Does Cannabis Legalization Encourage Adolescent Consumption?

Cannabis is one of the most widely used drugs in the world. The THC contained in the leaves, flowers, or resins is appreciated for its addictive psychoactive powers. But cannabis plants (Cannabis sativa) contain other cannabinoids like CBD – non-psychoactive – which have therapeutic value.

However, while Cannabis sativa has been used since time immemorial as a medicinal plant, the evidence of its effectiveness by the standard of modern science is only just beginning to reach us. Its benefits are numerous, ranging from better management of cancer symptoms to the relief of chronic pain that is resistant to other drugs.

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Legalization is increasingly coming under consideration

Faced with promising research, several countries are questioning the legalization of cannabis for medical or even recreational purposes. In Switzerland, Spain, and the Netherlands, medical cannabis is legal. In Germany or Belgium, it is decriminalized. In France, its use remains totally prohibited outside of strictly followed experimental protocols.

On April 10, the first round of the presidential election will take place where citizens will have the choice between twelve candidates from all political sides. If the legalization of cannabis for adults is not a priority measure of electoral programs, some candidates, mainly on the left of the political spectrum, are still in favor of this measure.

Proponents of legalization believe it could ensure control over the production, quality, and sale of cannabis whether for therapeutic or recreational use. The taxes collected could also be used to care for dependent people. For their part, critics of the legalization of cannabis fear that it will increase consumption and therefore the risk of addiction and associated health problems, especially among teenagers who are more likely to go from occasional to dependent users. Does the legalization of recreational and therapeutic cannabis promote consumption among teenagers? Studies conducted in the United States offer some answers.

Legalization of recreational cannabis and youth use

In the United States, the states of Washington and Colorado legalized the recreational use of cannabis for adults in November 2012. They were the first two states to do so, followed by Alaska, Oregon, and Washington DC in 2014; and California, Maine, Massachusetts, and Nevada in 2016. Even though the enacted law restricts cannabis use to adults, teens couldn’t ignore the news. What effects has the legalization of cannabis had on their consumption and their perception of the risks associated with this practice? American researchers published a study in Jama Pediatrics in 2017. The interest of the latter lies in the comparison between the use and the perception of the dangers associated with cannabis among middle and high school students before the ratification of the law (2010-2012) and after (2013-2015). The results obtained for the states of Washington and Colorado were then compared with those obtained in other neighboring states where the recreational use of cannabis remains prohibited.

They observed that the legalization of cannabis in 2012 reduced the perception of the dangers associated with the consumption of this drug by 14.6% and 16.1% among 13-14-year-olds and 15-16-year-olds, respectively, living in Washington State. At the same time, cannabis consumption increased by 2% and 4% for the same age groups. The results obtained for 17-18-year-olds are not significant.

When we compare these trends to states that have not legalized recreational cannabis, we note that the perception of the dangers of the drug is also down, but to a lesser extent (by 4.9% among 13-14-year-olds and 7.2% among 15-16-year-olds). On the other hand, consumption remains in decline, decreasing from 1.3% to 0.9% for 13-14-year-olds and 15-16-year-olds after the adoption of the law in 2012.

Researchers offer several explanations for the trends observed in Washington State. The 2021 law has reduced the stigma and dangerousness associated with cannabis use, a social change is taking place making recreational use more tolerable since it is legal. With legalization, cannabis may also have become easier to access, especially in 2014 with the opening of the first and less expensive marijuana store in Washington State. 

No differences in cannabis use or risk perception were observed among Colorado teens across the three age groups studied and compared to states where recreational cannabis is illegal. How to explain this? According to the researchers, the people of Colorado have a long-standing relationship with cannabis. In this state, there is an organized network of pharmacies where medical cannabis is available under prescription, and this long before the legalization of recreational use. Teenagers who live in this state have therefore been accustomed to seeing advertisements for these establishments and the law has not changed their habits or their perception. Of all the states considered here,

Legalization of therapeutic cannabis and use by young people

Medical cannabis is not smoked but administered to patients by inhalation or orally. Several medicinal products containing cannabis are authorized by the European Medicines Agency. They are composed of either THC, CBD, or an equivalent mixture of the two. For example, nabilone is a synthetic cannabinoid similar to THC, marketed as Cesamet or Canemes; Nabiximol, or Epidiolex, is a mixture of CBD and THC in equal amounts.

The use of medical cannabis is legal in 33 states in the United States. In Europe, 21 countries have authorized it, at different levels. Has the legalization of the medical form of cannabis had the same effect on consumption as recreational legislation? A meta-analysis published in 2018 takes stock. The 2,999 publications compiled by scientists have not demonstrated that the legalization of medical cannabis promotes consumption among teenagers.

In France, therapeutic cannabis is only available within the framework of an experiment directed by the ANSM which aims to estimate its relevance and feasibility. Patients with neuropathic pain refractory to accessible therapies, certain forms of severe epilepsy, certain symptoms related to cancer or its treatment, but also patients in palliative care or suffering from painful spasticity (constant muscle stiffness) of sclerosis in patches can claim therapeutic cannabis to relieve them, where traditional treatments prove ineffective. 

In conclusion, the legalization of recreational cannabis seems to lead to greater consumption of this drug among teenagers; a phenomenon that has not been observed in the legalization of medical cannabis. These two studies alone cannot take into account all the negative or positive effects that the legalization of cannabis would have in the short term as well as in the long term, especially among the youngest. The question is likely to be debated for many years to come, both on the political and scientific sides.

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(Featured image by Nicolas Lobo via Unsplash)

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