One of the primary concerns of public health research related to cannabis has been to ascertain whether the legalization of marijuana and acceptance of it for medical uses will lead to greater use among more – and particularly younger – people. As more states accept marijuana for medical use over time, this can lower the perception of risk in using marijuana because it can be used as an alternative method to relieve symptoms associated with certain diseases and health conditions.
In other words, legalization may erode certain barriers to using marijuana and, although the health risks remain, not all individuals are likely to perceive such risks as serious barriers to engaging in the use of marijuana. More to the point, there may be a perception that there is some implicit or explicit endorsement of the safety of marijuana use once it is legalized and/or pronounced suitable for medical use.
Regarding the potential impact of medical marijuana laws on the use and abuse of other drugs, some writers have alluded to a “spillover” effect. There are two contexts in which the term is used. First, researchers have questioned whether medical marijuana law implementation tends to increase the use of other substances in medical marijuana patients. Second, once medical marijuana laws are implemented, a certain amount of marijuana product is thereby released to designated patient groups but may easily spill over into non-patient populations.
Kerr et al. (2023) examined rates of marijuana use among young adults before and after legalization of recreational marijuana and found that past month cannabis use increased slightly (21% vs. 24%), but only among young adults not in college. They found no changes in past month’s alcohol use or binge drinking.
Sabia et al. (2024) examined statistics in states with legal recreational marijuana, both pre and post legalization. They found that the use of marijuana by adults increased in such states, but there were no indications of increased use of illicit drugs, admissions to substance abuse treatment facilities, or violent crime. There were indications that availability of legal marijuana resulted in some individuals using cannabis in place of opioids.
Walker et al. (2023) examined several variables pre and post legalization of recreational marijuana, and perhaps not surprising, found that cannabis-related visits to the emergency department increased suddenly with legalization. However, relationships between legalization and use of alcohol or opioids were unclear.
Public Support for Legalizing Marijuana
Public opinion about legalizing marijuana has changed over the years. In 1969, only 12% of US adults favored legalization. As of 2024, 88% of US adults thought marijuana should be legal in some form, including 57% of Americans who believe marijuana should be legal for recreational use and 32% who believe it should be legal for medical use only (Pew Research Center, 2024).
Concern Over Legalizing Marijuana
Few healthcare professionals feel equipped to treat patients/clients who use medical marijuana. This is in part due to a lack of supporting evidence for its efficacy but also from a lack of formal training on how to treat such patients. Worldwide, across all disciplines, healthcare professionals reported not being ready to answer patient questions about medical marijuana (Cheng et al., 2022).
With the increasing number of states (and countries) legalizing marijuana in some form, healthcare professionals desperately need knowledge and guidance on a substance that has grown in public favor. We will now review why the evidence is lacking, what the available evidence says, what the adverse effects are, and the implications for healthcare professionals.
Course excerpt from Medical Marijuana – click to learn more!
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