As cannabis legalization continues to expand across the United States, the implications for public health remain a critical area of study. Recent research evaluating trends from 2011 to 2021, in states with Medical Cannabis Laws (MCL) and Recreational Cannabis Laws (RCL), shows how different cannabis policies may influence the prevalence of cannabis use disorder (CUD) and cannabis poisoning.
Cannabis use disorder (CUD) is characterized by problematic pattern of cannabis use, leading to major impairments or distress. The study revealed an increase of 42.7% in CUD diagnoses in states with MCLs. This association of MCL with higher rates of CUD was observed across all age groups and genders, with the most significant rise among female and individuals aged 35-44.
The delayed impact revealed by the study, where diagnoses of CUD only became significant after the sixth quarter following the implementation of medical cannabis laws (MCL), highlights the long-term risks associated with medical cannabis use.
Next to CUD, cannabis poisoning, which can result from consuming excessive quantities of THC, is another significant concern. Following the implementation of MCLs and RCLs, cannabis poisoning diagnoses increased by 88.6% and 31.6%, respectively. Interestingly, the risk associated with RCLs manifested immediately after policy enactment, while MCLs exhibited a delayed effect like that seen with CUD.
The differences in timing and magnitude between MCLs and RCLs may stem from regulatory discrepancies. For instance, recreational cannabis often lacks the purchasing limits imposed on medical cannabis, potentially increasing the risk of overconsumption. Over time, however, the incidence of cannabis poisoning linked to RCLs began to wane, potentially due to individuals learning to navigate the risks associated with the increased potency of cannabis and its recreational use or possibly due the differences in the timing of the enactment of RCLs.
An unexpected factor affecting these trends was the COVID-19 pandemic. During this time, states with MCLs saw a more pronounced increase in cannabis-related health issues, likely due to heightened cannabis use amid pandemic-induced stress and isolation. Conversely, states with RCLs did not exhibit a similar trend, suggesting that the context of use may differ significantly between medical and recreational users.
As cannabis legalization evolves, so too must our understanding of its public health implications. The increase in CUD and cannabis poisoning diagnosed following MCL and RCL implementation highlights the risks associated with increased access. To protect public health and safety, we must work to prevent further legalization and its associated harms. Through research, education, and proactive interventions, we can mitigate the negative consequences of cannabis use and prevent policies that would further normalize and expand its availability.
References:
Jayawardhana J, Hou J, Freeman P, Talbert JC. (2024). Association of State Cannabis Legalization With Cannabis Use Disorder and Cannabis Poisoning. JAMA Psychiatry. https://doi:10.1001/jamapsychiatry.2024.4145
