Recently, as cannabis was legalized for recreational use in an increasing number of states, it has become more important to understand the effects of cannabis policies, especially on youth. Marketers of other recreational substances are also paying close attention to cannabis policy changes. Alcohol and tobacco companies typically view the cannabis industry as a potential threat and are often found among the opponents to its legalization.
However, based on extant research, the treatment effects of recreational cannabis legalization (RCL) and its cross-commodity effects on the alcohol and tobacco industries remain inconclusive. Analyzing large-scale web-based behavioral data, we find that although RCL significantly increases cannabis search, the increase comes from adults only, but not youth. RCL also influences alcohol and tobacco industries asymmetrically: it reduces search volume and advertising effectiveness for alcohol but increases those for tobacco. Hence, cannabis appears to be a substitute for alcohol but not tobacco.
Research on health professional’s attitudes toward medical marijuana have failed to include addictions treatment professionals. The current study attempted to address this gap in the literature.
Study participants were recruited by e-mail using mailing lists supplied by multiple state licensing/certification boards and through snowball sampling. Participants completed a 22-item survey addressing attitudes toward medical and recreational marijuana. The 13 items relating to medical marijuana were analyzed.
Our sample (N = 966) was largely female (69.1%) with a Masters’ or Doctoral degree (80%) and a mean age of 46.5 (SD = 12.8). Participants were mostly split between the mid-west and east coast. Overall, participants held mixed views toward medical marijuana. For example, 71.3% of the sample supported legalization of marijuana for medical purposes and yet 63.6% believed that medical marijuana is often abused.
More research is needed to develop a more nuanced understanding of substance use treatment provider’s mixed attitudes toward medical marijuana legalization.
Therapeutic Prospects Of Cannabidiol, Cannabidiol (CBD) is a natural component of cannabis that possesses a widespread and complex immunomodulatory, antioxidant, anxiolytic, and antiepileptic properties. Much experimental data suggest that CBD could be used for various purposes in alcohol use disorder (AUD) and alcohol-related damage on the brain and the liver.
To provide a rationale for using CBD to treat human subjects with AUD, based on the findings of experimental studies.
Narrative review of studies pertaining to the assessment of CBD efficiency on drinking reduction, or on the improvement of any aspect of alcohol-related toxicity in AUD.
Experimental studies find that CBD reduces the overall level of alcohol drinking in animal models of AUD by reducing ethanol intake, motivation for ethanol, relapse, anxiety, and impulsivity. Moreover, CBD reduces alcohol-related steatosis and fibrosis in the liver by reducing lipid accumulation, stimulating autophagy, modulating inflammation, reducing oxidative stress, and by inducing death of activated hepatic stellate cells. Finally, CBD reduces alcohol-related brain damage, preventing neuronal loss by its antioxidant and immunomodulatory properties.
CBD could directly reduce alcohol drinking in subjects with AUD. Any other applications warrant human trials in this population. By reducing alcohol-related steatosis processes in the liver, and alcohol-related brain damage, CBD could improve both hepatic and neurocognitive outcomes in subjects with AUD, regardless of the individual’s drinking trajectory. This might pave the way for testing new harm reduction approaches in AUD, in order to protect the organs of subjects with an ongoing AUD.
Cannabis Doesn’t Alter Brain Structure, Cannabis exerts its psychoactive effect through cannabinoid receptors that are widely distributed across the cortical surface of the human brain. It is suggested that cannabis use may contribute to structural alterations across the cortical surface.
In a large, multisite dataset of 120 controls and 141 cannabis users, we examined whether differences in key characteristics of the cortical surface – including cortical thickness, surface area, and gyrification index were related to cannabis use characteristics, including (i) cannabis use vs. non-use, (ii) cannabis dependence vs. non-dependence vs. non-use, and (iii) early adolescent vs. late adolescent onset of cannabis use vs. non-use. Our results revealed that cortical morphology was not associated with cannabis use, dependence, or onset age.
The lack of effect of regular cannabis use, including problematic use, on cortical structure in our study is contrary to previous evidence of cortical morphological alterations (particularly in relation to cannabis dependence and cannabis onset age) in cannabis users. Careful reevaluation of the evidence on cannabis-related harm will be necessary to address concerns surrounding the long-term effects of cannabis use and inform policies in a changing cannabis regulation climate.
