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Background and Objectives: Legalization of medical marijuana has increased unintentional exposure to marijuana in young children. We aim to explore the sociodemographic disadvantage profile, prevalence, and clinical presentation of children diagnosed with unintentional exposure to marijuana. Methods: We conducted a retrospective chart abstraction of 121 children (aged 0–6) seen at the Emergency Department (ED) at a single tertiary hospital center in Dayton, Ohio between January 01, 2010 and January 09, 2022. Results: Majority were female (62.8%), white (50.4%), and with Medicaid as their primary insurance (84.3%). The median age at exposure was 1.8 years. There was a 14‐fold increase in unintentional marijuana cases pre‐2017 (7 cases) versus post‐2017 (114 cases), the year of legalization of medical marijuana in the state of Ohio. Majority of the patients were using public assistance (66.4%). 26.7% of the cases had a prior social work consultation and 38.1% had a prior children services consultation. 51.3% of the children had a social disadvantage index score of 3 or greater (range 0–5) with higher scores indicating greater disadvantage. Discussion and Conclusions: The number of patients presenting to the ED at the hospital has increased 14‐fold since the legalization of medical marijuana in Ohio. Half of the children displayed a higher sociodemographic disadvantage index score. Scientific Significance: Our study is the first study investigating the sociodemographic profile of children exposed to marijuana. The findings of this study may be utilized to inform policy for safely dispensing recreational and medicinal marijuana products and focus the efforts on families with sociodemographic disadvantage. [ABSTRACT FROM AUTHOR]

Many states have legalized medical and recreational marijuana use in the past decade, which has potential consequences for roadway safety. Using a state‐level panel of heavy truck crash statistics from 2005 to 2021 and a difference‐in‐difference estimation strategy, we test whether legalization has affected crash rates. Our results show that legalization does not increase crash rates on average; however, responses are heterogeneous across states, with Colorado, New Jersey, and Washington (state) showing crash reductions, while Connecticut and Virginia saw crashes increase. These results suggest that marijuana legalization does not have a straightforward relationship with heavy truck accidents, warranting continued research and policy scrutiny. [ABSTRACT FROM AUTHOR]

Background and Objectives Methods Results Conclusion and Scientific Significance Despite marijuana's association with adverse pregnancy and birth outcomes, its use during pregnancy increased over the last two decades. During this period, medical marijuana has been legalized in 38 states and the District of Columbia. States with legalized medical marijuana have observed increased marketing of marijuana and related products. This study aims to examine the association between state‐level medical marijuana legalization and marijuana use during pregnancy in the United States.Using the 2015–2021 National Survey on Drug Use and Health, we evaluated the association between marijuana use in the past month among currently pregnant mothers (N = 4338) and legalized medical marijuana in their state of residence. Survey‐weighted descriptive, bivariate, and multivariable logistic regression analyzes were performed.About 5.7% of pregnant women reported using marijuana in the past month, and 59.0% lived in a state where medical marijuana was legalized across 2015–2021. Compared to those living in states without marijuana legalization, more pregnant women living in states with marijuana legalization reported using marijuana (4.6% vs. 6.5%). In the multivariable model, pregnant women residing in states with medical marijuana legalization were more likely to use marijuana than residents of states without legalization (adjusted Odds Ratio: 1.56; 95% Confidence Interval: 1.11–2.18).This is the first known study to find that pregnant women living in states where medical marijuana is legalized are more likely to use marijuana during pregnancy. Pregnant women should be informed of adverse pregnancy and birth outcomes linked to marijuana use during pregnancy. [ABSTRACT FROM AUTHOR]

Amid increasing awareness regarding opioid addiction, medical marijuana has emerged as a substitute to opioids for pain management. Concurrently, opioid manufacturers are putting significant research into making opioids safer yet effective. Interactions between these manufacturers and physicians are critical to advance existing pain management protocols. Direct payments from opioid manufacturers to physicians are established practices that often moderates such interactions. We study the effects of passage of a medical marijuana law (MML) on these direct payments to physicians. To draw causal conclusions, we develop a novel penalized synthetic control (SC) method that accommodates zero-payment related latent structures inherent in these payments. Under a truncated flexible additive mixture model, we show that the SC method has uncontrolled maximal risk without the penalty; by contrast, the proposed penalized method provides efficient estimates. Our analysis finds a significant decrease in direct payments from opioid manufacturers to pain medicine physicians as an effect of MML passage. We provide evidence that this decrease is due to medical marijuana becoming available as a substitute. Finally, our heterogeneity analyses indicate that the decrease in direct payments is comparatively higher for physicians practicing in localities with higher white populations, lower affluence, and a larger proportion of working-age residents. [ABSTRACT FROM AUTHOR]

