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A Systematic Mapping of 447 Studies on Cannabis Legalization Found Major Evidence Gaps on Long-Term Health and Socioeconomic Outcomes

Evidence Gap MapStrong evidence
The takeaway

An evidence and gap map of 447 studies on cannabis liberalization found most research focused on cannabis use as an outcome, while more than half of the 113 outcomes identified were addressed by three or fewer studies, revealing massive evidence gaps.

Cannabis policy researchers, research funders, legislators, public health agencies.

Over half of 113 cannabis policy outcomes had 3 or fewer studies

What the researchers found

The EGM includes 447 studies (438 primary, 9 systematic reviews). Most research is from the US. Research concentrates on medical and recreational cannabis laws; industrial hemp, CBD, and decriminalization laws are rarely studied. Cannabis use was the most frequently studied outcome. Over half of 113 documented outcomes had 3 or fewer studies. Only 7 systematic reviews existed, and 5 were rated minimal quality.

Why it matters

With 21+ US states having recreational cannabis and more countries legalizing, this map shows that policy decisions are being made with enormous evidence gaps. The finding that most studies just measure cannabis use, not downstream health or socioeconomic outcomes, is a systemic weakness.

The numbers in context

447 studies included. 438 primary, 9 systematic reviews. 113 distinct outcomes. Over half with 3 or fewer studies. 5 of 7 systematic reviews rated minimal quality. Most research from US.

How the study worked

Evidence and gap map following Campbell Collaboration methodology. Searched 23 academic databases and 11 gray literature sources through August 2020. Dual screening and extraction with third-person deconfliction. Maryland Scientific Methods Scale for primary studies, AMSTAR 2 for reviews.

What this study cannot tell us

Maps evidence availability, not evidence quality or findings. Search through August 2020 may miss recent studies. English-language studies only. Evidence gaps identified do not necessarily indicate negative effects exist; they indicate effects are unstudied.

How to read the evidence

Rigorous evidence gap map using Campbell Collaboration methodology. Comprehensive search across 23 databases.

When this study was published

Published in 2023 searching through August 2020.

The bigger picture

This is the most comprehensive mapping of cannabis policy research ever conducted. Its finding that the evidence base is shallow on the outcomes that matter most (long-term health, safety, socioeconomic effects) should be a wake-up call for research funders and policy makers.

Questions still open

  • Will research funding shift toward the understudied long-term outcomes?
  • How should policy makers weigh evidence from areas with thin research bases?

Common questions

How much do we know about cannabis legalization effects?
Less than you might think. This systematic mapping found 447 studies, but over half of 113 documented outcomes were addressed by 3 or fewer studies, and most research just measures cannabis use, not downstream health or economic effects.
What topics need more research?
Industrial hemp laws, medical CBD policies, decriminalization effects, and long-term health, safety, and socioeconomic outcomes of cannabis liberalization are all severely understudied.

Read the original research

Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map.

Campbell systematic reviews, 19(4), e1362

Citation

Sevigny, Eric L; Greathouse, Jared; Medhin, Danye N. (2023). Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map.. Campbell systematic reviews, 19(4), e1362. https://doi.org/10.1002/cl2.1362