Recreational marijuana legalization

There is mixed evidence about the effects of recreational marijuana laws (RMLs) on opioid-related outcomes and alcohol use. More research is needed to determine the effects of legalizing recreational marijuana on long-term health, safety, and socioeconomic outcomes (Campbell-Sevigny 2023).

RMLs increase marijuana use in adults (Pawar 2024, Farrelly 2023, Anderson 2023, Athanassiou 2023, Sabia 2024) and may modestly increase use in young adults, particularly among college students (Pawar 2024, Farrelly 2023, Athanassiou 2023, Bae 2020). RMLs may have no significant impact on adolescent marijuana use (Anderson 2023, Pawar 2024, Athanassiou 2023, Melchior 2019); however, inconsistent findings across studies highlight the need for more research on youth use (Pawar 2024, Cil 2024, Farrelly 2023). RMLs are associated with increased risk of marijuana-related emergency visits and healthcare utilization among youth (i.e. unintentional toxic ingestions of marijuana products) (Farrelly 2023, Athanassiou 2023, RAND-Pacula 2017, Wilkinson 2016). RMLs may be associated with increases in use among women who are pregnant (Young-Wolff 2024, Farrelly 2023).

RMLs may be associated with reductions in opioid prescribing but its effects on other opioid-related mortality and use are unclear, with studies finding mixed effects across various opioid-related outcomes (Anderson 2023, Farrelly 2023, Athanassiou 2023, Nguyen 2024, McMichael 2020, Chan 2020b). Most evidence of the effect of RMLs on alcohol use suggest it may be associated with either no impact or reductions (Farrelly 2023, Athanassiou 2023, Anderson 2023). RMLs are not associated with increases in crime and in some cases may be associated with reductions in crime (Farrelly 2023, Anderson 2023, NBER-Sabia 2021). RMLs impact on traffic safety outcomes is uncertain: Studies have found either little to no impact on traffic safety or increases in traffic crashes and fatalities after the enactment of RMLs (Farrelly 2023, Anderson 2023, Athanassiou 2023). There is insufficient evidence of effects on mental health and suicides (Farrelly 2023, Athanassiou 2023, Hammond 2024).

Experts and healthcare professionals have several concerns about legalization. Smoking marijuana may increase the risk of marijuana dependence (e.g., cannabis use disorder) (O'Grady 2024, Lapham 2023, Cerda 2020, Smart 2019, Pacula 2017), respiratory problems, heart attacks, and cancers (NASEM 2017, Leung 2011). Marijuana use may increase the risk of psychotic and schizophrenic symptoms (Caulkins 2012, Bostwick 2012). Marijuana initiation before adulthood may increase the likelihood of dependence and related harms (Caulkins 2012, Wilsey 2008, Bostwick 2012); initiation over the age of 25 rarely results in dependence (Bostwick 2012). Cannabis retail store density is associated with lower perceived risk of marijuana use, greater exposure to advertising, more healthcare service or poison control calls, more frequent use of marijuana, and greater cannabis use disorder in adolescents; stores are disproportionately located in communities with more economic disadvantage and higher concentration of racial and ethnic minority residents (Anderson 2023).

The American Academy of Pediatrics (AAP) recommends routine screening and counseling for parents and youth about potential harms including damage to brain development, psychiatric illness, dropout, and suicide, particularly if recreational marijuana use is legal (Ryan 2017, AAP-Ammerman 2015).

One study suggests that 10% of state marijuana tax revenues can be attributed to individuals who live in a state without an RML traveling to a state with an RML (Hansen 2020).

It is unclear what impact recreational marijuana legalization could have on disparities in marijuana-related arrests and harms (Crawford 2021, Schlussel 2017). Some recreational marijuana laws (RMLs) include racial justice policy reforms that seek to rectify the disproportionate impacts of past marijuana prohibition, such as automatic expungement for certain marijuana-related crimes (Crawford 2021). More research is needed to determine effects of RMLs and, when enacted, the impact of racial justice reforms. While RMLs have been enacted in 25 states, marijuana remains a federally classified Schedule I narcotic, making possession or use of marijuana a criminal act under federal code (NBER-Dave 2022).

Marijuana prohibition has disproportionately impacted communities of color, despite similar rates of marijuana usage and distribution among racial groups. Nationally, a Black person is almost four times more likely to be arrested for possession than a white person, a disparity that increased by 32.7% from 2001 to 2010 (Schlussel 2017). Enforcement practices differ widely at the local level; in some states, Black people were more than six times as likely as whites to be arrested for possession and in some counties the magnitude reached 10, 15, and even 30 (Schlussel 2017). Even after legalization, disparities in arrest rates persist (Farrelly 2023). For example, after Colorado legalized recreational marijuana, Black adults and juveniles still outpaced whites and Latinos in every kind of marijuana arrest (e.g. on-view, warrant, citations/summons) between 2012 and 2017. In the first two years after marijuana reform in Colorado, Black individuals were arrested for possession of marijuana at the highest rates of any group in state history (Crawford 2021, Males 2014). Disparities extend to convictions, as well. For example, in Washington, D.C. between 2001 and 2010 over 90% of individuals prosecuted for marijuana crimes were Black (Schlussel 2017).

