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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 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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Why We Must Legalize Marijuana

The federal prohibition of marijuana has been unnecessarily cruel—wasting billions of dollars, unjustly harming millions of lives, and furthering racist policies. 

by Robert Reich

May 28, 2019

AP Photo/Richard Vogel

The federal prohibition on marijuana has been a disaster. For decades, millions of Americans have been locked up and billions of dollars have been wasted. It's also deepened racial and economic inequality.

We must end this nonsensical prohibition.

The facts are staggering. In 2017, more Americans were arrested for marijuana possession than for murder, rape, aggravated assault and robbery combined. That’s one marijuana arrest every minute.

The costs associated with enforcing this ban—including arrests, court costs, and incarceration— reach nearly $14 billion a year .

Prohibition also hurts the economy in terms of lost wages. And Americans with criminal records have a harder time finding a job and getting the education they need.

On the other hand, legalizing, taxing, and regulating is good for the economy and creates jobs.

By simply levying a tax on marijuana like we do cigarettes and alcohol, state and local governments could raise more than $6 billion a year . This doesn’t even include additional revenue from taxes on the marijuana industry.

States like Colorado and Washington that tax and regulate marijuana have already generated millions of dollars for health care, education, and other public investments.

But this is more than an economic issue. It's also a matter of racial justice and equality.

The federal prohibition on marijuana dates back to anti-Mexican sentiment in the 1930s. In large part, it was nothing more than another way to criminalize communities of color.

Today, black and brown Americans are still much more likely to be arrested for marijuana than white Americans , despite using marijuana at similar rates.

Given the racist legacy of these laws, it's particularly important that the economic gains of legalization extend to communities that have been most harmed by the war on drugs.

Support for marijuana legalization has surged in recent years, with two-thirds of Americans now in favor of it. Even a majority of Republicans are in support , and more states are taking action to reform their laws and move toward legalization.

Yet Donald Trump and his administration are trying to turn back the clock. They've even formed a task force to weaken public support for legalization and help spread misinformation about so-called “marijuana threats.”

Just as with the prohibition on alcohol in the 1920s, the federal prohibition of marijuana has been unnecessarily cruel—wasting billions of dollars, unjustly harming millions of lives, and furthering racist policies.

It's time to legalize marijuana.

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Pros and Cons of Legalizing Marijuana

• Legalization Pros
• Scientific Evidence

The pros and cons of legalizing marijuana are still being debated. Today, 38 U.S. states and the District of Columbia allow for the medical use of marijuana. A growing number allow recreational use.

However, as a Schedule I controlled substance, marijuana is illegal under federal law. This Drug Enforcement Administration designation means that marijuana is considered to have "no currently accepted medical use and a high potential for abuse." It also limits medical studies into the potential benefits of cannabis .

This article explains the positions of those who want to legalize marijuana as well as the arguments of those who do not want to see marijuana legalized.

The Pros of Legalizing Marijuana

Americans overwhelmingly support the legalization of marijuana. In fact, according to the Pew Research Center, 88% of Americans support legalizing marijuana. Of those, 59% say it should be legal for medical and recreational use, and 30% say it should be legal for medical reasons only.

Several possible health benefits of medical marijuana have been proposed:

• Nausea : Marijuana is effective in relieving nausea and vomiting. Studies have shown that cannabis can decrease nausea caused by chemotherapy and almost eliminate vomiting.
• Spasticity : Marijuana can relieve pain and spasticity associated with multiple sclerosis.
• Appetite : Marijuana can help treat appetite loss associated with conditions like  HIV/AIDS and certain types of cancers.
• Chronic pain : Marijuana can relieve certain types of chronic pain, including neuropathic pain, which is caused by nerve damage.

Arguments in favor of using medical marijuana include:

• It's safer : Marijuana is safer than some other medications prescribed to treat pain. For example, some people may use it instead of opioids for pain management. Opioids are highly addictive and are typically not recommended for long-term use in treating chronic pain.
• You can use it in many ways : You do not need to smoke cannabis for its benefits. Products such as topical pain relief treatments, edibles, and other non-smoking applications are now available.
• It's natural : People have used marijuana for centuries as a natural medicinal agent with good results.

Recreational Marijuana

Marijuana is legal for recreational use in 20 states and the District of Columbia. In 20 other states, marijuana has been decriminalized. This means there are no criminal penalties in these states for minor marijuana-related offenses like possession of small amounts or cultivation for personal use.

The Cons of Legalizing Marijuana

Those who oppose the legalization of marijuana point to the health risks of the drug, including:

• Memory issues : Frequent marijuana use may seriously affect your short-term memory.
• Cognition problems : Frequent use can impair your cognitive (thinking) abilities.
• Lung damage : Smoking anything, whether it's tobacco or marijuana, can damage your lung tissue. In addition, smoking marijuana could increase the risk of lung cancer .
• Abuse : Marijuana carries a risk of abuse and addiction.
• Accidents : Marijuana use impairs driving skills and increases the risk for car collisions.

