increasing monthly rates seen prior to RCL. 79 Another Canadian study that examined cannabis hyperemesis syndrome emergency visits found that rates of admissions were increasing prior to RCL and the enactment of RCL was not associated with any changes in rates of emergency admissions. 80 As this attenuation occurred in Canada prior to commercialization where strict purchasing policy was in place, it may suggest that having proper regulations in place can prevent the uptick in cannabis-related emergency visits seen in U.S. studies.

Other hospital-related outcomes examined included admissions for cannabis misuse and other substance use exposure. One study found decreasing CUD admission rates over time (95% CI: −4.84, −1.91), with an accelerated, but not significant, decrease in Washington and Colorado (following RCL) compared to the rest of the U.S. 81 In contrast, another study found increased rates of healthcare utilization related to cannabis misuse in Colorado compared to New York and Oklahoma ( P s ⩽.0005). 82 With respect to other substance use, findings revealed post-RCL increases in healthcare utilization in Colorado for alcohol use disorder and overdose injuries but a decrease in chronic pain admissions compared to both controls ( P  ⩽ .05). 82 However, two Canadian studies found the rate of emergency department visits with co-ingestant exposure of alcohol, opioid, cocaine, and unclassified substances in older adolescents and adults decreased post-RCL. 73 , 77 Another Canadian study found no change in cannabis-induced psychosis admissions nor in alcohol- or amphetamine-induced admissions. 83

Finally, three studies examined miscellaneous hospital-related outcomes. A study examining hospital records in Colorado to investigate facial fractures (of significance as substance impairment can increase the risk of accidents) showed a modest but not significant influence of RCL. 84 The only significant increases of facial trauma cases were maxillary and skull base fracture cases ( P s ⩽ .001) suggesting a partial influence of RCL on select trauma fractures. The second study found increased trauma activation (need for additional clinical care in hospital) post-RCL in California ( P  = .01). 57 Moreover, both adult and pediatric trauma patients had increased mortality after RCL ( P  = .03; P  = .02, respectively). 57 The final study examining inflammatory bowel disease (IBD) outcomes in the U.S. found more cannabis users on total parenteral nutrition post-RCL (95% CI: 0.02, 0.89) and lower total hospital costs in users post-RCL (95% CI: −15 717, −1119). 58 No other IBD outcomes differed pre- to post-RCL (eg, mortality, length of stay, need for surgery, abscess incision and drainage).

Overall, these studies point to increased cannabis-related health-care utilization following RCL for youth and pediatrics (75% finding an increase). However, the impact of legalization on adult rates of cannabis-related emergency visits is mixed (44% finding lack of an association with RCL). As findings also varied across different countries (ie, Canada vs the U.S.), it suggests the importance of continually monitoring the role of RCL across different jurisdictions which may have different cannabis regulations in place. These studies also suggest there may be other health consequences associated with RCL. Further research should be done to examine trends of other emergency service use that could be influenced by RCL.

Two studies reported a weak or non-existent effect of RCL on opioid related outcomes. 85 , 86 First, a U.S. administrative study found no association of RCL and opioid prescriptions from orthopedic surgeons. 85 The second study found that, of U.S. states that passed RCL, those that passed policies before 2015 had fewer Schedule III opioid prescriptions ( P  = .003) and fewer total doses prescribed ( P  = .027), 86 but when compared to states with medicinal cannabis legislation, there were no significant differences. However, 3 studies suggested a potential protective effect of RCL, with one study finding a significant decrease for monthly opioid-related deaths following RCL (95% CI: –1.34, –0.03), compared to medical cannabis legalization and prohibition. 87 A Canadian study examining opioid prescription claims also found an accelerated decline in claims for public payers post-RCL compared to declines seen pre-RCL ( P  ⩽ .05). 88 Next a study examining women with pelvic pain found that post-RCL patients were less likely to report daily opioid use, including use for pain ( P  = .026). 59 These studies indicate some inconsistencies in relationships between RCL, opioid prescriptions and use indicators in the current literature, while the literature on balance points to a potential relationship with RCL (60%), the overall evidence is still mixed as 40% of studies support a weak association with RCL.

Adverse birth outcomes

Changes in adverse birth outcomes including small for gestational age (SGA) births, low birth weight, and congenital anomalies were examined in two studies. The first study, which examined birth outcomes in both Colorado and Washington, found that RCL was associated with an increase in congenital anomaly births for both states ( P  ⩽ .001, P  = .01 respectively). 89 Preterm births also significantly increased post-RCL, but only in Colorado ( P  ⩽ .001). Regarding SGA outcomes, there was no association with RCL for either state. 89 Similarly, the second study did find an increase in the prevalence of low birth weight and SGA over time, but RCL was not directly associated with these changes. 90 Although the current literature is small and limited to studies in Washington and Colorado, the evidence suggests minimal changes in adverse birth outcomes following RCL.

Mental health outcomes

Six studies examined mental health related outcomes. A Canadian study examining psychiatric patients did not see a difference in rates of psychotic disorders pre- to post-RCL. 45 Similarly, another Canadian study did not see a difference in hospital admissions with schizophrenia or related codes post-RCL. 83 However, the prevalence of personality disorders and “other” diagnoses was higher post-RCL ( P  = .038). 45 In contrast, another Canadian study found that rates of pediatric cannabis-related emergency visits with co-occurring personality and mood-related co-diagnoses decreased post-RCL among older adolescents. 73 A U.S. study examining the relationship between cannabis use and anxious mood fluctuations in adolescents found RCL had no impact on the association. 91 Similarly, another Canadian study found no difference in mental health symptomology pre- to post-RCL. 61 In contrast, anxiety scores in women with pelvic pain were higher post-RCL compared to pre-RCL ( P  = .036). 59 The small number and mixed findings of these studies, 66.7% finding no association or mixed findings and 33.3% finding an association but in opposite directions, identify a need for further examination of mental health outcomes post-RCL.

Miscellaneous health outcomes

Three studies examined additional health-related outcomes. First, a California study examined changes in medical cannabis status across RCL. Post-RCL, 47.5% of medical cannabis patients remained medical cannabis patients, while 73.8% of non-patients remained so. 92 The transition into medical cannabis patient status post-RCL represented the smallest group (10%). Cannabis legalization was the most reported reason for transition out of medical cannabis patient status (36.2%). 92 Next, a study examining pelvic pain in women found that post-RCL patients reported greater pain catastrophizing ( P  ⩽ .001), less anti-inflammatory ( P  ⩽ .001) and nerve medication use ( P  = .027), but more herbal pain medication use ( P  = .010). 59 Finally, a Canadian study that examined cannabinoids in post-mortem blood samples reported that post-RCL deaths had higher odds of positive cannabis post-mortem screens compared to pre-RCL (95% CI: 1.09-1.73). 93 However, the majority of growth for positive cannabinoid screens took place in the two years prior to RCL implementation. In sub-group analyses, only 25- to 44-year-olds had a significant increase in positive cannabinoid screens (95% CI: 0.05-0.19). Additional post-mortem drug screens found an increase in positive screens for amphetamines ( P  ⩽ .001) and cocaine ( P  = .042) post-RCL. These additional health outcomes demonstrate the wide-ranging health impacts that may be associated with RCL and indicate a continued need to examine the role of RCL on a variety of outcomes.

Driving-related outcomes

Six studies examined rates of motor vehicle accidents and fatalities (see Table 4 ). Two U.S. studies found no statistical difference in fatal motor vehicle collisions associated with RCL. 94 , 95 Further, a California-based study examining THC toxicology screens in motor vehicle accident patients, did find a significant increase in positive screens, but this increase was not associated with implementation of RCL. 96 However, three studies suggest a negative impact of RCL, as one U.S. study found both RCL states and their neighboring states had an increase in motor vehicle fatalities immediately following RCL. 97 Additionally, a Canadian study did find a significant increase in moderately injured drivers with cannabis positive blood screens post-RCL. 98 Finally, a study in Uruguay found RCL was associated with increased immediate fatal crashes for cars, but not motorcycles; further investigation suggested this effect was noticeable in urban areas, but not rural areas. 99 While the overall evidence was inconsistent, current evidence does suggest a modest increase, seen in two studies, in motor vehicle accidents associated with RCL. Further longitudinal research in more jurisdictions is needed to understand the long-term consequences of RCL on motor vehicle accidents.

Studies looking at recreational cannabis legalization and driving related outcomes.

Crime-related outcomes

Three studies explored crime-related outcomes associated with RCL (see Table 5 ). A Washington study examining cannabis-related arrest rates in adults did find significant drops in cannabis-related arrests post-RCL for both 21+ year olds (87% drop; P  ⩽ .001) and 18 to 20-year-olds (46% drop; P  ⩽ .001). 100 However, in another study examining Oregon youth this post-RCL decline for arrests was not seen; cannabis-related allegations in youth actually increased following RCL (28%; 95% CI = 1.14, 1.44). 101 Further, declines in youth allegations prior to RCL ceased after RCL was implemented. In contrast, a Canadian study did find significant decreases in cannabis-related offenses in youth post RCL ( P  ⩽ .001), but rates of property and violent crime did not change across RCL. 102 These studies highlight the diverse effects of RCL across different age groups. However, there remains a need for a more comprehensive evaluation on the role of RCL on cannabis-related arrests.

Studies investigating recreational cannabis legalization and crime related outcomes.

Author, Author of article; Year, Publication year of article; Location, Jurisdiction article data was collected in; Date of Legalization, Year legalization was enacted in jurisdiction; Sample, Total N of article sample; RCL, Recreational Cannabis Legalization.

Notably, two studies also examined race disparities in cannabis-related arrests. For individuals 21+ relative arrest disparities between Black and White individuals grew post-RCL. 100 When looking at 18 to 20-year-olds, cannabis-related arrest rates for Black individuals did slightly decrease, albeit non-significantly, but there was no change in racial disparities. 100 In youth ages 10 to 17, Indigenous and Alaska Native youth were more likely than White youth to receive a cannabis allegation before RCL (95% CI: 2.31, 3.01), with no change in disparity following RCL (95% CI: 2.10, 2.81). 101 On the other hand, Black youth were more likely to receive a cannabis allegation than White youth prior to RCL (95% CI: 1.66, 2.13), but the disparity decreased following RCL (95% CI: 1.06, 1.43). 101 These studies suggest improvements in racial disparities for cannabis-related arrests following RCL, although there ware only two studies and they are limited to the U.S.

The aim of this systematic review was to examine the existing literature on the impacts of RCL on a broad range of behavioral and health-related outcomes. The focus on more rigorous study designs permits greater confidence in the conclusions that can be drawn. The literature revealed five main outcomes that have been examined: cannabis use behaviors, cannabis attitudes, health-related outcomes, driving-related outcomes, and crime-related outcomes. The overall synthesizing of the literature revealed heterogenous and complex effects associated with RCL implementation. The varied findings across behavioral and health related outcomes does not give a clear or categorical answer as to whether RCL is a negative or positive policy change overall. Rather, the review reveals that while a great deal of research is accumulating, there remains a need for more definitive findings on the causal role of RCL on a large variety of substance use, health, attitude-related, driving, and crime-related outcomes.