Aims Design Setting and participants Measurements Findings Conclusions To measure the association between state cannabis policies and use among adults and youth in the United States from 2002 to 2019, given rapid policy liberalization and complex state cannabis policy environments.Repeated cross‐sectional time series analysis. Three sets of models assessed the linear association between the Cannabis Policy Scale (CPS), an aggregate measure of 17 state cannabis policy areas that weights each policy by its efficacy and implementation rating, and prevalence of cannabis use. The first included year and state fixed effects; the second added state‐level controls; the third replaced state fixed effects with state random effects. Standard errors were clustered at the state level in all models.United States.Past‐month prevalence of cannabis use is from the National Survey on Drug Use and Health Small Area Estimates, a nationally and state‐representative cross‐sectional survey of household population ages 12 and older for years 2002–2003 to 2018–2019. Exposure data include the CPS.A 10 percentage‐point increase in the CPS (i.e. greater cannabis policy restrictiveness) was associated with lower past‐month use prevalence by 0.81 (95% confidence interval [CI] = ‐1.05 to −0.56) to 0.97 (95% CI = ‐1.19 to −0.75) percentage‐points for the population ages 12 years and older. When models were stratified by age, a 10 percentage‐point increase in the CPS was associated with a 0.87 (95% CI = ‐1.13 to −0.61) to 1.04 percentage‐point (95% CI = ‐1.03 to −0.84) reduction in past‐month use prevalence for adults ages 18 years and older, and a 0.17 (95% CI = ‐0.24 to −0.09) to 0.21 percentage‐point (95% CI = ‐0.35 to −0.07) reduction for youth ages 12–17 years.More restrictive US cannabis policies appear to be associated with reduced cannabis use for both adults and youth. [ABSTRACT FROM AUTHOR]

Background: Dabbing is recently getting popular among young adults. It is a new method of using the most active form of marijuana where large amounts of concentrated tetrahydrocannabinol are inhaled. Tetrahydrocannabinol is associated with a feeling of 'High' which makes the user feel joyous and relaxed. With increasing use of such techniques, dabbing becomes an important differential for evaluation of acute respiratory failure with pneumonitis especially in the adult population. Case presentation: A Fifty-one years old Caucasian man presented to the hospital with chest pressure and shortness of breath. The patient was noted to be hypoxic, desaturating down to 82–83% on nasal cannula oxygen. Imaging revealed bilateral lung infiltrates. Patient was started on high flow oxygen, broad spectrum antibiotics and intravenous corticosteroids. The patient gradually improved and was able to come off oxygen completely. He was discharged home on prednisone taper. Conclusions: Dabbing is a newer technique which has been gaining popularity for marijuana usage. With the legalization of marijuana, newer techniques are getting popular. Our case report emphasizes the importance of keeping dabbing as a differential when a patient presents with respiratory failure and has concerns for pneumonitis. Patients might not reveal until specifically asked about their practices. [ABSTRACT FROM AUTHOR]

Introduction. The use of medical marijuana was legalized in Mexico in 2017. In June 2021, the Supreme Court authorized personal marijuana use, as well as its planting, cultivation, harvest, preparation, possession, and transportation for recreational purposes by persons aged 18 and over, decriminalizing its use. Objectives. 1) To determine which variables are associated with favorable opinions regarding medical use, recreational use, and the legalization of marijuana use; and 2) to determine whether there are differences in the variables that best predict support for medicinal and recreational use and legalization of marijuana among marijuana users and non-users. Method. Data are drawn from the 2016 National Survey on Drug, Alcohol, and Tobacco Use, administered to a nationally representative sample of Mexican households. A validated questionnaire was used with questions on demographic characteristics, marijuana use (including the number of times it has been used), respondents' opinions regarding the legalization of marijuana and recreational use, whether they have been offered marijuana without having to pay for it, perception of risk associated with marijuana use, and excessive alcohol consumption. Results. Being male and having a low perception of the risks of marijuana use are the variables mostly strongly associated with approving medical and recreational use and its legalization, irrespective of whether respondents used it. Other variables associated with approval are age, educational attainment, and income level. Discussion and Conclusion. Legislators and policy makers should consider the full range of public opinion concerning the use and legalization of marijuana and incorporate it into their proposals. [ABSTRACT FROM AUTHOR]

In Canada, in the early 2000s, the decriminalization of cannabis for recreational use seemed imminent. Between 2003 and 2005, three government decriminalization bills were introduced in the Canadian House of Commons, but none were adopted, and decriminalization efforts were abandoned. Subsequently, Canada went beyond decriminalization and legalized recreational cannabis in 2018. This paper examines why the Canadian decriminalization efforts failed, using the Advocacy Coalition Framework (ACF) and ACF policy change theory. Three ACF-based hypotheses to explain the failed reform attempts are developed and investigated, but none are empirically supported. A fourth hypothesis is developed using information processing insights from Punctuated Equilibrium Theory (PET) but adapted to the ACF. This hypothesis is empirically supported showing that Canada's decriminalization efforts failed, despite a supportive advocacy coalition, favourable conditions in the cannabis policy subsystem and favourable conditions in the Canadian political system, because its systemic advocates did not give it priority relative to other issues from other subsystems. This finding has implications for ACF policy change theory, identifying a necessary condition for major policy change that has been potentially overlooked, and illustrates the potential for cross-fertilization between PET and ACF theories of policy change. [ABSTRACT FROM AUTHOR]

