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Marijuana legalization

Health Factors: Alcohol & Drug Use
Decision Makers: State Government
Evidence Rating: Mixed Evidence
Population Reach: 50-99% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

Legalizing marijuana entails removing prohibitions on its production, distribution, and possession by adults. Legalizing may simply repeal laws prohibiting marijuana, or may also institute regulations and impose taxes on the marijuana market (RAND-Kilmer 2012).

Expected Beneficial Outcomes

Reduced alcohol-related harms
Improved health outcomes
Reduced illegal drug use

Evidence of Effectiveness

There is mixed evidence about the health risks and benefits of legalizing marijuana, and the effects it would have on alcohol use (Caulkins 2012). Available evidence indicates that legalization would drastically reduce the price of marijuana (RAND-Kilmer 2012), increasing the likelihood of use among youth (RAND-Kilmer 2012) and possibly lowering the age of initiation (Van Ours 2012). Initiation before adulthood could increase the likelihood of dependence and related harms (Caulkins 2012, Wilsey 2008, Bostwick 2012) whereas initiation over the age of 25 rarely results in dependence (Bostwick 2012).

Smoking marijuana could lead to respiratory problems, heart attacks, and cancers (Leung 2011); vaporizing instead of smoking may reduce these effects (Caulkins 2012, Bostwick 2012). Marijuana use may also increase the risk of psychotic and schizophrenic symptoms and may worsen schizophrenia, especially in genetically susceptible individuals and youth (Caulkins 2012, Bostwick 2012).

Using marijuana for medical purposes, however, appears to reduce neuropathic pain in some patients (Caulkins 2012, Cinti 2009, Wilsey 2008), and could also control nausea and stimulate appetite (Caulkins 2012). Some studies find that legalizing marijuana use for medical purposes does not increase use in the general population, but others find associations between legalization and use, perhaps because medical marijuana laws vary considerably (RAND-Kilmer 2012).

There are conflicting findings about the relationship between marijuana and alcohol use. Some studies suggest that marijuana availability increases alcohol use, other studies suggest that availability decreases use. Marijuana use impairs driving, although less so than alcohol use. If marijuana legalization reduced alcohol use, dependence, crime, and automotive crashes would decrease (Caulkins 2012).

Legalizing marijuana may not reduce drug-related violence in communities (RAND-Kilmer 2012, Caulkins 2012). States rarely imprison offenders for possession alone, but do arrest and detain them pretrial (RAND-Reuter 2010); only 8% of state and federal prisoners incarcerated for drug offenses are serving time for marijuana offenses alone (Caulkins 2012). Blacks are more likely to be arrested for marijuana possession than whites, despite similar prevalence rates (Ramchand 2006). Preliminary, California-based research suggests that state financial gains from legalization could offset associated increases in youth treatment costs and hospitalization (RAND-Pacula 2010). State taxation could counter expected increases in marijuana use, but very high taxes would lead to tax evasion (RAND-Kilmer 2012).

Implementation

United States

No nation has fully legalized recreational marijuana. Nations such as Portugal and the Netherlands have decriminalized marijuana possession but not production, and some nations have legalized marijuana for medical purposes (RAND-Kilmer 2012). Marijuana is illegal in the United States at the federal level. Colorado and Washington legalized recreational marijuana in 2012 (Coffman 2012). Both state governments regulate but do not own marijuana distribution venues, and impose modest sales taxes (RAND-Kilmer 2012). Alaska allows citizens to grow a small amount of marijuana for personal use only (Caulkins 2012). As of 2014, 20 states and Washington DC allow residents to use medical marijuana (LawAtlas-Marijuana). State and local police conducted approximately 736,000 arrests for marijuana possession and 96,000 for sales in 2010 (Caulkins 2012).

Wisconsin

Possession and sale of marijuana is illegal in Wisconsin (FindLaw-WI Marijuana).

Citations - Description

RAND-Kilmer 2012 - Kilmer B, Caulkins JP, Pacula RL. Marijuana legalization: What we know and what we don’t. In: RAND Congressional Briefing Series. Santa Monica: RAND Corporation; 2012. Accessed on November 9, 2015

Citations - Evidence

Bostwick 2012 - Bostwick JM. Blurred boundaries: The therapeutics and politics of medical marijuana. Mayo Clinic Proceedings. 2012;87(2):172-86. Accessed on February 16, 2016
Caulkins 2012* - Caulkins JP, Hawken A, Kilmer B, Kleiman MAR. Marijuana legalization: What everyone needs to know. New York: Oxford University Press; 2012. Accessed on December 12, 2015
Cinti 2009* - Cinti S. Medical marijuana in HIV-positive patients: What do we know? Journal of the International Association Providers of AIDS Care. 2009;8(6):342-6. Accessed on December 8, 2015
Leung 2011 - Leung L. Cannabis and its derivatives: Review of medical use. Journal of the American Board of Family Medicine. 2011;24(4):452-62. Accessed on February 24, 2016
Ramchand 2006* - Ramchand R, Pacula RL, Iguchi MY. Racial differences in marijuana-users’ risk of arrest in the United States. Drug and Alcohol Dependence. 2006;84(3):264-72. Accessed on May 24, 2016
RAND-Kilmer 2012 - Kilmer B, Caulkins JP, Pacula RL. Marijuana legalization: What we know and what we don’t. In: RAND Congressional Briefing Series. Santa Monica: RAND Corporation; 2012. Accessed on November 9, 2015
RAND-Pacula 2010 - Pacula RL. Examining the impact of marijuana legalization on harms associated with marijuana use. Santa Monica: RAND Corporation; 2010:WR-769. Accessed on May 20, 2016
RAND-Reuter 2010 - Reuter PH. Marijuana legalization: What can be learned from other countries? Santa Monica: RAND Corporation; 2010:WR-771. Accessed on November 9, 2015
Van Ours 2012 - Van Ours JC. The long and winding road to cannabis legalization. Addiction. 2012;107(5):872-3. Accessed on November 19, 2015
Wilsey 2008* - Wilsey B, Marcotte T, Tsodikov A, et al. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. Journal of Pain. 2008;9(6):506-21. Accessed on November 23, 2015

Citations - Implementation

Caulkins 2012* - Caulkins JP, Hawken A, Kilmer B, Kleiman MAR. Marijuana legalization: What everyone needs to know. New York: Oxford University Press; 2012. Accessed on December 12, 2015
Coffman 2012 - Coffman K, Neroulias N. Colorado, Washington first states to legalize recreational pot. Reuters. 2012. Accessed on December 8, 2015
FindLaw-WI Marijuana - FindLaw. Wisconsin marijuana laws. Accessed on February 5, 2016
LawAtlas-Marijuana - LawAtlas. Medical marijuana laws for patients map. Accessed on March 9, 2016
RAND-Kilmer 2012 - Kilmer B, Caulkins JP, Pacula RL. Marijuana legalization: What we know and what we don’t. In: RAND Congressional Briefing Series. Santa Monica: RAND Corporation; 2012. Accessed on November 9, 2015

Page Last Updated

March 10, 2014

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