Overall, studies examining cannabis use behavior revealed evidence for cannabis use increases following RCL, particularly for young adults (100%), peri-natal users (66%), and certain clinical populations (66%). 47 , 54 , 59 While general adult samples had some mixed findings, the majority of studies (80%) suggested increasing rates of use associated with RCL. 51 Of note, the increasing cannabis use rates found in peri-natal and clinical populations are particularly concerning as they do suggest increasing rates in more vulnerable samples where potential adverse consequences of cannabis use are more pressing. 103 However, for both groups the overall literature revealed only a few studies and thus requires further examination. Further, a reason to caution current conclusions surround RCL impacts on substance use, is that there is research suggesting cannabis use rates were increasing prior to RCL in Canada. 104 Thus, there still remains a need to better disentangle causal consequences of RCL on cannabis use rates.

In contrast to studies of adults, studies of adolescents pointed to inconsistent evidence of RCL’s influence on cannabis use rates, 38 , 45 with 60% of studies finding no change or inconsistent evidence surrounding adolescent use following RCL. Thus, a key conclusion of the cannabis use literature is that there is not overwhelming evidence that RCL is associated with increasing rates of cannabis among adolescents, which is notable as potential increases in adolescent use is a concern often voiced by critics of RCL. 16 This might suggest that current RCL policies that limit access to minors may be effective. However, a methodological explanation for the discrepancy between findings for adolescents and adults is that adults may be more willing to report their use of cannabis following RCL as it is now legal for them to use. However, for adolescents’ cannabis use remained illicit, which may lead to biased reporting from adolescents. Thus, additional research using methods to overcome limitations of self-reports may be required.

With regard to other substance use, primarily alcohol and cigarettes, there is little evidence that RCL is associated with increased use rates and may even be associated with decreased rates of cigarette use. 42 , 61 The lack of a relationship with RCL and increasing alcohol and other substance use, seen in 60% of studies, is relevant due to concerns of RCL causing “spill-over” effects to substances other than cannabis. However, the decreasing rates on cigarette use associated with RCL seen in 33% of studies may also suggest a substitution effect of cannabis. 105 It is possible that RCL encourages a substitution effect where cannabis is used to replace use other substances such as cigarettes, but 66% of studies found no association of RCL and cigarette use so further research examining a potential substitution effect is needed. In sum, the literature points to a heterogenous impact of RCL on cannabis and other substance use rates, suggesting complex effects of RCL on use rates that may vary across age and population. However, the review also highlights that there are still limited studies examining RCL and other substance use, particularly a lack of multiple studies examining the same age group.

The current evidence for the impact of RCL on attitudes surrounding cannabis revealed mixed or limited results, with 44% studies finding some sort of relationship with attitudes and RCL and 55% studies suggest a lack of or inconsistent relationship. Studies examining cannabis use attitudes or willingness to use revealed conflicting evidence whereas some studies pointed to increased willingness to use associated with RCL, 43 and others found no change or that changes were not specific to regions that implemented RCL. 48 For attitude-related studies that did reveal consistent findings (eg, use motivation changes, perceptions of lower risk and greater benefits of use), the literature was limited in the number of studies or involved heterogenous samples, making it difficult to make conclusive statements surrounding the effect of RCL. As cannabis-related attitudes (eg, perceived risk, intentions to use) can have implications for cannabis use and consequences 106 , 107 it is interesting that current literature does not reveal clear associations of cannabis-related attitudes and RCL. Rather, this review reveals a need for more research examining changes in cannabis-attitudes over time and potential impacts of RCL.

In terms of health outcomes, the empirical literature suggests RCL is associated with increased cannabis-related emergency visits 24 , 67 , 70 , 76 and other health consequences (eg, trauma-related cases 57 ). The literature also suggests there may be other potential negative health consequences associated with RCL, such as increasing adverse birth outcomes and post-mortem cannabis screens. 45 , 89 Synthesizing of the literature points to a well-established relationship of RCL and increasing cannabis-related emergency visits. While some extant literature was mixed, on balance most studies included in the review (70.6%) found consistent evidence of increased emergency service use (eg, emergency department admissions and poison control calls) for both adolescents and adults with only 31% of studies finding mixed or no association with RCL. This points to a need for stricter RCL policies to prevent unintentional consumption or hyperemesis such as promoting safe or lower risk use of cannabis (eg, using lower THC products, avoiding deep inhales while smoking), clearer packaging for cannabis products, and safe storage procedures.

However, the literature on health outcomes outside of emergency service utilization is limited and requires more in-depth evaluations to be fully understood. Additionally, not all health-outcomes indicated negative consequences associated with RCL. There is emerging evidence of the potential of RCL to help decrease CUD and multiple substance hospital admissions 74 , 82 Furthermore, while some findings were mixed and the number of studies limited, 60% of studies found potential for RCL to have protective effects for opioid-related negative consequences. 87 , 88 However, opioid-related findings should be considered in the context of population-level changes in opioid prescriptions and shifting opioid policy influence. 108 Thus, findings may be a result of changes driven by the response to the opioid epidemic rather than RCL, and there remains a need to better disentangle RCL impacts on opioid-related consequences. It is also worth noting that some opioid and cannabis studies are underwritten by the cannabis industry, so the findings should be interpreted with caution due to potential for conflicts of interest. 88 In sum, the overall literature suggests that RCL is associated with both negative and positive health-related consequences and reveals a need to examine the role of RCL across a wide range of health outcomes.

The findings from the driving-related literature do suggest RCL is associated with increased motor vehicle accidents (50% of studies) although the literature was quite evenly split as higher accident rates were not seen across all studies (50% studies). These results point to potential negative consequence associated with RCL and may indicate a need for better measures to prevent driving while under the influence of cannabis in legalized jurisdictions. However, as the evidence was split and predominately in the U.S. additional studies spanning diverse geographical jurisdictions are still needed.

On the other hand, the findings from crime-related outcomes showed some inconsistencies. While one study did suggest minimal decreases for substance-use related arrests in adults, the findings were not consistent across the two studies examining arrest-rates in youth. 100 - 102 These potential decreases in arrest rates for adults can have important implications as cannabis-related crime rates make up a large amount of overall crime statistics and drug-specific arrests. 30 , 31 This discrepancy in youth findings between a U.S. and Canadian study are notable as Canadian RCL policies do include stipulations to allow small scale regulations in youth. Thus, it suggests RCL policies that maintain prohibition of use among underage youth do not address issues related to arrests and crime among youth. In fact, the current literature suggests that cannabis-related charges are still being enforced for youth under the legal age of consumption in the U.S. Another important outcome revealed is racial disparities in cannabis-related arrests. Previous evidence has shown there are racial disparities, particularly between Black, Indigenous, and Hispanic individuals compared to White counterparts, in cannabis-related charges and arrests. 109 , 110 Regarding racial disparities and RCL, there was very little evidence of decreases in disparities for cannabis-related arrests following RCL. 100 , 101 This racialized arresting is significant as it can be associated with additional public health concerns such as physical and mental health outcomes, harm to families involved, and to communities. 111 This finding is particularly concerning as it suggests racialized arrests for cannabis are still occurring despite the intentions of liberalization of cannabis policies to help reduce racial disparities in the criminal justice system. However, it is important to note that there were only 2 studies of racial disparities in cannabis-related arrests and both were conducted in the U.S. Thus, additional research is required before drawing any firm conclusions about the ability of RCL to address systemic issues in the justice system.

Limitations

The findings should be considered within context of the following limitations. The research was predominately from North America (U.S. and Canada). While both countries have either federal or state RCL, findings only from two countries that are geographically connected may not reflect the influence of RCL across different cultures and countries globally. The majority of studies also relied on self-report data for cannabis-related outcomes. Thus, there is a risk that any increases in use or other cannabis-related outcomes may be due to an increased comfort in disclosing cannabis use due to RCL.

Given the large number of studies on multiple outcomes, we chose to focus on implementation of RCL exclusively, rather than related policy changes such as commercialization (ie, the advent of legal sales), to allow for clearer conclusions about the specific impacts on RCL. However, a limitation is that the review does not address the impact of commercialization or changes in product availability. While outside the scope of the current review, it does limit the conclusions that can be drawn about RCL overall as some jurisdictions implemented features of commercialization separately from legalization. For example, in Ontario, Canada, storefronts and edible products became legal a year after initial RCL (when online purchase was the exclusive modality), which may have had an additional impact on behavioral and health-related outcomes. Additionally, the scope of the review was limited to recreational legalization and did not consider other forms of policy changes such as medicinal legalization or decriminalization, as these have been summarized more comprehensively in prior reviews. 112 - 114 Further, this review focused on behavioral and health outcomes; other important outcomes to examine in the future include economic aspects such as cannabis pricing and purchasing behaviors, and product features such as potency. Finally, as this review considered a broad range of outcomes, we did not conduct a meta-analysis which limits conclusions that can be drawn regarding the magnitude of the associations.

Conclusions

The topic of RCL is a contentious and timely issue. With nationwide legalization in multiple countries and liberalizing policies across the U.S., empirical research on the impacts of RCL has dramatically expanded in recent years. This systematic review comprehensively evaluated a variety of outcomes associated with RCL, focusing on longitudinal study designs and revealing a wide variety of findings in terms of substance use, health, cannabis attitudes, crime, and driving outcomes examined thus far. However, the current review highlights that the findings regarding the effects of RCL are highly heterogenous, often inconsistent, and disproportionately focused on certain jurisdictions. With polarizing views surrounding whether RCL is a positive or negative policy change, it is noteworthy that the extant literature does not point to one clear answer at the current time. In general, the collective results do not suggest dramatic changes or negative consequences, but instead suggest that meaningful tectonic shifts are happening for several outcomes that may or may not presage substantive changes in personal and public health risk. Furthermore, it is clear that a more in-depth examinations of negative (eg, frequent use, CUD prevalence, ‘gateway’ relationships with other substance use), or positive consequences (eg, therapeutic benefits for mental health and/or medical conditions, use of safer products and routes of administration), are needed using both quantitative and qualitative approaches.

Acknowledgments

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding support from the Peter Boris Chair in Addictions Research and a Canada Research Chair in Translational Addiction Research (JM). Funders had no role in the design or execution of the review.

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: James MacKillop discloses he is a principal and senior scientist in Beam Diagnostics, Inc, and a consultant to ClairvoyantRx. No other authors have disclosures.

Author Contributions: The author’s contribution is as follows: study conceptualization and design: KF, JW, JT, JM; data collection and interpretation: KF, EM, MS; manuscript writing and preparation: KF, EM, MS, PN; manuscript reviewing and editing: JW, JT, JM. All authors have reviewed and approved the final manuscript.

