Marijuana

States That Legally Regulate Medical and/or Adult Social Use of Marijuana

Related Chapters:
CBD (Cannabidiol)
Hemp
Marijuana Policy Reform - Decriminalization, Legalization, and Medicalization
Medical Marijuana
Driving

Looking for information on synthetic cannabinoids (e.g. "Kush," "spice," "K2," etc.)? Check our chapter on New Psychoactive Substances

Looking for specific, detailed information on cannabidiol (CBD)? In addition to the items below, check out Project CBD.

21. Prevalence of Past-Month (Current) Marijuana Use in the US

"As noted in the illicit drug use section, an estimated 24.0 million Americans aged 12 or older in 2016 were current users of marijuana (Figure 15). This number of past month marijuana users corresponds to 8.9 percent of the population aged 12 or older (Figure 17). The percentage of people aged 12 or older who were current marijuana users in 2016 was higher than the percentages from 2002 to 2015. This increase in marijuana use among people aged 12 or older reflects the increase in marijuana use by adults aged 26 or older and, to a lesser extent, the increase in marijuana use among young adults aged 18 to 25."

Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
https://www.samhsa.gov/data/si...
https://www.samhsa.gov/data/si...

22. Total Annual Arrests in the US by Type of Offense

In 2018, law enforcement agencies in the US made an estimated 10,310,960 arrests for all offenses, of which 1,654,282 were drug arrests.

Although the intent of a 'War on Drugs' may have been to target drug smugglers and 'King Pins,' of the 1,654,282 arrests for drug law violations in 2018, 86.4% (1,429,300) were for mere possession of a controlled substance. Only 13.6% (224,982) were for the sale or manufacturing of a drug. Further, 40.1% of drug arrests in 2018 were for marijuana offenses -- a total of 663,367. Of those, an estimated 608,776 arrests (36.8% of all drug arrests) were for marijuana possession alone. By contrast in 2000, a total of 734,497 Americans were arrested for marijuana offenses, of which 646,042 (40.9%) were for possession alone.

Click here to open table displaying Total Annual Arrests in the US by Year and Type of Offense, 1996-2017

"Crime in the United States 2018 - Arrests," FBI Uniform Crime Report (Washington, DC: US Dept. of Justice, September 2019), p. 2, and Arrest Table: Arrests for Drug Abuse Violations.
https://ucr.fbi.gov/crime-in-t...
https://ucr.fbi.gov/crime-in-t...
https://ucr.fbi.gov/crime-in-t...
"Crime in the United States - 2000," FBI Uniform Crime Reports (Washington, DC: US Government Printing Office, 2001), p. 216, Tables 29 and 4.1.
http://www.fbi.gov/about-us/cj...

23. Positivity Rate for Marijuana Use Among US Workers Subjected to Drug Testing

"Marijuana positivity continued its upward climb in both the federally-mandated, safety-sensitive and general U.S. workforces. In oral fluid testing, which detects recent drug use, marijuana positivity increased nearly 75 percent, from 5.1 percent in 2013 to 8.9 percent in 2016 in the general U.S. workforce. Marijuana positivity also increased in both urine testing (2.4% in 2015 versus 2.5% in 2016) and hair testing (7.0% in 2015 versus 7.3% in 2016) in the same population.
"Among the federally-mandated, safety-sensitive workforce, which only utilizes urine testing, marijuana positivity increased nearly ten percent (0.71% in 2015 versus 0.78% in 2016), the largest year-over-year increase in five years.
"In Colorado and Washington, the first states in which recreational marijuana use was legalized, the overall urine positivity rate for marijuana outpaced the national average in 2016 for the first time since the statutes took effect. The increase was more pronounced in Colorado, which increased 11 percent (2.61% in 2015 versus 2.90% in 2016), than in Washington, which increased nine percent (2.82% in 2015 versus 3.08% in 2016). The national positivity rate for marijuana in the general U.S. workforce in urine testing increased four percent (2.4% in 2015 compared to 2.5% in 2016).
"'We have been tracking the trends in marijuana positivity in states that have passed medical and recreational marijuana use statutes for several years now. 2016 is the first year since Colorado and Washington approved recreational use that the rates of year-over-year change were sharply higher than the national average,' said Dr. Sample."

