From Prohibition to Progress: What We Know About Marijuana Legalization in Eight States and D.C.

Media contact.

Contact: Jag Davies 212-613-8035 Jolene Forman 510-679-2316

Congress and numerous states are moving to legalize marijuana this year, building on positive outcomes in Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, Washington state, and Washington, D.C. In Vermont , Governor Phil Scott is expected to sign the state’s marijuana legalization bill between now and Monday, making it the 9th state to legalize marijuana – and the first to do so via state legislature – in a rebuke to Attorney General Jeff Sessions, who rescinded Obama-era guidance this month allowing states to implement their own marijuana laws with limited federal interference.   A new report by the Drug Policy Alliance, From Prohibition to Progress: A Status Report on Marijuana Legalization , demonstrates how and why marijuana legalization is working so far.

On Tuesday, January 23 at 1pm (ET) / 10am (PT) , DPA will host a press teleconference to discuss the report’s findings with key policymakers and elected officials:

  • Jolene Forman, Staff Attorney, Drug Policy Alliance (report author)
  • Reggie Jones-Sawyer, California State Assembly Member and author of the Legal Cannabis Protection Act
  • Colorado State Representative Jonathan Singer
  • Shaleen Title, Commissioner, Massachusetts Cannabis Control Commission
  • Roseanne Scotti, Senior Director of Resident States and New Jersey State Director, Drug Policy Alliance (moderator)

Additional speakers will be announced Monday.

Members of the press are invited to join Tuesday’s teleconference – please contact Tony Newman for call-in info.

From Prohibition to Progress finds that states are saving money and protecting the public by comprehensively regulating marijuana for adult use. There have been dramatic decreases in marijuana arrests and convictions, saving states millions of dollars and preventing the criminalization of thousands of people.

Marijuana legalization is having a positive effect on public safety and health. Youth marijuana use has remained stable in states that have legalized. Access to legal marijuana is associated with reductions in some of the most troubling harms associated with opioid use, including opioid overdose deaths and untreated opioid use disorders. DUI arrests for driving under the influence, of alcohol and other drugs, have declined in Colorado and Washington, the first two states to legalize marijuana. At the same time, states are exceeding their marijuana revenue estimates and filling their coffers with hundreds of millions of dollars.

“Marijuana criminalization has been a massive waste of money and has unequally harmed Black and Latino communities,” says Jolene Forman , staff attorney at the Drug Policy Alliance. “This report shows that marijuana legalization is working. States are effectively protecting public health and safety through comprehensive regulations. Now more states should build on the successes of marijuana legalization and advance policies to repair the racially disparate harms of the war on drugs.”

The Drug Policy Alliance has launched campaigns to legalize, tax and regulate marijuana in New Jersey , New York , and New Mexico , which are among several states considering legalization measures this year.

“This report answers the questions that elected officials and the public have been asking about how marijuana legalization has worked in other states,” said Roseanne Scotti , Senior Director of Resident States and New Jersey State Director for the Drug Policy Alliance. “The findings are extremely positive and provide important lessons on how New Jersey can structure its marijuana legalization law so that it will be fair and equitable and provide benefits for all New Jersey residents.”

“As New York moves to study the implications of legalizing marijuana for adult use, as Gov. Cuomo announced this week, we would be wise to learn from the experiences of the states that have done so successfully,” said Kassandra Frederique , New York State Director for the Drug Policy Alliance. “There is ample evidence that ending marijuana prohibition is a smart way to uphold people’s rights by slashing arrests, while shielding against opioid overdose deaths and supporting sustainable economic growth. Ultimately, the best way to address the disparities and challenges posed by prohibition is to create a system to tax and regulate marijuana that will repair and reinvest in communities that have been most harmed by New York’s marijuana arrest crusade.”

“Legalizing marijuana for adult use is an opportunity to grow New Mexico’s economy, keeping us true to our values and what we care most about: the wellbeing of our children, healthy communities, and a robust economic future for our state,” said Emily Kaltenbach , New Mexico State Director for the Drug Policy Alliance. “Equally importantly, by directing reinvestment into communities most harmed by the drug war, legalization can begin to repair some of the harms of prohibition that have fallen hardest on Hispanic/Latino, Black and Native populations in New Mexico.”

The report’s key findings include:   Marijuana arrests are down . Arrests for marijuana in all legal marijuana states and Washington, D.C. have plummeted, saving states hundreds of millions of dollars and sparing thousands of people from being branded with lifelong criminal records.

  • The total number of low-level marijuana court filings in Washington fell by 98 percent between 2011 and 2015.
  • The total number of marijuana‐related court filings in Colorado declined by 81 percent between 2012 and 2015, and marijuana possession charges dropped by 88 percent.
  • In Washington, D.C., marijuana arrests decreased 76 percent from 2013 to 2016, with possession arrests falling by 98.6 percent.
  • In Oregon, the number of marijuana arrests declined by 96 percent from 2013 to 2016.
  • In Alaska, the number of marijuana arrests for possession and sales/manufacturing declined by 93 percent from 2013 to 2015.

Youth marijuana use is stable . Youth marijuana use rates have remained stable in states that have legalized marijuana for adults age 21 and older.

  • In Washington, Colorado and Alaska, rates of marijuana use among high school students largely resemble national rates. These results are promising, suggesting that fears of widespread increases in use have not come to fruition.
  • In Oregon, Nevada, California, Maine, Massachusetts and Washington, D.C., marijuana regulatory programs are not yet established or are so new that they are unlikely to have affected youth use rates in an immediately measurable way. While rates of use vary widely in these states, they have mostly stabilized or declined over the years leading up to legalization.

