A recent study published in the journal Preventative Medicine Reports has found that the odds of a patient visiting the emergency department being diagnosed with cannabis use disorder (CUD) are nearly 50 percent lower in states that have legalized marijuana compared to non-legal states. This finding, though counterintuitive, could possibly be attributed to the destigmatization of cannabis use within the medical community as prohibition ends.
The study analyzed emergency department data from 2017 to 2020 in two states that had legalized cannabis (Colorado and Oregon) and two states where it was prohibited at the time (Maryland and Rhode Island). Specifically, the researchers examined rates of “treat and release” visits where patients received a CUD diagnosis indicating problematic marijuana use. A multivariate logistic regression model was employed to analyze a total of 17,434,655 emergency room visits over the four-year period.
Contrary to their expectations, the study authors discovered that states with recreational cannabis legalization had lower rates of CUD compared to states where it was illegal. In fact, legalizing cannabis for recreational use was associated with a nearly 50 percent decrease in the adjusted odds of CUD. These findings challenge previous studies that have found increased rates of marijuana use among adults following legalization.
One possible explanation for this unexpected result is the decreased stigma and increased social acceptability of cannabis use in states that have legalized it. Providers in these states may be more tolerant of cannabis use and less likely to recognize problematic behavior associated with CUD. As a result, they may be less likely to diagnose and document CUD in the medical record, leading to lower prevalence in emergency departments.
It is important to note that prior research on post-legalization hospitalizations and emergency department visits primarily focused on youth, which means even marginal changes could appear more pronounced given the relatively low rate of cannabis use within that population. However, this latest study provides evidence of a negative association between recreational cannabis legalization and CUD among emergency department visits, suggesting that such laws may not pose a risk to public health and safety.
The findings of this study contribute to the growing body of research on CUD and challenge the arguments put forth by opponents of legalization regarding its potential negative impact on public health. A 2019 study found that rates of CUD have actually decreased amid the state-level legalization movement. Additionally, research has shown that youth cannabis use has been decreasing as more states replace prohibition with regulated systems of recreational sales for adults.
Furthermore, a separate study funded by the National Institute on Drug Abuse found that state-level cannabis legalization is not associated with increased youth use. The researchers observed that adolescents who spent more time under legalization were no more or less likely to have used cannabis at age 15 than those who had little exposure to legalization.
Another study conducted by Michigan State University found that the occurrence of cannabis use in legal states increased among older adults but not underage individuals who are unable to purchase cannabis products from retail outlets.
In conclusion, this recent study provides valuable insights into the relationship between cannabis legalization and CUD diagnoses in emergency departments. It suggests that the destigmatization of cannabis use within the medical community as prohibition ends may contribute to lower rates of CUD in states where marijuana is legal for recreational use. Nevertheless, further research is needed to fully understand this complex relationship and its implications for public health and safety.