The fact that the federal government groups it in the same category as drugs like heroin, LSD, and ecstasy is reason enough to keep it illegal, some say. As Schedule I drugs are defined by having no accepted value, legalization could give users the wrong impression about where research on the drug stands.

Scientific Evidence Remains Limited

In the past, clinical trials to determine if marijuana is effective in treating certain conditions have been restrictive and limited. However, as medical marijuana becomes more common throughout the world, researchers are doing more studies.

Expert reviews of current research continue to say more studies are needed. In addition, many hurdles involve controlling the quality and dosing of cannabis with what is legally available to researchers.

One review of research noted that the long-term effects of cannabis are still unknown. Without more research into dosage and adverse effects, scientific evidence of risks and therapeutic effects remains soft.

Researchers need to evaluate marijuana using the same standards as other medications to understand whether it is valuable for managing any conditions.

Until the federal government downgrades marijuana from a Schedule I drug, widespread clinical trials are unlikely to happen in the United States.

Medical marijuana is increasingly available in the U.S. It is often used to treat chronic pain, muscle spasms, nausea, and vomiting, and to increase appetite. However, it can affect thinking and memory, and increase the risk of accidents, plus smoking it may harm the lungs and lead to cancer.

More studies are needed to understand the benefits of medical marijuana. However, unless the federal government removes it as a Schedule I controlled substance, research, access, and legality will remain complicated.

National Conference of State Legislatures. State medical cannabis laws .

United States Drug Enforcement Administration. Drug scheduling .

Pew Research Center. Americans overwhelmingly say marijuana should be legal for recreational or medical use .

Badowski ME. A review of oral cannabinoids and medical marijuana for the treatment of chemotherapy-induced nausea and vomiting: a focus on pharmacokinetic variability and pharmacodynamics . Cancer Chemother Pharmacol. 2017;80(3):441-449. doi:10.1007/s00280-017-3387-5

Filippini G, Lasserson TJ, Dwan K, et al. Cannabis and cannabinoids for people with multiple sclerosis . Cochrane Database Syst Rev . 2019;2019(10):CD013444. doi:10.1002/14651858.CD013444

American Cancer Society. Marijuana and Cancer .

Hill KP. Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: A clinical review . JAMA. 2015;313(24):2474-83. doi:10.1001/jama.2015.6199

Choo EK, Feldstein Ewing SW, Lovejoy TI. Opioids out, cannabis in: Negotiating the unknowns in patient care for chronic pain . JAMA . 2016;316(17):1763-1764. doi:10.1001/jama.2016.13677

Corroon J, Sexton M, Bradley R. Indications and administration practices amongst medical cannabis healthcare providers: a cross-sectional survey . BMC Fam Pract. 2019;20(1):174. doi:10.1186/s12875-019-1059-8

The Council of State Governments. State approaches to marijuana policy .

Harvard Health Publishing, Harvard Medical School. The Effects of Marijuana on your Memory .

Ghasemiesfe M, Barrow B, Leonard S, Keyhani S, Korenstein D. Association between marijuana use and risk of cancer: a systematic review and meta-analysis . JAMA Netw Open. 2019;2(11):e1916318. doi:10.1001/jamanetworkopen.2019.16318

Preuss U, Huestis M, Schneider M et al. Cannabis use and car crashes: A review . Front Psychiatry . 2021;12. doi:10.3389/fpsyt.2021.643315

Deshpande A, Mailis-Gagnon A, Zoheiry N, Lakha SF. Efficacy and adverse effects of medical marijuana for chronic noncancer pain: Systematic review of randomized controlled trials . Can Fam Physician. 2015;61(8):e372-81.

Hill KP, Palastro MD, Johnson B, Ditre JW. Cannabis and pain: a clinical review .  Cannabis Cannabinoid Res . 2017;2(1):96-104. doi:10.1089/can.2017.0017

Maida V, Daeninck PJ. A user's guide to cannabinoid therapies in oncology . Curr Oncol. 2016;23(6):398-406. doi:10.3747/co.23.3487

Meier MH, Caspi A, Cerdá M, et al. Associations between cannabis use and physical health problems in early midlife: A longitudinal comparison of persistent cannabis vs tobacco users. JAMA Psychiatry. 2016;73(7):731-40. doi:10.1001/jamapsychiatry.2016.0637

By Angela Morrow, RN Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.

What do you think? Leave a respectful comment.

Amy Adamczyk, The Conversation Amy Adamczyk, The Conversation

Christopher Thomas, The Conversation Christopher Thomas, The Conversation

Jacob Felson, The Conversation Jacob Felson, The Conversation

• Copy URL https://www.pbs.org/newshour/science/why-so-many-americans-now-support-legalizing-marijuana-in-4-charts

Why so many Americans now support legalizing marijuana, in 4 charts

American views on marijuana have shifted incredibly rapidly. Thirty years ago, marijuana legalization seemed like a lost cause. In 1988 , only 24 percent of Americans supported legalization.