Drawing from the Ethics Position theory and the Theory of Planned Behavior, this study was conducted with a comprehensive four‐part goal. It seeks to explore the moderating influences of the consumption status and ethical positions in elucidating (i) individuals' attitude toward recreational marijuana consumption, (ii) individuals' perceived ethical stance regarding recreational marijuana legalization, (iii) individuals' CSR perception of firms operating within the marijuana industry often deemed as morally contentious, and (iv) the interrelationships among the aforementioned variables. Based on a sample of 411 Canadians and two grouping variables, ANOVA tests and a structural Equation Modeling were used to test the research hypotheses. The results show that individuals' attitudes toward the consumption of marijuana, perceived ethicalness of legalizing it, and perceived CSR significantly vary across the three groups of consumption status (i.e., non‐consumer, occasional, and regular) and the four groups of ethical positions (i.e., absolutism, exceptionism, situationism, and subjectivism). The SEM results, however, show that, except for a few cases, there were no notable variations in the model's path coefficients among the identified groups. This study has intriguing implications for academicians, practitioners, politicians, managers, social welfare activists, and other stakeholders. [ABSTRACT FROM AUTHOR]

Objective: Recreational cannabis legalization (RCL) is expanding rapidly. RCL's effects on mental health issues are of particular concern because cannabis use is more frequent among people receiving psychiatric care and is associated with several psychiatric disorders. The authors conducted a scoping review to examine the evidence and discern gaps in the literature concerning the effects of RCL on mental health and to assess the factors responsible for an observed heterogeneity in research results. Methods: This scoping literature review followed PRISMA guidelines. Five databases—MEDLINE, CINAHL, Embase, APA PsycInfo, and Web of Science—were searched for English- or French-language reports published between January 1, 2012, and April 30, 2023. Results: Twenty-eight studies from the United States and Canada were found. The studies were classified by category of the study's data (patients receiving psychiatric care [k=1], death records [k=4], emergency department or hospital records [k=10], and the general population [k=13]) and by the diagnosis (schizophrenia or psychoses, mood disorders, anxiety disorders and symptoms, suicide or suicidal ideation, or other mental health issues) examined. The review findings revealed a paucity of research and indicated mixed and largely inconclusive results of the studies examined. Research gaps were found in the examination of potential changes in cannabis use patterns among people receiving psychiatric care and in the availability of longitudinal studies. Conclusions: Clinicians, researchers, and policy makers need to collaborate to address the research gaps and to develop evidence-based policies that reflect a thorough understanding of the effects associated with RCL. [ABSTRACT FROM AUTHOR]

Causal inference using quasi-experimental data is of great interest to marketers. The factor model approach to estimate treatment effects accommodates a large number of control units and can easily handle a large number of treatment units while flexibly allowing for cases where the treatment is outside the range of the control units. However, the factor model method lacks formal inference theory, instead relying on bootstrap or permutation procedures with strong assumptions. Specifically, the extant Xu (2017) bootstrap procedure requires that the treatment and control error variances are equal. In this research the authors establish that when this assumption is violated, the bootstrap procedure results in biased coverage intervals. The authors develop a formal inference theory for the factor model approach to estimate the average treatment effects on the treated. The approach enables formal quantification of uncertainty through hypothesis testing and confidence intervals. The inference method is applicable to both stationary and nonstationary data. More importantly, the inference theory accommodates treatment and control unit outcomes with different distributions, which includes different error variances as a special case. The authors show the performance of the inference theory with simulated data. Finally, they apply the method to empirically quantify the uncertainty in the effect of legalizing recreational marijuana on the beer market and the sales effect of a digitally native online brand opening a physical showroom. [ABSTRACT FROM AUTHOR]

Introduction: The increment in marijuana use across the world is concerning and needs to be addressed. There has been a cultural change regarding the perception and use of marijuana medicinally and recreationally, even among medical students. This needs to be studied to understand the outlook towards marijuana among young adults, including future doctors, to help improve their awareness of the risks and pitfalls of marijuana usage. Aim: To evaluate the knowledge, attitude, and practices regarding marijuana usage among medical students. Materials and Methods: This cross-sectional study recruited 159 medical undergraduate students from the tertiary healthcare institute, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India via an online, anonymised, semistructured, self-designed questionnaire that was circulated over social media. The duration of the study was from October 2023 to February 2024. The study population was grouped into first-year and final-year MBBS students to identify differences, if any, in knowledge, attitude, and practices regarding marijuana usage among students between the start and end of their MBBS training. The responses to questions were compared to establish any statistical significance. Results: Out of the total 159 participants, 106 (66.67%) were first-year MBBS students, and 53 (33.33%) were final-year MBBS students. Most students from both groups reported that marijuana was illegal in India. Both groups responded affirmatively to questions regarding their awareness of the effects of marijuana and whether it could be used as a medical therapeutic drug. The majority of students, 81 (76.42%) and 32 (60.38%), respectively in both groups, agreed with the statement that marijuana impairs concentration and movement. A total of 88 (83.02%) and 41 (77.36%) participants, respectively, were largely in favour of legalising marijuana, with a greater proportion of respondents from both groups opining that marijuana should be legalised, be it for medical therapeutic use or as a recreational drug. Conclusion: Study results showed that the majority of students from both groups responded positively to the question about the legalisation of marijuana in India. Some interesting differences were found between the two groups with respect to marijuana use and the perceptions about its positive or negative effects. It is essential to educate medical students, as future physicians, on the adverse effects and implications of marijuana use. [ABSTRACT FROM AUTHOR]

The article focuses on the significant developments and regulatory adjustments surrounding the legalization and implementation of adult-use cannabis in Minnesota, U.S. following the initial legalization in May 2023. It outlines key legislative changes from the 2024 session, including the introduction of a new licensing structure prioritizing social equity applicants and shifting from a merit-based to a qualified lottery system.