Some adolescent minority populations that experience discrimination based on their race, gender, or sexual identity may be more likely to use marijuana (Wheldon 2023). Experts suggest that those seeking to advance health equity should understand the unique patterns of marijuana use across identities and develop tailored strategies (Dai 2024).

Experts suggest that tax revenue could help address past harms related to drug enforcement activities. For example, Illinois, Massachusetts, New Jersey, and New York all dedicate a portion of their cannabis tax revenue to programs that support economic and workforce development in communities disproportionally harmed by previous drug laws and enforcement (TPC-Cannabis taxes).

Marijuana was first introduced in the U.S. during the early 1600s for hemp production and was commonly used by physicians to treat a variety of health ailments until the early 20^th century (NBER-Dave 2022). States started to ban marijuana in the 1910s when marijuana began to be negatively associated with both Black people and Mexican immigrants (Schlussel 2017). These efforts culminated with federal marijuana prohibition in 1937 (Schlussel 2017). The federal ban of the possession, consumption, and sale of marijuana led to openly racist enforcement tactics that have disproportionately harmed people of color (Schlussel 2017).

In 1971 President Nixon’s administration launched the “War on Drugs” (NBER-Dave 2022, Schlussel 2017). Proponents of the “War on Drugs” used coded language (e.g., “tough on crime” and “law and order”) to reference and exploit white concerns about racial minorities, social movements, and perceived disorder by using the lens of drug crimes (Schlussel 2017). Some of these “dog whistle” politics and negative stereotyping continue to be perpetuated in the current legalization landscape (Mortenson 2020). Marijuana was classified as a Schedule I drug, making marijuana possession or use is a criminal act under the federal code. This classification led to a massive expansion in marijuana criminalization with significant racial disparities in enforcement (NBER-Dave 2022, Schlussel 2017). Simultaneously, some states enacted decriminalization and depenalization laws intended to eliminate incarceration as a penalty for possession of a small quantity of marijuana. Scholars and experts highlight these efforts as a whitening of marijuana use in response to increases in young white adults smoking marijuana to decrease their risk of incarceration (Schlussel 2017).

Significant disparities in enforcement of marijuana laws have imposed arrests, prosecutions, and convictions on individuals and communities, separated families, and deprived individuals of child custody, immigration status, voting rights, eligibility for public housing, financial aid for education, and access to employment (Crawford 2021, Schlussel 2017). Legalizing marijuana is seen as a way to rectify the harms of marijuana prohibition, however, the interests of the most impacted have yet to be fully addressed (Crawford 2021). Only three states include automatic expungement for certain marijuana-related crimes as a part of their legislative design (Crawford 2021).

Disparities exist in the emerging $1 billion marijuana industry because communities of color have borne the consequences of marijuana prohibition. It is estimated that about 80% of marijuana business owners are white, highlighting how states prohibit people with marijuana convictions from receiving business licenses (Crawford 2021, Schlussel 2017). Additionally, potential Black and Latino entrepreneurs are more likely to be denied small-business loans because of discriminatory lending practices, and to be charged higher interest rates and subjected to predatory terms when they receive a line of credit (Crawford 2021). Furthermore, cannabis retail stores are disproportionately located in communities with more economic disadvantage and higher concentration of minority residents (Kephart 2025, Williams 2023a). There are some state efforts to address these barriers, such as Illinois’ Adult-Use Social Equity program to increase the awarding of marijuana dispensary licenses to those that have been systematically excluded from the marijuana industry (Crawford 2021).

• If your state has recreational marijuana laws, do they have components that address past harms of marijuana prohibition, such as automatic expungement of certain marijuana-related offenses?
• If your state is considering legalizing marijuana, who can you contact to make sure the perspectives of those harmed by marijuana prohibition are included in the legislative design? What stakeholders could you engage to support equitable implementation of such legislation?
• If your state has recreational marijuana laws, do current laws systematically exclude those harmed by previous marijuana prohibition from the legalized marijuana industry? How can you advocate for change so those harmed by previous marijuana prohibition can participate in the legalized marijuana industry?

As of November 2023, recreational marijuana is legal for a person age 21 or older in twenty-four states and Washington, D.C. (NCSL-Marijuana). These states also regulate licensing and location of recreational marijuana dispensaries with substantial variation in density of stores per capita (NCSL-Marijuana). Detailed regulations on the maximum amount of marijuana possession, use, transfer, product testing standards and home grow vary by state (NCSL-Marijuana). The number of different types of marijuana products is rapidly expanding from just dried flower to concentrates, edibles and vape oils that can contain higher concentrations of tetrahydrocannabinols (known as THC) (NASEM-Cannabis policy). Most states apply an excise tax on the sale of marijuana at either the retail or wholesale level, or both levels, and base it on price, weight, or potency (NCSL-Brainerd 2021). Furthermore, states may direct tax revenue toward public health purposes to balance the potential public health impacts of marijuana use (NCSL-PH Marijuana).

As of April 2023, medical marijuana is legal in 38 states, three U.S. territories and Washington, D.C.; these states also have comprehensive medical marijuana and cannabis programs. Nine states allow limited use of low THC, high cannabidiol (CBD) products for specific medical conditions (NCSL-Marijuana). As of December 2022, 27 states and the District of Columbia have adopted decriminalization laws. In early October 2022, President Joe Biden issued a pardon to all individuals with a federal conviction for marijuana possession and urged all state governors to do the same with respect to state convictions (NBER-Dave 2022).

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