But steadily, the nation began to liberalize. By 2018 , 66 percent of U.S. residents offered their approval, transforming marijuana legalization from a libertarian fantasy into a mainstream cause. Many state laws have changed as well. Over the last quarter-century, 10 states have legalized recreational marijuana , while 22 states have legalized medical marijuana.

So why has public opinion changed dramatically in favor of legalization? In a study published this February , we examined a range of possible reasons, finding that the media likely had the greatest influence.

Chart by The Conversation, CC-BY-ND. Data via Science Research (2019)

It’s not about use, geography or demographics

Our study ruled out a few obvious possibilities.

For one, it’s not about marijuana use. Yes, marijuana use has increased. Data from the National Survey on Drug Use and Health show that, in 2002, about 10 percent of adults reported using marijuana the previous year. By 2015, 13.5 percent reported using. But that increase is too small to have had much of an impact on attitudes.

And it’s not about older, more conservative Americans being replaced by younger generations who are more familiar with marijuana. Both younger and older people developed more liberal views about the legalization of marijuana at a similar pace over the last 30 years. In this way, changes in attitudes about marijuana legalization mirror recent increases in support for LGBTQ individuals .

We looked to see if people who lived in states where it was illegal, but resided next to ones where it became legal, were more likely to have changed their views. But the rate of change has been no different in states that legalized marijuana than in others.

Chart by The Conversation, CC-BY-ND. Data via Social Science Research (2019)

Likewise, the pace of change has been similar across political parties, religions, educational levels, racial and ethnic groups and gender. As politically polarized as the country may seem, when it comes to marijuana, Americans have been changing their attitudes together, as a nation.

We did find that a small part of the increase in support was related to more people disaffiliating with religion. The proportion of people who do not identify with a religion has increased some, by about 7 percent between 2007 and 2014 . People who do not have a religion tend to be more liberal than others. However, this factor accounts for only a small proportion of the change.

Media medical framing

So what’s going on? What has likely made the biggest difference is how the media has portrayed marijuana. Support for legalization began to increase shortly after the news media began to frame marijuana as a medical issue.

We took The New York Times as a case study, looking at the number of published articles from 1983 to 2015 about marijuana. Just before the number of Americans supporting legalization began to increase, we found a sharp increase in the proportion of articles about marijuana that discussed its medical uses.

In the 1980s, the vast majority of New York Times stories about marijuana were about drug trafficking and abuse or other Schedule I drugs. At that time, The New York Times was more likely to lump marijuana together in a kind of unholy trinity with cocaine and heroin in discussions about drug smuggling, drug dealers and the like.

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During the 1990s, stories discussing marijuana in criminal terms became less prevalent. Meanwhile, the number of articles discussing the medical uses of marijuana slowly increased. By the late 1990s, marijuana was rarely discussed in the context of drug trafficking and drug abuse. And marijuana had lost its association with other Schedule I drugs like cocaine and heroin in the New York Times. Gradually, the stereotypical persona of the marijuana user shifted from the stoned slacker wanting to get high to the aging boomer seeking pain relief.

Of course, many Americans do not read The New York Times. But analysis of newspapers of record, like this one, provide insight into how the news media has changed its framing of marijuana, especially during an era when newspapers were still a primary news source.

Harsh criminal justice system

As Americans became more supportive of marijuana legalization, they also increasingly told survey researchers that the criminal justice system was too harsh.

In the late 1980s, the “war on drugs” and sentencing reform laws put a large number of young men, often black and Latino, behind bars for lengthy periods of time. As Americans started to feel the full social and economic effects of tough-on-crime initiatives, they reconsidered the problems with criminalizing marijuana.

Because support for the legalization of marijuana and concerns about the harshness of the criminal justice system changed at about the same time, it’s difficult to know what came first. Did concern about the harshness of the criminal justice system affect support for legalization – or vice versa?

By contrast, the cause and effect is clearer with respect to the media framing of marijuana. The news media’s portrayal of marijuana began to change shortly before the public did, suggesting that the media influenced support for the legalization of marijuana.

Once attitudes begin to change, it is difficult to know what keeps the momentum moving. Whatever the initial impetus, attitudes today are drastically more supportive, and legalization is increasing fast.

This article was originally published on The Conversation . Read the original article .

Amy Adamczyk is professor of sociology at John Jay College of Criminal Justice and the Programs of Doctoral Study in Sociology and Criminal Justice at The Graduate Center, City University of New York.

Christopher Thomas is a Ph.D candidate in criminal justice at John Jay College of Criminal Justice.

Jacob Felson is chair of the department of sociology and criminal justice at William Paterson University.

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The Data On Legalizing Weed

Greg Rosalsky

Editor's note: This is an excerpt of Planet Money 's newsletter. You can sign up here .

