Abstract
Introduction State legalization of marijuana for medical purposes could increase illicit marijuana use among young people. Medical marijuana laws may boost the availability of marijuana and reduce perceptions of its harmfulness, leading more young people to try it. Prior studies report little evidence that these laws are impacting marijuana consumption by young Americans, and none have systematically compared developmentally distinct age groups. Methods We performed multilevel, serial cross-sectional analyses on ten annual waves of U.S. National Survey on Drug Use and Health, from 2004 to 2013, comparing young people in states with and without medical marijuana laws. Disaggregated analyses compared multiple measures of marijuana use across approximately 450,300 individuals in early adolescence (12–14 years), late adolescence (15–17 years) and young adulthood (18–25 years). Results Dwelling in a state that had legalized medical marijuana was not associated with marijuana consumption in the past month among early adolescents, late adolescents or young adults. However, young adults living in medical marijuana states were significantly more likely to have initiated first use in the past year. Conclusions Medical marijuana laws increase the likelihood that young adults will start using marijuana but do not affect more vulnerable developmental groups in early and late adolescence. Delaying the age of first use into young adulthood can reduce the risk of a drug use disorder later in life. Young adults are in the peak years of engagement with illicit drugs and state medical marijuana laws appear to be leading larger numbers to try the drug.
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References
Anderson, D. M., Hansen, B., & Rees, D. I. (2012). Medical marijuana laws and teen marijuana use. American Law and Economics Review, 17(2), 495–528.
Anderson, D. M., Hansen, B., & Rees, D. I. (2013). Medical marijuana laws, traffic fatalities, and alcohol consumption. Journal of Law and Economics, 56(2), 333–369. https://doi.org/10.1086/668812.
Asbridge, M., Hayden, J. A., & Cartwright, J. L. (2012). Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis. BMJ, 344, e536.
Babor, T., Brown, J., & Boca, F. D. (1990). Validity of self-reports in applied research on addictive behaviors: Fact or fiction? Behavioral Assessment, 12, 5–31.
Babor, T. F., Edwards, P. C. J., Fischer, G., Foxcroft, B., Humphreys, D. R., Reuter, K., P (2010). Drug Policy and the Public Good. New York: Oxford University Press.
Bachman, J. G., Wadsworth, K. N., O’Malley, P. M., Johnston, L. D., & Schulenberg, J. E. (2013). Smoking, drinking, and drug use in young adulthood: The impacts of new freedoms and new responsibilities. New jersey: Psychology Press.
Cerdá, M., Wall, M., Keyes, K. M., Galea, S., & Hasin, D. (2012). Medical marijuana laws in 50 states: Investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug And Alcohol Dependence, 120(1), 22–27.
Chapman, S. A., Spetz, J., Lin, J., Chan, K., & Schmidt, L. A. (2016). Capturing heterogeneity in medical marijuana policies: A taxonomy of regulatory regimes across the United States. Substance Use & Misuse, 51(9), 1–11.
Choo, E. K., Benz, M., Zaller, N., Warren, O., Rising, K. L., & McConnell, K. J. (2014). The impact of state medical marijuana legislation on adolescent marijuana use. Journal of Adolescent Health, 55(2), 160–166.
Compton, W. M., Grant, B. F., Colliver, J. D., Glantz, M. D., & Stinson, F. S. (2004). Prevalence of marijuana use disorders in the United States: 1991–1992 and 2001–2002. JAMA, 291(17), 2114–2121. https://doi.org/10.1001/jama.291.17.2114.
Dawson, D. A., Grant, B. F., Stinson, F. S., & Chou, P. S. (2006). Maturing out of alcohol dependence: The impact of transitional life events. Journal of Studies on Alcohol and Drugs, 67(2), 195–203.
Degenhardt, L., Hall, W., & Lynskey, M. (2003). Testing hypotheses about the relationship between cannabis use and psychosis. Drug and Alcohol Dependence, 71(1), 37–48.
Feeney, K. E., & Kampman, K. M. (2016). Adverse effects of marijuana use. The Linacre Quarterly, 83(2), 174–178.
Flory, K., Lynam, D., Milich, R., Leukefeld, C., & Clayton, R. (2004). Early adolescent through young adult alcohol and marijuana use trajectories: Early predictors, young adult outcomes, and predictive utility. Development and psychopathology, 16(01), 193–213.
Franz, C. A., & Frishman, W. H. (2016). Marijuana use and cardiovascular disease. Cardiology in Review, 24(4), 158–162.
Froot, K. A. (1989). Consistent covariance matrix estimation with cross-sectional dependence and heteroskedasticity in financial data. Journal of Financial and Quantitative Analysis, 24(03), 333–355.