2018 Theses Doctoral

Essays on Cannabis Legalization

Thomas, Danna Kang

Though the drug remains illegal at the federal level, in recent years states and localities have increasingly liberalized their marijuana laws in order to generate tax revenue and save resources on marijuana law enforcement. Many states have adopted some form of medical marijuana and/or marijuana decriminalization laws, and as of 2017, Washington, Colorado, Maine, California, Oregon, Massachusetts, Nevada, Alaska, and the District of Columbia have all legalized marijuana for recreational use. In 2016 recreational marijuana generated over $1.8 billion in sales. Hence, studying marijuana reforms and the policies and outcomes of early recreational marijuana adopters is an important area of research. However, perhaps due to the fact that legalized recreational cannabis is a recent phenomenon, a scarcity of research exists on the impacts of recreational cannabis legalization and the efficacy and efficiency of cannabis regulation. This dissertation aims to fill this gap, using the Washington recreational marijuana market as the primary setting to study cannabis legalization in the United States. Of first order importance in the regulation of sin goods such as cannabis is quantifying the value of the marginal damages of negative externalities. Hence, Chapter 1 (co-authored with Lin Tian) explores the impact of marijuana dispensary location on neighborhood property values, exploiting plausibly exogenous variation in marijuana retailer location. Policymakers and advocates have long expressed concerns that the positive effects of the legalization--e.g., increases in tax revenue--are well spread spatially, but the negative effects are highly localized through channels such as crime. Hence, we use changes in property values to measure individuals' willingness to pay to avoid localized externalities caused by the arrival of marijuana dispensaries. Our key identification strategy is to compare changes in housing sales around winners and losers in a lottery for recreational marijuana retail licenses. (Due to location restrictions, license applicants were required to provide an address of where they would like to locate.) Hence, we have the locations of both actual entrants and potential entrants, which provides a natural difference-in-differences set-up. Using data from King County, Washington, we find an almost 2.4% decrease in the value of properties within a 0.5 mile radius of an entrant, a $9,400 decline in median property values. The aforementioned retail license lottery was used to distribute licenses due to a license quota. Retail license quotas are often used by states to regulate entry into sin goods markets as quotas can restrict consumption by decreasing access and by reducing competition (and, therefore, increasing markups). However, license quotas also create allocative inefficiency. For example, license quotas are often based on the population of a city or county. Hence, licenses are not necessarily allocated to the areas where they offer the highest marginal benefit. Moreover, as seen in the case of the Washington recreational marijuana market, licenses are often distributed via lottery, meaning that in the absence of an efficiency secondary market for licenses, the license recipients are not necessarily the most efficient potential entrants. This allocative inefficiency is generated by heterogeneity in firms and consumers. Therefore, in Chapter 2, I develop a model of demand and firm pricing in order to investigate firm-level heterogeneity and inefficiency. Demand is differentiated by geography and incorporates consumer demographics. I estimate this demand model using data on firm sales from Washington. Utilizing the estimates and firm pricing model, I back out a non-parametric distribution of firm variable costs. These variable costs differ by product and firm and provide a measure of firm inefficiency. I find that variable costs have lower inventory turnover; hence, randomly choosing entrants in a lottery could be a large contributor to allocative inefficiency. Chapter 3 explores the sources of allocative inefficiency in license distribution in the Washington recreational marijuana market. A difficulty in studying the welfare effects of license quotas is finding credible counterfactuals of unrestricted entry. Therefore, I take a structural approach: I first develop a three stage model that endogenizes firm entry and incorporates the spatial demand and pricing model discussed in Chapter 2. Using the estimates of the demand and pricing model, I estimate firms' fixed costs and use data on locations of those potential entrants that did not win Washington's retail license lottery to simulate counterfactual entry patterns. I find that allowing firms to enter freely at Washington's current marijuana tax rate increases total surplus by 21.5% relative to a baseline simulation of Washington's license quota regime. Geographic misallocation and random allocation of licenses account for 6.6\% and 65.9\% of this difference, respectively. Moreover, as the primary objective of these quotas is to mitigate the negative externalities of marijuana consumption, I study alternative state tax policies that directly control for the marginal damages of marijuana consumption. Free entry with tax rates that keep the quantity of marijuana or THC consumed equal to baseline consumption increases welfare by 6.9% and 11.7%, respectively. I also explore the possibility of heterogeneous marginal damages of consumption across geography, backing out the non-uniform sales tax across geography that is consistent with Washington's license quota policy. Free entry with a non-uniform sales tax increases efficiency by over 7% relative to the baseline simulation of license quotas due to improvements in license allocation.

• Cannabis--Law and legislation
• Marijuana industry
• Drug legalization
• Drugs--Economic aspects

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Five Reasons Why We Should Legalize Cannabis

Cannabis use in the United States has had a long and complicated history. For decades, people who used cannabis were subject to social ostracization and criminal prosecution. However, attitudes toward cannabis have been evolving in recent years. An increasing number of states have started to legalize cannabis for medical or recreational use. This shift in policy has been driven by a variety of factors including changing public attitudes and the potential economic benefits of legalization. In this article, we will explore the potential benefits of legalizing cannabis in our country.

1. Legalization for the Environment

Legalizing cannabis can have significant benefits for the environment. When cannabis is grown illegally, it is often done in environmentally damaging ways, such as using chemical pesticides or clearing primary forests to make room for crops. Legalization could allow customers to support more environmental growers. This will incentivize more responsible growing practices, such as the use of organic farming methods or the use of renewable energy sources to power indoor grow operations. In addition, the culture of growing cannabis can help to discover and preserve precious marijuana seeds , increasing biodiversity and facilitating a deeper understanding of cannabis plants and their cultivation.

2. Legalization for Justice

Where cannabis is illegal, people are being arrested and charged for possession or sale, which leads to costly court cases and a burden on the criminal justice system. Legalization would free up law enforcement resources to focus on more serious crimes and simultaneously reduce the number of people incarcerated for non-violent drug offenses. This could help to reduce the overall prison population and save taxpayers money.

In addition, legalization can have significant benefits for justice and equity, particularly for marginalized communities that have been disproportionately affected by the criminalization of cannabis. Communities of color have been particularly affected by the war on drugs, with Black Americans being nearly four times more likely to be arrested for cannabis possession than white Americans, despite similar rates of use.

By regulating cannabis cultivation and sales, legalization can help to eliminate the black market and reduce the involvement of criminal organizations in the cannabis industry. This can lead to safer communities and reduced drug-related violence in communities that have been most affected by the criminalization of cannabis.

3. Legalization for Public Health

Cannabis has been shown to have many beneficial and therapeutic effects on both physical and mental health. However, people may be hesitant to seek medical marijuana treatment due to fear of legal repercussions if cannabis is illegal. Legalization can allow more people to enjoy better health outcomes. It can also promote the safer use of cannabis by educating the public on appropriate cannabis use and providing quality control measures for cannabis products. Legalization can also lead to increased research into potential medical applications of cannabis and could lead to the development of innovative treatments.

Another potential perk of cannabis legalization is that it could reduce the use of more harmful drugs. In the absence of cannabis, people may turn to more dangerous drugs like heroin or fentanyl to manage chronic pain or other conditions. By legalizing cannabis, we can provide a safer alternative for these individuals and could reduce the overall demand for these more dangerous drugs. States that have legalized cannabis found a decrease in opioid overdose deaths and hospitalizations, suggesting that cannabis are an effective alternative to prescription painkillers.

4. Legalization for the Economy

The legalization of cannabis can generate significant tax revenue for governments and create new economic opportunities. When cannabis is illegal, it is sold on the black market, and no taxes are collected on these sales. However, when it is legal, sales can be regulated, and taxes can be imposed on those sales. In states that have legalized cannabis, tax revenue from cannabis sales has been in the millions of dollars , with California registering a whopping $1.2 billion in cannabis tax revenue in 2021. This impressive income can be used to reduce budget deficits, fund various public services such as education and healthcare, and create new opportunities for investment in projects that revitalize the economy.

Aside from tax revenue, legalizing cannabis can create new jobs. The cannabis industry is a rapidly growing industry, and legalization could lead to the creation of new jobs in areas such as cultivation, processing, and retail sales. This can help to reduce unemployment and create new gainful opportunities for people who may have struggled to find employment in other industries. Legalization can also lead to increased investment in related industries, such as the development of new products or technologies to improve cannabis cultivation or the creation of new retail businesses. There are now several venture capital funds and investment groups that focus solely on cannabis-related enterprises.

5. Legalization for Acceptance

Finally, legalization could help reduce the stigma surrounding cannabis use. Before cannabis legalization, people who use the plant were often viewed as criminals or deviants. Legalization can help change this perception and lead to more open and honest conversations about cannabis use. Ultimately, legalization could lead to a more accepting and inclusive society where individuals are not judged or discriminated against for their personal and healthcare choices. By legalizing cannabis, we can harness the power of a therapeutic plant. Legalization can heal not just physical and mental ailments of individuals but also the social wounds that have resulted from its criminalization.

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The arguments for and against marijuana legalization in the u.s. [infographic].

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Towards the end of last year, a Gallup poll found that U.S. public support for marijuana legalization surged to 66%. Especially noteworthy was a newfound majority support for legalization among Republicans and Americans aged 55 and older. The increasing popularity behind the notion of giving pot the green light raises an obvious yet seldom asked question: why do people want to legalize it? Gallup recently released more polling about marijuana , this time focusing on the arguments for and against legalization.

86% of supporters say that the medicinal benefits of marijuana are a very important reason for legalization. Freeing up law enforcement to focus on other types of crime is cited as a very important reason by 70% of respondents while 60% say it's a matter of freedom and personal choice. Given that Colorado passed $1 billion in marijuana state revenue this week, how did the survey's respondents feel about the economic benefits of the drug? Gallup found that just over half of supporters, 56%, say that tax revenue for state and local governments is a very important reason for legalization.

When the roughly one-third of Americans opposing legalization were asked about the most important reasons for keeping legal marijuana out of circulation, driver safety was the chief reason. 79% said that an increase in the number of accidents involving drivers using marijuana is a major reason for their opposition. Those opposed also fear a general increase in drug usage with "leading people to use stronger and more addictive drugs" and legal marijuana "encouraging more people to use it" cited as very important reasons for opposition by 69% and 62% of opponents respectively.

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U.S. marijuana supporters/opponents views on marijuana legalization

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Argumentative Essay On Marijuana Legalization

Published by gudwriter on May 27, 2018 May 27, 2018

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Why Marijuana Should be Legalized Argumentative Essay Outline

Introduction.

Thesis: Marijuana should be legalized as it is more beneficial that it may be detrimental to society.

Paragraph 1:

Marijuana has not caused turmoil in some of the countries where it has been legalized.

• Marijuana does not increase violent, and property crimes as many suggest.
• Studies reveal that in Colorado, violent crimes have declined following the legalization of marijuana.

Paragraph 2:

Prohibiting use of marijuana does not limit its consumption.

• In spite of the many laws prohibiting the use of marijuana, it is one of the most highly abused drugs.
• 58% of young people from all over the world use marijuana.
• It has not been attributed to any health complications.

Paragraph 3:

Legalization of marijuana would help state governments save taxpayers money.

