Uruguay's Cannabis Legalization Did Not Increase Youth Use or Risky Consumption

Using data from over 204,000 students in Uruguay and Chile, researchers found that Uruguay's 2013 cannabis legalization was not associated with increases in past-year or past-month use, or sustained increases in risky or frequent cannabis use among secondary students.

Rivera-Aguirre, Ariadne et al.·Addiction (Abingdon·2022·Strong EvidenceCross-Sectional
RTHC-04170Cross SectionalStrong Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Strong Evidence
Sample
N=204,730

What This Study Found

Past-year and past-month cannabis use decreased after legalization. Among students 18-21 (legally eligible), there was a transitory increase in risky use in 2014 that decreased afterward. No sustained increases in risky or frequent cannabis use were found for any age group.

Key Numbers

204,730 students. Past-year and past-month use decreased after enactment/implementation. Ages 18-21 showed transitory increases in 2014: risky use PD=13.5% (95% CI 2.0-24.9), frequent use PD=4.5% (95% CI 1.0-8.1), but these decreased after 2014.

How They Did This

Difference-in-differences analysis comparing repeated cross-sectional surveys of secondary students in Uruguay and Chile (control) from 2007-2018. 204,730 students in 8th, 10th, and 12th grade. Examined changes after enactment (2014) and implementation (2016) of legalization.

Why This Research Matters

Uruguay was the first country to fully legalize recreational cannabis. This large-scale evaluation provides crucial evidence that a non-commercial legalization model did not increase youth cannabis use, countering a primary concern about legalization.

The Bigger Picture

Uruguay's non-commercial model (state-regulated pharmacies, home growing, cannabis clubs) is fundamentally different from the commercial models adopted in US states and Canada. The finding that this model did not increase youth use adds support for regulated non-commercial approaches.

What This Study Doesn't Tell Us

Chile as a control country may not be perfectly comparable. School surveys miss adolescents who have dropped out. Self-reported cannabis use may be affected by changing social norms post-legalization. The implementation period was gradual, making effect attribution difficult.

Questions This Raises

  • ?Would a commercial legalization model produce different youth outcomes?
  • ?Did the transitory 2014 increase reflect curiosity that naturally faded?
  • ?How do youth in Uruguay perceive cannabis risk after legalization?

Trust & Context

Key Stat:
No sustained increases in youth cannabis use after Uruguay legalization
Evidence Grade:
Strong: large sample, appropriate difference-in-differences design with a control country, covering 11 years of data.
Study Age:
Published in 2022, covering data from 2007-2018.
Original Title:
Does recreational cannabis legalization change cannabis use patterns? Evidence from secondary school students in Uruguay.
Published In:
Addiction (Abingdon, England), 117(11), 2866-2877 (2022)
Database ID:
RTHC-04170

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Did legalizing cannabis increase teenage use in Uruguay?

No. This study found that past-year and past-month cannabis use actually decreased after legalization. There was a brief uptick in risky use among 18-21 year olds in the first year, but it subsided quickly.

Is Uruguay's legalization model different from the US?

Yes. Uruguay uses a non-commercial model with state-regulated pharmacies, registered cannabis clubs, and home growing. There is no commercial advertising or branded retail as seen in many US states, which may contribute to different youth outcomes.

Read More on RethinkTHC

Cite This Study

RTHC-04170·https://rethinkthc.com/research/RTHC-04170

APA

Rivera-Aguirre, Ariadne; Castillo-Carniglia, Alvaro; Laqueur, Hannah S; Rudolph, Kara E; Martins, Silva S; Ramírez, Jessica; Queirolo, Rosario; Cerdá, Magdalena. (2022). Does recreational cannabis legalization change cannabis use patterns? Evidence from secondary school students in Uruguay.. Addiction (Abingdon, England), 117(11), 2866-2877. https://doi.org/10.1111/add.15913

MLA

Rivera-Aguirre, Ariadne, et al. "Does recreational cannabis legalization change cannabis use patterns? Evidence from secondary school students in Uruguay.." Addiction (Abingdon, 2022. https://doi.org/10.1111/add.15913

RethinkTHC

RethinkTHC Research Database. "Does recreational cannabis legalization change cannabis use ..." RTHC-04170. Retrieved from https://rethinkthc.com/research/rivera-aguirre-2022-does-recreational-cannabis-legalization

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.