"Quest Diagnostics Drug Testing Index™ Full year 2016 tables," Quest Diagnostics, Table 2, last accessed Nov. 13, 2017.
http://www.questdiagnostics.co...
http://www.questdiagnostics.co...
"Increases in Illicit Drugs, Including Cocaine, Drive Workforce Drug Positivity to Highest Rate in 12 Years, Quest Diagnostics Analysis Finds," Quest Diagnostics, May 16, 2017.
http://newsroom.questdiagnosti...

24. Federal Interagency Assessment of Cannabis Use in the US

"One area representative, from New York City, reported the continuing predominance in indicators and serious consequences of marijuana (as well as heroin and cocaine) and changes in marijuana trends as a key finding in that area for this reporting period. Marijuana indicator levels continued to be reported as high relative to other drugs, however, across all CEWG areas, based on treatment admissions and reports identified as marijuana/cannabis among drug items seized and analyzed. New marijuana/cannabis laws legalizing both medical and recreational marijuana use were expected by area representatives to be influencing indicators in several areas currently and in the future. Representatives from Texas and Chicago reported a shift in trafficking and marketing away from Mexican marijuana (due to a drought and poor quality Mexican marijuana) to local markets and local 'grow' operations."

"Epidemiologic Trends in Drug Abuse: Proceedings of the Community Epidemiology Work Group, Advance Report, June 2013" (Bethesda, MD: National Institute on Drug Abuse, December 2013), p. 18.
http://www.drugabuse.gov...

25. Vulnerability of Teens to Effects of Drugs

"The teen brain is a work in progress, making it more vulnerable than the mature brain to the physical effects of drugs. The potential for developing substance abuse and dependence is substantially greater when an individual’s first exposure to alcohol, nicotine and illicit drugs occurs during adolescence than in adulthood."

Steinberg, L., Distinguished University Professor and Laura H. Carnell Professor of Psychology, Department of Psychology, Temple University and author of You and Your Adolescent: The Essential guide for ages 10 to 25 (personal communication, June 9, 2011), as quoted in "Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 13.
http://www.casacolumbia.org...

26. Prevalence of Marijuana Use among People in the US Aged 12 or Older

In 2015:
an estimated 117,865,000 people aged 12 or older in the US had tried marijuana at least once in their lifetimes.
an estimated 36,043,000 people aged 12 or older in the US had tried marijuana at least once in the past year.
an estimated 22,226,000 people aged 12 or older in the US had tried marijuana at least once in the past month.

Click here for the complete datatable "Marijuana Use in Lifetime, Past Year, and Past Month among Persons in the US Aged 12 or Older, by Demographic Characteristics: Number in Thousands"

Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD, p. 242, Table 1.33A.
https://www.samhsa.gov...
https://www.samhsa.gov...

27. Effect of Cannabis on Mortality

"In summary, this study showed little, if any, effect of marijuana use on non-AIDS mortality in men and on total mortality in women. The increased risk of AIDS mortality in male marijuana users probably did not reflect a causal relationship, but most likely represented uncontrolled confounding by male homosexual behavior. The risk of mortality associated with marijuana use was lower than that associated with tobacco cigarette smoking."

Stephen Sidney, MD, Jerome E. Beck, DrPH, Irene S. Tekawa, MA, Charles P Quesenberry, Jr, PhD, and Gary D. Friedman, MD, “Marijuana Use and Mortality.” American Journal of Public Health 87.4 (1997) pp. 589–590.
http://www.ncbi.nlm.nih.gov...

28. Prevalence of Marijuana Use in the US, by State, 2009-2010

"In 2009-2010, past month marijuana use was reported by 6.8 percent of the U.S. population aged 12 years or older, an increase from 6.4 percent in 2008-2009 (Table C.3). Nine States that were in the top fifth for past month illicit drug use among persons aged 12 or older also were ranked in the top fifth for past month marijuana use: Alaska, Colorado, District of Columbia, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont (Figures 2.1 and 2.9).
"Seven States were ranked in the top fifth for past month marijuana use in age groups 12 to 17, 18 to 25, 26 or older, and 12 or older: Colorado, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont (Figures 2.9 to 2.12). The rate of past month marijuana use in the 12 or older population ranged from 3.1 percent in Utah to 11.8 percent in Alaska (Table B.3). Utah had the lowest rate in all age groups. Between 2008-2009 and 2009-2010, past month marijuana use among persons 12 or older increased in 10 States: Colorado, District of Columbia, Idaho, Illinois, Massachusetts, Michigan, New Mexico, Oklahoma, Texas, and Washington (Table C.3). During the same time period, past month marijuana use increased in one State among 12 to 17 year olds (District of Columbia), eight States among 18 to 25 year olds (Florida, Illinois, Iowa, New Mexico, North Carolina, Oklahoma, Pennsylvania, and Washington), and four States among persons aged 26 or older (District of Columbia, Idaho, Michigan, and Texas). Decreases only occurred in two States: Tennessee, among persons aged 12 or older, and Utah, among youths aged 12 to 17. All four census regions had higher rates of past month marijuana use among persons aged 12 or older in 2009-2010 compared with 2008-2009."

