According to a recent study, the odds of a patient being diagnosed with cannabis-use disorder (CUD), when they visit an emergency department in a state that has legalized marijuana are nearly 50% lower than those who do not. Researchers say that the “counterintuitive finding” could be attributed to the destigmatization cannabis use in the medical community after prohibition ends.
The study was published last week in Preventative Medical Reports. It looked at emergency department statistics from 2017 to 2020 for two states (Colorado, Oregon) that have legalized marijuana and two other states (Maryland, Rhode Island), where cannabis is still illegal.
They examined the rates of “treat-and-release” visits when patients were diagnosed with CUD, indicating problematic marijuana usage. Researchers used a logistic regression model with multivariate variables to analyze 17,434,655 visits to emergency rooms over a four-year period.
Authors of the study said that they expected higher rates of CUD to be found in states that allow recreational cannabis use, given that previous studies had shown that legalization was associated with a slight increase in marijuana usage among adults. The data revealed the opposite. “Compared to states in which recreational cannabis was illegal use, legalizing marijuana for recreational purposes was associated with a nearly 50 percent reduction in adjusted odds of CUD.”
Our findings could help policymakers make decisions. For example, recreational cannabis laws might not put public safety and health at risk.
Researchers said that prior research on hospitalizations after legalization and emergency department visits focused largely on youth. This means even small changes may appear more pronounced due to the low cannabis usage rate in this population.
Some studies have linked legalization with increased rates of CUD diagnosis in publicly funded substance abuse treatment facilities. Others have found that forced referrals to treatment declined faster after reform was enacted. The authors of the latest research claim that it is the first study to show a statistically significant negative association between legalizing recreational cannabis and CUD in ED visits.
What could predict this relationship?” Researchers who found a decline in CUD admissions into substance abuse disorder treatment programs after legalization hypothesized that reduced stigma and increased social acceptance of cannabis use could explain their findings,” says the report.
The authors concluded that “If providers in states with legalized cannabis are more tolerant to cannabis use and less likely recognize problematic behaviors associated with CUD, (e.g. persistent or recurrent interpersonal or social problems, cravings, and withdrawal), they may also be less likely diagnose and document CUD on the medical record.” This could explain the lower CUD prevalence at EDs in states that have legalized cannabis.
The researchers added that if their findings were valid, “policymakers can continue to pass recreational marijuana laws for all the reasons why states are enacting this legislation” without risking public health or safety.
A separate study from 2019 found that the rates of CUD have decreased amid the state-level legalization movement. Separately, a 2019 study found that the rate of CUD has decreased in the wake of the state-level movement.
A growing body of research, including a study by the American Medical Association in September, has found that youth marijuana use is actually decreasing as more and more states are replacing prohibition systems with regulated recreational sales to adults.
Another study funded by the National Institute on Drug Abuse and published in American Journal of Preventive Medicine, last year, found that state-level marijuana legalization was not associated with an increase in youth use. This study found that adolescents who had spent a greater portion of their adolescence in ‘legalized’ states were not more or less likely than those who did not.
Another federally-funded study by Michigan State University, published in PLOS One in 2013, found that cannabis retail sales could be followed in some states by an increase in cannabis use among older adults. “But this is not true for minors who are prohibited from purchasing cannabis products at a retail outlet.”
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The first time Marijuana moment published the article States that Legalize Marijuana Have a ‘Significantly Lower’ Rate of Cannabis Use Disorder Cases in ERs Than Non-Legal State, Study Finds.