Marijuana legalization is linked to lower rates of opioid-related harm . Increased access to legal marijuana has been associated with reductions in some of the most troubling harms associated with opioids, including opioid overdose deaths and untreated opioid use disorders.

  • In states with medical marijuana access, overdose death rates are almost 25 percent lower than in states with no legal access to marijuana, and the reductions in overdose death rates strengthened over time.
  • Legal access to medical marijuana has been associated with a 23 percent reduction in opioid dependence or abuse-related hospitalizations and 15 percent fewer opioid treatment admissions.
  • An analysis of opioid overdose deaths in Colorado found that after marijuana was legalized for adult use there was a reduction of 0.7 deaths per month in the state and that the decades-long upward trend of overdoses began to decline after 2014, the first year of marijuana retail sales in the state.

Calls to poison control centers and visits to emergency departments for marijuana exposure remain relatively uncommon .

  • In Oregon, less than one percent of calls to the state’s poison centers in 2016 were related to marijuana exposure.
  • In Colorado, less than one tenth of one percent (0.04 percent) of the state’s 2.3 million emergency department visits in 2014 were for marijuana exposure.

Legalization has not made our roads less safe .

  • DUI arrests are down in Colorado and Washington. The total number of arrests for driving under the influence, of alcohol and other drugs, has declined in Colorado and Washington, the first two states to regulate marijuana for adult use.
  • There is no correlation between marijuana legalization and crash rates. The crash rates in both states are statistically similar to comparable states without legal marijuana.

Marijuana tax revenues are exceeding initial estimates . Marijuana sales in Colorado, Washington, Oregon, Alaska, and most recently in Nevada, began slowly as consumers and regulators alike adjusted to new systems. Once up and running, however, overall sales and tax revenue in each state quickly exceeded initial estimates. (Sales in California started on January 1, 2018, and no data are available yet. Sales in Massachusetts will not begin until July 2018. Sales in Maine are on hold pending approval of an implementation bill for the state’s regulated marijuana program. In D.C. no retail cultivation, manufacturing or sales are permitted at this time.)

  • Marijuana sales in Washington generated $315 million in tax revenues in the 2016-17 fiscal year.
  • Marijuana sales have generated almost $600 million for Colorado since sales began on January 1, 2014.
  • By the end of the 2016-17 fiscal year, Oregon collected $70 million, more than double the predicted revenue.

States are allocating marijuana tax revenues for social good .

  • Colorado distributed $230 million to the Colorado Department of Education between 2015 and 2017 to fund school construction, early literacy, bullying prevention, and behavioral health.
  • Oregon allocates 40 percent of marijuana tax revenue to its state school fund, depositing $34 million into the fund so far. The state also distributes 20 percent to alcohol and drug treatment.
  • Nevada’s 15 percent wholesale tax is projected to bring in $56 million over the next two years to fund state schools.
  • Washington dedicates 25 percent to substance use disorder treatment, education and prevention. The state also distributes 55 percent of its marijuana tax revenues to fund basic health plans.
  • Alaska will collect an estimated $12 million annually, which will fund drug treatment and community residential centers.
  • California and Massachusetts will invest a share of their marijuana tax revenues in the communities most adversely impacted by drug arrests and incarceration, particularly low-income communities of color, to help repair the harms of unequal drug law enforcement.

The marijuana industry is creating jobs . Preliminary estimates suggest that the legal marijuana industry employs between 165,000 to 230,000 full and part-time workers across the country. This number will only continue to grow as more states legalize marijuana and replace their unregulated markets with new legal markets.   The report also includes considerations for policymakers and advocates going forward:   We need to foster equity in the marijuana industry . The communities most harmed by marijuana criminalization have struggled to overcome the many barriers to participation in the legal industry. Some states and cities, however, are implementing rules to help increase equity and reduce barriers to entry in the marijuana industry.

  • Massachusetts is adopting rules aimed at ensuring that people most harmed by marijuana criminalization can participate in the regulated market.
  • In California, a prior drug felony cannot be the sole basis for denying a marijuana license. This mitigates the harms to low-income, Black, and Latino people who have borne decades of disproportionate arrests and convictions for marijuana offenses.

We need to reduce racial disparities and reform police practices . While marijuana legalization dramatically reduces the number of people arrested for marijuana offenses, it clearly does not end racially disparate policing. Police practices must be reformed to fully remedy the unequal enforcement of marijuana laws. It is widely documented that there are vast racial disparities in the enforcement of marijuana laws. Black and Latino people are far more likely to be arrested for marijuana offenses than white people, despite similar rates of use and sales across racial groups.   We need to establish safe places for people to use marijuana . Consuming marijuana in public is illegal in all jurisdictions that have legalized marijuana for adults 21 and older. It is a misdemeanor in Nevada and Washington, D.C., and a civil penalty subject to fines and fees in all other states. This means that people who lack the means to pay the fines and fees, or those without homes or in federally-subsidized housing, risk being jailed for consuming a lawful substance. Public use violations are also disproportionately enforced against people of color, particularly Black people.   We need to promote marijuana decriminalization and penalty reductions for youth and young adults . In several states, marijuana legalization has had the unintended consequence of reducing historically high numbers of youth (under 18 years of age) and young adults (between 18 and 20 years old) stopped and arrested for marijuana offenses. However, these reductions are inconsistent from state-to-state. In some circumstances, youth now comprise a growing number of people charged with marijuana offenses. California’s approach is too new to be evaluated, but it appears to be a good step toward reducing youth and young adults’ risk of criminal justice involvement for marijuana-related conduct:

  • In California, youth under the age of 18 may only be charged with civil infractions for marijuana offenses. They are no longer threatened with incarceration or financial penalties. Instead, they are required to attend drug awareness education, counseling, or community service.
  • All marijuana offenses will be automatically expunged from a young person’s record when they turn 18.
  • The penalties for most marijuana-related activities were either decriminalized or reduced for young adults 18-to-20 years old.

