According to an American Medical Association study, young adults who smoked marijuana regularly before legalization showed “significant reductions in their use and the consequences they experienced” after the policy change. This contradicts the widely held belief that ending the prohibition would lead to an increase in the use of cannabis by youth.
The study published in the Journal of the American Medical Association Network Open on Wednesday found that consumption did increase slightly among young adults who said they had never used marijuana before legalization. However, this slight rise in consumption didn’t result in a corresponding rise in cannabis-related effects.
The six-person team of researchers concluded that high-risk youth showed distinct patterns of change across Canadian cannabis legalization. “Those who used cannabis frequently before legalization showed reductions in use consistent with ageing out, while those who did not use cannabis prelegalization showed modest increases over time.”
The authors noted that, despite the common fear that legalization could lead to an increase in teen marijuana usage, “there are very few studies that focus on this population.”
The study notes that “in all jurisdictions that legalized cannabis, there has been a concern that cannabis use and harms related to cannabis would increase among young adults and youths due to easy access, increasing social acceptance, decreasing perception of harm, cheaper prices, a broader array of products and methods of use, as well as an increasing product potency.” It also acknowledges that young adults have the highest rates and prevalence of cannabis-use disorder.
It continues: “There have been very few longitudinal studies that examine the impact of legalization. This represents a significant research gap.”
As legalization became a reality, cannabis use and its consequences decreased in terms of both frequency and overall. The authors admit that it is not clear if the shift in policy caused the results, or if such patterns would have continued regardless of legalization.
The report states that “rather than detecting an increase, the results revealed overall decreases, which is consistent with substance-use trajectories expected in this age group without any policy changes.” The changes observed in the study do not seem to have been markedly affected by cannabis legalization.
In order to reach their conclusions, the authors interviewed young adults aged 19.5 to 23 who had reported two or more “heavy episodes of drinking”. The criteria was “intended to attract a sample with common patterns in substance use that are associated with an elevated risk of adverse consequences.” Participants then were surveyed about consumption and “related effects” before and after cannabis legalization took place in Canada.
The survey included 619 respondents. The authors noted that gender and sex “overlapped in 99.7 per cent” and 55.9 per cent of those surveyed were women. Psychosis, whether current or previous, was excluded.
Before legalization, approximately a third of participants (31.6%) said that they used marijuana frequently or regularly. Another third (33.3%) said that they only used cannabis occasionally. A third (35%) reported never using cannabis.
The participants were asked about their marijuana usage as well as the so-called “cannabis related consequences”, as measured by the B-MACQ, a short, 21-question, version of the Marijuana Consequences Questionnaire. This includes statements like “I’ve been less sharp mentally due to my marijuana consumption,” “I’ve been overweight due to my marijuana consumption,” and “I neglected my obligations to my family, my work, or my school because of marijuana use.”
After legalization, the use of cannabis by those who only used it occasionally either increased (or decreased): 32 percent stopped using it altogether and 23 percent started to use it regularly. After legalization, only 40 percent of occasional cannabis users continued to be occasional users.
The trends among other participants differed depending on the frequency of use before legalization.
Individuals who used cannabis the most often pre-legalization showed, on average a significant decrease in use after legalization. The study also found that this group showed a reduction in cannabis-related effects. Participants who had not used cannabis in the past increased their use of the drug over time.
The authors note that “although the frequency of the second group increased, this increase did not result in problematic outcomes over the course of the study.”
The study concluded that participants who had never used cannabis prior to its legalization “showed no significant increase in use or side effects postlegalization.”
In terms of marijuana-related effects, the authors noted that “B-MACQ scores of 0 (no consequences related to cannabis) were most prevalent both pre- and post-legalization. However, this category increased between these two time points.” Before legalization, 51% of respondents had reported no such results. After legalization, this proportion increased slightly to 57 per cent. The team noted that this was the category which remained most stable over time.
Those who had reported between one and four cannabis-related effects prior to legalization saw their consequences generally decrease. After legalization, 47 percent of participants reported no effects. 16 percent had five or more.
The study found that “those in the frequent cannabis usage category maintained high levels of cannabis consumption and consequences over time.” “69 of those who used cannabis frequently prelegalization (77%), remained in this category postlegalization. And 76 of those who had a B-MACQ of 5 or higher prelegalization (56%), still experienced 5 or more cannabis related consequences postlegalization.
The Canadian study’s authors said that it “aligns” with U.S. research which has found, in large part, that legalization of marijuana did not dramatically alter consumption patterns among young people and adults. This is because marijuana was widely used even during the prohibition.
They wrote that “the lack of significant change in such a large policy shift may be due to the fact that cannabis use was already normalized in Canada prior to legalization.” Prelegalization, Canadians who used marijuana believed that cannabis was easy to obtain and the risk of using it was low. Cannabis legalization has not had a significant impact on the use patterns of this age group.
Researchers concluded that “further longitudinal monitoring is crucial to evaluate the effects of cannabis legalization empirically, and promote evidence-informed policy.”
A federally-funded study published in the U.S. last month showed that teenage use of marijuana was stable despite the legalization movement, even though adult cannabis and psychedelic use reached “historic heights.”
Gallup’s poll, released last month found that more than half of American adults had tried marijuana in the past, and that cannabis consumption was higher than tobacco. According to a Gallup poll, 29 percent of Americans aged 18-34 smoke marijuana. However, this is not representative of cannabis consumption as the survey asked only about smoking, not edibles, tinctures, or vaping.
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 more time in legalization during their adolescence 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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