Treatment Of Substance Use Disorder, Substance use disorder is characterized by repeated use of a substance, leading to clinically significant distress, making it a serious public health concern. The endocannabinoid system plays an important role in common neurobiological processes underlying substance use disorder, in particular by mediating the rewarding and motivational effects of substances and substance-related cues.
In turn, a number of cannabinoid drugs (e.g., rimonabant, nabiximols) have been suggested for potential pharmacological treatment for substance dependence. Recently, cannabidiol (CBD), a non-psychoactive phytocannabinoid found in the cannabis plant, has also been proposed as a potentially effective treatment for the management of substance use disorder. Animal and human studies suggest that these cannabinoids have the potential to reduce craving and relapse in abstinent substance users, by impairing reconsolidation of drug-reward memory, salience of drug cues, and inhibiting the reward-facilitating effect of drugs.
Such functions likely arise through the targeting of the endocannabinoid and serotonergic systems, although the exact mechanism is yet to be elucidated. This article seeks to review the role of the endocannabinoid system in substance use disorder and the proposed pharmacological action supporting cannabinoid drugs’ therapeutic potential in addictions, with a focus on CBD.
Subsequently, this article will evaluate the underlying evidence for CBD as a potential treatment for substance use disorder, across a range of substances including nicotine, alcohol, psychostimulants, opioids, and cannabis. While early research supports CBD’s promise, further investigation and validation of CBD’s efficacy, across preclinical and clinical trials will be necessary.
More Marijuana Less Binge Drinking, Marijuana use among college students has been trending upward for years, but in states that have legalized recreational marijuana, use has jumped even higher.
An Oregon State University study published today in Addiction shows that in states where marijuana was legalized by 2018, both occasional and frequent use among college students has continued to rise beyond the first year of legalization, suggesting an ongoing trend rather than a brief period of experimentation.
Overall, students in states with legal marijuana were 18% more likely to have used marijuana in the past 30 days than students in states that had not legalized the drug. They were also 17% more likely to have engaged in frequent use, defined as using marijuana on at least 20 of the past 30 days.
The differences between states with and without legalization escalated over time: Six years after legalization in early-adopting states, students were 46% more likely to have used marijuana than their peers in non-legalized states.
Between 2012 and 2018, overall usage rates increased from 14% to 17% in non-legalized states, but shot up from 21% to 34% in the earliest states to legalize the drug. Similar trends appeared in states that legalized marijuana more recently.
Conducted by Harold Bae from OSU’s College of Public Health and Human Sciences and David Kerr from OSU’s College of Liberal Arts, this is the first study of college students to look broadly at multiple states that have legalized recreational marijuana and to go beyond the first year following legalization.
The past decade has seen unprecedented shifts in the cannabis policy environment, and the public health impacts of these changes will hinge on how they affect patterns of cannabis use and the use and harms associated with other substances.
To review existing research on how state cannabis policy impacts substance use, emphasizing studies using methods for causal inference and highlighting gaps in our understanding of policy impacts on evolving cannabis markets.
Narrative review of quasi-experimental studies for how medical cannabis laws (MCLs) and recreational cannabis laws (RCLs) affect cannabis use and use disorders, as well as the use of or harms from alcohol, opioids, and tobacco.
Research suggests MCLs increase adult but not adolescent cannabis use, and provisions of the laws associated with less regulated supply may increase adult cannabis use disorders. These laws may reduce some opioid-related harms, while their impacts on alcohol and tobacco use remain uncertain. Research on RCLs is just emerging, but findings suggest little impact on the prevalence of adolescent cannabis use, potential increases in college student use, and unknown effects on other substance use.
Research on how MCLs influence cannabis use has advanced our understanding of the importance of heterogeneity in policies, populations, and market dynamics, but studies of how MCLs relate to other substance use often ignore these factors. Understanding effects of cannabis laws requires greater attention to differences in short- versus long-term effects of the laws, nuances of policies and patterns of consumption, and careful consideration of appropriate control groups.
The prevalence of cannabis use disorder decreased in frequent cannabis users.
Endorsement of cannabis abuse items decreased in adolescents and young adults.
Endorsement of cannabis dependence items decreased mainly in young adults.
Changes in social attitudes and frequent users’ features may explain findings.