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UN drug report shines light on cannabis, cocaine and methamphetamine trends

Cannabis legalization in parts of the world appears to have accelerated daily use and related health impacts, according to the UN Office on Drugs and Crime (UNODC)’s World Drug Report 2022.

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Legalized cannabis use in some countries and states appears to have accelerated daily use and related health impacts, the UN Office on Drugs and Crime (UNODC) revealed in a new report released on Monday.

The World Drug Report 2022 also details the environmental consequences of the illicit drugs trade, the expansion of synthetic drugs to new markets, and an all-time high in cocaine production.

“ Numbers for the manufacturing and seizures of many illicit drugs are hitting record highs , even as global emergencies are deepening vulnerabilities,” said UNODC chief Ghada Waly.

“At the same time, misperceptions regarding the magnitude of the problem and the associated harms, are depriving people of care and treatment and driving young people towards harmful behaviours”.

Out now! The 2022 #WorldDrugReport offers a deep dive into cannabis legalization and the impacts of drugs on the environment.The report also takes a closer look at the data on drugs and conflict.Read it here to #CareInCrises: https://t.co/yY3jjLU49f pic.twitter.com/tzR9gj2Zag UN Office on Drugs & Crime UNODC

Global overview

The report outlined that some 284 million 15 to 64-year-olds used drugs in 2020, indicating a 26 per cent increase during the course of a decade.

Globally, 11.2 million people were estimated to inject drugs, around half of whom were living with hepatitis C; 1.4 million with HIV, and 1.2 million with both.

In Africa and Latin America, those under 35 represent most of the people being treated for drug use disorders .  

Repercussions of cannabis legalization

In North America, legalized cannabis on a state level – especially new potent products containing elevated levels of high-inducing THC - appears to have increased daily usage, particularly among young adults.

In addition to increasing tax revenues, it has also caused a reported surge among people with psychiatric disorders, increased suicides and hospitalizations while generally reducing possession arrests. 

Cocaine, meth and opium

In 2020, global cocaine manufacturing grew 11 per cent from the previous year to 1,982 tons and, despite the COVID-19 pandemic, seizures increased to a record 1,424 tons.

Nearly 90 per cent of cocaine seized last year was trafficked via land and/or sea, reaching regions beyond the regular markets of North America and Europe.

Methamphetamine (or meth) trafficking continued to expand geographically , with 117 countries reporting seizures between 2016 and 2020, versus 84 from 2006‒2010, with volume growing an astonishing five-fold, between 2010 and 2020.

While the global area being used for opium poppy cultivation fell globally by 16 per cent to 246,800 hectares between 2020 and 2021, increased Afghan production triggered a seven per cent jump to 7,930 tons during that period. 

Key drug trends

Most people in drug rehabilitation throughout Africa and South and Central America are primarily being treated for cannabis abuse while those in eastern and south-eastern Europe and central Asia, most often require help for the misuse of opioids.

In the United States and Canada, overdose deaths, predominantly driven by an epidemic of the non-medical use of fentanyl – which can be fatal in tiny doses, and is commonly used to ‘cut’ other drugs such as street cocaine - continue to break records.

Estimates in the US point to more than 107,000 drug overdoses last year, up from nearly 92,000 in 2020 .

Conflict zone magnets

Meanwhile, the report reveals data from the Middle East and Southeast Asia suggesting that conflict can act as magnets for synthetic drug manufacturing, which may increase if the violence is close to large consumer markets.  

Historically, parties to conflict have often used illegal drug profits to finance war.

Conflicts may also disrupt and shift drug trafficking routes, as has happened in the Balkans and most recently in Ukraine, since Russia annexed Crimea and separatists took control of areas of the east in 2014.

Indoor cannabis leaves a carbon footprint between 16 and 100 times greater than outdoor cannabis.

Reported clandestine laboratories in Ukraine have skyrocketed from 17 dismantled in 2019, to 79 in 2020 – 67 of which were producing amphetamines – the highest number of disassembled labs reported in any given country, in 2020.  

Environmental impacts

The carbon footprint of indoor cannabis is between 16 and 100 times greater, than for outdoor cannabis, on average, according to the report – due to the intensive energy demands of artificial cultivation. And it is 30 times greater for lab-produced cocaine, than that for cocoa bean production.

Other environmental impacts include substantial deforestation associated with illicit coca cultivation; waste generated during synthetic drug manufacturing, which can be 5-30 times the volume of the end product; and dumping other waste that can affect soil, water and air directly.

Other organisms, animals and the overall food chain, suffer indirectly, said UNODC.

Gender treatment gap

Although women remain in the minority of drug users globally, their consumption rate increases more rapidly than men on average, said the report, and fewer get treatment.

They use an estimated 45-49 per cent of amphetamine and non-medical pharmaceutical stimulants, pharmaceutical opioids, sedatives, and tranquilizers.

And although women represent almost one in two amphetamines users, they constitute only one in five people in treatment for amphetamine use .

Moreover, they play a range of roles in the global cocaine economy, from cultivating coca to transporting small quantities and selling to consumers.

“We need to devote the necessary resources and attention to addressing every aspect of the world drug problem, including the provision of evidence-based care to all who need it, and we need to improve the knowledge base on how illicit drugs relate to other urgent challenges, such as conflicts and environmental degradation,” said UNODC chief Ghada Waly.

Global drug users as estimated in the World Drug Report 2022.

  • World Drug Report

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Drug Legalization and Decriminalization Beliefs Among Substance-Using and Non-using Individuals

Associated data, objectives:.