• Governments spend lots of funds on law enforcement agencies that uphold laws restricting the use of marijuana.
• They also spend vast sums of money on sustaining arrested dealers and consumers in prison.
• Legalizing marijuana would result in saving vast sums of money.

Paragraph 4:

Marijuana is less noxious than other legal substances.

• Marijuana has less health side effects than other legal substances such as alcohol and tobacco.
• Alcohol is 114 times more destructive than marijuana.

Paragraph 5:

Marijuana has been proven to have medical benefits.

• Marijuana helps stop seizures in epileptic patients.
• It helps stop nausea in cancer patients undergoing chemotherapy .

Paragraph 6:

Marijuana has been proven to be a stress reliever.

• Marijuana relieves stress and depression in their users by causing excitement.
• Its use reduces violence and deaths related to stress and depression.

Conclusion.

There are many misconceptions about marijuana existent in the modern world. People have continued to ignore health benefits linked to this substance citing their unproven beliefs. Owing to its ability to stop seizures, nausea, and stress in individuals governments should highly consider marijuana legalization. Its legalization will also help state governments reduce expenses that result from maintaining suspects convicted of marijuana possession and consumption.

Why Marijuana Should be Legalized Argumentative Essay

The argument that marijuana use should be made legal has gained momentum both in the U.S. and elsewhere in the world in recent years. This has seen the drug being legalized in some states in the U.S. such that by 2013, twenty states had legalized medical marijuana. As of the same year, Colorado and Washington had legalized recreational marijuana. The arguments behind the push for legalization majorly revolve around the idea that the drug has medicinal effects. However, there are also arguments that there are serious health effects associated with the drug and this has only further fueled the already raging debate. This paper argues that marijuana should be legalized as it is more beneficial that it may be detrimental to society.

Marijuana has not caused any notable negative effects in countries where it has been legalized. There is a general belief that marijuana consumers are violent. However, no authentic research can prove these assertions. As already seen, some states in the United States have legalized both medicinal and recreational marijuana. In spite of this, no cases of marijuana-related violence have been recorded so far in such states (Markol, 2018). Reports reveal that the rate of violence and property crimes have decreased in Colorado following the legalization of the drug. If marijuana does not increase violent crimes, there is no reason as to why it should not be legalized.

It is also noteworthy that prohibiting marijuana use does not limit its consumption. Less than 10% of countries in the world prevent the use of marijuana, but according to research, 58% of young people in most of these countries are marijuana users (Head, 2016). General reports reveal that marijuana is one of most commonly abused drug in the world. It is also readily available in most states as it is a naturally growing plant (Head, 2016). In spite of its continued use, there are few cases, if any, of marijuana-related health complications that have been reported in any of these countries (Head, 2016). Therefore, if the illegality of marijuana does not limit its consumption, then state governments should consider its legalization.

Legalization of marijuana would further help state governments save taxpayers’ money. It is widely known that in countries where marijuana is illegal, authorities are stringent and will arrest any individual found in possession of the drug (Sanger, 2017). However, as earlier mentioned, laws prohibiting the use of the drug do not prevent its consumption, and this means that many people are arrested and prosecuted for possessing it (Sanger, 2017). State governments therefore use a lot of funds to support law enforcement agencies that seek to uphold laws prohibiting the use of marijuana (Sanger, 2017). Many people have been arrested and incarcerated for either possessing or consuming the drug, and the government has to use taxpayers’ money to sustain such people in prison. Since these actions do not limit consumption of marijuana, state governments should legalize the drug so as to save taxpayers money.

Another advantage of marijuana is that it is less noxious than other legal substances. According to research, marijuana is the least harmful drug among the many legal drugs existent in the world today (Owen, 2014). There are millions of campaigns every year cautioning people against smoking cigarettes, but there has been none seeking to warn people about marijuana consumption (Owen, 2014). Lobby groups have even been making efforts to push for legalization of marijuana. If marijuana had severe health effects as many purport, state governments would be investing heavily in campaigns aimed at discouraging its consumption (Owen, 2014). According to studies, alcohol, which is legal in many countries, is 114 times more harmful than marijuana (Owen, 2014). Therefore, if such harmful substances can be legalized, then there are no justifications as to why marijuana should not be legalized.

Further, marijuana has been proven to have medicinal benefits. Several countries, particularly in Europe, and the United States have legalized both medicinal and recreational marijuana. Their move to legalize marijuana was based on medical reports that showed a variety of health benefits linked to the drug (Noonan, 2017). Research shows that marijuana can reduce seizures in epileptic persons. Several studies have also proven that the drug indeed has a variety of health benefits. For instance, Charlotte Figi, who is now aged 10, used to have more than 100 seizures every month at age three, but since Colorado legalized medicinal and recreational marijuana, her parents started treating her with the substance, and today her seizures have significantly reduced (Noonan, 2017). Marijuana has as well been proven to reduce nausea in cancer patients undergoing chemotherapy. Owing to this medicinal value, state governments should consider legalizing the drug.

Additionally, marijuana has been proven to be a stress reliever. Consumption of the drug causes excitement among its users enabling them to forget about troubling situations. Unlike alcohol which is likely to aggravate stress and depression, marijuana works wonders in alleviating anxiety and depression (Sanger, 2017). There are many health and social effects associated with stress, including mental disorders and violence against others (Sanger, 2017). To avoid cases of stress-related violence and mental disorders, state governments should make marijuana consumption legal.

There are many misconceptions about marijuana in the world today. People have continued to ignore the health benefits linked with this substance and have instead focused on citing yet-to-be proven misconceptions. Owing to the ability of the drug to stop seizures, nausea, and stress in individuals, governments should seriously consider its legalization. The legalization will also help state governments reduce expenses that result from sustaining suspects convicted of marijuana possession and consumption. So far, there is more than enough evidence proving that marijuana has lots of benefits to individuals, the society, and the government, and therefore should be legalized.

Head, T. (2016). “8 reasons why marijuana should be legalized”. ThoughtCo . Retrieved June 27, 2020 from https://www.thoughtco.com/reasons-why-marijuana-should-be-legalized-721154

Markol, T. (2018). “5 reasons why marijuana should be legalized”. Marijuana Reform . Retrieved June 27, 2020 from http://marijuanareform.org/5-reasons-marijuana-legalized/

Noonan, D. (2017). “Marijuana treatment reduces severe epileptic seizures”. Scientific American . Retrieved June 27, 2020 from https://www.scientificamerican.com/article/marijuana-treatment-reduces-severe-epileptic-seizures/

Owen, P. (2014). “6 powerful reasons to legalize marijuana”. New York Times . Retrieved June 27, 2020 from https://www.alternet.org/drugs/6-powerful-reasons-new-york-times-says-end-marijuana-prohibition

Sanger, B. (2017). “10 legit reasons why weed should be legalized right now”. Herb . Retrieved June 27, 2020 from https://herb.co/marijuana/news/reasons-weed-legalized

Why Marijuana Should be Legal Essay Outline

Thesis:  Marijuana has health benefits and should thus be legal.

Benefits of Marijuana

Marijuana slows and stops the spread of cancer cells.

• Cannabidiol can turn off a gene called Id-1 and can therefore stop cancer.
• In an experiment, researchers were able to treat breast cancer cells with Cannabidiol.

Marijuana helps with pain and nausea reduction for people going through chemotherapy.

• Cancer patients undergoing chemotherapy suffer from severe pains and nausea.
• This can further complicate their health.
• Marijuana can stir up their appetite, decrease nausea, and reduce pain.

Paragraph  3:

Marijuana can control epileptic seizure.

• Marijuana extract stopped seizures in epileptic rats in ten hours.
• The seizures were controlled by the THC.

Disadvantages of Marijuana

Marijuana is addictive.

• One in ten marijuana users become addicted over time.
• If one stops using the drug abruptly, they may suffer from such withdrawal symptoms.

Marijuana use decreases mental health.

• Users suffer from memory loss and restricted blood flow to the brain.
• Users have higher chances of developing depression and schizophrenia.

Marijuana use damages the lungs more than cigarette smoking .

• Marijuana smokers inhale the smoke more deeply into their lungs and let it stay there for longer.
• The likelihood of lung cancer can be increased by this deeper, longer exposure to carcinogens.

Why Marijuana Should Be Legal

Paragraph 7:

Improved quality and safety control.

• Legalization would lead to the creation of a set of standards for safety and quality control.
• Users would know what they exactly get in exchange for the money they offer.
• There would be no risks of users taking in unknown substances mixed in marijuana.

Paragraph 8:

Marijuana has a medicinal value.

• Medical marijuana treats a wide assortment of “untreatable” diseases and conditions.
• Public health would be improved and the healthcare system would experience less of a drain.  

Paragraph 9: 

Among the major arguments against marijuana legalization is often that legalization would yield an increase in drug-impaired driving.

• This argument holds that even now when the drug is yet to be fully legalized in the country, it is a major causal factor in highway deaths, injuries, and crushes.
• It however beats logic why marijuana is illegalized on the ground that it would increase drug-impaired driving while alcohol is legal but also significantly contributes to the same problem.

Legalization of marijuana would have many benefits. The drug is associated with the treatment of many serious illnesses including the dreaded cancer. Legalization would also save users from consuming unsafe marijuana sold by unscrupulous people.

Why Marijuana Should Be Legal Essay

There is an ongoing tension between the belief that marijuana effectively treats a wide range of ailments and the argument that it has far-reaching negative health effects. There has nevertheless been a drive towards legalization of the drug in the United States with twenty nine states and the District of Columbia having legalized it for medical and recreational purposes. It was also found by a study that there is a sharp increase in the use of marijuana across the country (Kerr, Lui & Ye, 2017). Major public health concerns are being prompted by this rise. This should however not be the case because marijuana has health benefits and should thus be legal.

Marijuana slows and stops the spread of cancer cells. A study found that Cannabidiol can turn off a gene called Id-1 and can therefore stop cancer. A 2007 report by researchers at California Pacific Medical Center in San Francisco also indicated that the spread of cancer may be prevented by Cannabidiol. In their lab experiment, the researchers were able to treat breast cancer cells with this component (Nawaz, 2017). The positive outcome of the experiment showed that Id-1 expression had been significantly decreased.

Marijuana also helps with pain and nausea reduction for people going through chemotherapy. Cancer patients undergoing chemotherapy suffer from severe pains, appetite loss, vomiting, and painful nausea. This can further complicate their already deteriorating health. Marijuana can be of help here by stirring up the appetite, decreasing nausea, and reducing pain (Nawaz, 2017). There are also other cannabinoid drugs used for the same purposes as approved by the FDA.

It was additionally shown by a 2003 study that the use of marijuana can control epileptic seizure. Synthetic marijuana and marijuana extracts were given to epileptic rats by Virginia Commonwealth University’s Robert J. DeLorenzo. In about ten hours, the seizures had been stopped by the drugs (Nawaz, 2017). It was found that the seizures were controlled by the THC which bound the brain cells responsible for regulating relaxation and controlling excitability.