Gorman, D. M., & Charles Huber, J. Jr. (2007). Do medical cannabis laws encourage cannabis use? International Journal of Drug Policy, 18(3), 160–167. https://doi.org/10.1016/j.drugpo.2006.10.001
Hadland, S. E., Knight, J. R., & Harris, S. K. (2015). Medical marijuana: Review of the science and implications for developmental-behavioral pediatric practice. Journal of Developmental & Behavioral Pediatrics, 36(2), 115–123. https://doi.org/10.1097/dbp.0000000000000129.
Hall, W., & Weier, M. (2015). Assessing the public health impacts of legalising recreational cannabis use in the USA. Clinical Pharmacology & Therapeutics, 97(6), 607–615. https://doi.org/10.1002/cpt.110.
Harper, S., Strumpf, E. C., & Kaufman, J. S. (2012). Do medical marijuana laws increase marijuana use? replication study and extension. Annals Epidemiology, 22(3), 207–212. https://doi.org/10.1016/j.annepidem.2011.12.002.
Hartman, R. L., Brown, T. L., Milavetz, G., Spurgin, A., Pierce, R. S., Gorelick, D. A., et al. (2016). Cannabis effects on driving longitudinal control with and without alcohol. Journal of Applied Toxicology, 36(11), 1418–29
Hasin, D. S., Wall, M., Keyes, K. M., Cerdá, M., Schulenberg, J., O’Malley, P. M., et al.(2015). Medical marijuana laws and adolescent marijuana use in the usa from 1991 to 2014: Results from annual, repeated cross-sectional surveys. The Lancet Psychiatry, 2(7), 601–608. https://doi.org/10.1016/S2215-0366(15)00217-5.
Jacobi, L., & Sovinsky, M. (2016). Marijuana on main street? estimating demand in markets with limited access. American Economic Review, 106(8), 2009–2045.
Joffe, A., & Yancy, W. S. (2004). legalization of marijuana: Potential impact on youth. Pediatrics, 113(6), e632–e638.
Johnston, L. D., O’Malley, P. M., & Bachman, J. G. (2016). Monitoring The Future National Survey Results On Drug Use,1975–2015: Overview, Key Findings On Adolescent Drug Use. Ann Arbor.
Kandel, D. B. (1980). Drug and drinking behavior among youth. Annual Review of Sociology, 6(1), 235–285.
Krupnick, M. (2016). High times and agency unite to sell marijuana to mainstream, The New York Times. Retrieved from http://www.nytimes.com/2016/05/02/business/media/high-times-and-agency-unite-to-sell-marijuana-to-mainstream.html?_r=3.
Li, M. C., Brady, J. E., DiMaggio, C. J., Lusardi, A. R., Tzong, K. Y., & Li, G. (2012). Marijuana use and motor vehicle crashes. Epidemiologic Reviews, 34(1), 65–72. https://doi.org/10.1093/epirev/mxr017.
Lynne-Landsman, S. D., Livingston, M. D., & Wagenaar, A. C. (2013). Effects of state medical marijuana laws on adolescent marijuana use. American Journal of Public Health, 103(8), 1500–1506. https://doi.org/10.2105/AJPH.2012.301117.
Lynskey, M. T., Heath, A. C., Bucholz, K. K., et al. (2003). Escalation of drug use in early-onset cannabis users versus co-twin controls. JAMA, 289(4), 427–433. https://doi.org/10.1001/jama.289.4.427.
Meier, M. H., Caspi, A., Ambler, A., Harrington, H., Houts, R., Keefe, R. S. E., et al. (2012). Persistent cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences, 109(40). https://doi.org/10.1073/pnas.1206820109.
Merline, A. C., O’Malley, P. M., Schulenberg, J. E., Bachman, J. G., & Johnston, L. D. (2004). Substance use among adults 35 years of age: prevalence, adulthood predictors, and impact of adolescent substance use. American Journal of Public Health, 94(1), 96–102.
Midanik, L. (1982). The validity of self-reported alcohol consumption and alcohol problems: A literature review. British Journal of Addiction, 77, 357–382.
National Survey on Drug Use and Health. (2011). Person-Level Sampling Weight Calibration. Maryland: Rockville.
Nussbaum, A. M., Thurstone, C., McGarry, L., Walker, B., & Sabel, A. L. (2015). Use and diversion of medical marijuana among adults admitted to inpatient psychiatry. The American Journal of Drug and Alcohol Abuse, 41, 166–172. https://doi.org/10.3109/00952990.2014.949727.