There has been advocacy for legalization of abusable substances, but systematic data on societal beliefs regarding such legalization are limited. People who use substances may have unique beliefs about legalization, and this study assessed whether they would be in favor of drug legalization/decriminalization. It was hypothesized that those who use particular drugs (especially marijuana) would support its legalization/decriminalization, but that this would not be the case across all classes (especially opioids and stimulants).

A nationwide sample of 506 adults were surveyed online to assess demographic characteristics, substance misuse, and beliefs regarding drug legalization/decriminalization. Legalization/decriminalization beliefs for specific drugs were assessed on an 11-point scale (0=strongly disagree; 10=strongly agree).

For persons with opioid misuse (15.4%), when asked about their agreement with: “heroin should be legalized,” the mean score was 4.6 (SEE= 0.4; neutral). For persons with stimulant misuse (12.1%), when asked about their agreement with: “cocaine should be legalized,” the score was 4.2(0.5). However, for persons with marijuana misuse (34.0%), when asked about their agreement with: “medical marijuana should be legalized” the score was 8.2 (0.3; indicating agreement), and for “recreational marijuana” the score was also 8.2(0.3).

Conclusions:

These results suggest that persons who used marijuana strongly support the legalization of both recreational and medical marijuana, whereas persons who primarily have opioid or stimulant misuse have less strongly held beliefs about legalization of substances within those respective categories. By including those who misuse drugs, these data assist in framing discussions of drug legalization and have the potential to inform drug policy considerations.

1.0. Introduction

Substance use is a major concern in both the United States (US) and abroad, with important consequences related not only to morbidity and mortality, but legal and economic concerns as well. In 2010, the Global Burden of Diseases, Injuries, and Risk Factors Study found that mental illness was the leading cause of years living with disability worldwide, with illicit substance use disorders (SUDs) and alcohol use disorders (AUDs) accounting for 11% and 10% of disability-adjusted life years within that category, respectively ( Whiteford et al., 2013 ). The 2016 National Survey on Drug Use and Health (NSDUH) estimates that 7.8% of adults in the US had a SUD during that year ( Center for Behavioral Health Statistics and Quality, 2017 ).

While much drug use remains illegal, there are growing efforts to legalize and/or decriminalize certain drug classes (such as marijuana and heroin), despite international drug treaties prohibiting the non-medical use of marijuana, cocaine, amphetamines, and heroin ( Hall, 2017 ). This is related, in part, to evidence that drugs such as marijuana or heroin, which had been previously categorized as having no medicinal value, may have potential medical benefit. These efforts are also premised upon the experiences of countries like Portugal, which decriminalized all illicit drugs in 2001 and reported subsequent decreases in drug-related societal problems, as well as support for legalizing drugs like marijuana for non-medical use in countries such as Canada and Uruguay ( Room, 2014 ; Goncalves et al., 2015 ; Cox, 2018 ). Several European countries and Canada have now endorsed the use of medicinal injectable and oral heroin (diacetylmorphine or diamorphine) as an effective medication for heroin use disorder among persons who are not otherwise responding to treatments ( Ayanga et al., 2016 ).

The US is beginning to demonstrate varied support for drug legalization and decriminalization. For instance, although not formally supported by the US federal government, eight states and the District of Columbia have legalized recreational marijuana, and twenty-nine states have legalized medicinal marijuana. However, systematic data on the opinions of Americans regarding the legalization/decriminalization of marijuana are lacking, and attitudes regarding the legalization/decriminalization of other substances are even sparser. Data show that the public’s opinions about marijuana seem to have changed over time ( Carliner et al., 2017 ), with 12% of the public supporting legalization in 1969 (based on survey data), compared with 61% per an online poll conducted in 2017 ( Geiger, 2018 ). Another recent online poll of registered US voters found that a modest majority (68%) was in support of legalization of marijuana for medical purposes, with 52% supporting its legalization for recreational purposes. However, this sample was vastly opposed to the legalization and decriminalization of other drugs (including cocaine, heroin, and methamphetamine), for both medical and recreational purposes ( Lopez, 2016 ).

Opinions about drug legalization/decriminalization can differ based on whether a person has a personal history of substance use and as a function of demographic and ideological characteristics (such a religious or political preference); these associations have only been evaluated in a few studies. The first such study was conducted in 2002 among 188 out-of-treatment persons who used substances, and persons who did not use substances, from low income, high drug-use sections of a US urban setting (Houston, TX), and reported that persons who used substances (marijuana, heroin, cocaine, or methamphetamine) were more likely to support the legalization of marijuana (68% in favor) than persons who did not use substances (33%), while each group showed little support for the legalization of heroin (12% vs. 8%) or cocaine (14% vs. 8%, respectively; Trevino and Richard, 2002 ). More recently, an online poll reported that Americans identifying as Democrats were more likely to be in favor of marijuana legalization (69%) than Republicans (43%). Also, white mainline Protestants were more in favor of marijuana legalization (64%) than white evangelical Protestants (38%) or Catholics (52%), while those who were not affiliated with any religion showed the highest support (78%; Geiger, 2018 ).

These polls have various limitations, and have not focused upon the attitudes and beliefs of people who use drugs. This population may have unique beliefs about legalization and/or decriminalization of a drug - either their drug of choice, or illicit drugs more broadly. The direct experience of using a drug might predispose a person to support more ready availability of that drug or, conversely, might make a person more cautious about decreasing barriers to its use. Survey data have demonstrated that opinions on drug legalization/decriminalization can differ based on the person’s belief system, such as varying as a function of political or religious affiliation. Persons who are generally more conservative may not be in favor of legalizing or decriminalizing substances. Surprisingly, there is little information on attitudes regarding legalization/decriminalization of drugs that systematically evaluates these domains. This study aimed to address this gap by surveying both persons who used substances and persons who did not use substances about their opinions regarding legalization and decriminalization of drugs, and to also evaluate whether differences in these attitudes were associated with different religious and political affiliations, or the lack thereof, as a secondary outcome. It was hypothesized that individuals who use marijuana would support the legalization and decriminalization of that drug, but that this would not be the case for heroin or cocaine among persons who used opioids or stimulants, respectively.