Some scientists claim that marijuana is addictive. According to them, one in ten marijuana users become addicted over time. They argue that if one stops using the drug abruptly, they may suffer from such withdrawal symptoms as anxiety and irritability (Barcott, 2015). However, the same argument could be applied to cigarette smoking, which is notably legal. There is need for more studies to be conducted into this claim being spread by opponents of marijuana legalization.

It is also argued that marijuana use decreases mental health. Those opposed to the legalization of recreational marijuana like to cite studies that show that users of the drug suffer from memory loss and restricted blood flow to the brain. They also argue that users have higher chances of developing depression and schizophrenia. However, these assertions have not yet been completely ascertained by science (Barcott, 2015). The claim about depression and schizophrenia is particularly not clear because researchers are not sure whether the drug triggers the conditions or it is used by smokers to alleviate the symptoms.

It is further claimed that marijuana use damages the lungs more than cigarette smoking. It is presumed that marijuana smokers inhale the smoke more deeply into their lungs and let it stay there for longer. The likelihood of lung cancer, according to this argument, can be increased by this deeper, longer exposure to carcinogens. However, the argument touches not on the frequency of use between marijuana and cigarette smokers (Barcott, 2015). It neither takes into account such alternative administration methods as edibles, tinctures, and vaporizing.

Legalization of marijuana would lead to improved quality and safety control. Purchasing the drug off the street provides end users with no means of knowing what they are exactly getting. On the other hand, legalizing it would immediately lead to the creation of a set of standards for safety and quality control (Caulkins, Kilmer & Kleiman, 2016). This would certainly work in the marijuana industry just as it is working in the tobacco and alcohol industries. Users would be able to know what they exactly get in exchange for the money they offer. Additionally, there would be no risks of users taking in unknown substances mixed in marijuana sold on the streets.

Marijuana should also be legal because it has a medicinal value. It has been proven that medical marijuana treats a wide assortment of “untreatable” diseases and conditions. These include problems due to chemotherapy, cancer, post-traumatic stress disorder, migraines, multiple sclerosis, epilepsy, and Crohn’s disease (Caulkins, Kilmer & Kleiman, 2016). Public health would be improved and the healthcare system would experience less of a drain if medical cannabis products were made available to those suffering from the mentioned conditions. Consequently, more public funds would be available for such other public service initiatives as schools and roads.

Among the major arguments against marijuana legalization is often that legalization would yield an increase in drug-impaired driving. This argument holds that even now when the drug is yet to be fully legalized in the country, it has already been cited to be a major causal factor in highway deaths, injuries, and crushes. Among the surveys those arguing along this line might cite is one that was conducted back in 2010, revealing that of the participating weekend night-time drivers, “8.6 percent tested positive for marijuana or its metabolites” (“Why We Should Not Legalize Marijuana,” 2010). It was found in yet another study that 26.9% of drivers who were being attended to at a trauma center after sustaining serious injuries tested positive for the drug (“Why We Should Not Legalize Marijuana,” 2010). It however beats logic why marijuana is illegalized on the ground that it would increase drug-impaired driving while alcohol is legal but also significantly contributes to the same problem.

As the discussion reveals, legalization of marijuana would have many benefits. The drug is associated with the treatment of many serious illnesses including the dreaded cancer. Legalization would also save users from consuming unsafe marijuana sold by unscrupulous people. There are also other health conditions that can be controlled through the drug. Arguments against its legalization based on its effects on human health also lack sufficient scientific support. It is thus only safe that the drug is legalized in all states.

Barcott, B. (2015).  Weed the people: the future of legal marijuana in America . New York, NY: Time Home Entertainment.

Caulkins, J. P., Kilmer, B., & Kleiman, M. (2016).  Marijuana legalization: what everyone needs to know . New York, NY: Oxford University Press.

Kerr, W., Lui, C., & Ye, Y. (2017). Trends and age, period and cohort effects for marijuana use prevalence in the 1984-2015 US National Alcohol Surveys.  Addiction ,  113 (3), 473-481.

Nawaz, H. (2017).  The debate between legalizing marijuana and its benefits for medical purposes: a pros and cons analysis . Munich, Germany: GRIN Verlag.

Why We Should Not Legalize Marijuana. (2010). In  CNBC . Retrieved June 25, 2020 from  https://www.cnbc.com/id/36267223 .

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Most Americans Favor Legalizing Marijuana for Medical, Recreational Use

Legalizing recreational marijuana viewed as good for local economies; mixed views of impact on drug use, community safety, table of contents.

• The impact of legalizing marijuana for recreational use
• Partisan differences on impact of recreational use of marijuana
• Demographic, partisan differences in views of marijuana legalization
• Views of marijuana legalization vary by age within both parties
• Views of the effects of legalizing recreational marijuana among racial and ethnic groups
• Wide age gap on views of impact of legalizing recreational marijuana
• Acknowledgments
• The American Trends Panel survey methodology

Pew Research Center conducted this study to understand the public’s views about the legalization of marijuana in the United States. For this analysis, we surveyed 5,140 adults from Jan. 16 to Jan. 21, 2024. Everyone who took part in this survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used for the report and its methodology .

As more states pass laws legalizing marijuana for recreational use , Americans continue to favor legalization of both medical and recreational use of the drug.

An overwhelming share of U.S. adults (88%) say marijuana should be legal for medical or recreational use.

Nearly six-in-ten Americans (57%) say that marijuana should be legal for medical and recreational purposes, while roughly a third (32%) say that marijuana should be legal for medical use only.

Just 11% of Americans say that the drug should not be legal at all.

Opinions about marijuana legalization have changed little over the past five years, according to the Pew Research Center survey, conducted Jan. 16-21, 2024, among 5,14o adults.

While a majority of Americans continue to say marijuana should be legal , there are varying views about the impacts of recreational legalization.

About half of Americans (52%) say that legalizing the recreational use of marijuana is good for local economies; just 17% think it is bad and 29% say it has no impact.

More adults also say legalizing marijuana for recreational use makes the criminal justice system more fair (42%) than less fair (18%); 38% say it has no impact.

However, Americans have mixed views on the impact of legalizing marijuana for recreational use on:

• Use of other drugs: About as many say it increases (29%) as say it decreases (27%) the use of other drugs, like heroin, fentanyl and cocaine (42% say it has no impact).
• Community safety: More Americans say legalizing recreational marijuana makes communities less safe (34%) than say it makes them safer (21%); 44% say it has no impact.

There are deep partisan divisions regarding the impact of marijuana legalization for recreational use.

Majorities of Democrats and Democratic-leaning independents say legalizing recreational marijuana is good for local economies (64% say this) and makes the criminal justice system fairer (58%).

Fewer Republicans and Republican leaners say legalization for recreational use has a positive effect on local economies (41%) and the criminal justice system (27%).

Republicans are more likely than Democrats to cite downsides from legalizing recreational marijuana:

• 42% of Republicans say it increases the use of other drugs, like heroin, fentanyl and cocaine, compared with just 17% of Democrats.
• 48% of Republicans say it makes communities less safe, more than double the share of Democrats (21%) who say this.

Sizable age and partisan differences persist on the issue of marijuana legalization though small shares of adults across demographic groups are completely opposed to it.

Older adults are far less likely than younger adults to favor marijuana legalization.

This is particularly the case among adults ages 75 and older: 31% say marijuana should be legal for both medical and recreational use.

By comparison, half of adults between the ages of 65 and 74 say marijuana should be legal for medical and recreational use, and larger shares in younger age groups say the same.

Republicans continue to be less supportive than Democrats of legalizing marijuana for both legal and recreational use: 42% of Republicans favor legalizing marijuana for both purposes, compared with 72% of Democrats.

There continue to be ideological differences within each party:

• 34% of conservative Republicans say marijuana should be legal for medical and recreational use, compared with a 57% majority of moderate and liberal Republicans.
• 62% of conservative and moderate Democrats say marijuana should be legal for medical and recreational use, while an overwhelming majority of liberal Democrats (84%) say this.

Along with differences by party and age, there are also age differences within each party on the issue.

A 57% majority of Republicans ages 18 to 29 favor making marijuana legal for medical and recreational use, compared with 52% among those ages 30 to 49 and much smaller shares of older Republicans.

Still, wide majorities of Republicans in all age groups favor legalizing marijuana at least for medical use. Among those ages 65 and older, just 20% say marijuana should not be legal even for medical purposes.

While majorities of Democrats across all age groups support legalizing marijuana for medical and recreational use, older Democrats are less likely to say this.

About half of Democrats ages 75 and older (53%) say marijuana should be legal for both purposes, but much larger shares of younger Democrats say the same (including 81% of Democrats ages 18 to 29). Still, only 7% of Democrats ages 65 and older think marijuana should not be legalized even for medical use, similar to the share of all other Democrats who say this.

Substantial shares of Americans across racial and ethnic groups say when marijuana is legal for recreational use, it has a more positive than negative impact on the economy and criminal justice system.

About half of White (52%), Black (53%) and Hispanic (51%) adults say legalizing recreational marijuana is good for local economies. A slightly smaller share of Asian adults (46%) say the same.

Criminal justice

Across racial and ethnic groups, about four-in-ten say that recreational marijuana being legal makes the criminal justice system fairer, with smaller shares saying it would make it less fair.

However, there are wider racial differences on questions regarding the impact of recreational marijuana on the use of other drugs and the safety of communities.

Use of other drugs

Nearly half of Black adults (48%) say recreational marijuana legalization doesn’t have an effect on the use of drugs like heroin, fentanyl and cocaine. Another 32% in this group say it decreases the use of these drugs and 18% say it increases their use.

In contrast, Hispanic adults are slightly more likely to say legal marijuana increases the use of these other drugs (39%) than to say it decreases this use (30%); 29% say it has no impact.

Among White adults, the balance of opinion is mixed: 28% say marijuana legalization increases the use of other drugs and 25% say it decreases their use (45% say it has no impact). Views among Asian adults are also mixed, though a smaller share (31%) say legalization has no impact on the use of other drugs.

Community safety

Hispanic and Asian adults also are more likely to say marijuana’s legalization makes communities less safe: 41% of Hispanic adults and 46% of Asian adults say this, compared with 34% of White adults and 24% of Black adults.

Young Americans view the legalization of marijuana for recreational use in more positive terms compared with their older counterparts.

Clear majorities of adults under 30 say it is good for local economies (71%) and that it makes the criminal justice system fairer (59%).

By comparison, a third of Americans ages 65 and older say legalizing the recreational use of marijuana is good for local economies; about as many (32%) say it makes the criminal justice system more fair.

There also are sizable differences in opinion by age about how legalizing recreational marijuana affects the use of other drugs and the safety of communities.

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9 facts about Americans and marijuana

Most americans now live in a legal marijuana state – and most have at least one dispensary in their county, americans overwhelmingly say marijuana should be legal for medical or recreational use, clear majorities of black americans favor marijuana legalization, easing of criminal penalties, concern about drug addiction has declined in u.s., even in areas where fatal overdoses have risen the most, most popular, report materials.

