Cannabis school discipline initially rose after decriminalization but fell after full legalization in Massachusetts

Cannabis-related school discipline incidents increased 34% after Massachusetts decriminalized cannabis but then dropped 45% after medical legalization and another 20% after recreational legalization.

English, Faith et al.·American journal of preventive medicine·2025·Moderate EvidenceRetrospective Cohort
RTHC-06407Retrospective CohortModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=1,000

What This Study Found

Decriminalization was associated with a 34% increase in cannabis-related disciplinary incidents in schools. However, medical legalization reversed this trend with a 45% decrease, and recreational legalization produced a further 20% decrease compared to the prior policy period.

Key Numbers

Decriminalization (2008-2011): 34% increase (IRR 1.34). Medical legalization (2012-2015): 45% decrease (IRR 0.55). Recreational legalization (2016-2019): 20% decrease (IRR 0.80). Average incidents per district: 4.6, 4.7, and 5.1 across the three periods.

How They Did This

Multilevel time-series analysis of 2005-2019 data from all 399 Massachusetts public school districts, examining cannabis-related disciplinary incidents per 1,000 students across three policy periods.

Why This Research Matters

There is widespread concern that cannabis legalization will increase youth problems in schools. This study suggests the opposite occurred in Massachusetts, with discipline rates declining as policies expanded.

The Bigger Picture

These findings challenge the assumption that cannabis policy liberalization automatically translates to more youth cannabis problems in schools, and support harm-reduction approaches to school discipline.

What This Study Doesn't Tell Us

Observational study cannot prove policy changes caused the discipline trends. Discipline practices may have shifted independently of cannabis policy. Data does not capture actual cannabis use, only disciplinary responses.

Questions This Raises

  • ?Did actual cannabis use among students change, or just how schools responded to it?
  • ?Would these patterns replicate in other states with different policy timelines?

Trust & Context

Key Stat:
Cannabis school discipline fell 45% after medical legalization
Evidence Grade:
15 years of statewide school district data with appropriate interrupted time-series analysis. Cannot separate policy effects from concurrent changes in school discipline practices.
Study Age:
Published in 2025, data 2005-2019.
Original Title:
Associations Between Evolving Cannabis Policies and Cannabis-Related School Discipline Among Secondary School Students in Massachusetts, 2005-2019.
Published In:
American journal of preventive medicine, 70(4), 108129 (2025)
Database ID:
RTHC-06407

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Did cannabis legalization increase school discipline problems?

In Massachusetts, no. While decriminalization initially coincided with a 34% increase, subsequent medical and recreational legalization were associated with significant decreases in cannabis-related school discipline.

Why might school discipline decrease after legalization?

The study suggests schools may have shifted toward less punitive, harm-reduction approaches as cannabis laws evolved. The data captures disciplinary responses, not necessarily actual student cannabis use.

Read More on RethinkTHC

Cite This Study

RTHC-06407·https://rethinkthc.com/research/RTHC-06407

APA

English, Faith; Laws, Holly B; Yi, Youngmin; Martínez, Airín D; Bertone-Johnson, Elizabeth; Whitehill, Jennifer M. (2025). Associations Between Evolving Cannabis Policies and Cannabis-Related School Discipline Among Secondary School Students in Massachusetts, 2005-2019.. American journal of preventive medicine, 70(4), 108129. https://doi.org/10.1016/j.amepre.2025.108129

MLA

English, Faith, et al. "Associations Between Evolving Cannabis Policies and Cannabis-Related School Discipline Among Secondary School Students in Massachusetts, 2005-2019.." American journal of preventive medicine, 2025. https://doi.org/10.1016/j.amepre.2025.108129

RethinkTHC

RethinkTHC Research Database. "Associations Between Evolving Cannabis Policies and Cannabis..." RTHC-06407. Retrieved from https://rethinkthc.com/research/english-2025-associations-between-evolving-cannabis

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.