2.0. Methods

2.1. participants.

The sample was recruited online between July and November 2017. Participants (N=506) were registered as “workers” on the Amazon Mechanical Turk (AMT) platform ( Paolacci et al., 2010 ; Bartneck et al., 2015 ), which is an online forum where workers can anonymously complete tasks (such as surveys) assigned by “requestors” for a wage. Workers receive requestor approval ratings based on the quality of their work and completion time, which serves as an index of credibility and reliability ( Peer et al., 2014 ). To take the present survey, workers had to have an average requestor approval rating of 90% (as a quality control measure) and be located in the US. A short screening survey was given to ensure that participants were at least 18 years old, and it included other demographic questions, such as sex and race, to distract from the subject of the survey. The screening survey also limited the number of persons per category of primary substance used (including no use) using quotas, with a goal of obtaining at least 60 people in each primary substance category. A total of 2,672 persons attempted the screening survey, and 545 persons completed the primary survey. Those who were not eligible to continue on to the primary survey received $0.10 for completing the screening survey. After providing consent by agreeing to participate in the survey, those who answered questions in the primary survey received a bonus of two dollars, for a total of $2.10. The following quality control questions were included: 1) “Have you taken this survey before?” and 2) “Is there any reason for which we should not use your responses? For instance, you weren’t paying attention, you did not answer honestly, you had major computer issues, etc.” Those who answered “yes” to either of these questions were not included. The survey was hosted on Qualtrics (Provo, UT). The Johns Hopkins University Institutional Review Board approved the use of AMT for this survey research.

2.2. Measures

Demographic and drug use characteristics:.

Primary survey questions included demographic information such as education level, employment status, and income, as well as characteristics related to religious and political affiliations and whether the participant or someone close to them had ever experienced legal consequences related to substance use ( Table 1 ). Participants were asked whether they identified with a particular religion and to choose which major political party they identified with most among a list of the most common options; the options “none” and “other” were also provided. Additionally, participants were provided a list of substances and asked which they had used in the past year (including a write-in “other” option); for each substance they reported using, they were then asked to characterize use based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) SUD criteria ( American Psychiatric Association, 2013 ). Answering “yes” to two or more symptoms was operationalized as meeting criteria for a SUD for that substance. Participants who indicated using more than one substance in the past year were asked to identify which substance they would consider their primary substance; this was the basis upon which they were categorized for the remainder of the survey analyses.

Participant demographic data (N=506) 1

Decriminalization and Legalization Questions:

Participants were provided with definitions of legalization and decriminalization, and were then asked to rate their level of agreement with statements about legalization and decriminalization of heroin, cocaine, medical marijuana, and recreational marijuana on an 11-point scale with 0 representing “strongly disagree,” and 10 representing “strongly agree.” Some statements were worded in support of legalization/decriminalization of the substance while others were worded against legalization/decriminalization, to ensure participants were maintaining attention. Responses to the latter were reverse coded for consistency in reporting.

2.3. Statistical analyses

Participants were categorized into groups based on their self-reported primary substance used in the past year, with heroin and prescription painkiller misuse (taking pills other than how they were prescribed) collapsed into the “opioids” group; cocaine, methamphetamines, prescription stimulant misuse, or other stimulant use collapsed into the “stimulants” group; marijuana products, including synthetics, making up the “marijuana” group; any alcohol use included in the “alcohol” group; and no substance use in the “none” group. The degree to which demographic characteristics were associated with ratings for decriminalization/legalization was also assessed. Some demographic characteristics with multiple subgroups were dichotomized given limited numbers in some subgroups, including marital status (never married vs. ever married), race (minority vs. Caucasian), employment status (employed full time vs. other), education level (associates degree vs. less education), household income (less than or equal to $45,000 vs. more than $45,000) and political affiliation (Democrat vs. other).

Opinions on drug legalization and decriminalization as a function of primary substance used served as the primary analyses, while all others were secondary analyses. Categorical data, including demographics and SUD categorization were analyzed with chi-square analyses. Continuous data, such as age and drug legalization/decriminalization ratings, were analyzed with ANOVA or ANCOVA as appropriate. ANCOVAs controlled for those demographic variables that were significantly different among groups and showed a significant relationship with the outcome measure (see Table 2 ). Between-group planned comparisons of drug legalization/decriminalization ratings were compared between the primary substance categories, and then as a function of the group for whom the rating was deemed most relevant (e.g., ratings for heroin among persons who primarily used opioids, for cocaine among persons who primarily used stimulants, and for medical/recreational marijuana among persons who primarily used marijuana). Analyses used Type III sums of squares and planned comparisons among the primary substance use groups, and Pearson’s correlations to evaluate the relationship between legalization/decriminalization ratings. The primary outcome variables (legalization and decriminalization ratings) were not normally distributed. For the analyses in which we needed to control for certain demographic variables, ANCOVA were used as the main analyses, based on support for analyzing Likert data with parametric statistics ( Lubke and Muthén, 2004 ; De Winter and Dodou, 2010 ). The analyses by primary substance were significant when analyzed with Kruskal-Wallis tests, indicating that parametric and nonparametric statistics are approximately equivalent for these data. There were minor exceptions among the secondary analyses, but not the primary analyses. All analyses were performed in SPSS version 24.0. Statistical tests were considered significant at the p < 0.05 level.