We investigate the economic value of cash management. In the legal marijuana industry, where only half of businesses have access to cash management services from a financial institution, we examine dispensary profitability using administrative and survey data. Our results show that businesses with cash management charge higher retail prices (8.3%), pay lower wholesale prices (7.3%), and have higher sales volume (19%). Together, these advantages create a 40% increase in profitability. These results support our model in which reputational capital and administrative costs drive profitability regardless of whether national banks, credit unions, or fintech provide the cash management functions. [ABSTRACT FROM AUTHOR]

Drug treatment courts are challenged by the ongoing trend of marijuana legalization. In states where it is legal for adult citizens to consume marijuana for medical and recreational purposes, treatment courts need to determine whether participants should be allowed to consume or possess marijuana. By analyzing the written policies of treatment courts in states that have legalized recreational and medical marijuana, this study explores how treatment courts address such challenges. The review shows a large percentage of drug treatment courts have yet to clearly communicate their marijuana policies with the participants in writing. However, among the drug treatment courts that have established marijuana-specific policies, the vast majority of courts continue to ban the use of marijuana while a few courts allow medical marijuana use on an individual basis. [ABSTRACT FROM AUTHOR]

This paper examines how recreational marijuana legalization (RML) affects first‐time college enrollment in the US using a unique college‐level dataset and various estimation methods such as difference‐in‐differences and event study. I find that RML increases enrollments by approximately up to 9%, without compromising degree completion or graduation rate, and it boosts college competitiveness by offering a positive amenity, as evidenced by the rise in out‐of‐state enrollments relative to neighboring states. In addition, I find no evidence that RML affects college prices, quality, or in‐state enrollment. This effect is stronger for non‐selective public colleges in early‐adopting RML states. [ABSTRACT FROM AUTHOR]

The legalization of marijuana varies across countries, with some prohibiting its use while others are starting to legalize it for medical purposes. Despite its potential therapeutic benefits, marijuana use is often stigmatized due to concerns about addiction. In Indonesia, marijuana is classified as a Class I narcotic, prohibiting its use for medicinal purposes under Law Number 35 of 2009, which restricts access to medical marijuana and raises human rights issues for individuals seeking necessary treatments. This study aims to analyze the potential benefits of legalizing medical marijuana in Indonesia and propose regulatory changes that align with the evolving needs of society and human rights principles. The research method used is a normative legal research method, involving the analysis of legal documents, literature reviews, and interviews with experts in law and health to evaluate the impact of regulatory changes on medical marijuana use. The findings suggest that appropriate legal reforms can reduce stigma, ensure access to treatment, and uphold the right to health without the threat of criminal penalties. Therefore, revising narcotic laws to allow the use of marijuana for medical purposes with proper regulations is crucial to provide those in need of treatment the opportunity to access marijuana legally without fear of criminal punishment, and to help reduce the stigma associated with its use. [ABSTRACT FROM AUTHOR]

This article examines the emerging legal cannabis sector in Zimbabwe since 2018, which focuses on medicinal and industrial cannabis with unlicenced uses remaining criminalised, as well as its implications for agrarian change. It shows that the formal sector is set up in a way that prioritises those with substantial resources – marginalising small-scale farmers and illicit cultivators. While this presents the risk of corporate capture, various factors combine to undermine agribusiness' production. However, prohibition of recreational cannabis and the formal sector's focus on export markets combine to preserve illicit cannabis markets and allow continuation of illicit livelihoods. [ABSTRACT FROM AUTHOR]

Using data on banking transactions, we analyse how people changed their spending behaviour when recreational cannabis became legal in Canada. In the data set, we identify people with purchases in a cannabis store after legalization. We apply a difference-in-difference approach to compare their spending before and after legalization. People with cannabis purchases after legalization reduced significantly and persistently their cash spending and electronic transfers, indicating a shift from the black to the legal cannabis market. [ABSTRACT FROM AUTHOR]

Legalization of marijuana has led to increased prevalence of medical and recreational cannabis use, underscoring the importance for anesthesiologists, surgeons, and perioperative physicians to understand the effects of this drug in patient care. Bariatric surgical patients represent a unique target population to understand peri-operative cannabis use and its effects as these patients undergo an extensive preoperative psychological and nutritional evaluation. Standardized guidelines on cannabis use in bariatric surgery are lacking and many clinicians remain uncertain on how to handle cannabis use in the peri-operative period. Here, we summarize the data on cannabis use in bariatric patients, specifically exploring anesthetic considerations, weight loss, complications, mortality, and psychiatric outcomes. We propose a clinical pathway to assist clinicians with perioperative decision making in bariatric patients who use marijuana. [ABSTRACT FROM AUTHOR]

The War on Drugs resulted in increased arrest rates for women. Most of these arrests have been for low-level offenses, often involving cannabis. As states legalize cannabis, it is important to examine trends in arrests for women in a setting of early cannabis law reform. We examine National Incident-Based Reporting System (NIBRS) monthly cannabis arrest rates in Colorado, one of the first two states to legalize cannabis for recreational purposes, from January 2010 through December 2016 using an interrupted time series approach. The interruption is conceptualized as the legalization of recreational marijuana in December 2012. Our results document an immediate statistically significant and sizable drop in cannabis-related arrests for women following legalization. However, troublesome racial and ethnic disparities persist. [ABSTRACT FROM AUTHOR]