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Why Weed Should Be Legal: a Case for Legalizing in America

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Marijuana, also known as cannabis, is a psychoactive drug derived from the Cannabis sativa plant. It is typically consumed for its mind-altering effects, which can induce feelings of relaxation, euphoria, and altered sensory perception. The plant contains various chemical compounds called cannabinoids, with delta-9-tetrahydrocannabinol (THC) being the most well-known and responsible for its psychoactive properties.

Marijuana legalization in the United States refers to the process of legalizing the recreational and/or medicinal use of marijuana at the state level. Over the past few decades, there has been a significant shift in public opinion and policy towards marijuana, leading to various states enacting their own laws to regulate its use. The movement towards marijuana legalization gained momentum in the 1990s with the passage of medical marijuana laws in California and other states. These laws allowed patients with certain medical conditions to access marijuana for therapeutic purposes. Since then, many states have followed suit, legalizing medical marijuana and establishing regulated systems for cultivation, distribution, and consumption. In recent years, there has been a growing trend towards the legalization of recreational marijuana. As of now, several states, including Colorado, Washington, Oregon, and California, have legalized the recreational use of marijuana for adults. These states have implemented strict regulatory frameworks to control its production, sale, and use. It's important to note that while some states have legalized marijuana, it remains illegal at the federal level in the United States. This has created a complex legal landscape, with variations in regulations and enforcement across different jurisdictions.

The historical context of marijuana legalization in the world and the United States is marked by changing perceptions, legal battles, and evolving social attitudes. Globally, the prohibition of marijuana can be traced back to the early 20th century when various countries, influenced by international treaties, criminalized its use. However, in recent decades, several countries have started to challenge this approach. The Netherlands, for example, adopted a tolerant stance towards marijuana in the 1970s, allowing small quantities to be sold and consumed in designated coffee shops. Uruguay became the first country to fully legalize marijuana in 2013, followed by Canada in 2018. In the United States, marijuana was criminalized with the passage of the Marihuana Tax Act in 1937. The federal government classified it as a Schedule I controlled substance under the Controlled Substances Act of 1970, considering it to have no medical value and a high potential for abuse. However, starting in the 1990s, a wave of states began to pass medical marijuana laws to allow its use for medicinal purposes. This paved the way for further changes, and as of 2021, recreational marijuana is legal in several states, with more considering or implementing similar measures.

Public opinion on marijuana legalization has undergone a significant transformation in recent years. While marijuana was once heavily stigmatized and associated with criminality, the general attitude towards its legalization has become more favorable. Polls and surveys consistently show that a majority of Americans now support the legalization of marijuana. Public opinion has shifted primarily due to changing perceptions of marijuana's potential benefits and a reevaluation of the social and economic consequences of its prohibition. Supporters argue that marijuana legalization can generate tax revenue, create job opportunities, and redirect law enforcement resources towards more pressing issues. They also highlight the medicinal properties of marijuana, advocating for its use as a treatment option for various conditions. Opponents, on the other hand, express concerns about the potential risks associated with marijuana use, particularly among young people. They worry about increased accessibility, impaired driving, and the potential for marijuana to serve as a gateway drug.

1. Medicinal benefits: Marijuana has proven medical benefits for conditions such as chronic pain, epilepsy, and nausea associated with chemotherapy. 2. Economic opportunities: Legalizing marijuana can create a new industry, generate tax revenue, and create jobs. 3. Individual freedom: Advocates emphasize that adults should have the right to make decisions about their own bodies, including the choice to use marijuana responsibly. 4. Criminal justice reform: Marijuana legalization would help reduce arrests and convictions related to marijuana possession, alleviating the burden on the criminal justice system and addressing racial disparities in law enforcement. 5. Regulation and safety: Legalization allows for the regulation of marijuana production, quality control, and sales. This would help ensure product safety, discourage the use of illicit substances, and promote responsible consumption.

1. Health risks: Marijuana use can have negative health effects, including respiratory problems, cognitive impairment, and addiction. 2. Gateway drug: Marijuana can serve as a gateway drug, potentially leading to the use of more dangerous substances. 3. Impaired driving: Legalization may lead to an increase in impaired driving incidents, posing risks to public safety. 4. Youth exposure: Legalization may make marijuana more accessible to minors. 5. Public health and societal costs:Marijuana legalization could lead to increased healthcare costs, workplace productivity issues, and other social problems.

In recent years, there has been an increase in media coverage that highlights the potential benefits and challenges of marijuana legalization. Documentaries like "Weed" by CNN's Dr. Sanjay Gupta and "The Culture High" shed light on the medical uses of marijuana and the impact of prohibition on individuals and communities. News outlets have covered various aspects of marijuana legalization, including its economic impact, public health concerns, and criminal justice reform. Publications like The New York Times and The Washington Post have published opinion pieces and investigative reports discussing the pros and cons of legalization. Popular TV shows like "Weeds" and "High Maintenance" have depicted the marijuana industry and its cultural influence, showcasing both positive and negative aspects. Additionally, social media platforms have provided a space for diverse voices and perspectives on marijuana legalization. Online discussions, podcasts, and YouTube channels have emerged, allowing individuals to share their experiences and opinions.

1. According to a report by New Frontier Data, the legal cannabis industry in the United States was projected to generate $30 billion in annual sales by 2025, creating numerous job opportunities and contributing to tax revenues. 2. A survey conducted by the Pew Research Center in 2021 found that 91% of Americans believed marijuana should be legal for medical or recreational use, indicating a significant increase in support over the years. 3. In states where marijuana is legal, there has been a decrease in marijuana-related arrests, reducing the burden on the legal system and freeing up resources for more serious crimes. For example, a study published in the journal Drug and Alcohol Dependence found that states with legalized medical marijuana experienced a 20% decrease in arrests for possession of marijuana.

The topic of marijuana legalization is important to write an essay about due to its multifaceted impact on society, economy, and public health. With shifting attitudes and changing laws surrounding marijuana, understanding the implications of its legalization is crucial. Firstly, marijuana legalization has significant social and criminal justice implications. It affects the lives of individuals who use marijuana for medical or recreational purposes, as well as those who have been disproportionately affected by the war on drugs. Exploring the social justice aspects, such as racial disparities in marijuana-related arrests and convictions, can shed light on the need for equitable policies. Secondly, the economic impact of marijuana legalization is noteworthy. Legalizing and regulating the cannabis industry can stimulate economic growth, create jobs, and generate tax revenue. Analyzing the economic benefits and potential challenges, such as market competition and taxation, can provide insights into the broader economic landscape. Lastly, the public health implications of marijuana legalization cannot be overlooked. Studying the effects of marijuana on physical and mental health, as well as its potential therapeutic uses, can inform public health policies and interventions.

1. Caulkins, J. P., Kilmer, B., & Kleiman, M. A. R. (2016). Marijuana legalization: What everyone needs to know. Oxford University Press. 2. National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. The National Academies Press. 3. Pacula, R. L., Kilmer, B., Wagenaar, A. C., & Chaloupka, F. J. (Eds.). (2014). Marijuana legalization: What everyone needs to know (2nd ed.). Oxford University Press. 4. ProCon.org. (2021). Should marijuana be a medical option? Retrieved from https://medicalmarijuana.procon.org/ 5. Caulkins, J. P., & Bond, B. M. (2019). The marijuana legalization paradox. Addiction, 114(9), 1614-1620. 6. National Conference of State Legislatures. (2021). State medical marijuana laws. Retrieved from https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx 7. Centers for Disease Control and Prevention. (2021). Marijuana and public health. Retrieved from https://www.cdc.gov/marijuana/index.htm 8. Rosenthal, E. (2013). The big book of buds: Marijuana varieties from the world's great seed breeders. Quick Trading Company. 9. Caulkins, J. P., Hawken, A., Kilmer, B., & Kleiman, M. A. R. (2012). Marijuana legalization: What everyone needs to know. Oxford University Press. 10. Drug Policy Alliance. (2021). Marijuana legalization and regulation. Retrieved from https://drugpolicy.org/marijuana-legalization-and-regulation

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The Evidence—and Lack Thereof—About Cannabis

Research is still needed on cannabis’s risks and benefits. 

Lindsay Smith Rogers

Although the use and possession of cannabis is illegal under federal law, medicinal and recreational cannabis use has become increasingly widespread.

Thirty-eight states and Washington, D.C., have legalized medical cannabis, while 23 states and D.C. have legalized recreational use. Cannabis legalization has benefits, such as removing the product from the illegal market so it can be taxed and regulated, but science is still trying to catch up as social norms evolve and different products become available. 

In this Q&A, adapted from the August 25 episode of Public Health On Call , Lindsay Smith Rogers talks with Johannes Thrul, PhD, MS , associate professor of Mental Health , about cannabis as medicine, potential risks involved with its use, and what research is showing about its safety and efficacy. 

Do you think medicinal cannabis paved the way for legalization of recreational use?

The momentum has been clear for a few years now. California was the first to legalize it for medical reasons [in 1996]. Washington and Colorado were the first states to legalize recreational use back in 2012. You see one state after another changing their laws, and over time, you see a change in social norms. It's clear from the national surveys that people are becoming more and more in favor of cannabis legalization. That started with medical use, and has now continued into recreational use.

But there is a murky differentiation between medical and recreational cannabis. I think a lot of people are using cannabis to self-medicate. It's not like a medication you get prescribed for a very narrow symptom or a specific disease. Anyone with a medical cannabis prescription, or who meets the age limit for recreational cannabis, can purchase it. Then what they use it for is really all over the place—maybe because it makes them feel good, or because it helps them deal with certain symptoms, diseases, and disorders.

Does cannabis have viable medicinal uses?

The evidence is mixed at this point. There hasn’t been a lot of funding going into testing cannabis in a rigorous way. There is more evidence for certain indications than for others, like CBD for seizures—one of the first indications that cannabis was approved for. And THC has been used effectively for things like nausea and appetite for people with cancer.

There are other indications where the evidence is a lot more mixed. For example, pain—one of the main reasons that people report for using cannabis. When we talk to patients, they say cannabis improved their quality of life. In the big studies that have been done so far, there are some indications from animal models that cannabis might help [with pain]. When we look at human studies, it's very much a mixed bag. 

And, when we say cannabis, in a way it's a misnomer because cannabis is so many things. We have different cannabinoids and different concentrations of different cannabinoids. The main cannabinoids that are being studied are THC and CBD, but there are dozens of other minor cannabinoids and terpenes in cannabis products, all of varying concentrations. And then you also have a lot of different routes of administration available. You can smoke, vape, take edibles, use tinctures and topicals. When you think about the explosion of all of the different combinations of different products and different routes of administration, it tells you how complicated it gets to study this in a rigorous way. You almost need a randomized trial for every single one of those and then for every single indication.

What do we know about the risks of marijuana use?  

