In March, Nebraska’s Republican Gov. Pete Ricketts alleged: “If you legalize marijuana, you’re going to kill your kids.”

But actual studies of adult-use states keep showing no or little effect on teen use, and now—hospital admissions.

A November 2020 report from the Centers for Disease Control and Prevention found far fewer teens going to the hospital for pot as adult-use laws took effect nationwide.

The CDC report found “a precipitous national decline in adolescent treatment admissions, particularly in states legalizing recreational marijuana use,” states study author Jeremy Mennis, Ph.D.

“7 of 8 states with recreational legalization during the study period fall into the class with the steepest level of admissions decline.”

—Centers for Disease Control, 2020

CDC data aligns with most surveys

As legalization throttled up from 2008 to 2017, teens going to the hospital for pot treatment plummeted from about 60 cases per 100,000 to 31. Furthermore, legalization states led the way: “7 of 8 states with recreational legalization during the study period fall into the class with the steepest level of admissions decline.”

The bulk of the research continues to suggest legalizing pot for adults age 21 and older has not enticed more teens to a life of weed.

The CDC data comports with a study published in the Journal of the American Medical Association (JAMA) Pediatrics in 2019 that surveyed 1.4 million kids and concluded, “consistent with the results of previous researchers, there was no evidence that the legalization of medical marijuana encourages marijuana use among youth.”

Similarly, a study published this month in the journal Substance Abuse also showed a decline in adolescent cannabis use in states with medical marijuana laws.

“The data on this issue is clear, consistent, and available. Those who continue to push this unsubstantiated narrative are either woefully ignorant or willfully ignorant.”

Paul Armentano, NORML Deputy Director

Beau Kilmer, director of the RAND Drug Policy Research Center, and a senior policy researcher at the RAND Corporation said: “With respect to recreational cannabis legalization, the bulk of the peer-reviewed research suggests that it’s not associated with an increase in the past-month prevalence so far, and some studies suggest a decrease.”

NORML Deputy Director Paul Armentano said, “The data on this issue is clear, consistent, and available. Those who continue to push this unsubstantiated narrative are either woefully ignorant or willfully ignorant.”

Legalization critics not buying it

Conversely, Lynn Silver, a California pediatrician, who leads the anti-marijuana group Getting it Right From the Start, called studies showing teen marijuana use going down a “gross simplification and not reflecting current data.”

Getting It Right From the Start trumpets health concerns in support of banning many cannabis extracts, as well as all events, and advertising on packages, and capping the number of local stores.

Dueling national surveys

Silver points to the 2019 National Survey on Drug Use and Health which shows an uptick in teen cannabis use.

Two different national surveys on teen marijuana use show flat or slightly rising rates. (NSDUH, 2020)
Two different national surveys on teen marijuana use show flat or slightly rising rates. (NSDUH, 2020)

“Some of the early studies did not find decreases in youth use, but more recent ones are finding increases and particularly in sub-areas like vaping where the potency is much higher than a traditional joint,” Silver said. “The data is complex, but I would say the balance right now is telling us to worry more than not to worry.” 

“I wouldn’t say 100% of the data points in one direction, but enough of it points in the direction of increases, it’s a real cause for concern,” she said. “There are some studies that found declines, but I would say the larger national studies, certainly for vaping, give cause for concern.”

Monitoring the Future: Kids are OK

Contradicting Silver, results of the longtime national study from Monitoring the Future (MTF) also indicate an overall decline in youth using marijuana. Teen weed vaping went up in some age groups from 2018-2019, but not in 2020.

The national Monitoring the Future survey shows teen use rates flat amid the rise of legalization in 2012. Teen use peaked during prohibition in the '70s. (Monitoring the Future)
The national Monitoring the Future survey shows teen use rates flat amid the rise of legalization in 2012. Teen use peaked during prohibition in the ’70s. (Monitoring the Future)

“Use levels in 2020 were slightly lower than they were in 1996-97, after a decline of about ten percentage points through 2007-2008 and some subsequent rebound, with little change in 2020.”

CHKS also shows healthy kids

Furthermore, the most recent California Healthy Kids Survey (CHKS), showed a decline in teen pot use amid legalization.

The California Healthy Kids Survey shows teen use falling or flat amid widespread medical and adult-use access for adults age 21 and over. (California Healthy Kids Survey)
The California Healthy Kids Survey shows teen use falling or flat amid widespread medical and adult-use access for adults age 21 and over. (California Healthy Kids Survey)

Silver counters that the decline has leveled off, and teen vaping is up.

“This suggests that the previous declines in reported marijuana use might reflect that asking just about use, in general, was not capturing the rising number of users consuming marijuana via vaping or oral ingestion,” the report states.

Dueling journal articles

Another drug law reform critic, Project SAM, points to a study—published by the Journal of Studies of Alcohol and Drugs—that did show a rise in adolescent marijuana use in California since cannabis was legalized for adult-use in 2016.

NORML said the study is flawed. 

“The reality is that this one particular study is inconsistent with the overwhelming majority of the relevant literature, which is why it is the only study opponents cite on the subject,” Armentano said.

Teen report lower access to cannabis amid adult-use and medical legalization than during prohibition. Dispensaries check IDs, high school dealers don't. (Monitoring the Future)
Teens report lower access to cannabis amid adult-use and medical legalization than during prohibition. Dispensaries check IDs, high school dealers don’t. (Monitoring the Future)

A separate peer-reviewed analysis of California data, also published this year in the journal Addictive Behaviors, undercuts Project SAM’s claims.

“Findings suggest legalization of recreational marijuana sales had a negligible overall impact on days of use among young adults but may have prompted increased interest in marijuana among some, particularly women and e-cigarette users.”

‘Small’ uptick in ‘cannabis use disorder’

So teens aren’t going to the hospital for pot, and they’re not using it more in most surveys, but are the ones who are using it doing worse?

Kilmer noted one study from JAMA Psychiatry in 2020 looking at “cannabis use disorder” found a “small” increase in teens having trouble stopping pot.

Disorders increased in the age 12 to 17 group—going from 2.18% of that population to 2.72%.

Dr. Jami Wolf-Dolan, a psychologist based in New York City, looks for signs such as using larger amounts for longer than intended and the inability to manage things such as work, home, and school.

Related

Is cannabis addictive?

“Essentially, if you are noticing that you are becoming increasingly reliant on marijuana as a coping skill to manage stress; numb out; avoid; reduce anxiety,” she said.

Teens who use cannabis are at risk for impairing their cognitive skills and memory, she claims.

But, as always, such claims have to be backed up by empirical findings.

Actual scans of former teen stoner brains published in 2019 in the journal Drug and Alcohol Dependence “found no differences in adult brain structure” among the subjects who reported heavy cannabis use in their youth, those who reported a variety of occasional use, and those who reported no use, the researchers wrote.

Drug War propaganda from the 1930s alleged marijuana was an “assassin of youth,” when in reality, the War on Drugs remains an assassin of truth.

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Ellen Holland

Ellen Holland is an Oakland-based journalist who has written about cannabis since 2013. A former senior editor at Cannabis Now magazine, she also edits books about marijuana strains and cultivation.

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