@article{ref1,
title="The design of medical marijuana laws and adolescent use and heavy use of marijuana: analysis of 45 states from 1991 to 2011",
journal="Drug and alcohol dependence",
year="2016",
author="Johnson, Julie and Hodgkin, Dominic and Harris, Sion Kim",
volume="170",
number="",
pages="1-8",
abstract="OBJECTIVES: To assess the association between U.S. state medical marijuana laws (MML), the most liberal category of marijuana policies before legalization, their specific provisions, and adolescent past-30-day use and heavy marijuana use. <br><br>METHODS: This quasi-experimental study used state Youth Risk Behavior Survey (YRBS) data collected during 1991-2011 from 45 states (N=715,014) to examine MML effects, taking advantage of heterogeneity across states in MML status and design. Multiple logistic regression modeling was used to adjust for state and year effects, and youth demographics. <br><br>RESULTS: Unadjusted analyses found that MMLs were associated with higher rates of adolescent past-30-day marijuana use (odds ratio [OR]=1.08, 95% confidence interval, [(CI)=1.03,1.13]) and heavy marijuana use (OR=1.12, [CI=1.05,1.21]). However, analyses adjusting for state/year effects found a 7% lower odds of use (OR=0.99, [CI=0.98,0.999]) and no difference in heavy use. In the adjusted models, years since MML enactment (OR=0.93, [CI=0.86,0.99]) and MML inclusion of more liberalized provisions (OR=0.98, [CI=0.96,0.998]) were associated with slightly lowered odds of past-30-day marijuana use. Conversely, allowance for ≥2.5 usable marijuana ounces was associated with higher past-30-day marijuana use odds (OR=1.21, [CI=1.09,1.34]) and a voluntary vs. mandatory patient registration with higher odds of both past-30-day use (OR=1.41, [CI=1.28,1.56]) and heavy use (OR=1.23, [CI=1.08,1.40]). <br><br>CONCLUSIONS: MML enactment, years since enactment, and inclusion of more liberalized provisions were not associated with increased adolescent marijuana use in this dataset after adjusting for state and year effects; however, higher possession limits and a voluntary registration were. It is possible that state norms are the impetus for MML enactment.<br><br>Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2016.10.028",
url="http://dx.doi.org/10.1016/j.drugalcdep.2016.10.028"
}