Last month, New Jersey Governor Phil Murphy signed three bills making it official: marijuana will soon be growing legally in the gardens of the Garden State for anyone over 21 to enjoy. The bills follow through on a marijuana legalization ballot initiative that New Jerseyans approved overwhelmingly last year. New Jersey is now one of a dozen states, plus the District of Columbia, which have let loose the magic dragon — and more states, like Virginia, may be on the way.

It's been almost a decade since Colorado and Washington legalized marijuana. That's given economists and other researchers enough time to study the effects of the policy. Here are some of the most interesting findings:

Legalization didn't seem to substantially affect crime rates — Proponents of legalizing weed claimed it would reduce violent crimes. Opponents said it would increase violent crimes. A study by the CATO Institute finds, "Overall, violent crime has neither soared nor plummeted in the wake of marijuana legalization."

Legalization seems to have little or no effect on traffic accidents and fatalities — Opponents of marijuana legalization argued it would wreak havoc on the road. A few studies have found that's not the case. Economists Benjamin Hansen, Keaton S. Miller & Caroline Weber, for instance, found evidence suggesting it had no effect on trends in traffic fatalities in both Colorado and Washington.

Legalization has barely affected the price of marijuana — Many people believed that marijuana prices would crash after legalization, providing an increased incentive to use it. But a recent study by the CATO institute found prices have barely budged. The price of getting high has stayed high. In California, for example, the price of marijuana actually increased after legalization, before leveling off at about $260 an ounce. Before full legalization, it cost about $250 an ounce. All the states that have legalized marijuana have seen prices converge around that level. "The convergence in prices across states is consistent with the idea that legalization diverts marijuana commerce from underground markets to legal retail shops, allowing retailers to charge a premium as the preferred sources of supply," the authors write.

Legalization has created jobs. Lots of jobs — A new report by Leafly and Whitney Economics finds the marijuana industry is booming. In 2020 alone, they calculate, it created 77,000 jobs. Across the country, there are about 321,000 jobs in the legal marijuana industry. That's more than the mining industry .

Legalization is good for state budgets — Tax revenue from legal recreational marijuana has surpassed everyone's expectations. Colorado usually collects more than $20 million a month. In 2020, the state collected a total of $387 million. The California government collects more than $50 million a month. You can find similar stories in other states that have legalized.

Legalization may be good for states' workers' comp programs — A new working paper by economists Rahi Abouk, Keshar M. Ghimire, Johanna Catherine Maclean and David Powell finds that states that legalized recreational marijuana saw a significant decline in the use of their worker compensation systems. They estimate that the number of workers aged 40-62 who received income from workers comp fell by about 20 percent following legalization. Evidence suggests that the reason for the decline is that marijuana provides "an additional form of pain management therapy" that reduces use of opioids, which are highly addictive and can be much more debilitating. Marijuana's effect on reducing opioid abuse has been documented in other studies .

Depending on whom you ask, it's not all good news. If you believe smoking marijuana is bad, then you'll be unhappy to hear that its use, naturally, increases after legalization. A study in the American Journal For Preventative Medicine , for example, found that legalization in Washington may be stalling the decades-long decline of marijuana use amongst teens. Another study found adults over 26 consume more cannabis after legalization. It seems even the AARP crowd is toking up more these days, too.

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This week on “The Argument” podcast, the columnists talk pot. First, Michelle Goldberg presses former New York Times reporter Alex Berenson on his forthcoming book about the dangers of marijuana, “ Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence .”

Then, the columnists debate which marijuana policy the country should pursue. Michelle argues the harms of criminalizing weed outweigh the harms of legalizing it. Ross Douthat worries about the broader social impacts of legalization and the growth of the cannabis industry. And David Leonhardt favors a middle path, one that forgoes harsh penalties for marijuana use without incentivizing more Americans to try it.

And finally, merry … Advent? Ross taps into his liturgical side to recommend a solution to the seasonal “Merry Christmas” versus “Happy Holidays” dilemma.

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Analysis of Arguments: Should Marijuana Be Legalized? Annotated Bibliography

• To find inspiration for your paper and overcome writer’s block
• As a source of information (ensure proper referencing)
• As a template for you assignment

Title of Article #1: Green, T. V. (2021). Americans overwhelmingly say marijuana should be legal for recreational or medical use. Pew Research Center. Web.

Pro Arguments (Support for your position):

• The majority of Americans agree on the necessity to legalize marijuana.
• Its medical and recreational use is a sufficient basis for this change.

Con Arguments (Opposing Views):

• The resistance of older populations to this idea is highly possible.
• This initiative is accompanied by concerns regarding the actual use of marijuana.

Definition(s)

History/background information.

Over the past years, the number of people in the United States supporting the legalization of marijuana doubled, which means the need for action.

Facts/Statistics/Expert Testimony

Numerous surveys conducted over the past decades confirm the support of marijuana legalization by 91% of Americans, whereas the opposition does not provide substantial objections.

Title of Article #2: Lopez, G. (2019). 9 questions about marijuana legalization you were too embarrassed to ask. The Vox. Web.