An important public concern surrounding the legalization of recreational marijuana is its impact on offenses related to hard drugs such as heroin, cocaine, and other dangerous drugs, about which competing perspectives exist. Prior research using rigorous methodology to empirically examine this issue remains limited. Based on Uniform Crime Reporting (UCR) Program data from 2007 to 2019 and a quasi-experimental research design involving interrupted time series analysis (ITSA) and the synthetic control method (SCM), this study examines the effects of recreational marijuana legalization on the rates of a variety of drug offenses including possession violations related to marijuana, heroin/cocaine and their derivatives, and other dangerous nonnarcotic drugs in Washington State (WA), which passed its recreational marijuana law (RML) in late 2012 and began legal sales in July 2014. This study found that WA has experienced decreases in the rate of possession offenses for the two categories of more harmful drugs—heroin/cocaine and their derivatives, and other dangerous nonnarcotic drugs—over the post-sale period, relative to the states that have not legalized marijuana for recreational use, offering some evidence suggesting a drug offense reduction effect of marijuana legalization. [ABSTRACT FROM AUTHOR]

This article provides an update on the legal status, FDA approvals, patient safety, and public perception of cannabis. It highlights the growing use of cannabis in the US, particularly with the legalization of recreational marijuana and the development of related products like CBD and edibles. The article reviews the legal and regulatory status of cannabis, discusses its safety concerns, and explores the economic impact of the booming cannabis industry. It also emphasizes the need for high-quality research and clear information to strike a balance between the benefits and harms of cannabis. [Extracted from the article]

The article explores the challenges faced by the cannabis industry in California and proposes a solution through AB 374, a bill aimed at revitalizing the industry. It discusses the struggles of cannabis businesses, including high taxes and competition from the illegal market. AB 374 seeks to address these issues by allowing social consumption lounges to expand their activities and by reducing the state excise tax on cannabis sales. The bill is seen as a positive step towards preserving the legal cannabis industry and encouraging consumers to purchase from the legal market. [Extracted from the article]

The marijuana legalization trend in the U.S. will likely lead to increased use by younger adults during gestation and postpartum. The current study examined the hypothesis that delta-9-tetrahydrocannabinol (THC) would disrupt voluntary maternal care behaviors and negatively impact offspring development. Rat dams were gavaged with 0, 2, 5, or 10 mg/kg THC from the 1st day of gestation through the 21st postnatal day. Somatic growth and developmental milestones were measured in the offspring, and maternal pup retrieval tests were conducted on postnatal days 1, 3, and 5. THC did not affect body growth but produced transient delays in the righting reflex and eye opening in offspring. However, there was significant pup mortality due to impaired maternal care. Dams in all THC groups took significantly longer to retrieve their pups to the nest and often failed to retrieve any pups. Serum levels of THC and metabolites measured at this time were comparable to those in breastfeeding women who are chronic users. Benchmark doses associated with a 10% reduction of pup retrieval or increased pup mortality were 0.383 (BMDL 0.228) and 0.794 (BMDL 0.442) mg/kg THC, respectively. The current findings indicate that maternal care is an important and heretofore overlooked index of THC behavioral toxicity and should be included in future assessments of THC's health risks. [ABSTRACT FROM AUTHOR]

A mathematical model for the dynamics of alcohol-marijuana coabuse is presented in this work. In the past years legalization of recreational marijuana in several states in the United States has added a new layer to alcohol addiction. Much research has been done for alcohol addiction or drug abuse independently, but few include the incidence of marijuana use for alcohol users. A compartmental epidemiological model is used, and results such as the existence and boundedness of solutions, the basic reproduction number using the next-generation method, the disease-free equilibrium, and an analytical expression for the endemic equilibrium are included. Numerical simulations with parameters obtained from data in the United States are performed for different compartments of the population as well as the reproduction number for the alcohol and marijuana sub-models. The model can be adapted for different regions worldwide using appropriate data. This work contributes to understanding the dynamics of the co-abuse of addictive substances. Even though alcohol and marijuana are both legal, they can be of great harm to the brain of the individual when combined, having tremendous consequences for society as a whole. Creating awareness of a public health concern with facts based on scientific research is the ultimate goal of this work. [ABSTRACT FROM AUTHOR]

Using a two‐way fixed effects difference‐in‐differences model, we investigate the effects of local recreational marijuana (RMJ) policy changes on college applications and find that the three largest state public schools reaped, on average, an almost 54% increase in applications. This increase does not appear to come solely from low‐ability students as both first and third quartiles of admitted student composite SAT scores to the largest three public schools do not decrease. Rather, they both increase by almost 3.8% though these estimates are not statistically significant. Robust difference‐in‐difference and event study models support the signs and magnitudes of these gains and show they diminish over time. [ABSTRACT FROM AUTHOR]

Many North American jurisdictions have legalized the operation of recreational marijuana dispensaries. A common concern is that dispensaries may contribute to local crime. Identifying the effect of dispensaries on crime is confounded by the spatial endogeneity of dispensary locations. Washington State allocated dispensary licenses through a lottery, providing a natural experiment to estimate the causal effect of dispensaries on neighborhood-level crime. Combining lottery data with detailed geocoded crime data, we estimate that the presence of a dispensary has no significant impact on local crime in the average neighborhood. We estimate a small rise in property crime in low-income neighborhoods specifically. [ABSTRACT FROM AUTHOR]

