Elsevier

Preventive Medicine

Volume 104, November 2017, Pages 31-36
Preventive Medicine

The potential impact of cannabis legalization on the development of cannabis use disorders

https://doi.org/10.1016/j.ypmed.2017.06.034Get rights and content

Highlights

  • Legal cannabis law provisions may differentially impact risk of cannabis addiction.

  • Such laws may influence cannabis pharmacology, access, and culture.

  • Known factors that contribute to addiction should guide cannabis policy design.

  • Increased funding is needed to bolster cannabis regulatory science.

Abstract

Specific provisions of legal cannabis legislation and regulation could influence cannabis initiation, frequency and quantity of use, and progression to cannabis use disorder. This brief essay highlights scientifically based principles and risk factors that underlie substance use and addiction that can be leveraged to inform policies that might mitigate the development and consequences of cannabis use disorder. Specifically, pharmacologic, access/availability, and environmental factors are discussed in relation to their influence on substance use disorders to illustrate how regulatory provisions can differentially affect these factors and risk for addiction. Relevant knowledge from research and experience with alcohol and tobacco regulation are also considered. Research designed to inform regulatory policy and to evaluate the impact of cannabis legislation on cannabis use and problems is progressing. However, definitive findings will come slowly, and more concerted efforts and resources are needed to expedite this process. In the meantime, policymakers should take advantage of the large body of scientific literature on substance use to foster empirically-guided, common sense approaches to cannabis policy that focus on prevention of addiction.

Section snippets

Pharmacology

Substances, including cannabis, that are used recreationally and which pose a risk for the development of a clinical substance use disorder (“addiction”) are attractive to most humans because they function as reinforcers (Higgins et al., 2004). That is, the experience that immediately follows drug taking is desirable, and therefore the drug is likely to be used again. The strength of such a reward or reinforcement is determined by multiple factors, the most obvious of which is the direct

Access/availability

The ease or difficulty of accessing an intoxicating substance has an obvious, but often underestimated, influence on individual and population-level substance use initiation, frequency and amount of use, and consequently the risk of developing a substance use disorder. Behavioral economics provides a multi-dimensional conceptualization of access or availability of a reinforcer (e.g., cannabis) that can help one appreciate its potential impact on use and addiction (Bickel et al., 2014, Hursh and

Environmental factors

Multiple aspects of the environment or context in which substances are available (e.g., neighborhood socioeconomic status, cultural factors, societal norms and laws, marketing and advertising) exert an impact on the age of onset, probability, frequency, and amount of use, and problem development (Bickel and DeGrandpre, 1996). Here we briefly discuss just two such factors that are particularly susceptible to the influence of legislation and regulations—marketing and social norms regarding the

Concluding comments

States across the U.S. are attempting to achieve a difficult legislative goal - the regulation of legal cannabis without increasing the prevalence of problematic cannabis use and CUD. Such efforts can benefit from a comprehensive working knowledge of the multiple factors that influence addiction. In this brief essay, we have identified a few well-established risk factors, based on research from multiple scientific disciplines, and attempted to illustrate how specific provisions of cannabis laws

Funding

NIDA: R01-DA032243, R01DA015186, T32-DA037202, P30-DA029926.

The funding sources were not involved in the study design; collection, analysis, and interpretation of data; writing of the report; or in the decision to submit the article for publication.

Conflict of interest statement

The authors declare no conflict of interest other than the receipt of research funding support from the NIH-NIDA as indicated above.

Transparency document

Transparency document.

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