• Marijuana has already been legalized in eleven states, and their experience can be adopted.
• The need in unity in legislature is required for avoiding conflicts.
• With the development of marijuana market, manufacturers might avoid responsibility.
• The possibility of addiction does not allow introducing this change all over the country.

Over time, there has been no clear opinion of legislators regarding the legalization of marijuana, and the differences are attributed to the policies of Democratic and Republican activists.

Surveys among American indicate their support of the legalization of marijuana, but marijuana laws are varied across the country.

Title of Article #3: McCarthy, N. (2019). The arguments for and against marijuana legalization in the U.S. [Infographic]. Forbes. Web.

• New population groups, including adults aged 55 and older, begin to support this idea.
• The possibility of focusing on other crimes rather than the use of marijuana seems beneficial for their investigation.
• Driver safety after using marijuana does not make this idea an optimal initiative.
• The legalization of marijuana might encourage more people to use it.

In the past, the growing popularity of marijuana resulted in the formation of supporters and opponents of its legalization.

The conducted polls showed that both supporters and opponents of the legalization of marijuana provide substantial evidence for underpinning their particular views.

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IvyPanda. (2023, August 1). Analysis of Arguments: Should Marijuana Be Legalized? https://ivypanda.com/essays/analysis-of-arguments-should-marijuana-be-legalized/

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1. IvyPanda . "Analysis of Arguments: Should Marijuana Be Legalized?" August 1, 2023. https://ivypanda.com/essays/analysis-of-arguments-should-marijuana-be-legalized/.

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IvyPanda . "Analysis of Arguments: Should Marijuana Be Legalized?" August 1, 2023. https://ivypanda.com/essays/analysis-of-arguments-should-marijuana-be-legalized/.

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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.

* Click below to enlarge (charted by  Statista )

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

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How to Write Legalization of Marijuana Essays

By: Angelina Grin

Since the legalization of marijuana has been a heated subject in recent years, many teachers give essay writing assignments on this to judge a student's knowledge of current affairs. Although you may have a basic understanding of what an essay on the legalization of marijuana is and how to write one, it is critical to continue to improve your research, composition, and essay structure. You can always build in some respects.

Essay Sample: Should Marijuana Be Legalized?

Health benefits of legalizing marijuana, negative effects of legalizing marijuana, use of medical studies, use of sub-headings and sub-points, references to use in the essay.

Studybay has provided a sample essay, its analysis, reviewed some essay fundamentals, and what the examiner will be looking for. If you want to go the extra mile, you can also seek   homework help . 

Marijuana is one most vehement adversaries in the war on drugs by Americans. And, given that alcohol and tobacco, two life-threatening drugs, are legal, it's fair to wonder why medical marijuana is prohibited. When taxpayers in America fill out their tax forms and hear the government's hash argument against marijuana, they will partially address this issue.

Marijuana, which is derived from Cannabis plants, is known by a variety of names. Marijuana has a variety of nicknames, ranging from cannabis to ganja to weed. Marijuana is made up of the leaves and flowers of the Cannabis plant. 

THC, or delta-9-tetrahydrocannabinol, is the primary active ingredient in marijuana. It enters the bloodstream and travels to the brain. This substance induces a state of relaxation in the body.

There have been several debates on whether or not marijuana should be legalized. Many people assume that this substance is toxic to the human body, but there is hard evidence to the contrary. Marijuana has real advantages that can outweigh the ostensibly negative consequences. Arguments for drug legalization began in the United States of America. It has been shown to have many medical benefits, including anxiety relief, pain relief, nausea relief, and the reduction of epileptic seizures. A significant number of states in the United States allow for the use of marijuana on a prescription basis.

Medical Cannabis is commonly used to treat sleeping problems, appetite deficiency, autism, and cancer therapies such as chemotherapy. Cannabis can also be used to cure anorexia until it is approved. Emotion and mood control are two immediate effects of cannabis for medicinal purposes. Marijuana has been shown to have mild side effects when used in controlled doses.

The legalization of marijuana is expected to improve the country's economic development. If state officials vote to legalize marijuana, they will save a lot of money for taxpayers. 

State officials spend a lot of money on the branches of law enforcement that are in charge of enforcing drug prohibition laws. Every year, thousands of people are prosecuted for either using or possessing marijuana, and governments pay vast sums of money to keep them locked up. Legalizing marijuana would save this money.

Marijuana has not caused any apparent harm in countries where cannabis has been legalized. Marijuana users are thought to be abusive, according to some stereotypes. However, there is no concrete evidence to back up this claim to date. In the United States, several states have allowed marijuana for both medicinal and recreational uses, with no harmful consequences. In contrast, Colorado has seen a decline in marijuana-related property destruction and crime.

Essay Analysis

The essay example above is a fairly insightful work that covers many of the essential facets of essay composition. There are, however, certain main segments and points that are required. The aspects that should have been included are as follows:

A Strong Argument

Since we don't necessarily agree with what's right or rational, a well-crafted argument will assist us in determining what's fair or real. It's used to resolve disagreements to find the facts. Argument shows us how to analyze competing theories, as well as how to evaluate proof and inquiry processes. Argument teaches one how to explain our views and express them clearly and objectively and how to respectfully and critically evaluate the ideas of others.

