Legalization and retail availability of recreational marijuana and adolescent use in schools

• Published in: Health economics 2024-01, Vol.33 (1), p.107-120
• Main Authors: Cil, Gulcan, Winters, Ken C., Austin, Sean C., Kittelman, Angus, Smolkowski, Keith, Westling, Erika, Seeley, John R.
• Format: Article
• Language: English
• Subjects: Academic disciplines; Academic failure; Adolescent; Adolescents; Adults; Cannabis; Drug policy; Drug use; Health economics; Humans; Legalization; Legislation, Drug; Marijuana; marijuana availability; marijuana legalization; marijuana policy; Marijuana Smoking - epidemiology; Marijuana Use; Medical referrals; Mental health; Middle school students; Middle schools; Normalization; Offenses; Policy making; Prevention programs; Public health; Recreation; Recreational drugs; recreational marijuana; Sales; school office discipline referrals; Schools; Secondary schools; States; Substance abuse; Substance-Related Disorders; Teenagers; youth marijuana use
• ISSN: 1057-9230; 1099-1050; 1099-1050
• DOI: 10.1002/hec.4763

Legalization of use and retail sales of recreational marijuana in U.S. states and the associated potential increase in access to marijuana and normalization of its use by adults could lead to increased use by adolescents. Studies have found that states with legal recreational marijuana have higher rates of adolescent use and frequency of use compared to states without legal use. We examined changes in student office discipline referrals (ODRs) for substance use offenses in Oregon middle and high schools before and after the legalization of recreational marijuana relative to comparison schools in other states. We found that rates of substance use related ODRs in middle schools increased by 0.14 per 100 students (30% of the mean) with legalization relative to comparison schools. This increase was moderated by the presence of a marijuana outlet within one mile of the school. We found no statistically discernible changes in high school ODRs. Marijuana use in adolescence has been linked to negative health and social consequences, including academic problems, mental health issues, and impaired driving. Potential adverse impact on adolescents and investments in school‐based prevention programs could be important considerations for policymakers and public health officials when evaluating marijuana legalization.