Associations between state-level policy liberalism, cannabis use, and cannabis use disorder from 2004 to 2012: Looking beyond medical cannabis law status

Abstract

Background: Medical cannabis laws (MCL) have received increased attention as potential drivers of cannabis use (CU), but little work has explored how the broader policy climate, independent of MCL, may impact CU outcomes. We explored the association between state-level policy liberalism and past-year cannabis use (CU) and cannabis use disorder (CUD). Methods: We obtained state-level prevalence of past-year CU and CUD for ages 12-17, 18-25, and 26+ from the 2004-2006 and 2010-2012 National Surveys on Drug Use and Health. States were categorized as liberal, moderate, or conservative based on state-level policy liberalism rankings in 2005 and 2011. Linear models with random state effects examined the association between policy liberalism and past-year CU and CUD, adjusting for state-level social and economic covariates and medical cannabis laws.

Medical cannabis laws and medical and non-medical prescription stimulant use among a nationally representative sample of US Adults: Examining the role of sexual identity and gender

“…While we observed a negative association between state MCL status and medical and non-medical prescription stimulant use among heterosexuals and bisexuals, there was no association among gay/lesbian adults. This finding builds on previous work that found a cross-sectional association between MCLs and medical and recreational cannabis use among LGB individuals (Philbin, Mauro, Greene, et al, 2019), and MCLs and prescription opioid use among LGB individuals (P. M. Mauro, Philbin, et al, 2020).…”

“…Specifically, the magnitude of the protective association between using prescription stimulants in MCL vs non-MCL states was stronger among bisexual versus heterosexual men. Lower prescription stimulant use in MCL states could be due to unique stressors faced by bisexual individuals living in non-MCL states which, historically, have been more politically conservative (Philbin, Mauro, Santaella-Tenorio, et al, 2019) and with higher reported levels of sexual identity-based discrimination (Hatzenbuehler, 2014). Past-year medical prescription stimulant use was higher in non-MCL states, which suggest a higher volume of prescriptions in circulation; increased prescriptions are associated with diversion and nonmedical use (Fischer et al, 2010).…”

“…We were also unable to include potential time lags between MCL enactment and cannabis availability, including regional variations in dispensaries. States that first passed MCLs tend to be more politically liberal (Philbin, Mauro, Santaella-Tenorio, et al, 2019) and may have other related factors in common with each other, for which we could not account. Past-year prescription stimulant use measures were self-reported, which could be affected by recall bias.…”

“…Research has found an association between MCLs and cannabis outcomes for LGB individuals (Philbin, Mauro, Greene, et al, 2019), as well as MCLs and prescription opioid use for LGB individuals (P. M. Mauro, Philbin, et al, 2020). Studies have yet to examine whether MCLs are associated with medical and non-medical prescription stimulant use, particularly among LGB individuals whose stimulant use is higher than heterosexuals (Bose et al, 2018;Kelly et al, 2013;Li & Mustanski, 2018).…”

Online survey into developing a model for a legal cannabis market in the United Kingdom

“…Early exposure to cannabis can have serious effects on cognitive functioning and many users who develop cannabis use disorders do so at a younger age than other substances such as alcohol. Therefore a minimum age requirement of 18 (consistent with tobacco and alcohol purchase laws in the UK) and monitoring of young people in particular seems prudent (Kelly, 2018;Lankenau et al, 2018;Parnes et al, 2018;Philbin et al, 2019;Wade et al, 2019;Wiens et al, 2018).…”