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The Legalization of Cannabis and Teen Use

Studies show that teen use has increased in states where cannabis is legal.

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Over the Labor Day holiday, and just before the school season traditionally starts, the Journal of the American Medical Association (JAMA) published a study which gave greater reassurance to those concerned about a possible link between cannabis legalization and increased use in teens. In fact, when all the numbers were crunched, the paper’s authors determined that the change in overall teen usage in states that had legalized was “statistically indistinguishable from zero.” While other peer-reviewed articles have made the same discovery, the comprehensiveness of the researchers’ examination should put wind in the sails of activists hoping to further cannabis’s forward march in states around the country, not to mention eventual legalization.

The paper builds on a 2019 study written by three of its co-authors. For this update, the authors drew upon a far more extensive data pool, using pre- and post-legalization data from 10 states before and after the beginnings of recreational marijuana sales in each state. Measuring the estimated odds ratio of current and frequent marijuana use amongst teenagers who responded to the Youth Risk Behavior Survey between the years 1993 to 2019, the study determined that adult-use legalization was not associated with any increase in use, either current or frequent. In fact, medical marijuana implementation was associated with a 6% drop in current and 7% drop in frequent marijuana use.

These findings assumed even greater resonance after a recent interview Dr. Nora Volkow, the director of the National Institute of Drug Abuse (NIDA), gave to former head of the pro-legalization Drug Policy Alliance Dr. Ethan Nadelmann. Having recently come out as a supporter of widespread drug decriminalization, Volkow acknowledged that while, at first, she anticipated that the level of marijuana use amongst teenagers would rise with legalization, “overall, it hasn’t.” (However, she had co-authored a paper which questioned the methodology of the 2019 JAMA study.)

As Nadelmann notes in the same interview, minors historically have enjoyed easy access to cannabis, with or without legalization. According to Monitoring the Future: National Survey on Drug Use 1975-2020, a research study co-published by NIDA and the National Institute of Health, between 75-90% of 12th graders have said that marijuana would be very easy to get if they wanted some. In the same interview, Volkow also noted that regular use among those teenagers that did use was going up. This may be connected with what is known as perceived risk, which measures whether teenagers see marijuana as a dangerous drug. This metric has declined sharply since the mid-2010s.

The JAMA findings are hardly unique, as previous researchers have noted a similar flatlining of reported teen use for years. A 2020 analysis of the Washington (state) Health Youth Survey found that after adult-use legalization, past 30-day cannabis use prevalence in eighth graders dropped 22%, 10% in 10th graders and held steady for 12th graders. The Washington State Healthy Youth Survey found similar past 30-day cannabis use declines from the beginning of the adult-use cannabis market in 2012 through 2016 for 10th graders, with a descent and leveling off for 12th graders. As for Colorado, past 30-day use has held steady for high schoolers at around 20% when last polled as part of Colorado’s Healthy Kids Colorado Survey — over one full percentage point below the US high school average.

Immediate responses to the study on Twitter ranged from the dismissive to the impressed. Longtime cannabis prohibitionist Kevin Sabet cattily observed, “Shocked that the same two researchers who *always* conclude that youth use is A-OK in legal states… came to that conclusion yet again!” However, PA Lieutenant Governor and Senate hopeful John Fetterman touted the study’s JAMA bonafides and stated “Reefer Madness is gateway drug to more bullshit. Legal Weed already.” David L. Nathan, founder of the Doctors for Cannabis Regulation (DFCR), used this opportunity to once again urge the American Medical Association to support cannabis regulation, “or perhaps they’ll continue to ignore the evidence and wait for the DFCR to shame them in a CNN opinion piece again.”

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