Impact of Medical Marijuana Laws on State-Level Marijuana Use by Age and Gender, 2004–2013
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In states that have passed medical marijuana laws (MMLs), marijuana use (MU) increased after MML enactment among people ages 26 and older, but not among ages 12–25. We examined whether the age-specific impact of MMLs on MU varied by gender. Data were obtained from the 2004–2013 restricted-use National Survey on Drug Use and Health, aggregated at the state level. The exposure was a time-varying indicator of state-level MML (0 = No Law, 1 = Before Law, 2 = After Law). Outcomes included past-month MU prevalence, daily MU prevalence among past-year users (i.e., 300+ days/year), and past-year marijuana use disorder (MUD) prevalence. Linear models tested the state-level MML effect on outcomes by age (12–17, 18–25, 26+) and gender. Models included a state-level random intercept and controlled for time- and state-level covariates. Past-month MU did not increase after enactment of MML in men or women ages 12–25. Among people 26+, past-month MU increased for men from 7.0% before to 8.7% after enactment (+ 1.7%, p < 0.001) and for women from 3.1% before to 4.3% after enactment (+ 1.1%, p = 0.013). Among users 26+, daily MU also increased after enactment in both genders (men 16.3 to 19.1%, + 2.8%, p = 0.014; women 9.2 to 12.7%, + 3.4%, p = 0.003). There were no statistically significant increases in past-year MUD prevalence for any age or gender group after MML enactment. Given the statistically significant increase in daily use among past-year users aged 26+ following enactment, education campaigns should focus on informing the public of the risks associated with regular marijuana use.
KeywordsMedical marijuana laws Cannabis Gender Marijuana use
Medical marijuana laws
Marijuana use disorder
This work was supported by the National Institutes of Health, National Institute on Drug Abuse (grant R01 DA037866 to S. S. Martins). Santaella-Tenorio is funded by the J. William Fulbright and the Colciencias doctoral scholarships. P. Mauro is funded through training grant T32 DA031099 (PI: Hasin).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent is not applicable as this was considered non-human subject research by Columbia University’s IRB.
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
- Chromy, J.R., Abeyasekera, S. (2005). Statistical analysis of survey data. In United Nations Publications (Ed.), Household Sample Surveys in Developing and Transition Countries, Series96, 389–417. Retrieved from: https://unstats.un.org/unsd/hhsurveys/pdf/Household_surveys.pdf. Accessed 15 July 2015.
- Davis, G. P., Compton, M. T., Wang, S., Levin, F. R., & Blanco, C. (2013). Association between cannabis use, psychosis, and schizotypal personality disorder: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Schizophrenia Research, 151, 197–202.CrossRefPubMedGoogle Scholar
- de Boor, C. (Ed.). (1978). A practical guide to splines. New York: Springer-Verlag.Google Scholar
- Harrison, L., Martin, S., Enev, T., & Harrington, D. (2007). Comparing drug testing and self-report of drug use among youths and young adults in the general population (DHHS Publication No. SMA 07-4249, Methodology Series M-7). Rockville: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.Google Scholar
- Hasin, D. S., Wall, M., Keyes, K. M., Cerdá, M., Schulenberg, J., O'Malley, P. M., et al. (2015b). Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: Results from annual, repeated cross-sectional surveys. Lancet Psychiatry, 2, 601–608.CrossRefPubMedPubMedCentralGoogle Scholar
- Hasin, D. S., Kerridge, B. T., Saha, T. D., Huang, B., Pickering, R., Smith, H., et al. (2016). Prevalence and correlates of DSM-5 cannabis use disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III. American Journal of Psychiatry, 173, 588–599.CrossRefPubMedPubMedCentralGoogle Scholar
- Hunter, S., Feder, M., Granger, B., Piper, L., Chromy, J. (2005). 2005 National Survey on Drug Use and Health, Reliability study pretest analysis. Research Triangle Park: Prepared for the Substance Abuse and Mental Health Services Administration, Office of Applied Studies, under Contract No. 283–2004-00022, RTI/0209009.Google Scholar
- Kim, J. H., Santaella-Tenorio, J., Mauro, C., Wrobel, J., Cerdá, M., Keyes, et al. (2016). State medical marijuana laws and the prevalence of opioids detected among fatally injured drivers. American Journal of Public Health, 106, 2032–2037.Google Scholar
- National Conference of State Legislatures. (2016). Marijuana overview. Retrieved from http://www.ncsl.org/research/civil-and-criminal-justice/marijuana-overview.aspx. Accessed 1 Nov 2016.
- Pew Research Center. (2014). America’s new drug policy landscape. U.S. politics & policy. Retrieved from: http://www.people-press.org/2014/04/02/americas-new-drug-policy-landscape/. Accessed 1 Nov 2016.
- Piper, L., Meyer, M., Snodgrass, J. (2006). Reliability study pretest final report. Rockville: Prepared for Substance Abuse and Mental Health Services Administration, Office of Applied Studies, under contract No. 283-2004-00022, RTI/0209009.Google Scholar
- Powell, D., Pacula, R.L., Jacobson, M. (2015). Do medical marijuana laws reduce addictions and deaths related to pain killers? RAND corporation, WR-1130. Retrieved from: http://www.rand.org/pubs/working_papers/WR1130.html. Accessed 1 Nov 2016.
- ProCon.org (2016). Legal medical marijuana states and DC: Laws, fees, and possession limits. Retrieved from: http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881. Accessed 1 Nov 2016.
- Ryan, C., Bauman, K. (2016). Educational attainment in the United States: 2015. U.S. Department of Commerce, U.S. Census Bureau. Retrieved from: https://www.census.gov/content/dam/Census/library/publications/2016/demo/p20-578.pdf. Accessed 1 Nov 2016.
- Substance Abuse and Mental Health Services Administration. (2014). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Rockville, MD: Center for Behavioral Health Statistics and Quality Retrieved from: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf. Accessed 1 Nov 2016.
- Substance Abuse and Mental Health Data Archive. (2017). National Survey on Drug Use and Health (NSDUH) [Data files]. U.S. Department of Health and Human Services. Retrieved from: http://www.datafiles.samhsa.gov/study-series/national-survey-drug-use-and-health-nsduh-nid13517. Accessed 15 July 2015.
- Wall, M. M., Mauro, C., Hasin, D. S., Keyes, K. M., Cerdá, M., Martins, S. S., & Feng, T. (2016). Prevalence of marijuana use does not differentially increase among youth after states pass medical marijuana laws: Commentary on and reanalysis of US National Survey on Drug Use in Households data 2002-2011. The International Journal on Drug Policy, 29, 9–13.CrossRefPubMedPubMedCentralGoogle Scholar
- Williams, A. R., Santaella-Tenorio, J., Mauro, C. M., Levin, F. R., & Martins, S. S. (2017). Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder. Addiction. https://doi.org/10.1111/add.13904.