Level of agreement with statements as a function of primary substance used 1

3.0. Results

3.1. participant characteristics.

A total of 506 participants completed the survey ( Table 1 ). Over the time of enrollment, the screening process targeted participants to ensure there were at least 60 subjects for each primary substance category. The final population had a mean age of 33.6 years old and was 53.0% male, 45.5% single (never married), and 25.9% racial minority (i.e., not Caucasian). Sixty-two percent of participants were employed full-time, 59.1% had at least an Associate’s degree, and 50.4% had a yearly household income of $45,000 or less. Among the total population, 36.4% of persons had experienced a legal consequence related to substance use among themselves or someone close to them. This was significantly more common among persons who used opioids (35.9%), stimulants (39.3%), marijuana (43.0%), or alcohol (36.4%), compared to those without substance use (19.5%). Participants were located in 43 states and the District of Columbia. For those persons who self-reported a primary substance used in the past year (N=429; 84.8%), a substantial proportion within each substance category reported symptoms meeting criteria for a SUD, including OUD (33/78; 42.3% of persons with opioid misuse), stimulant use disorder (25/61; 41.0%), marijuana use disorder (35/172; 20.3%), and AUD (39/118; 33.1%).

3.2. Preference for drug legalization and decriminalization of specific drug categories ( Table 2 )

3.2.1. heroin.

Overall, participants were not in favor of legalizing heroin (mean 3.8/10 for the total sample). However, persons whose primary substance was an opioid tended to have higher ratings (reflecting more positive attitudes) towards legalizing heroin (4.6/10) than persons who were classified as having primarily stimulant (3.3/10) or alcohol (3.4/10) use, as well as persons with no past-year substance use (3.4/10). The ratings of those with primary opioid misuse were similar to the ratings of persons with primary marijuana misuse with respect to attitudes towards heroin legalization (4.2/10). Ratings among all groups for decriminalization of heroin were even lower (total mean 2.9/10) indicating general lack of support. Persons who primarily misused opioids rated heroin decriminalization at 3.1 on average, which was not significantly different from other groups.

3.2.2. Cocaine

Similarly, the total sample of 506 persons was not in favor of cocaine legalization (3.8/10) or decriminalization (3.3/10). Persons with stimulant misuse rated cocaine legalization (4.2/10) and decriminalization (3.5/10) in a comparably low manner. Those who primarily used marijuana rated their agreement with cocaine decriminalization significantly higher (4.4/10), compared to those with primary alcohol use (2.8/10) and those with no use (2.8/10).

3.2.3. Marijuana

The total group of 506 participants was generally more in favor of the legalization and decriminalization of both medical (means for legalization = 7.2/10 and for decriminalization = 8.3/10) and recreational marijuana (legalization = 7.2/10 and decriminalization = 7.4/10), compared to legalization or decriminalization of heroin and cocaine. When examining the specific substance use groups, persons without any past-year substance use had lower ratings regarding legalization and decriminalization of marijuana, compared to other primary substance use groups. Conversely, persons with primary marijuana use had higher ratings for marijuana legalization (medical and recreational both = 8.2/10) and decriminalization (medical = 9.2/10 and recreational = 8.4/10).

3.3. Ratings as a function of primary substance used

This study hypothesized that respondents who identified a particular substance as their primary substance of use over the past year might be more inclined to see that substance legalized and/or decriminalized (particularly for marijuana). Results demonstrated that participants categorized as having primary opioid or stimulant misuse rated legalization and decriminalization of heroin and cocaine, respectively, at significantly lower values (indicating less endorsement) when compared to how those with primary marijuana use rated legalization and decriminalization of both medical and recreational marijuana (see corresponding cells of Table 2 ).

3.4. Religious characteristics

Whether persons identified with a particular religion or not proved to be an important variable among demographic characteristics, as well as legalization/decriminalization ratings (with religion serving as a covariate for those analyses). Thirty percent of participants identified with a religion. A significantly lower proportion of persons who used marijuana (21.5%) identified with a religion, compared to those who primarily used alcohol (37.3%), stimulants (36.1%), or no substances (37.7%). Similarly, those who identified with a religion were significantly less likely to report primary marijuana use (23.7%) than those who did not (38.6%). However, those persons who identified with a religion and used substances were significantly more likely to endorse 2 or more criteria on the DSM-5 SUD checklist (37.8%) than those who used substances but did not identify with a particular religion (27.8%).

There were statistically significant, though weak, negative correlations between identifying with a religion, and all drug legalization/decriminalization ratings (see Supplemental Table 1 ). Participants with a self-reported religious affiliation had significantly lower mean legalization/decriminalization ratings compared to those without any religious affiliation ( Figure 1a ).

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Mean drug legalization/decriminalization ratings as a function of (a) religious or (b) political affiliation 1

1 Scales rated from 0–10, with 0 being strongly disagree and 10 being strongly agree. Unadjusted mean differences between groups were assessed with one-way ANOVA, with Tukey’s post hoc comparisons among political groups. Asterisks indicate p < 0.05 (b). Error bars indicate standard error of the mean (SEM). Asterisks indicate p < 0.05 when comparing persons who identify as republicans to those who identify as Democrats or have no political affiliation. Abbreviations: L- legalization, D- decriminalization, MMJ- medical marijuana, RMJ- recreational marijuana

3.5. Political characteristics

Political party affiliation (or the lack thereof) was also a significant factor among the demographic makeup of this population, their substance use, and opinions on drug legalization/decriminalization (making it a covariate for these analyses). The majority of persons surveyed (88.7%) were registered to vote. Fifty-one percent of participants identified with the Democratic Party, and the proportion of persons who used marijuana and identified as Democrats (60.5%) was significantly higher than those who primarily used alcohol (44.1%) or no substances (42.9%). Those who identified as Democrats were significantly more likely to use marijuana (40%) compared to non-Democrats (27.6%). Among those persons whose primary substance was alcohol, Democrats were significantly less likely to have an alcohol use disorder (12.7%) compared to non-Democrats (19.1%). Persons who identified as Republicans had significantly lower legalization/decriminalization ratings for each substance compared to those who identified as Democrats and those without any political affiliation (see Figure 1b ).