Cannabis use disorder (CUD) prevalence among people reporting past-year cannabis use declined from 2002–2016. We examined whether similar reductions in CUD were observed among people reporting daily/almost daily cannabis use. We expected that CUD prevalence among people reporting daily/almost daily use would not decrease.
We used 2002–2016 National Survey on Drug Use and Health (NSDUH) data, including 22,651 individuals using cannabis 300+ days in the past year. CUD was defined using DSM-IV criteria for cannabis abuse and/or dependence. Age categories included: 12–17, 18–25, and 26 + . Annual prevalence of CUD, cannabis dependence, cannabis abuse, and each individual abuse/dependence items accounted for the complex survey design. Differences in trends over time were examined by age group.
From 2002–2016, the prevalence of CUD among people reporting daily/almost daily cannabis use decreased by 26.8% in adolescents, by 29.7% in ages 18–25, and by 37.5% in ages 26 + . Prevalence of DSM-IV cannabis dependence decreased significantly among adolescents (-43.9%) and young adults (-26.8%) but remained stable in adults 26 + . Reductions in most dependence items were observed in young adults, with less consistent patterns in adolescents and adults 26 + . Prevalence of DSM-IV cannabis abuse decreased overall and for each abuse item across all age groups.
Contrary to expectations, CUD prevalence decreased significantly across all ages reporting daily/almost daily cannabis use between 2002–2016. Cannabis dependence prevalence decreased for adolescents and young adults and was stable only among adults ages 26+ reporting daily/almost daily cannabis use. Potential drivers of this decrease should be further explored.
Camas-Washougal Post Record Article, February 27th, 2020
Political action committee, launched by New Vansterdam owners, hopes to get issue on November ballot.
Camas Washougal Post Article
When the issue of legalizing cannabis came before Washington voters in 2012, nearly half of Camas voters — 47 percent overall and more than 50 percent in the city’s Ward 1 — supported decriminalizing the drug. But when the issue of opening the one cannabis retail shop allowed in Camas under the state ordinance came before city council members in 2015, the council voted 5-2 to ban marijuana shops within city limits. Now, the owners of a popular Vancouver cannabis shop hope to reverse that decision.
Rachel and James Bean own the New Vansterdam cannabis retail shop located off Mill Plain Boulevard and hold the the lone cannabis retailer license available in Camas. Although the Beans would love to see Camas officials lift the 2015 retailer ban, they are prepared to take the issue to the city’s voters through a local ballot measure process.
“We would hope this could be resolved with the city council. I believe it would just take a little more education and more discussion,” said Rachel Bean. “But we will be moving forward with the (voter) initiative either way.”
Bean and her physician husband have formed the Camas for Cannabis Access political action committee (PAC) to gather the 2,377 Camas voter signatures needed to place the issue on the November general election ballot.
“We’ve been kind of sitting back a little, waiting and trying to work with the city council,” Bean said. “We have three other stores (in Vancouver, Tacoma and Wenatchee), so we were pretty busy and (the Camas license) wasn’t a high priority for us. But this year, with the big election, it seemed like the year to jump on this.”
A Camas native who now lives in Vancouver, Pitchford became involved in cannabis-legalization activism in 2008, after surviving a violent home invasion linked to the illicit marijuana trade. Home invaders mistook the home Pitchford, then a 19-year-old Clark College student, shared with roommates as being the site of an illegal stash of marijuana.
“Masked gang members held me hostage,” Pitchford said of the incident that led her into cannabis activism. “Afterward, I started thinking about the reasons why cannabis was illegal and about the people involved in violent crimes connected to the illicit cannabis market.”
Pitchford participated in early efforts to legalize cannabis in Washington state, and said she has seen a shift in people’s perception of marijuana since Washington voters approved Initiative 502, a measure that decriminalized recreational marijuana, in November 2012.
“People have been able to see what it looks like to go into a cannabis store, to see that these shops are a functional part of the community,” Pitchford said. “There is less stigma.”
Rachel Bean agreed.
“People have become much more open to the idea of retail cannabis,” she said. “I think things have changed drastically since 2012, when legalization was passed, and even more since stores started opening in 2014.”
Bean said people’s attitudes toward cannabis also is shifting as health providers start to understand the medicinal benefits of the herb, and as more research is conducted on cannabis’ ability to help with pain management, cancer treatments and opioid addiction.