This article provides a historical overview of cannabis use and regulation in the United States and discusses the impact of current regulations on the failure of cannabis businesses. It highlights the challenges faced by these businesses, including limited access to financial services and the power of local governments to prohibit cannabis within their jurisdictions. The article emphasizes the need for regulatory and tax reforms to support the profitability of cannabis companies. It also discusses the varying approaches to cannabis regulation at the federal, state, and local levels, as well as the role of direct democracy in cannabis reform efforts. The article concludes by suggesting that potential cannabis business owners should wait for meaningful reforms before entering the industry. [Extracted from the article]

Key Points: Question: What is the prevalence of self-reported Δ8-tetrahydrocannabinol (THC) and marijuana use among 12th-grade students in the US and its distribution across sociodemographic factors and state cannabis policies? Findings: In this nationally representative 2023 survey, 11.4% of 2186 US 12th-grade students self-reported Δ8-THC use and 30.4% self-reported marijuana use in the past year. Δ8-THC use prevalence was higher in the South and Midwest US and in states without legal adult-use marijuana or Δ8-THC regulations. Marijuana use prevalence did not differ by cannabis policies. Meaning: Δ8-THC use prevalence is appreciable among US adolescents and is a potential public health concern. Importance: Gummies, flavored vaping devices, and other cannabis products containing psychoactive hemp-derived Δ8-tetrahydrocannabinol (THC) are increasingly marketed in the US with claims of being federally legal and comparable to marijuana. National data on prevalence and correlates of Δ8-THC use and comparisons to marijuana use among adolescents in the US are lacking. Objective: To estimate the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use among US adolescents in the past 12 months. Design, Setting, and Participants: This nationally representative cross-sectional analysis included a randomly selected subset of 12th-grade students in 27 US states who participated in the Monitoring the Future Study in-school survey during February to June 2023. Exposures: Self-reported sex, race, ethnicity, and parental education; census region; state-level adult-use (ie, recreational) marijuana legalization (yes vs no); and state-level Δ8-THC policies (regulated vs not regulated). Main Outcomes and Measures: The primary outcome was self-reported Δ8-THC and marijuana use in the past 12 months (any vs no use and number of occasions used). Results: In the sample of 2186 12th-grade students (mean age, 17.7 years; 1054 [48.9% weighted] were female; 232 [11.1%] were Black, 411 [23.5%] were Hispanic, 1113 [46.1%] were White, and 328 [14.2%] were multiracial), prevalence of self-reported use in the past 12 months was 11.4% (95% CI, 8.6%-14.2%) for Δ8-THC and 30.4% (95% CI, 26.5%-34.4%) for marijuana. Of those 295 participants reporting Δ8-THC use, 35.4% used it at least 10 times in the past 12 months. Prevalence of Δ8-THC use was lower in Western vs Southern census regions (5.0% vs 14.3%; risk difference [RD], −9.4% [95% CI, −15.2% to −3.5%]; adjusted risk ratio [aRR], 0.35 [95% CI, 0.16-0.77]), states in which Δ8-THC was regulated vs not regulated (5.7% vs 14.4%; RD, −8.6% [95% CI, −12.9% to −4.4%]; aRR, 0.42 [95% CI, 0.23-0.74]), and states with vs without legal adult-use marijuana (8.0% vs 14.0%; RD, −6.0% [95% CI, −10.8% to −1.2%]; aRR, 0.56 [95% CI, 0.35-0.91]). Use in the past 12 months was lower among Hispanic than White participants for Δ8-THC (7.3% vs 14.4%; RD, −7.2% [95% CI, −12.2% to −2.1%]; aRR, 0.54 [95% CI, 0.34-0.87]) and marijuana (24.5% vs 33.0%; RD, −8.5% [95% CI, −14.9% to −2.1%]; aRR, 0.74 [95% CI, 0.59-0.94]). Δ8-THC and marijuana use prevalence did not differ by sex or parental education. Conclusions and Relevance: Δ8-THC use prevalence is appreciable among US adolescents and is higher in states without marijuana legalization or existing Δ8-THC regulations. Prioritizing surveillance, policy, and public health efforts addressing adolescent Δ8-THC use may be warranted. This cross-sectional nationally representative classroom-based survey of US 12th-grade students examines the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use during a 12-month period. [ABSTRACT FROM AUTHOR]

The article focuses on the interplay between the Dormant Commerce Clause and state marijuana regulations, particularly regarding residency requirements for retail licenses. Topics include an overview of Dormant Commerce Clause jurisprudence, the unique challenges posed by marijuana's conflicting legal status under state and federal laws, and recent federal court decisions and arguments for a temporary judicial exception for marijuana to limit interstate commerce.

