Use of Diverted Medical Cannabis Tripled Among Massachusetts Youth After Legalization
Among cannabis-using youth in Massachusetts, reported use of someone else's medical cannabis rose from 15% in 2013 to 44% in 2016 after medical cannabis legalization, and diverted users were more likely to drive after using.
Quick Facts
What This Study Found
Use of diverted medical cannabis increased from 15% in 2013 to 44% in 2016 (adjusted OR 4.66, 95% CI 1.81-11.95). Youth using diverted medical cannabis were more likely to ride with a cannabis-impaired driver or drive after cannabis use.
Key Numbers
273 youth surveyed. Mean age: 18.2 years. 32% female, 58% White, 70% with college-graduate parents. Diverted use: 15% (2013) vs 44% (2016), aOR 4.66. 97.9% said cannabis was easy to obtain at baseline. 89.4% viewed occasional use as no/slight risk. Youth using diverted cannabis had higher rates of driving-related risk.
How They Did This
Cross-sectional surveys of 273 cannabis-using youth (ages 13-24) from an outpatient substance treatment program and adolescent medicine clinic in Boston from 2013 (when medical cannabis took effect) through 2016 (when recreational became legal). Multiple logistic regression analyzed changes in attitudes and behaviors.
Why This Research Matters
Medical cannabis diversion to youth is a major policy concern. This study provides direct evidence that access through someone else's medical supply increased substantially in the years after legalization, with associated risky behaviors.
The Bigger Picture
This study captures a snapshot of the transition period between medical and recreational legalization in Massachusetts. The rapid increase in diversion suggests that medical programs may inadvertently increase youth access, which is relevant for states still designing their cannabis policies.
What This Study Doesn't Tell Us
The sample was drawn from clinical settings (substance treatment and adolescent medicine), so these youth were already at higher risk and may not represent the general adolescent population. Small sample sizes per year limit statistical power. Self-reported data.
Questions This Raises
- ?Did diversion patterns change after recreational legalization made cannabis more broadly available?
- ?Are secure storage requirements for medical cannabis effective at reducing youth diversion?
- ?Would universal legalization reduce diversion by eliminating the need to access medical supplies?
Trust & Context
- Key Stat:
- 15% to 44% increase in diverted medical cannabis use (2013-2016)
- Evidence Grade:
- Moderate: longitudinal trend data from a clinical sample with appropriate statistical controls, though limited by cross-sectional design within each year and clinical sample.
- Study Age:
- Published in 2022, covering data from 2013-2016.
- Original Title:
- Trends in cannabis-related attitudes and behaviors among cannabis-using adolescent and young adult outpatients following medical cannabis legalization in Massachusetts.
- Published In:
- Substance abuse, 43(1), 328-335 (2022)
- Authors:
- O'Connell, Maddie, Levy, Sharon(9), Shrier, Lydia A(8), Harris, Sion K
- Database ID:
- RTHC-04109
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
What is diverted medical cannabis?
Diversion means using cannabis that was legally obtained by someone else through a medical cannabis program. In this study, youth reported using a friend's or family member's medical cannabis rather than obtaining it themselves.
Did legalization make cannabis easier for youth to get?
At baseline, 97.9% of cannabis-using youth already said cannabis was easy to obtain. What changed was the source: medical cannabis diversion became increasingly common, and those using diverted medical cannabis were more likely to engage in risky behaviors like driving.
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Cite This Study
https://rethinkthc.com/research/RTHC-04109APA
O'Connell, Maddie; Levy, Sharon; Shrier, Lydia A; Harris, Sion K. (2022). Trends in cannabis-related attitudes and behaviors among cannabis-using adolescent and young adult outpatients following medical cannabis legalization in Massachusetts.. Substance abuse, 43(1), 328-335. https://doi.org/10.1080/08897077.2021.1941517
MLA
O'Connell, Maddie, et al. "Trends in cannabis-related attitudes and behaviors among cannabis-using adolescent and young adult outpatients following medical cannabis legalization in Massachusetts.." Substance abuse, 2022. https://doi.org/10.1080/08897077.2021.1941517
RethinkTHC
RethinkTHC Research Database. "Trends in cannabis-related attitudes and behaviors among can..." RTHC-04109. Retrieved from https://rethinkthc.com/research/o-connell-2022-trends-in-cannabisrelated-attitudes
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.