3.6. Ratings as a function of having a DSM-5 SUD vs. no SUD within primary drug categories

It is also possible that people with a more severe pattern of use (i.e., a SUD) would be more supportive of legalizing and/or decriminalizing the substance they use. However, there were no differences in ratings for legalization and decriminalization for any substance when comparing persons who use a substance but did not fulfill the DSM-5 SUD criteria, with those within that substance category who did meet the DSM-5 SUD criteria (data not shown).

3.7. Correlation of medical marijuana ratings to ratings of other substances

The use of medical marijuana is becoming more acceptable across the US, and it is possible that people who support the legalization/decriminalization of medical marijuana may also be open to supporting the legalization/decriminalization of other substances. We found a significant, though at times weak, positive correlation between how much participants agreed that medical marijuana should be decriminalized with ratings on heroin decriminalization (r=0.13, p=0.003), cocaine decriminalization (r= 0.15, p=0.001), recreational marijuana legalization (r=0.37, p=0.000) and recreational marijuana decriminalization (r=0.39, p=0.000). There was a significant, positive correlation between how participants rated medical marijuana legalization, and decriminalization of cocaine (r=0.09, p=0.038), legalization of recreational marijuana (r=0.43, p=0.000) and decriminalization of recreational marijuana (r=0.28, p=0.000).

4.0. Discussion

The current study provides new insights into opinions regarding the legalization and decriminalization of heroin, cocaine and marijuana. This study is unique in examining attitudes as a function of past year drug use, and hypothesized that persons who used substances would have differing drug legalization/decriminalization ratings for their self-reported primary substance, especially when comparing persons who primarily used marijuana to those who primarily used opioids and stimulants. Our hypothesis was supported by these findings, as persons who primarily used marijuana rated both the legalization and decriminalization of this drug favorably, but persons who primarily used opioids and simulants rated their support for both the legalization and decriminalization of heroin and cocaine relatively low, respectively. We found that overall most respondents were in favor of the legalization and decriminalization of marijuana (both medical and recreational), but not heroin and cocaine. These findings are consistent with the limited data that is currently known about opinions on marijuana legalization and decriminalization ( Lopez, 2016 ; Carliner et al., 2017 ; Geiger, 2018 ) as well as, heroin and cocaine ( Trevino and Richard, 2002 ; Geiger, 2018 ), though this is the first hypothesis-driven study of its kind since recent changes in marijuana laws have been made. Of note, while the concepts of legalization and decriminalization are fundamentally different, and were asked about separately in our survey, we found that they tended to track together (i.e. for each drug the mean ratings were either low, or below five, as in the case of heroin and cocaine, or above 5, as in the case of both recreational and medical marijuana). Thus, we will discuss the attitudes about both together.

These findings are particularly important because persons who misuse legal or illicit substances often have had interactions with the legal system, which may influence their attitudes and beliefs. Over a third of our participants had experienced legal consequences related to substance use themselves or through someone close to them. Data from the 2002–2008 NSDUH survey provides corroborating evidence of this relationship between drug use and legal consequences by showing that among those who had past year illicit drug dependence or abuse, 18% and 36% had been arrested once or more than once that year, respectively. Within the subsample of NSDUH respondents reporting past year alcohol dependence or abuse, these values increased to 38% and 52%, respectively ( Lattimore et al., 2014 ). The estimated prevalence of SUDs among incarcerated persons, while largely varied across studies, is substantial within both female (30–60%) and male (10–48%) prisoners ( Gerstein and Harwood, 1990 ; Mason et al., 1997 ; Lo and Stephens, 2000 ; Fazel et al., 2006 ). The high prevalence and comorbidity with SUDs indicates that legal issues are a significant factor in the current climate of substance use in the US.

The majority of our participants were not in favor of legalizing nor decriminalizing heroin and cocaine, even if they or someone they knew had suffered legal consequences related to substance use, or if they themselves met criteria for a SUD. These findings suggest that this population would not support policy changes related to heroin and cocaine legalization/decriminalization, which may reflect their own experiences, making them more cautious about increasing availability of these drugs. This sample was generally supportive of legalization and decriminalization of both medical and recreational marijuana. However, persons without any substance use in the last 12 months had significantly lower ratings than other groups, and were mainly neutral about marijuana legalization/decriminalization. The exception was that persons with no primary substance use had a higher rating on decriminalization of medical marijuana (mean 7.1/10) compared with their other ratings, perhaps because this was the most conservative marijuana option given. Interestingly, there was a positive relationship between agreement with decriminalizing medical marijuana, and decriminalizing heroin, cocaine, and recreational marijuana among our total population, suggesting an openness to minimizing criminal consequences associated with medical marijuana tracked with openness to the same for other drugs.

Understanding attitudes and associated characteristics towards drug legalization and decriminalization is important, especially in the currently changing social landscape, as several states in the US have passed laws legalizing and/or decriminalizing marijuana. For example, a study involving persons who voted on the initiative to legalize marijuana in Washington state reported that once marijuana stores began to open, persons who previously voted against the initiative were more likely to change their vote, if given the chance, compared to those who had voted in support of it ( Subbaraman and Kerr, 2016 ). Given the current changing environment, it is timely to determine whether persons continue to support legalization/decriminalization of marijuana and, more broadly, whether they would support legalization/decriminalization of other illicit drugs. Additionally, with other countries conducting research on heroin as a treatment for OUD ( Ayanga et al., 2016 ), it is important to consider how this may be perceived in the US and whether attitudes vary as a function of demographic and/or ideological beliefs.