Cannabis use is associated with suicide-related outcomes in both adolescents and adults, and may be increasing amid shifting cannabis policies. However, little is known about the impact of medical marijuana legalization (MML) and recreational marijuana legalization (RML) policies on youth suicide. Using 20 years of national data, we examined associations between MML, RML, and suicide-related mortality among US individuals aged 12 to 25 years, and assessed whether they varied based on age and sex. Suicide deaths (N = 113,512) from the 2000-2019 National Vital Statistics System Multiple Cause of Death files for age groups 12 to 13, 14 to 16, 17 to 19, 20 to 22, and 23 to 25 years were examined in relation to time-varying cannabis law status using a staggered adoption difference-in-difference (DiD) approach with a negative binomial regression to determine associations between MML, RML, and suicide rates, controlling for individual- and state-level covariates and accounting for the varying effective dates of MML and RML by state. The overall unadjusted annual suicide rate was 10.93/100,000, varying from 9.76 (states without marijuana laws (ML)) to 12.78 (MML states) to 16.68 (RML states). In multivariable analysis, both MML (incidence rate ratio [IRR] = 1.10, 95% CI: 1.05-1.15) and RML (IRR = 1.16, 95% CI: 1.06-1.27) were associated with higher suicide rates among female youth compared to those in states without ML. Youth aged 14 to 16 years had higher rates of suicide in states with RML compared to states with MML (IRR = 1.14, 95% CI: 1.00-1.30) and states without ML (IRR = 1.09, 95% CI: 1.00-1.20). Findings were consistent across sensitivity analyses. MML and RML were associated with increased suicide-related mortality in female youth and 14- to- 16-year-old individuals of both sexes. Mechanisms through which cannabis policies are related to increased youth suicide warrant further study and should inform legislative reform. [ABSTRACT FROM AUTHOR]

The legal cannabis industry in the United States has faced challenges in accessing banking services due to federal laws prohibiting cannabis sales and use. This has forced many businesses to operate on a cash-only basis, creating safety risks and inefficiencies. The SAFER Banking Act has been introduced to address these issues, but it has limitations and gaps. The text proposes targeted amendments to strengthen the SAFER Banking Act and promote equitable access to banking for legitimate cannabis businesses. The article discusses the history of cannabis banking legislation, the challenges faced by the industry, and the need for comprehensive solutions. [Extracted from the article]

This cross-sectional study uses data from the Youth Risk Behavior surveys to assess the association of state-level recreational marijuana laws and youth marijuana use. [ABSTRACT FROM AUTHOR]

Previous research on stigma reduction has been primarily confined to single industries. However, industry boundaries are porous in the eyes of audience members and can hardly act as artificial confines to moral reevaluations. We contend that evaluative spillovers induced by stigma reduction in a focal industry diffuse to other industries that share the same vilifying label when (a) they possess the morally approved attribute that underlies the reduction of stigma, and (b) the morally approved attribute is embedded in formal rules and procedures that ensure the desired purposes. Empirically, we focus our tests on the legalization of marijuana as a medicine in several U.S. states during the period 2000–2015, which has reduced the “vice” stigma around marijuana by highlighting the “health safety” attribute of marijuana, namely its safe consumption and potential health benefits. We show that legalization generated evaluative spillovers to other “vice” industries sharing the same health safety attribute as marijuana (i.e., alcohol), but not to those that did not share it (i.e., tobacco). Those spillovers were primarily observed when the law was accompanied by a patient registration system that highlighted the health safety attribute of marijuana by limiting its use to medical purposes. [ABSTRACT FROM AUTHOR]

Objective: Marijuana use is increasingly common among patients with chronic non-cancer pain (CNCP) and long-term opioid therapy (LTOT). We determined if lifetime recreational and medical marijuana use were associated with more frequent and higher dose prescription opioid use. Design: Cross-sectional Subjects: Eligible patients (n=1,037), who had a new period of prescription opioid use lasting 30-90 days, were recruited from two midwestern health care systems to a study of long-term prescription opioid use and mental health outcomes. The present cross-sectional analyses uses baseline data from this on-going cohort study. Methods: Primary exposures were participant reported lifetime recreational and medical marijuana use versus no lifetime marijuana use. Prescription opioid characteristics included daily versus non-daily opioid use and ≥50 morphine milligram equivalent (MME) dose per day vs. <50 MME. Multivariate, logistic regression models estimated the association between lifetime recreational and medical marijuana use vs. no use and odds of daily and higher dose prescription opioid use, before and after adjusting for confounding. Results: The sample was an average of 54.9 (SD±11.3) years of age, 57.3% identified as female gender, 75.2% identified as White, and 22.5% identified as Black race. Among all participants, 44.4% were never marijuana users, 21.3% were recreational only, 7.7% medical only and 26.6% were both recreational and medical marijuana users. After controlling for all confounders, lifetime recreational marijuana use, as compared to no use, was significantly associated with increased odds of daily prescription opioid use (OR=1.61; 95%CI:1.02-2.54). There was no association between lifetime recreational or medical marijuana use and daily opioid dose. Conclusion: Lifetime medical marijuana use is not linked to current opioid dose, but lifetime recreational use is associated with more than a 60% odds of being a daily prescription opioid user. Screening for lifetime recreational marijuana use may identify patients with chronic pain who are vulnerable to daily opioid use which increases risk for adverse opioid outcomes. Prospective data is needed to determine how marijuana use influences the course of LTOT and vice versa. [ABSTRACT FROM AUTHOR]