“Time and time again, I see people coming into the shop for the first time, including a lot of the elderly population, and they’re looking to try new things to help whatever ailment they might have. They have doctors telling them to try these new things,” Bean said. “(Cannabis) has become less taboo and more of an actual medicine that is helping people.”
Pitchford said the Camas for Cannabis Access PAC is training workers to collect signatures and help educate Camas voters about the legal cannabis industry and the benefits of having a cannabis retail shop within the city limits.
“This is really about access,” Pitchford said. “We know the support exists in Camas.”
Armed with statistics and research showing that legalizing marijuana has helped reduce marijuana use among teens, led to a reduction in violent crimes, provided living-wage jobs — New Vansterdam, Bean said, pays more than a living wage and provides a full range of benefits to its 20 employees — and helped bring millions of dollars in tax revenue to cities and counties that allow cannabis retailers, the Camas for Cannabis Access PAC is gearing up to attend local events and collect signatures to get the issue onto the November ballot.
“We want to be very respectful and help educate people,” Pitchford said. “A lot of the (signature collectors) have worked in the industry and are knowledgeable about cannabis and cannabis retail, so they will be able to answer questions people might have.”
The Beans, who live in Vancouver, said they hope Camas voters and officials will see them for who they are — professionals who run successful cannabis businesses in other Washington cities.
“I’d like people to know that we are a part of the community and that we respect the people and businesses around us,” Rachel Bean said. “We don’t want people to be concerned about who is holding this license.”
Already, the Beans have made a concession that they didn’t have to make — agreeing to not site the cannabis store in historic, downtown Camas if voters approve the initiative or if city council members decide to overturn their 2015 cannabis retail ban.
“That wasn’t something we had to do, but we had heard from council members that (not having a cannabis retailer) in the historic district was important to their constituents, so that was something we were more than happy to respect,” Rachel Bean said.
Pitchford said she hopes to get more information out to the Camas community about cannabis that will help dispel some of the fears and myths surrounding the drug. For instance, she said, although many people have said they worry that having a legal cannabis shop in Camas will lead to greater marijuana usage by children, the facts show otherwise.
“I’m the mother of two young children, so I understand why they would be concerned,” Pitchford said. “But when you look at the studies, including the Healthy Youth Survey that is done in Clark County, there is a decrease (in marijuana use among teens and children) and that is a direct result of legalizing cannabis. They just can’t get it anymore. The shops are very strict about that. Some of them even have scanners to make sure the IDs (for those over the age of 21) are real.”
During the 2015 hearing that led to the city’s ban on cannabis retailers, only two Camas officials — current Councilwoman Melissa Smith and former Camas Mayor Shannon Turk — voted against the ban.
“It will be a novelty at first for some, but as more people are aware of it I think it will de-stigmatize it,” Smith said in 2015, adding that she had researched cannabis several years prior, after receiving a doctor’s prescription for marijuana to treat pain.
Other council members who still serve as elected officials, including Councilman Don Chaney, spoke in favor of the ban in 2015.
“It’s not about the use or possession of marijuana, at least as far as I’m concerned,” Chaney said in 2015. “And it’s not about the personal qualities or business opportunities of the proponents. That’s not an issue here for me. The issue is, what’s it going to do to our community, and how does the fact that we do or do not (allow retail marijuana businesses) reflect the culture of our community?”
Washougal city officials also have banned cannabis retail operations, and both Camas and Washougal have bans in place on the growing and processing of retail marijuana within city limits. To learn more about the Camas for Cannabis Access group and its efforts, visit xray.fm/broadcasts/33110 and listen to XRAY FM’s interview with Rachel Bean and Pitchford. The group plans to launch a website soon and will have social media sites up and running within the next few weeks.
Legalization Leads to Increased Marijuana Use, But Evidence of “Gateway Drug” Lacking, Marijuana legalization is a growing trend among American state governments. Advocates of marijuana legalization argue that the drug is a good alternative for pain relief. Additionally, marijuana tax revenue can add to state economies. For instance, Colorado raised $247 million and Washington raised $319 million from taxes and fees related to marijuana in 2017.
Opponents of marijuana legalization often cite the “gateway drug” theory. First popularized in the 1980s, the gateway drug theory proposes that use of “soft” drugs like marijuana increases the risk of using more harmful substances, such as cocaine and opioids.
