Medical marijuana laws enjoy broad public support in the United States. Fifteen states and the District of Columbia have medical marijuana laws on the books and several states are contemplating similar legislation. Recent polls indicate that over 70 percent of Americans favor state laws allowing marijuana use for prescribed medical purposes (The Pew Research Center 2010). Despite their popularity, relatively few studies have considered how medical marijuana policies affect recreational marijuana use or individual and public health outcomes. The few published quantitative studies on the topic find disparate results, with some finding evidence consistent with higher recreational demand (Pacula et al. 2010) and others finding no relationship to recreational use (Gorman and Huber, 2007) or perceived harm of marijuana (Khatapoush and Hallfors, 2004). The goal of our work is to provide the most complete accounting to date of the nuanced features of medical marijuana laws and their implications for health. To do this we will examine the implementation of medical marijuana laws at the state, county and city level and assess whether provisions related to the supply of medical marijuana for patients influence access and use among recreational users. We will further consider whether and how these laws relate to harms caused by marijuana misuse/abuse including accidents, asthma, acute psychoses, alcohol dependence, schizophrenia, drugged driving, and crime. We will analyze these individual and public health outcomes at all three geographic levels allowing us to test the external validity of findings from any single data source or analysis as well as better understand whether the specifics of how laws get implemented is more important than the broad law itself. Our work should contribute to improved policymaking relating to medical marijuana by identifying the dimensions of state and local policy that are most clearly linked to individual and public health outcomes. By making our systematic coding of medical marijuana policies at the state, county and local levels available to other researchers, we will also lay the groundwork for future work in this area.

Public Health Relevance

The purpose of this four year project is to study the implementation of medical marijuana laws and assess whether provisions related to the supply of medical marijuana for patients influence access and use among recreational users. Our work will involve both a legal analysis of medical marijuana laws, as they exist on the books and get implemented in practice, and provide a quantitative assessment of individual and public health outcomes at three geographic levels-state, county, and local neighborhoods.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Study Section
Special Emphasis Panel (ZDA1)
Program Officer
Deeds, Bethany
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Rand Corporation
Santa Monica
United States
Zip Code
Hunt, Priscillia E; Miles, Jeremy (2017) The Impact of Legalizing and Regulating Weed: Issues with Study Design and Emerging Findings in the USA. Curr Top Behav Neurosci 34:173-198
Chang, Tom; Jacobson, Mireille (2017) Going to Pot? The Impact of Dispensary Closures on Crime. J Urban Econ 100:120-136
Hunt, Priscillia; Pacula, Rosalie Liccardo (2017) Early Impacts of Marijuana Legalization: An Evaluation of Prices in Colorado and Washington. J Prim Prev 38:221-248
Pacula, Rosalie Liccardo; Smart, Rosanna (2017) Medical Marijuana and Marijuana Legalization. Annu Rev Clin Psychol 13:397-419
Kilmer, Beau; Pacula, Rosalie Liccardo (2017) Understanding and learning from the diversification of cannabis supply laws. Addiction 112:1128-1135
Pacula, Rosalie Liccardo; Jacobson, Mireille; Maksabedian, Ervant J (2016) In the weeds: a baseline view of cannabis use among legalizing states and their neighbours. Addiction 111:973-80
Pacula, Rosalie L; Powell, David; Heaton, Paul et al. (2015) Assessing the effects of medical marijuana laws on marijuana use: the devil is in the details. J Policy Anal Manage 34:7-31
Pacula, Rosalie Liccardo; Kilmer, Beau; Wagenaar, Alexander C et al. (2014) Developing public health regulations for marijuana: lessons from alcohol and tobacco. Am J Public Health 104:1021-8
Sevigny, Eric L; Pacula, Rosalie Liccardo; Heaton, Paul (2014) The effects of medical marijuana laws on potency. Int J Drug Policy 25:308-19
Pacula, Rosalie Liccardo; Sevigny, Eric L (2014) Marijuana liberalization policies: why we can’t learn much from policy still in motion. J Policy Anal Manage 33:212-21

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