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Study breakdown

A New Way to Measure How Different State Cannabis Laws Actually Are

Narrative ReviewLow evidence
The takeaway

Three policy 'bundles' — pharmaceutical, permissive, and fiscal — capture 36 characteristics of state cannabis laws, enabling researchers to measure how policy design variation affects health outcomes.

Cannabis policy researchers, health services researchers, state legislators designing cannabis laws

What the researchers found

Three policy bundles were developed measuring 36 characteristics of state cannabis laws from 1994-2023: pharmaceutical (treating cannabis like a regulated drug), permissive (treating it like an over-the-counter product), and fiscal (revenue-focused). Measures distinguish between policies as adopted versus as implemented.

Why it matters

Most cannabis research treats legalization as binary (legal or not), but states vary enormously in how they design their laws. This measurement tool lets researchers actually study which specific policy features affect health outcomes.

The numbers in context

36 different characteristics measured across 3 bundles (pharmaceutical, permissive, fiscal). Coverage: 1994-2023. Measures available for both adopted and implemented policies. Massachusetts used as demonstration case.

How the study worked

Commentary presenting a policy bundles measurement approach with 36 characteristics of state medical and recreational cannabis laws organized into three conceptual bundles, demonstrated using Massachusetts as a case study.

What this study cannot tell us

Commentary/methodology paper without empirical testing of bundle validity or health outcome associations. Policy coding requires subjective judgment. Implementation measures may lag behind actual practice. 36 characteristics may not capture all relevant variation.

How to read the evidence

Methodological contribution proposing a measurement framework, without empirical validation of its predictive value for health outcomes.

When this study was published

Published 2026, covering US state policies from 1994-2023.

The bigger picture

The difference between 'cannabis is legal' and 'how cannabis is legal' may matter more for public health than the legalization decision itself. This measurement approach could finally enable the research needed to design optimal cannabis policies.

Questions still open

  • Which bundle characteristics are most predictive of health outcomes? Do pharmaceutical-style policies produce better health outcomes than permissive ones? How quickly do implemented policies diverge from adopted policies?

Common questions

Are all state cannabis laws the same?
Not at all — this study identified 36 different characteristics that vary across states, organized into three categories: pharmaceutical (regulating like a prescription drug), permissive (easy access like over-the-counter), and fiscal (focused on tax revenue).
Why does it matter how cannabis laws are designed?
Because a state that treats cannabis like a pharmaceutical may see very different health outcomes than one that treats it like an easily accessible consumer product. This measurement tool lets researchers study those differences for the first time.

Read the original research

Measuring State Cannabis Policy Design Variation for Research and Policy: A Bundles Approach.

Clinical therapeutics, 48(1), 29-33

Citation

Mallinson, Daniel J; Richardson, Lilliard E. (2026). Measuring State Cannabis Policy Design Variation for Research and Policy: A Bundles Approach.. Clinical therapeutics, 48(1), 29-33. https://doi.org/10.1016/j.clinthera.2025.07.027