Current Addiction Reports

, Volume 5, Issue 4, pp 403–417 | Cite as

Has the Legalisation of Medical and Recreational Cannabis Use in the USA Affected the Prevalence of Cannabis Use and Cannabis Use Disorders?

  • Janni LeungEmail author
  • Chui Ying Vivian Chiu
  • Daniel Stjepanović
  • Wayne Hall
Cannabis (D D'Souza and P Skosnik, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cannabis


Purpose of Review

Since California legalised medical use of cannabis in 1996, 29 other US states have done so. Eight US states have legalised the retail sale of cannabis to adults over the age of 21 years since 2012. Critics of these policy changes have suggested that they will increase the prevalence of cannabis use and cannabis use disorders. This paper (1) briefly describes the types of regulatory regimes for medical and recreational cannabis use in the USA, (2) describes possible effects of these policies on cannabis use and (3) assesses the impacts to date of the legalisation of medical and recreational cannabis use on the prevalence of cannabis use and cannabis use disorders in the US population. We (1) describe the regulatory regimes for medical and recreational cannabis use in the USA, (2) make predictions about their possible effects on the price and availability of cannabis, (3) conduct a review to summarise studies of the effects of legalising medical cannabis use in the USA on rates of cannabis use and cannabis use disorders and (4) assess early indications of the effects of legalising recreational cannabis use on cannabis use and cannabis use disorders.

Recent Findings

Liberal forms of medical cannabis regulation have probably reduced prices and increased the availability of cannabis. Analyses of survey data suggest that these changes have increased the prevalence and frequency of cannabis use among adults over the age of 21 years, but they have not to date increased rates of cannabis use among adolescents. Two series of epidemiological studies over a decade following the introduction of medical cannabis laws have produced inconsistent results on the effects of policy changes on the prevalence of cannabis use disorders in adults. One study found that the prevalence had increased; the other did not find an increase. An analysis of data on treatment seeking for cannabis use disorders showed an increase in states with medical cannabis laws in the number of adults seeking treatment who were not under legal coercion. There are major limitations with these studies, many of which have mistakenly assumed that all states with medical cannabis laws have similarly liberal policies.


It may be a decade or more before we can fully assess the effects of liberalisation of cannabis policies on cannabis use and cannabis use disorders in the USA. It is critical that the effects of these policy changes are evaluated to ensure that cannabis is regulated in ways that minimise the harmful effects of its regular use, especially among young people.


Medical marijuana laws Marijuana abuse Cannabis use disorder Health surveys USA 



We acknowledge Research librarian Sarah Yeates for assisting with literature searching, proofreading and editing, as well as bibliography management for this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Janni Leung
    • 1
    • 2
    Email author
  • Chui Ying Vivian Chiu
    • 1
    • 2
  • Daniel Stjepanović
    • 1
  • Wayne Hall
    • 1
    • 3
  1. 1.Centre for Youth Substance Abuse ResearchThe University of QueenslandSt. LuciaAustralia
  2. 2.The National Drug and Alcohol Research CentreUniversity of New South WalesRandwickAustralia
  3. 3.National Addiction CentreKings College LondonLondonUK

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