This report looks at drug use trends following legalization in Washington, Oregon, Alaska, and Colorado. These four states all legalized marijuana from 2012 to 2014, so several years of data are available from the Substance Abuse and Mental Health Services Administration (SAMHSA). Additionally, education and employment trends are included from other civic data sources.
The U.S. national average is provided as a dotted baseline on each chart. Readers of this report can hover over any trend lines to see the data points.
Recreational marijuana is legal in nine states. The years when states passed legislation allowing recreational marijuana are shown on this map. This report focuses on the first four states to legalize recreational marijuana since they have several years of trend data.
Marijuana use increased after state legalization.
chart, based on data from the SAMHSA survey, suggests that use of marijuana has increased in Oregon, Alaska, and Colorado, beginning in the year that the ballot measures passed, though slightly before the legalization took effect. The trend in Washington, by contrast, was not as noticeable.
Marijuana use in Colorado and Oregon continued an upward trend in 2016. However, the marijuana use trend appeared to have plateaued in Alaska and Washington by 2016.
Binge drinking rates are similar to national average.
Binge drinking among individuals 12 years and older has been inching up nationally between 2011 and 2016. The four states with legal marijuana had similar trajectories, with rates close to the national average.
Tobacco use is steadily declining across the United States.
Perhaps due to consistent public health marketing, tobacco use is in steady decline across the U.S. Similarly, Colorado, Washington, and Oregon experienced declines. Tobacco use in Alaska remained above the national rate, but also experienced a small decline.
Nationally, the biggest declines in tobacco use are among 12 to 25 year olds. For 12-17 year olds tobacco use went down by the most of any age group. 10.34 percent in 2011 to 5.66 in 2016. Among 18-25 year olds, tobacco use decreased from 40.17 percent in 2011 to 31.48 percent in 2016. The percent of tobacco use among people 26 and older remained around 25 percent between 2011 and 2016.
The decrease in tobacco use among 12 to 25 year olds has come about with the increasing number of anti-tobacco public health campaigns. States where marijuana is legal could use a similar tactic to prevent underage marijuana use.
Cocaine use remained relatively low in the U.S. between 2011 and 2016. Similarly, the use of cocaine continued to fluctuate between 2% and 3% from 2011 to 2016 for the four states with legal marijuana.
Cocaine use hovers between 2% to 3%.
The number of survey respondents who used cocaine is much smaller than other substances. (Note the high margins of error for this data.)
Opioid deaths increased across the United States, but Colorado, Washington, and Oregon are below the national average.
Deaths from opioids, including the illegal drug heroin, are spiking around the United States. While the four states with legal marijuana have not escaped this trend, these states have not suffered the skyrocketing mortality rates that have afflicted other regions of the country. Opioid overdose death rates in Colorado, Washington, and Oregon remained below the national average.
Note: The CDC does not report death counts fewer than 10 to prevent individuals from being identified in small datasets, and also suppresses rate measures with small amounts of data. States with “no data” may not necessarily have zero deaths.
Education and Employment in States with Legal Marijuana
While it is too soon to tell if marijuana legalization has an effect on education and employment, we can look at the available data trends to get a sense of where these states stand today. Among these four states, education levels have remained stable and at a high level between 2011 and 2016. Colorado, the first state to legalize marijuana, has 34.3% of residents with a college degree or higher, the second highest percentage of any state.
Nationally, unemployment rates have decreased significantly between 2011 to 2018. The four states with legal marijuana also experienced a decline. Unemployment in Colorado, Washington, and Oregon all decreased at least 50%. Alaska experienced less of a decline in unemployment.
Increased marijuana use fails to show connection to other substance use trends.
Since legalizing marijuana, Colorado, Washington, Oregon, and Alaska all had a significant increase in marijuana use. However, these states did not experience similar trends for more addictive substances like alcohol, tobacco, cocaine, and heroin.
Marijuana legalization does present the need for new health education strategies to discourage drug abuse, especially for minors. Health educators would benefit from studying tobacco prevention education, which has contributed to a steady decline of tobacco use among younger Americans.
State-level survey data for marijuana, tobacco, and alcohol use is from the Substance Abuse and Mental Health Services Administration’s (SAHMSA) National Survey on Drug Use and Health. Heroin death data is from CDC Wonder, published by the Centers for Disease Control and Prevention (CDC). State education data is from CDC’s Behavioral Risk Factor Surveillance System (BRFSS). State unemployment data is from Bureau of Labor Statistics (BLS).