In the above sample, the following sections on the effects of marijuana can be added:

• Pharmaceutical cannabis has been   shown in studies   to reduce nausea caused by cancer chemotherapy and almost entirely prevent vomiting.
• Marijuana can help with muscle spasticity, which is   often linked to multiple sclerosis   and paralysis.
• Marijuana can aid in the   treatment of appetite loss   caused by HIV/AIDS and some forms of cancers.
• Certain forms of chronic pain, such as neuropathic pain, may be   relieved by marijuana .
• When isolated, as CBD has been, these compounds can contribute to   further advances in medical treatment options   without the "high" provided by THC.
• Regular usage of marijuana causes a   negative impact   on your short-term memory.
• Smoking any substance, whether nicotine or marijuana,   will cause significant lung harm .
• Due to drug abuse, marijuana has a high potential for violence and addiction.
• Marijuana has been linked   to a large number of car collisions and industrial accidents.

No wild claims have been made. All the pros and cons are back up with solid evidence from studies and proper medical research journals. 

On this point, there are some vital benefits you should note while writing your essay:

• It adds creativity and interest to your essay.
• You have a lot of options for adding information.
• Your essay would be 100% original.
• Your ideas would be clearer and more efficient.

Headings describe the paper's main themes and supporting theories, subheadings, bullets, numbered lists, etc. They use visual cues to communicate significance levels. Readers can discern the key points from the others thanks to differences in text size.

For instance, in point 1, we see the sub-headings as 'Pros and Cons of Legalizing Marijuana' further by sub-points in alphabetical order. 

The sample essay lacks a summary, an analysis, or a conclusion to the topic. The following paragraph could have been added as a conclusion:

While medical marijuana is still controversial, it is gaining popularity as a legal treatment option for several ailments. Although many states have approved cannabis for medical uses (and a few for commercial use), it would require more lawmakers and the federal government to make it accepted and sold around the country. However, proving or disproving the effectiveness of medical marijuana and eventually loosening the prohibitions on its use would almost certainly necessitate a much broader body of legal clinical study.

Additional Points

The following points can be expanded upon in this essay:

• History of drug use in the medical history and as a recreational drug
• Recreational purposes of marijuana
• Decriminalization on the federal level
• How to approach the marijuana-related drug policy
• Other illegal drugs and their usage

You can also opt for   essay help   in covering the main points from professional services.

Here are some valuable research papers and sources to include and quote to get good grades:

• FDA and Cannabis: Research and Drug Approval Process
• Legalization of Marijuana: Potential Impact on Youth
• Experimenting with Pot: The State of Colorado's Legalization of Marijuana 
• Legalizing Marijuana: California's Pot of Gold?   (Covers the economic benefits)
• Medicinal and Recreational Marijuana Use by Patients Infected with HIV

After you've finished writing your cannabis Sativa legalization essay, be sure to address the following points:

• The grammar and distinctiveness of the marijuana essay have been double-checked and revised.
• A solid a backed up by ideas, arguments, and proof.
• The overview and analysis of the research and opinions of other authors.
• An introduction, body paragraphs, and a conclusion are all part of a coherent framework.

Keep in mind that you can get expert essay assistance from Studybay when writing your   research paper .

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1. A country that values liberty should not be punishing adults for using cannabis. Cannabis is far safer than alcohol, tobacco, and many medications. In a nation dedicated to “life, liberty, and the pursuit of happiness,” the government should not be tearing families apart over a plant that is safer than alcohol. 2. Prohibition wastes public resources, while legalizing and taxing cannabis brings in much-needed revenue. An estimate by the Congressional Research Service projected that replacing cannabis prohibition with taxation and regulation could yield $6.8 billion in excise taxes alone. In Washington State, taxes on cannabis sales brought in $600 million in 2020. 3. Arresting cannabis offenders prevents police from focusing on real crime. In 2019, the FBI reported 663,367 cannabis arrests and citations — more arrests than for all violent crimes combined. Meanwhile, FBI data showed that police only cleared 33 percent of rapes, 31 percent of robberies, and 14 percent of burglaries by making an arrest. Data published in Police Quarterly showed a higher percentage of some crimes were solved after legalization in both Colorado and Washington. 4. Prohibition sends an incredible number of Americans through the criminal justice system, ruining countless lives. According to the FBI, there have been more than 15 million cannabis arrests in the U.S. since 1995. While cannabis consumers who were not convicted have gone on to be president or Supreme Court justice, a criminal conviction can stand in the way of securing a job, getting housing, or receiving a professional license, student loan, food assistance, driver’s license, or firearms permit. 5. Cannabis laws are disproportionately enforced. According to the ACLU, Black individuals are more than 3.5 times as likely to be arrested for cannabis possession than white individuals nationwide, despite similar rates of use. 6. Replacing prohibition with regulation creates barriers to teens accessing cannabis. A 2012 survey by the National Center on Addiction and Substance Abuse at Columbia University found 40% of high schoolers reported knowing a student who sells cannabis at school — while under 1% know a peer who sells alcohol. Regulated cannabis businesses check IDs and aren’t allowed to sell to or employ minors. 7. Cannabis prohibition breeds violence. As was the case during alcohol prohibition, driving this lucrative market underground results in violence. Both buyers and sellers are vulnerable to assault. 8. Only regulation allows for control. Prohibition guarantees that cannabis will not be tested for purity and potency, creating the risk of contamination by dangerous pesticides, molds, bacteria, or even lacing. 9. Prohibition is bad for the environment. Illicit cannabis growers sometimes use banned pesticides, divert waterways, and leave hazardous waste in state and national parks. Regulated cannabis businesses are monitored to ensure compliance with zoning and environmental laws.   10. Cannabis is safer than alcohol. Researchers have consistently concluded that cannabis is less toxic than alcohol, it has less potential for addiction, and it is less likely to contribute to serious medical problems. The Centers for Disease Control and Prevention reports that every year more than 50,000 Americans die from the health impacts of chronic alcohol consumption, with 2,200 additional deaths from acute overdose. Cannabis has not been shown to increase mortality, and there has never been a verified cannabis overdose death in history. It makes no sense for the law to steer consumers to the more dangerous substance.