Substance Abuse and Mental Health Services Administration, State Estimates of Substance Use and Mental Disorders from the 2009-2010 National Surveys on Drug Use and Health, NSDUH Series H-43, HHS Publication No. (SMA) 12-4703. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.
http://www.samhsa.gov...
http://www.samhsa.gov...

29. The NY Times On Marijuana And Health

"For Michele Leonhart, the administrator of the Drug Enforcement Administration, there is no difference between the health effects of marijuana and those of any other illegal drug. 'All illegal drugs are bad for people,' she told Congress in 2012, refusing to say whether crack, methamphetamines or prescription painkillers are more addictive or physically harmful than marijuana.
"Her testimony neatly illustrates the vast gap between antiquated federal law enforcement policies and the clear consensus of science that marijuana is far less harmful to human health than most other banned drugs and is less dangerous than the highly addictive but perfectly legal substances known as alcohol and tobacco. Marijuana cannot lead to a fatal overdose. There is little evidence that it causes cancer. Its addictive properties, while present, are low, and the myth that it leads users to more powerful drugs has long since been disproved.
"That doesn’t mean marijuana is harmless; in fact, the potency of current strains may shock those who haven’t tried it for decades, particularly when ingested as food. It can produce a serious dependency, and constant use would interfere with job and school performance. It needs to be kept out of the hands of minors. But, on balance, its downsides are not reasons to impose criminal penalties on its possession, particularly not in a society that permits nicotine use and celebrates drinking."

The New York Times, "What Science Says About Marijuana," by Philip M. Boffey, July 30, 2014.
http://www.nytimes.com...

30. Early Initiation of Substance Use

“When initiation of substance use occurs in preadolescence or early in adolescence, the risk of addiction is magnified.8 CASA’s analysis of national data finds that individuals‡ who first used any addictive substance before age 15 are six and a half times as likely to have a substance use disorder as those who did not use any addictive substance until age 21 or older (28.1 percent vs. 4.3 percent).”

"Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 38
http://www.casacolumbia.org...

31. Alcohol Use v Marijuana Use - US Youth and "The Displacement Hypothesis"

"Alcohol and marijuana are the two most commonly used substances by teenagers to get high, and a question that is often asked is to what extent does change in one lead to a change in the other. If the substances co-vary negatively (an increase in one is accompanied by a decrease in the other) they are said to be substitutes; if they co-vary positively, they are said to be complements. Note that there is no evidence that the 13-year decline in marijuana use observed between 1979 and 1992 led to any accompanying increase in alcohol use; in fact, through 1992 there was some parallel decline in annual, monthly, and daily alcohol use, as well as in occasions of heavy drinking among 12th graders, suggesting that the two substances are complements. Earlier, when marijuana use increased in the late 1970s, alcohol use also increased. As marijuana use increased again in the 1990s, alcohol use again increased with it, although not as sharply. In sum, there has been little evidence from MTF over the years that supports what we have termed 'the displacement hypothesis,' which asserts that an increase in marijuana use will somehow lead to a decline in alcohol use, or vice versa.8 Instead, both substances appear to move more in harmony, perhaps both reflecting changes in a more general construct, such as the tendency to use psychoactive substances, whether licit or illicit, or in the frequency with which teens party. However, with alcohol use decreasing and marijuana use increasing over the past few years, it is possible that the displacement hypothesis is gaining some support. As a number of states are changing their policies regarding marijuana, our continued monitoring will provide the needed evidence concerning whether alcohol and marijuana are substitutes or complements."

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2015). Monitoring the Future national survey results on drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, pp. 161-162.
http://monitoringthefuture.org...
http://monitoringthefuture.org...

