Trying out cannabis at a younger age in medical marijuana states

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Adolescents living in America‘s medical marijuana states with a plethora of dispensaries are more likely to have tried new methods of cannabis use, such as edibles and vaping, at a younger age than those living in states with fewer dispensaries, found Dartmouth University study.

“This study was driven by two motivations – the need to understand if and how the shifting legal landscape of cannabis may affect kids, and the potential utility of social media as an epidemiological sampling method,” says Jacob Borodovsky, a PhD candidate at The Dartmouth Institute for Health Policy and Clinical Practice and the Centre for Technology and Behavioral Health, and the lead author of the study. “If it is true that certain components of legalisation change the way young people use cannabis, then we need to devote more resources to understanding the important consequences (good or bad) of the specific provisions included in the diverse cannabis laws that are emerging across the country.”

Borodovsky and colleagues examined associations between provisions of legal cannabis laws (such as allowing dispensaries, home cultivation, etc.) and cannabis consumption patterns among youth using online surveys distributed through Facebook, which proved to be a reliable method for generating geographically diverse samples of specific subgroups of cannabis-using youth.

“Our data suggest a relationship between the degree of regulatory oversight of legal cannabis and kids’ propensity for trying new ways of using cannabis,” Borodovsky says. “I think we need to start having a broader national conversation about how best to design the production and distribution regulations for legal cannabis to mitigate potential public health harms.”

As cannabis legalisation rapidly evolves, in both medical and recreational usage, understanding the laws’ effect on young people is crucial because this group is particularly vulnerable to the adverse effects of marijuana and possesses an inherent elevated risk of developing a cannabis disorder.

“Using social media to disseminate web surveys is a useful epidemiological research method. It allows us to quickly collect geographically diverse data on cannabis-related questions that aren’t asked in the traditional federally-sponsored drug use surveys,” Borodovsky says. “My hope is that we can use these and other types of results to create rational legal cannabis laws that are based on data rather than anecdotes.”

Background: Alternative methods for consuming cannabis (e.g., vaping and edibles) have become more popular in the wake of U.S. cannabis legalization. Specific provisions of legal cannabis laws (LCL) (e.g., dispensary regulations) may impact the likelihood that youth will use alternative methods and the age at which they first try the method – potentially magnifying or mitigating the developmental harms of cannabis use.
Methods: This study examined associations between LCL provisions and how youth consume cannabis. An online cannabis use survey was distributed using Facebook advertising, and data were collected from 2630 cannabis-using youth (ages 14–18). U.S. states were coded for LCL status and various LCL provisions. Regression analyses tested associations among lifetime use and age of onset of cannabis vaping and edibles and LCL provisions.
Results: Longer LCL duration (ORvaping: 2.82, 95% CI: 2.24, 3.55; ORedibles: 3.82, 95% CI: 2.96, 4.94), and higher dispensary density (ORvaping: 2.68, 95% CI: 2.12, 3.38; ORedibles: 3.31, 95% CI: 2.56, 4.26), were related to higher likelihood of trying vaping and edibles. Permitting home cultivation was related to higher likelihood (OR: 1.93, 95% CI: 1.50, 2.48) and younger age of onset (β: −0.30, 95% CI: −0.45, −0.15) of edibles.
Conclusion: Specific provisions of LCL appear to impact the likelihood, and age at which, youth use alternative methods to consume cannabis. These methods may carry differential risks for initiation and escalation of cannabis use. Understanding associations between LCL provisions and methods of administration can inform the design of effective cannabis regulatory strategies.

Jacob T Borodovsky, Dustin C Lee, Benjamin S Crosier, Joy L Gabrielli, James D Sargent, Alan J Budney

Geisel School of Medicine at Dartmouth material
Drugs and Alcohol Dependence abstract

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