Cannabis use disorder is a legitimate disorder in the DSM. There are, unfortunately, a lot of people who develop a problematic use of cannabis. We know there are risks for mental health consequences. The evidence is probably the strongest that if you have a family history of psychosis or schizophrenia, using cannabis early in adolescence is not the best idea. We know cannabis can trigger psychotic symptoms and potentially longer lasting problems with psychosis and schizophrenia. 

It is hard to study, because you also don't know if people are medicating early negative symptoms of schizophrenia. They wouldn't necessarily have a diagnosis yet, but maybe cannabis helps them to deal with negative symptoms, and then they develop psychosis. There is also some evidence that there could be something going on with the impact of cannabis on the developing brain that could prime you to be at greater risk of using other substances later down the road, or finding the use of other substances more reinforcing. 

What benefits do you see to legalization?

When we look at the public health landscape and the effect of legislation, in this case legalization, one of the big benefits is taking cannabis out of the underground illegal market. Taking cannabis out of that particular space is a great idea. You're taking it out of the illegal market and giving it to legitimate businesses where there is going to be oversight and testing of products, so you know what you're getting. And these products undergo quality control and are labeled. Those labels so far are a bit variable, but at least we're getting there. If you're picking up cannabis at the street corner, you have no idea what's in it. 

And we know that drug laws in general have been used to criminalize communities of color and minorities. Legalizing cannabis [can help] reduce the overpolicing of these populations.

What big questions about cannabis would you most like to see answered?

We know there are certain, most-often-mentioned conditions that people are already using medical cannabis for: pain, insomnia, anxiety, and PTSD. We really need to improve the evidence base for those. I think clinical trials for different cannabis products for those conditions are warranted.

Another question is, now that the states are getting more tax revenue from cannabis sales, what are they doing with that money? If you look at tobacco legislation, for example, certain states have required that those funds get used for research on those particular issues. To me, that would be a very good use of the tax revenue that is now coming in. We know, for example, that there’s a lot more tax revenue now that Maryland has legalized recreational use. Maryland could really step up here and help provide some of that evidence.

Are there studies looking into the risks you mentioned?

Large national studies are done every year or every other year to collect data, so we already have a pretty good sense of the prevalence of cannabis use disorder. Obviously, we'll keep tracking that to see if those numbers increase, for example, in states that are legalizing. But, you wouldn't necessarily expect to see an uptick in cannabis use disorder a month after legalization. The evidence from states that have legalized it has not demonstrated that we might all of a sudden see an increase in psychosis or in cannabis use disorder. This happens slowly over time with a change in social norms and availability, and potentially also with a change in marketing. And, with increasing use of an addictive substance, you will see over time a potential increase in problematic use and then also an increase in use disorder.

If you're interested in seeing if cannabis is right for you, is this something you can talk to your doctor about?

I think your mileage may vary there with how much your doctor is comfortable and knows about it. It's still relatively fringe. That will very much depend on who you talk to. But I think as providers and professionals, everybody needs to learn more about this, because patients are going to ask no matter what.

Lindsay Smith Rogers, MA, is the producer of the Public Health On Call podcast , an editor for Expert Insights , and the director of content strategy for the Johns Hopkins Bloomberg School of Public Health.

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Ross Douthat

Legalizing Marijuana Is a Big Mistake

By Ross Douthat

Opinion Columnist

Of all the ways to win a culture war, the smoothest is to just make the other side seem hopelessly uncool. So it’s been with the march of marijuana legalization: There have been moral arguments about the excesses of the drug war and medical arguments about the potential benefits of pot, but the vibe of the whole debate has pitted the chill against the uptight, the cool against the square, the relaxed future against the Principal Skinners of the past.

As support for legalization has climbed, commanding a two-thirds majority in recent polling , any contrary argument has come to feel a bit futile, and even modest cavils are couched in an apologetic and defensive style. Of course I don’t question the right to get high, but perhaps the pervasive smell of weed in our cities is a bit unfortunate …? I’m not a narc or anything, but maybe New York City doesn’t need quite so many unlicensed pot dealers …?

All of this means that it will take a long time for conventional wisdom to acknowledge the truth that seems readily apparent to squares like me: Marijuana legalization as we’ve done it so far has been a policy failure, a potential social disaster, a clear and evident mistake.

The best version of the square’s case is an essay by Charles Fain Lehman of the Manhattan Institute explaining his evolution from youthful libertarian to grown-up prohibitionist. It will not convince readers who come in with stringently libertarian presuppositions — who believe on high principle that consenting adults should be able to purchase, sell and enjoy almost any substance short of fentanyl and that no second-order social consequence can justify infringing on this right.

But Lehman explains in detail why the second-order effects of marijuana legalization have mostly vindicated the pessimists and skeptics. First, on the criminal justice front, the expectation that legalizing pot would help reduce America’s prison population by clearing out nonviolent offenders was always overdrawn, since marijuana convictions made up a small share of the incarceration rate even at its height. But Lehman argues that there is also no good evidence so far that legalization reduces racially discriminatory patterns of policing and arrests. In his view, cops often use marijuana as a pretext to search someone they suspect of a more serious crime, and they simply substitute some other pretext when the law changes, leaving arrest rates basically unchanged.

So legalization isn’t necessarily striking a great blow against mass incarceration or for racial justice. Nor is it doing great things for public health. There was hope, and some early evidence, that legal pot might substitute for opioid use, but some of the more recent data cuts the other way: A new paper published in The Journal of Health Economics found that “legal medical marijuana, particularly when available through retail dispensaries, is associated with higher opioid mortality.” There are therapeutic benefits to cannabis that justify its availability for prescription, but the evidence of its risks keeps increasing: This month brought a new paper strengthening the link between heavy pot use and the onset of schizophrenia in young men.

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A Republican’s argument for legalizing marijuana: Why I’m yes on Amendment 3

2024 Election , Opinion

By Jake Hoffman

Published Aug. 29, 2024, 12:59 p.m. ET | Updated Aug. 29, 2024

TAMPA, Fla. – In November, Florida voters will decide whether or not to legalize recreational marijuana in our state.

Much of the conversation regarding the issue is more reminiscent of reefer madness in the 1930s and does not take into account the landscape of the industry in 2024.

It’s time conservatives had a real conversation about the benefits of passing Amendment 3 and not just the fear mongering I’m seeing from across the State.

I believe in the “Free State of Florida” mantra, and I believe we should have as much freedom as 24 other States and the District of Columbia where recreational marijuana is already legal. So, let’s break down the key points against it and why they don’t hold up.

Argument 1: ‘Prevalence of Marijuana Usage In The State of Florida. ‘

There seems to be an illusion amongst Republicans that we do not already have marijuana in Florida. Florida currently has the most medical marijuana card holders in the country, with the number nearing 1 million patients, which roughly equals out to 1 in 17 people over 21 holding a medical marijuana card.

This is before even accounting for the thriving black market which is estimated to be near an additional 1.8 Million Floridians. This article will not even delve into the products currently available at smoke shops and gas stations.

So, I do not want to hear from anyone that somehow Florida is a puritanical oasis that is going to be inundated with the devil’s lettuce. It’s here and it’s everywhere. You can bury your head in the sand about reality or be pragmatic and make the market safer.

Argument 2: ‘Florida is NOT California, New York, or Colorado. ‘

You often hear the Governor say he doesn’t want Florida to turn into California.

Yeah, I don’t want that either. Which is why we have a supermajority Republican legislature in Tallahassee that can legislate a framework after the amendment passes.

Sens. Gruters and Rouson already announced a bill to ban public smoking across the state. If cities adopt a policy of handing out hefty fines in heavily trafficked areas, it will quickly be controlled.

We are not those states and we enforce laws here. It is a disingenuous argument to say that Florida can’t and won’t. 

Back in 2018 when I broke with the party line to endorse the amendment allowing felons to vote, the same hysteria occurred. The theory was we wouldn’t be able to control the liberals from inundating Florida voter rolls with Democrat-felon voters and we’d turn blue.

It turns out the legislature spent the next year defining the terms of the amendment, debating the interpretation and actually legislating. So it has been done recently, and a little known fact is that over 70% of returning voters in Florida register Republican.

Despite morally and constitutionally being the right thing to do, it also had the opposite effect of what was expected. That 1 million Republican voter registration lead the party likes to tout should also give some credit to the amendment they didn’t support.

The point is – we cannot compare our laws to New York or California. It is still illegal to assault people on the street and commit robberies in those States, but the difference in Florida is that we support police and enforce the laws here. The same would be true if we implement fines and fees for public use.

Argument 3: ‘Should this be amended by The Florida constitution? ‘

Floridians have the right to amend their own constitution, which could be avoided if the legislature took on the issue previously, but this issue has been widely ignored for some time during sessions.

The Republican Party has endorsed voting ‘Yes’ on FOUR constitutional amendments on the same ballot. The argument that we should not amend the constitution may have worked in the past, but are we now also going to campaign against the right to hunt and fish (Amendment 2) or make school board races partisan (Amendment 1)? Next…

Argument 4: ‘ Crime will increase! What about public safety? ‘

Again, we are not Colorado or California, where they have imported millions of illegal immigrants over the past four years and defunded their police. A common argument against legalized weed is that traffic accidents will increase and crime will skyrocket, yet there is no consistent research showing the correlation between marijuana being the cause of these issues.

Law enforcement is already well equipped to prevent people from driving under the influence and is capable of enforcing DUI laws involving marijuana.

I, for one, would theorize that if you give thousands of people without driver’s licenses free housing in downtown Denver, that would lead to an increase in crime and car crashes. Nobody is stealing catalytic converters in San Francisco to pay for a weed addiction.

There is also an old trope being purported that weed is a gateway drug and our youth will suffer. First, there is a consensus amongst scientific studies that teen marijuana use is actually decreasing significantly over the past decade, which would be counter-intuitive to what you would think if 38 states have some form of legalized cannabis. Unless you understand teenagers’ human nature to enjoy breaking rules.

When it becomes legal and no longer taboo, we take away a majority of the appeal as well as make the product safer if they do try it.

I cannot stress enough that it is 2024 and the weed on the streets is significantly more dangerous than that of a regulated licensed cannabis dispensary.

I’ve personally spoken to numerous nurses, crisis centers, and rehabs that will attest that there is really fentanyl in every street drug, including marijuana.

Thousands of people are permanently injured or killed by unintentionally ingesting illicit drugs every day across the USA. Moving the market and products into the sunshine ensures a safe process for consumption.

Florida has the opportunity now to lead on this issue and create a thriving market for entrepreneurs and small businesses. It’s not as complicated or impossible as it is being made out to be.

The Republicans in Tallahassee will only be right about this being a disaster if they butcher the implementation afterward.

If we regulate public use, enable local governments to fine people, enforce those statutes, keep taxation and bureaucracy to a minimum on dispensaries, and include small businesses in the equation of licenses; we can be the example for the rest of the country and reap an estimated extra $500M+ in new revenue while we’re at it. However, for us to move this issue forward and allow the debate to happen, we must vote Yes on Amendment 3.