32. Marijuana Use Among 50-Year-Olds in the US

"Among 50-year-old high school graduates in 2012, we estimate that about three quarters (74%) have tried marijuana, and that about two thirds (64%) have tried an illicit drug other than marijuana. (These estimates are adjusted to correct for panel attrition, as described in chapter 4 of Volume II.)
"Their current behavior is far less extreme than those statistics might suggest, but it is not by any means negligible. One in eight (12%) indicates using marijuana in the last 12 months, and one in ten (10%) indicates using any other illicit drug in the same period. Their past-month prevalence rates are lower—7.3% and 6.2%, respectively, for marijuana and any other illicit drug. About 1 in 43 (2.3%) is a current daily marijuana user, though substantially more indicate that they have used marijuana daily at some time in the past."

Johnston, L. D., O’Malley, P. M., Bachman, J. G., and Schulenberg, J. E., (2013). Monitoring the Future national survey results on drug use, 1975–2012: Volume 2, College students and adults ages 19–50. Ann Arbor: Institute for Social Research, The University of Michigan, p. 37.
http://www.monitoringthefuture...

33. Daily Marijuana, Alcohol, and Tobacco Use Among 19-30 Year Olds in the US

"Daily marijuana use held steady at 6.8% in 2015 among young adults, but that is triple the rate in 1992 (2.3%), the low point since estimates for this age group first became available in 1986. The 2014 and 2015 rates are the highest levels of daily use ever observed in this young adult population since tracking of their use began 29 years ago."

Click here for complete datatable of Thirty-Day Prevalence of Daily Marijuana, Alcohol, and Tobacco Use Among 19-30 Year Olds in the US

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2016). Monitoring the Future national survey results on drug use, 1975-2015: Volume 2, College students and adults ages 19–55. Ann Arbor: Institute for Social Research, The University of Michigan, p. 141, and Table 4-5, p. 117. Available at http://monitoringthefuture.org...
http://monitoringthefuture.org...

34. Lower Opioid Overdose Mortality Rates In States With Medical Cannabis Laws

"Although the mean annual opioid analgesic overdose mortality rate was lower in states with medical cannabis laws compared with states without such laws, the findings of our secondary analyses deserve further consideration. State-specific characteristics, such as trends in attitudes or health behaviors, may explain variation in medical cannabis laws and opioid analgesic overdose mortality, and we found some evidence that differences in these characteristics contributed to our findings. When including state-specific linear time trends in regression models, which are used to adjust for hard-to-measure confounders that change over time, the association between laws and opioid analgesic overdose mortality weakened. In contrast, we did not find evidence that states that passed medical cannabis laws had different overdose mortality rates in years prior to law passage, providing a temporal link between laws and changes in opioid analgesic overdose mortality. In addition, we did not find evidence that laws were associated with differences in mortality rates for unrelated conditions (heart disease and septicemia), suggesting that differences in opioid analgesic overdose mortality cannot be explained by broader changes in health. In summary, although we found a lower mean annual rate of opioid analgesic mortality in states with medical cannabis laws, a direct causal link cannot be established."

Bacchuber, Marcus A., MD; Saloner, Brendan, PhD; Cunningham, Chinazo O., MD, MS; and Barry, Colleen L., PhD, MPP. "Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010." JAMA Intern Med. doi:10.1001/jamainternmed.2014.4005. Published online August 25, 2014.
jamanetwork.com...

35. Estimated Prevalence of Cannabis Dependence or Abuse in the US

"• Marijuana was the illicit drug with the largest number of persons with past year dependence or abuse in 2013, followed by pain relievers, then by cocaine. Of the 6.9 million persons aged 12 or older who were classified with illicit drug dependence or abuse in 2013, 4.2 million persons had marijuana dependence or abuse (representing 1.6 percent of the total population aged 12 or older, and 61.4 percent of all those classified with illicit drug dependence or abuse), 1.9 million persons had pain reliever dependence or abuse, and 855,000 persons had cocaine dependence or abuse (Figure 7.2)."
"• The number of persons who had marijuana dependence or abuse in 2013 (4.2 million) was similar to the number in 2012 (4.3 million) and in each year from 2002 through 2011 (ranging from 3.9 million to 4.5 million) (Figure 7.3). The rate of marijuana dependence or abuse in 2013 (1.6 percent) was lower than the rates in 2002 (1.8 percent) and 2004 (1.9 percent). Otherwise, the rate in 2013 was similar to the rates in prior years (ranging from 1.6 to 1.8 percent).
"• The number of persons who had pain reliever dependence or abuse in 2013 (1.9 million) was similar to the number in 2012 (2.1 million) and in each year from 2006 through 2011 (ranging from 1.6 million to 1.9 million) (Figure 7.3). However, the number in 2013 was higher than the numbers in 2002 to 2005 (ranging from 1.4 million to 1.5 million)."

Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014, p. 83.
http://www.samhsa.gov...
http://www.samhsa.gov...

36. Estimated Prevalence of Cannabis Dependence

"Some 4.3 percent of Americans have been dependent on marijuana, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000), at some time in their lives. Marijuana produces dependence less readily than most other illicit drugs. Some 9 percent of those who try marijuana develop dependence compared to, for example, 15 percent of people who try cocaine and 24 percent of those who try heroin. However, because so many people use marijuana, cannabis dependence is twice as prevalent as dependence on any other illicit psychoactive substance (cocaine, 1.8 percent; heroin, 0.7 percent; Anthony and Helzer, 1991; Anthony, Warner, and Kessler, 1994)."

Budney A, Roffman R, Stephens R, Walker D. Marijuana dependence and its treatment. Addiction Science and Clinical Practice. 2007;4(1):4–16.
http://www.ncbi.nlm.nih.gov...
http://www.ncbi.nlm.nih.gov...

37. Admissions to Treatment for Marijuana in the US

According to the Substance Abuse and Mental Health Service's Treatment Episode Data Set, in 2015 in the US there were 213,001 admissions to treatment with marijuana reported as the primary substance of abuse out of the total 1,537,025 admissions to treatment in the US for those aged 12 and older for all substances that year. This is the lowest number of marijuana admissions and total treatment admissions in at least a decade: marijuana admissions peaked in 2009 at 373,338, and total admissions peaked in 2008 at 2,074,974.

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2005-2015. National Admissions to Substance Abuse Treatment Services. BHSIS Series S-91, HHS Publication No. (SMA) 17-5037. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2017, Table 1.1A, p. 47.
https://www.samhsa.gov/data/si...

38. Daily/Frequent Marijuana Use in the US

"In 2011, an estimated 16.7 percent of past year marijuana users aged 12 or older used marijuana on 300 or more days within the past 12 months. This translates into nearly 5.0 million persons using marijuana on a daily or almost daily basis over a 12-month period.
"• In 2011, an estimated 39.1 percent (7.1 million) of current marijuana users aged 12 or older used marijuana on 20 or more days in the past month. This was similar to the 2010 estimate of 39.8 percent or 6.9 million users."

Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012, p. 27.
http://www.samhsa.gov...

39. Difficulties in Assessing "Problem" Marijuana Use

"The issues of measurement and conceptualization described above in relation to efforts to screen for problematic or harmful cannabis use highlight the shortcomings of ‘one-size-fits-all’ approaches to screening. Our examination of the existing literature and of cannabis users from a general population study and from a mixed-methods study of adult, stable, socially integrated users suggests that many cannabis users who may otherwise meet the criteria for being at moderate risk for problematic use are nonetheless able to successfully integrate cannabis use into everyday life with few associated problems. Indeed, our findings advocate that regular use of small amounts of cannabis does not appear to increase an individual’s likelihood of experiencing problems, and it does not threaten one’s ability to function well and perform expected roles. Even so, the tools used to assess potentially harmful cannabis use invariably serve to classify almost all ‘regular’ users as problematic users."

Asbridge M, Duff C, Marsh D, C, Erickson P, G, Problems with the Identification of ‘Problematic' Cannabis Use: Examining the Issues of Frequency, Quantity, and Drug Use Environment. Eur Addict Res 2014;20:254-267.
https://www.ncbi.nlm.nih.gov/p...
https://www.karger.com/Article...

40. Racial Bias In Marijuana Arrests

"In 1990, half of California’s marijuana possession arrestees were African-American, Latino, Asian, or other nonwhite and 35% were under age 20. In 2010, 64% were nonwhite and 52% were under age 20. Marijuana possession arrests of teenagers of color rose from 3,100 in 1990 to 16,400 in 2010 – an arrest surge 300% greater than population growth in that group."

Males, Mike, "Misdemeanor marijuana arrests are skyrocketing and other California marijuana enforcement disparities," Center on Juvenile and Criminal Justice (San Francisco, CA: November 2011), p. 2.
http://www.cjcj.org...

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