Background: To address the research question of how simultaneous users of alcohol and cannabis differ from concurrent users in risk of cannabis use problems after the recreational marijuana legalization in Washington State. Methods: We used generalized estimating equations with a Poisson distribution to analyze the association between simultaneous use of alcohol and marijuana (SAM) and cannabis-related problems compared to concurrent use. The data is a longitudinal sample of drinkers and cannabis users (n = 257, 47% female) aged 18 years and older from Washington State in 2014–2016. We adjusted for survey weights to account for differential probability of selection and response rates. The primary outcome is the past-six-month CUDIT problem subscale (ranging from 0 to 28), which is the total score for seven CUDIT problem items, after excluding the three items that covered marijuana use frequency. Covariates include marijuana use frequency (daily/near daily use, regular use, or infrequent use), marijuana daily quantity, alcohol daily volume, panel survey cycle, medical marijuana recommendation, driving time to nearest marijuana outlet, age of marijuana use onset, and other demographics. Results: After adjusting for covariates, we found that compared to concurrent use, SAM was significantly positively associated with CUDIT problem subscale (IRR = 1.68, 95% CI: 1.25–2.27, p < 0.001); daily/near daily use of marijuana was strongly significantly associated with CUDIT problem subscale compared with infrequent use (IRR = 5.1, 2.71–9.57, p < 0.001) or regular use (IRR = 3.05, 1.91–4.85, p < 0.001). Secondary analyses using CUDIT total score as the outcome also showed a significant positive association with SAM compared to concurrent use (IRR = 1.17, 1.02–1.34, p < 0.05). Conclusions: This study highlighted the importance of SAM, in addition to cannabis use frequency for predicting cannabis-related problems. [ABSTRACT FROM AUTHOR]

We investigated associations between the retail distribution of recreational marijuana in Colorado and (i) past 30-day marijuana use and (ii) driving after marijuana use (DAMU) among a representative sample of public high school students using four waves of data from a state surveillance system. Past 30-day marijuana use was assessed among all sampled students (n = 85,336). DAMU was assessed among students 15 years or older who indicated driving (n = 47,518). Modified Poisson regression with robust variance estimates was used to estimate prevalence ratios (PR) comparing the pre-distribution (2013) and post-distribution (2015, 2017, 2019) periods for marijuana-related behaviors. Frequency of behavioral engagement was assessed using a multinomial approach. An estimated 20.3% of students engaged in past 30-day marijuana use and 10.5% of student drivers engaged in DAMU. Retail distribution of recreational marijuana was not significantly associated with the prevalence of any marijuana use or DAMU. However, it was associated with 1.16 (95% CI: 1.04–1.29) times the prevalence of using marijuana one or two times in the last 30 days, 1.27 (1.03, 1.55) times the prevalence of DAMU one time, and 0.82 (0.69, 0.98) times the prevalence of DAMU six or more times. No significant associations were observed for the remaining frequency categories. Approximately 1 in 10 students who drive reported DAMU. Varying prevalence in the frequency of past 30-day marijuana use and DAMU was observed following the retail distribution of recreational marijuana in Colorado. Care should be taken to properly educate adolescent drivers regarding the dangers of DAMU. [ABSTRACT FROM AUTHOR]

In 2020, Arizonans approved Proposition 207, the Smart and Safe Arizona Act, which legalized recreational marijuana sales. Previous research has typically used non‐spatial survey data to understand marijuana legalization voting patterns. However, voting behavior can, in part, be shaped by geographic context, or place, which is unaccounted for in aspatial survey data. We use multiscale geographically weighted regression to analyze how place shaped Proposition 207 voting behavior, independently of demographic variations across space. We find significant spatial variability in the sensitivity of voting for Proposition 207 to changes in several of the predictor variables of opposition and support for recreational marijuana legalization. We argue that local statistical modeling approaches provide a more in‐depth understanding of ballot measure voting behavior than the current use of global models. Related Articles: Branton, Regina, and Ronald J. McGauvran. 2018. "Mary Jane Rocks the Vote: The Impact of Climate Context on Support for Cannabis Initiatives." Politics & Policy 46(2): 209–32. https://doi.org/10.1111/polp.12248. Brekken, Katheryn C., and Vanessa M. Fenley. 2020. "Part of the Narrative: Generic News Frames in the U.S. Recreational Marijuana Policy Subsystem." Politics & Policy 49(1): 6–32. https://doi.org/10.1111/polp.12388. Fisk, Jonathan M., Joseph A. Vonasek, and Elvis Davis. 2018. "'Pot'reneurial Politics: The Budgetary Highs and Lows of Recreational Marijuana Policy Innovation." Politics & Policy 46(2): 189–208. https://doi.org/10.1111/polp.12246. [ABSTRACT FROM AUTHOR]

Recreational marijuana legislation (RML) has been enacted at the state-level but not federally. Given the link between public opinion and RML, we examine 2021 national poll (N = 995) data that assessed views about different types of proposed federal actions concerning cannabis. Less than half of Americans preferred full legalization, 21% approved of medical legalization only, 23% believed in states' rights, and 11% supported the current prohibition. Using multinomial logistic regression modeling, respondents who associated legalized recreational marijuana with adverse/negative effects were less likely to favor full legalization. In contrast, respondents who associated legalized recreational marijuana with beneficial effects were most supportive of full legalization. Uncertainty surrounding cannabis shaped preferences but not as dramatically as having a clear opinion. [ABSTRACT FROM AUTHOR]