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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.

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• In Debate Over Legalizing Marijuana, Disagreement Over Drug’s Dangers

In Their Own Words: Supporters and Opponents of Legalization

Table of contents.

• About the Survey

Survey Report

Public opinion about legalizing marijuana, while little changed in the past few years, has undergone a dramatic long-term shift. A new survey finds that 53% favor the legal use of marijuana, while 44% are opposed.  As recently as 2006, just 32% supported marijuana legalization, while nearly twice as many (60%) were opposed.

Millennials (currently 18-34) have been in the forefront of this change: 68% favor legalizing marijuana use, by far the highest percentage of any age cohort. But across all generations –except for the Silent Generation (ages 70-87) – support for legalization has risen sharply over the past decade.

The latest national survey by the Pew Research Center, conducted March 25-29 among 1,500 adults, finds that supporters of legalizing the use of marijuana are far more likely than opponents to say they have changed their mind on this issue.

Among the public overall, 30% say they support legalizing marijuana use and have always felt that way, while 21% have changed their minds; they say there was a time when they thought it should be illegal. By contrast, 35% say they oppose legalization and have always felt that way; just 7% have changed their minds from supporting to opposing legalization.

When asked, in their own words, why they favor or oppose legalizing marijuana, people on opposite sides of the issue offer very different perspectives. But a common theme is the danger posed by marijuana: Supporters of legalization mention its perceived health benefits, or see it as no more dangerous than other drugs. To opponents, it is a dangerous drug, one that inflicts damage on people and society more generally.

The most frequently cited reasons for supporting the legalization of marijuana are its medicinal benefits (41%) and the belief that marijuana is no worse than other drugs (36%) –with many explicitly mentioning that they think it is no more dangerous than alcohol or cigarettes.

With four states and Washington, D.C. having passed measures to permit the use of marijuana for personal use, 27% of supporters say legalization would lead to improved regulation of marijuana and increased tax revenues. About one-in-ten (12%) cite the costs and problems of enforcing marijuana laws or say simply that people should be free to use marijuana (9%).

Why Should Marijuana Be Legal? Voices of Supporters

Main reason you support legalizing use of marijuana…

“My grandson was diagnosed with epilepsy a year ago and it has been proven that it helps with the seizures.” Female, 69

“I think crime would be lower if they legalized marijuana. It would put the drug dealers out of business.” Female, 62

“Because people should be allowed to have control over their body and not have the government intervene in that.” Male, 18

“I think that we would have more control over it by allowing a federal agency to tax and regulate it like alcohol.” Male, 25

The most frequently mentioned reason why people oppose legalization is that marijuana generally hurts society and is bad for individuals (43% say this). And while many supporters of legalization say that marijuana is less dangerous than other drugs, 30% of opponents have the opposite view: They point to the dangers of marijuana, including the possibility of abuse and addiction.

About one-in-five opponents of legalization (19%) say marijuana is illegal and needs to be policed, 11% say it is a gateway to harder drugs and 8% say it is especially harmful to young people. A small share of opponents (7%) say that while the recreational use of marijuana should be illegal, they do not object to legalizing medical marijuana. 1

Why Should Marijuana Be Illegal? Voices of Opponents

Main reason you oppose legalizing use of marijuana…

“It’s a drug and it has considerable side effects. It should not be used recreationally, only for medicinal use.” Female, 20

“It’s a drug that makes you stupid. It affects your judgment and motor skills and in the long term it makes you lazy.” Male, 52

“It gets too many people on drugs. It would put too many drugs on the street, we don’t need that.” Male, 84

“I’m thinking of my child. I don’t want her to try this. I know it’s not good for her health or brain.” Female, 33

“We have enough addictive things that are already legal. We don’t need another one.” Male, 42

Current Opinion on Legalizing Marijuana

The pattern of opinion about legalizing marijuana has changed little in recent years. Beyond the wide generation gap in support for legalization, there continue to be demographic and partisan differences.