POLIDATA. Demographic & political guides: Political data analysis. http://www.polidata.org.
Richter, K. P., & Levy, S. (2014). Big marijuana–lessons from big tobacco. New England Journal of Medicine, 371(5), 399–401. https://doi.org/10.1056/NEJMp1406074.
Robins, L. N. (1984). The natural history of adolescent drug use. American Journal of Public Health, 74(7), 656.
Rogeberg, O., & Elvik, R. (2016). The effects of cannabis intoxication on motor vehicle collision revisited and revised. Addiction. https://doi.org/10.1111/add.13347.bib>
Rogers, W. (1993). Quantile regression standard errors. Stata Technical Bulletin, 2(9).
Room, R., Fischer, B., Hall, W., Lenton, S., & Reute, P. (2010). Cannabis policy: Moving beyond stalemate. New York: Oxford University Press.
Saloner, B., McGinty, E. E., & Barry, C. L. (2015). Policy strategies to reduce youth recreational marijuana use. Pediatrics, 135(6), 955–957.
SAMHDA. (2011). National survey on drug use and health, 2011. Ann Arbor, MI: SAMHDA.
Schmidt, L. A., Jacobs, L. M., & Spetz, J. (2016). Young people’s more permissive views about marijuana: Local impact of state laws or national trend? American Journal of Public Health, 106(8), 1498–1503.
StataCorp. (2015). Stata statisitical software: Release 14. College station. TX: StataCorp LP.
Stuart, E. A., & Green, K. M. (2008). Using full matching to estimate causal effects in nonexperimental studies: Examining the relationship between adolescent marijuana use and adult outcomes. Developmental Psychology, 44(2), 395–406. https://doi.org/10.1037/0012-1649.44.2.395.
Substance Abuse and Mental Health Services Administration. (2016). Youth Perception of Marijuana Harm Decreases as “710” Becomes More Potent. http://newsletter.samhsa.gov/2016/05/25/710-oil-risks/.
The Office of Environmental Health Hazard Assessment. (2009). Health and safety code sect. 25249.8(b) and title 27, cal code of regs., Sect. 25302 et seq.A. Availability of Hazard Identification Materials for Marijuana Smoke. Retrieved April 2, 2017 from http://oehha.ca.gov/proposition-65/crnr/availability-hazard-identification-materials-marijuana-smoke.
Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. B. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370(23), 2219–2227. https://doi.org/10.1056/NEJMra1402309.
Volkow, N. D., Swanson, J. M., Evins, A. E., DeLisi, L. E., Meier, M. H., Gonzalez, R., et al. (2016). Effects of cannabis use on human behavior, including cognition, motivation, and psychosis: A review. JAMA Psychiatry, 73(3), 292–297.
Wall, M. M., Poh, E., Cerdá, M., Keyes, K. M., Galea, S., & Hasin, D. S. (2011). Adolescent marijuana use from 2002 to 2008: Higher in states with medical marijuana laws, cause still unclear. Annals of Epidemiology, 21(9), 714–716.
Wen, H., Hockenberry, J. M., & Ciummings, J. R. (2014). The Effect of Medical Marijuana Laws on Marijuana, Alcohol, and Hard Drug Use. National Bureau of Economic Research Working Paper Series, No. 20085.
Wen, H., Hockenberry, J. M., & Cummings, J. R. (2015). The effect of medical marijuana laws on adolescent and adult use of marijuana, alcohol, and other substances. Journal of Health Economics, 42, 64–80.
Williams, R. L. (2000). A note on robust variance estimation for cluster-correlated data. Biometrics, 56(2), 645–646.
Wooldridge, J. M. (2002). Econometric analysis of cross section and panel data. Cambridge: MIT Press.
Acknowledgements
We would like to thank our colleagues who assisted in the data collection and technical execution of this manuscript, including Timothy Bates MA, Susan Chapman PhD, Casey Palmer MS, and Juliana Fung of the University of California at San Francisco. We would also like to acknowledge staff at the Substance Abuse and Mental Health Administration and the University of Michigan for their assistance in data acquisition and management. This study was supported by a grant from the U.S. National Institute on Drug Abuse (Grant No. R01 DA034091) but played no role in the design and conduct of the study; data collection, management, analysis, and interpretation of the data; or in the preparation of this manuscript.
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Schmidt, L.A., Jacobs, L.M., Vlahov, D. et al. Impacts of Medical Marijuana Laws on Young Americans Across the Developmental Spectrum. Matern Child Health J 23, 486–495 (2019). https://doi.org/10.1007/s10995-018-2656-1
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DOI: https://doi.org/10.1007/s10995-018-2656-1