A review of recent evidence found most studies showed no significant change in youth cannabis use after recreational legalization, but unintentional pediatric ingestion of edibles increased markedly, along with some increases in youth alcohol, vaping, and e-cigarette use.
Policymakers evaluating cannabis legalization impact on young people
No significant youth use change
What the researchers found
Most studies found no significant association between recreational legalization and changes in youth cannabis use across Europe, Uruguay, the U.S., and Canada. Some studies reported increases in adult and youth use that appeared to predate legalization. Unintentional pediatric ingestion of cannabis edibles increased significantly after legalization. Some evidence linked legalization to increased alcohol, vaping, and e-cigarette use among adolescents and young adults.
Why it matters
The most politically charged question about cannabis legalization is whether it increases youth use. This review suggests it largely has not, but the increase in accidental pediatric edible ingestion represents a clear safety concern that needs policy attention.
The numbers in context
Most studies found no significant youth use changes post-legalization; marked increase in unintentional pediatric edible ingestion; some increases in use appeared to predate legalization
How the study worked
Narrative review of recent literature on the impact of recreational cannabis legalization on cannabis and other substance use across different population groups including youth and adults.
What this study cannot tell us
Narrative review covering multiple jurisdictions with different legalization models. Short follow-up periods in many studies. Self-reported use data may not capture actual changes. Different age groups defined differently across studies.
How to read the evidence
Narrative review of recent evidence with consistent findings across jurisdictions, but limited by heterogeneous study designs
When this study was published
2023 study
The bigger picture
The evidence suggests that legalization's biggest impact on youth is not through increased intentional use but through accidental edible exposure in young children. This has implications for packaging, storage, and child-proofing regulations.
Questions still open
- Will longer-term follow-up reveal different trends? Are child-resistant packaging regulations reducing pediatric ingestions? Does the method of legalization implementation affect youth use outcomes?
Common questions
Did cannabis legalization increase teen use?
What about younger children?
Read the original research
Effects of cannabis legalization on the use of cannabis and other substances.
Current opinion in psychiatry, 36(4), 283-289
Citation
Assanangkornchai, Sawitri; Kalayasiri, Rasmon; Ratta-Apha, Woraphat; Tanaree, Athip. (2023). Effects of cannabis legalization on the use of cannabis and other substances.. Current opinion in psychiatry, 36(4), 283-289. https://doi.org/10.1097/YCO.0000000000000868