Majorities of blacks (58%) and whites (55%) favor legalizing marijuana, compared with just 40% of Hispanics. Men (57% favor) continue to be more likely than women (49%) to support legalization.

Nearly six-in-ten Democrats (59%) favor legalizing the use of marijuana, as do 58% of independents. That compares with just 39% of Republicans.

Both parties are ideologically divided over legalizing marijuana. Conservative Republicans oppose legalizing marijuana by roughly two-to-one (65% to 32%); moderate and liberal Republicans are divided (49% favor legalization, 50% are opposed).

Among Democrats, 75% of liberals say the use of marijuana should be legal compared with half (50%) of conservative and moderate Democrats.

Other Opinions: Federal Enforcement of Marijuana Laws

The new survey also finds that as some states have legalized marijuana – placing them at odds with the federal prohibition against marijuana – a majority of Americans (59%) say that the federal government should not enforce laws in states that allow marijuana use; 37% say that they should enforce these laws. Views on federal enforcement of marijuana laws are unchanged since the question was first asked two years ago.

In contrast to overall attitudes about the legal use of marijuana, there are only modest differences in views across partisan groups: 64% of independents, 58% of Democrats and 54% of Republicans say that the federal government should not enforce federal marijuana laws in states that allow its use.

A substantial majority of those who say marijuana should be legal (78%) do not think the federal government should enforce federal laws in states that allow its use. Among those who think marijuana should be illegal, 59% say there should be federal enforcement in states that allow marijuana use, while 38% say there should not be.

Concerns About Marijuana Use

While most Americans support legalizing marijuana, there are concerns about public use of the drug, if it were to become legal. Overall, 62% say that if marijuana were legal it would bother them if people used it in public; just 33% say this would not bother them. Like overall views of legalizing marijuana, these views have changed little in recent years.

There is less concern about the possibility of a marijuana-related business opening legally in people’s own neighborhood: 57% say it would not bother them if a store or business selling marijuana opened legally in their neighborhood, while 41% say this would bother them.

And just 15% say they would be bothered if people used marijuana in their own homes; 82% say this would not bother them.

As might be expected, there are sharp differences in these concerns between people who favor and oppose legalizing marijuana. A large majority of opponents of marijuana legalization (85%) say they would be bothered by public use of the drug, if it were legal; about four-in-ten supporters (43%) also say they would be bothered by this. On the other hand, a majority of opponents of legalization (65%) say they would not be bothered if people used marijuana in their own homes; virtually all supporters of legalization (97%) would not be bothered by this.

And while 77% of those who oppose legalizing marijuana say, if it were legal, they would be bothered if a store or business selling marijuana opened in their neighborhood, just 12% of supporters of legalization say this would bother them.

About Half Say They Have Tried Marijuana

Overall, 49% say they have ever tried marijuana, while 51% say they have never done this. Self-reported experience with marijuana has shown no change over the past two years, but is higher than it was early last decade: In 2003, 38% said they had tried marijuana before, while 61% said they had not.

About a quarter of those who have tried marijuana (12% of the public overall) say they have used marijuana in the past year. Similar percentages reported using marijuana in the prior 12 months in two previous surveys, conducted in February 2014 and March 2013.

Men (56%) are 15 points more likely than women (41%) to say they have ever tried marijuana.

About half of whites (52%) and blacks (50%) say they have tried marijuana before. Among Hispanics, 36% say they have tried marijuana, while 63% say they have not.

Across generations, 59% of Baby Boomers say they’ve tried marijuana before; this compares with 47% of Generation Xers and 52% of Millennials. Among those in the Silent generation, only 19% say they have ever tried marijuana. Nearly a quarter of Millennials (23%) say they have used the drug in the past year, the highest share of any age cohort.

There is little difference in the shares of Democrats (48%) and Republicans (45%) who say they’ve tried marijuana. However, there are differences within each party by ideology. By a 61%-39% margin, most conservative Republicans say they have never tried marijuana. Among moderate and liberal Republicans, about as many say they have (52%) as have not (48%) tried marijuana before.

Among Democrats, liberals (58%) are more likely than conservatives and moderates (42%) to say they’ve tried marijuana.

While a majority of those who say marijuana should be legal say they’ve tried the drug before (65%), 34% of those who support legalization say they’ve never tried marijuana. Among those who say marijuana should be illegal, 29% say they have tried it before, while 71% say they have not.

• These are volunteered responses among those who oppose legalizing marijuana. A 2013 poll found that, among the public overall, 77% said that marijuana had “legitimate medical uses.” ↩

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