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Legalization of Marijuana: Arguments For and Against Essay

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There have been arguments about marijuana for a very long time now with some people supporting it while others opposing its use in the society. People have proposed that marijuana is very addictive and can cause dire health effects to people who use it. On the other hand, marijuana has been used for medicinal purposes since historical times. Nevertheless, marijuana has destroyed people’s lives and made them totally irresponsible.

It has also helped reduce the excruciating pain that other patients undergo in various health facilities. The crux of the matter is whether marijuana should be made legal and its use accepted in the society or not. If marijuana is made legal, people will not be restricted on how to use it because getting it will be easy. On the contrary, illegalizing it ensures that its use is at least put under control and many of its effects are not large scale.

The medical use of marijuana goes back to ancient periods when it was smoked by people to reduce pain. Additionally, recent studies in the medical field have also depicted the importance of marijuana patients especially cancer patients. There are several patients who have testified that use of marijuana has had an impact on their pain.

Scientific research has also proved that marijuana can really help in pain alleviation. While scientists are really trying to ensure that efforts are made to enhance the quality of service that patients receive, they hit a dead end in their research due to legal restrictions (Goldberg 251). Debates about marijuana in the political arena have found their way into scientific studies thus hindering any progress that would have been made.

The government’s argument of illegalizing marijuana is to deter people from harming themselves. However, it is rather difficult to determine what is good or bad for a person. People should have the freedom of choosing what is right or wrong for their lives.

The government’s role should be to limit choices made by people if the choices endanger the person’s live or that of others. But if a patient chooses to use marijuana to alleviate the pain he or she is undergoing, the act is beneficial to the patient and the community at large (Ponto 1081). As a result, the patient should not be compelled not to have a choice where his or her own live is involved.

Moreover, the argument that illegalizing marijuana will be beneficial to the whole community is wrong. Tobacco and alcohol are legal and their effects are not any different from those of marijuana. On the contrary, nobody is campaigning against tobacco and alcohol though they are both responsible for destroying lives. Marijuana is addictive and so is tobacco and alcohol. Why should marijuana be treated differently?

Currently marijuana is illegal and yet many people still have access to it. Each year numerous people are arrested for using marijuana and sent to prisons.

These people strain the government facilities which are already overpopulated. The government has to provide for the basic necessities of this people while they are in prison. The law also requires the government to put in place measures that will ensure that any person found using marijuana is arrested.

In addition, the government spends money to ensure that distribution channels of marijuana are curtailed. All these require the government to spend a lot of money thus increasing public expenses. Despite all this expenses, marijuana still finds its way into the hands of its users. However, if marijuana was legal the government will not only safe the money it spends but would also increase its income through taxing marijuana (Rabin Par 1).

Lets think for a moment the effect that illegalization of marijuana has had to our community. Young people still get marijuana whenever they want without any hindrance. It is also not possible to associate illegalization of marijuana with reduction of its use. Various studies have shown that the number of people using marijuana has steadily risen over the past years. Given that marijuana is sold under great secrecy, it is easy for young people to get it than it is to get alcohol or tobacco.

Distributors of illegal commodities usually do not care who they sell the commodities to. People who are below the legal age usually get and use marijuana as they wish. All this show that illegalization of marijuana has not met the intended objectives of reducing its use in the community (Rosenthal and Steve 108). Therefore, it is worthless trying to implement a policy that does not have any positive impact to the society.

Our constitution outlines that people have freedom to exercise their religious practices. It is stated that people should not be discriminated against on grounds of their gender, religion, racial background or any other grounds. Christians are allowed to enjoy their freedom without any regulation from the government and so are some other religions.

In the latter and spirit of this requirement, no restriction should be placed on the religions that use marijuana (caulkins, Angela, Beau and Mark 58). There are religions especially the Rastafarians which use marijuana as part of their practices. Illegalizing marijuana is tantamount to restricting religious practices of these religions.

On the same note, it can be proved that implementation of the law against marijuana is discriminative. There are many people who use marijuana in the United States of America and they are not restricted to the low economic class only. People from all economic classes as well as different racial backgrounds use marijuana.

However, people from the economically upper class are able to disguise themselves and slip the net of police. Consequently, it is people from low class and mostly the colored that are arrested and charged for using marijuana. The Whites usually find a way of getting themselves out of the hook.

However, there are people who are against the idea that marijuana should be made legal. As a result, they have forwarded several points to support their position. Firstly, the addictiveness of marijuana is not like that of tobacco or alcohol.

While addicts of alcohol and tobacco will stick to them even when it is hard to get them, addicts of marijuana will turn to other narcotics in case they are unable to get marijuana. Moreover, even when marijuana is available research has shown that marijuana users will be using other narcotics (Ponto 1082). It is therefore clear that legalizing marijuana will bring a lot of problems in regulating the use of other narcotics.

Secondly, the argument that marijuana is a good painkiller is insufficient to counter the negative impacts that the substance has to human life. So far the medical use of marijuana is not so common that it can make any impact in the medical field. Moreover, there are other pain relievers which are as effective as marijuana. On the same note, research can be done to come up with an alternative painkiller that would be effective but not addictive.

It is therefore not necessary to legalize marijuana solely on the reason that it has medical benefits (Rabin par 2). It is important to note that legalizing marijuana for medical use will open avenues for people to misuse it. Arguably, it would be very difficult to define what is meant by medical use. Furthermore, there is a possibility that people will fake different diseases so that they can be able to use marijuana. Additionally, cases of people taking too much doses than required would be very high thus leading to addiction.

It has been argued that illegalization of marijuana has not stopped illegal selling of the substance. But nobody has proved beyond reasonable doubt that legalizing it will do any good in reducing illegal trading.

As a matter of fact, legalization of marijuana on any grounds whether medical or otherwise will increase illegal trading because that will provide an excuse for illegal dealers to transport the substance. It will therefore be difficult to regulate the use of marijuana among young people and other unauthorized people if it is legalized (Goldberg 253). Consequently, abuse of the substance will be uncontrollable and this will lead to even dire negative effects.

On the same note, while other medical drugs are subjected to several stiff safety tastes before they are allowed to be used; it is difficult to subject marijuana to the same.

Of all the medical researches that have been done on marijuana, none has identified it as totally safe to be used for medical purposes. Moreover, legalizing marijuana would be tantamount to encouraging its smoking. It should be noted that marijuana has various negative effects to the health of people. Marijuana has been associated with tachycardia and motor impairment (Earleywine 76).

On the same note, research has shown that marijuana can lead to increased chances of one getting lung infections besides weakening the immune system. Moreover, continuous use of marijuana can cause fatal complication in older people. Similarly, marijuana has been depicted to cause negative effects to brain and nerve cells. All these negative effects of marijuana increases doubt on its benefits to society. It shows that there would be many negative impacts associated with the substance if it is legalized (Rosenthal and Steve 109).

There are those who have argued that illegalization of marijuana has had no effect to the society. The fact that marijuana gets its way into people’s homes and even high school children can get it cannot be swept under the carpet. But imagine for a second that there were no regulations on the use of marijuana.

Everybody in need of it could just go to the nearby shop and purchase it. More youth would be using marijuana than they do today. Cases of people dropping out of schools due to over indulgence in marijuana would be very high. The fear of being caught and imprisoned has reduced the quantity of marijuana that is distributed in the community. Legalizing marijuana will increase its availability leading to increased number of users both legal and illegal. Given the side effects marijuana has, this will spell doom to the society as a whole.

Though people are supposed to have freedom to decide what is good for their lives, other people’s affair should be put into consideration. Religion should not be an excuse for people to use harmful substances.

The effects of marijuana to secondary smokers should be minimized as much as possible. The side effects of marijuana are too many to be left unchecked. It is the role of the government to ensure the well being of all its citizens. In this regard, it is upon any government to ensure that any harmful product to people is not available for choices (Goldberg 249).

On the same note, it has been argued that legalization of marijuana will save a lot of money that is currently used trying to implement the policy illegalizing marijuana. The same argument proposes that there would be increase in government income from taxing marijuana. This argument is as wrong as it is misleading.

Research has shown that use of marijuana leads to increase in crime rates. When addicts of marijuana cannot get money to purchase the drug, they will turn to crime to get money. As a result, the government will still have to spend on keeping criminals in prison. Moreover, there should be some regulation to ensure that marijuana meets some specified safety standards before it is allowed into the market. The cost of implementing these regulations is likely to exceed the tax collected in the case of marijuana.

The social impacts of marijuana are also negative and many. To begin with, marijuana is known to make people violent. Therefore, many families will be marred with cases of violence thus leading to family breakdown.

Consequently, more and more children will grow up without proper parental care which will increase juvenile delinquencies. On the same note, it would be morally wrong to legalize a substance whose negative effects are well known to everybody. Moreover, legalization of marijuana will increase the chances of minors getting access to it.

This will not only increase cases of juvenile delinquency but also other economic problems. Similarly, marijuana is known to be addictive and makes people dependent on it (Rosenthal and Steve 107). Consequently, massive use of the substances will be problematic economically since most people will stop providing for their families just to have money to buy the substance. This will lead to low living standards.

Many people will give reasons why marijuana should be made legal. Alcohol and tobacco have been made legal so why is marijuana treated like it kills instantly. Some will argue that no study has directly linked marijuana with any of the health conditions it is suspected of causing. On the same note, it is a fact that marijuana is still being used even by high school students yet it is illegal.

Others will argue that it will be unfair and morally wrong to deny patients the chance of reducing he pain they endure by illegalizing marijuana. However, we should ask ourselves which option is better between getting alternative pain relievers and having a society where majority are addicts of marijuana. Clearly, if it was not for the regulation against marijuana, there could have been a disaster especially in schools.

It would be immoral to allow patients touse marijuana as a pain reliever knowing very well that the substance has dire impacts on their health. Consequently, legalizing marijuana will do more harm than good. In this regard, the subject of whether to legalize marijuana or not should be dropped.

Works Cited

Earleywine, Mitch. Understanding Marijuana: Anew look at the scientific Evidence . Oxford: Oxford University Press, 2002. Print.

Caulkins, Jonathan P., Angela Hawken, Beau Kilmer and Mark R. Kleiman. Marijuana Legalization: What Everyone Needs to Know . Oxford: Oxford University Press, 2012. Print.

Goldberg, Ray . Drugs Across the Spectrum . Stanford: Cengage learning.

Ponto, Laura L. Challenges of Marijuana Research. Oxford Journals 129.5 (2006): 1081-1083. Print.

Rabin, Roni C. “ Legalizing of Marijuana Raises Health Concerns .” The New York Times. 2013. Web.

Rosenthal, Ed and Steve Kubby. Why Marijuana Should be Legal . New York: Running Press, 2003. Print.

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IvyPanda. (2018, December 19). Legalization of Marijuana: Arguments For and Against. https://ivypanda.com/essays/legalization-of-marijuana-2/

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IvyPanda . (2018) 'Legalization of Marijuana: Arguments For and Against'. 19 December.

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IvyPanda . "Legalization of Marijuana: Arguments For and Against." December 19, 2018. https://ivypanda.com/essays/legalization-of-marijuana-2/.