There are several limitations to this work. The use of an online survey through AMT involves some selection bias, and resulted in a population which, while diverse, is not completely representative of the US population as a whole though it is demographically consistent with other studies involving AMT workers ( Chandler and Shapiro, 2016 ). Additional studies conducted within a representative sample of the US population would be helpful to determine the impact of demographic characteristics, as well as legal status of marijuana in the state of residence, on perceptions of drug decriminalization/legalization. The fact that self-reported substance use was not verified, and was from an anonymous population, is another limitation, in addition to the fact that all persons who used opioids or stimulants were grouped together, due to small numbers, instead of being able to assess those who used heroin and cocaine, specifically. We were also unable to look at how the use of multiple substances (especially those with primary use of alcohol, a legal substance, in addition to illegal substances) affected attitudes toward drug legalization/decriminalization.

This study appears to be the first to systematically study opinions of persons from across the US who use substances, and those who do not, about the legalization and decriminalization of multiple substances, and results have relevance for current and future policies. Legalization/decriminalization of marijuana was supported, but not in the case of other drugs, despite changes in apparent attitudes in other countries. As more information is learned about potential health benefits of certain substances that may drive policy changes in favor of their legalization/decriminalization, it is critical that persons who are directly affected by any policy changes (i.e. those who use substances) be included in these discussions to provide their unique perspectives. Studies among persons in SUD treatment, or those with varying SUD severity, are also warranted, as they may prove even more insightful to inform policies on legalization/decriminalization and the use of currently illicit drugs as treatment for SUDs. It is also important to monitor and track the evolution in changes in attitudes and beliefs over time. These nuances may impact public health messaging and the ability to target certain groups.

Supplementary Material

Supplemental table, conflict of interest and source of funding:.

This work was supported by internal funding from the Johns Hopkins University School of Medicine. No conflicts declared.

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United Nations

Office on drugs and crime, unodc world drug report 2022 highlights trends on cannabis post-legalization, environmental impacts of illicit drugs, and drug use among women and youth.

drug legalization report

Vienna (Austria), 27 June 2022 - Cannabis legalization in parts of the world appears to have accelerated daily use and related health impacts, according to the UN Office on Drugs and Crime (UNODC)’s World Drug Report 2022. Released today, the report also details record rises in the manufacturing of cocaine, the expansion of synthetic drugs to new markets, and continued gaps in the availability of drug treatments, especially for women.  

According to the report, around 284 million people aged 15-64 used drugs worldwide in 2020, a 26 per cent increase over the previous decade. Young people are using more drugs, with use levels today in many countries higher than with the previous generation. In Africa and Latin America, people under 35 represent the majority of people being treated for drug use disorders.  

Globally, the report estimates that 11.2 million people worldwide were injecting drugs. Around half of this number were living with hepatitis C, 1.4 million were living with HIV, and 1.2 million were living with both.  

Reacting to these findings, UNODC Executive Director Ghada Waly stated: “Numbers for the manufacturing and seizures of many illicit drugs are hitting record highs, even as global emergencies are deepening vulnerabilities. At the same time, misperceptions regarding the magnitude of the problem and the associated harms are depriving people of care and treatment and driving young people towards harmful behaviours. We need to devote the necessary resources and attention to addressing every aspect of the world drug problem, including the provision of evidence-based care to all who need it, and we need to improve the knowledge base on how illicit drugs relate to other urgent challenges, such as conflicts and environmental degradation.”  

The report further emphasizes the importance of galvanizing the international community, governments, civil society and all stakeholders to take urgent action to protect people, including by strengthening drug use prevention and treatment and by tackling illicit drug supply.

Early indications and effects of cannabis legalization

Cannabis legalization in North America appears to have increased daily cannabis use, especially potent cannabis products and particularly among young adults. Associated increases in people with psychiatric disorders, suicides and hospitalizations have also been reported. Legalization has also increased tax revenues and generally reduced arrest rates for cannabis possession. 

Continued growth in drug production and trafficking

Cocaine manufacture was at a record high in 2020, growing 11 per cent from 2019 to 1,982 tons. Cocaine seizures also increased, despite the Covid-19 pandemic, to a record 1,424 tons in 2020. Nearly 90 per cent of cocaine seized globally in 2021 was trafficked in containers and/or by sea. Seizure data suggest that cocaine trafficking is expanding to other regions outside the main markets of North America and Europe, with increased levels of trafficking to Africa and Asia.

Trafficking of methamphetamine continues to expand geographically, with 117 countries reporting seizures of methamphetamine in 2016‒2020 versus 84 in 2006‒2010. Meanwhile, the quantities of methamphetamine seized grew five-fold between 2010 and 2020.

Opium production worldwide grew seven per cent between 2020 and 2021 to 7,930  tons – predominantly due  to an increase in production in Afghanistan. However, the global area under opium poppy cultivation fell by 16 per cent to 246,800 ha in the same period. 

Key drug trends broken down by region

In many countries in Africa and South and Central America, the largest proportion of people in treatment for drug use disorders are there primarily for cannabis use disorders. In Eastern and South-Eastern Europe and in Central Asia, people are most often in treatment for opioid use disorders.

In the United States and Canada, overdose deaths, predominantly driven by an epidemic of the non-medical use of fentanyl, continue to break records. Preliminary estimates in the United States point to more than 107,000 drug overdose deaths in 2021, up from nearly 92,000 in 2020.

In the two largest markets for methamphetamine, seizures have been increasing – they rose by seven per cent in North America from the previous year, while in South-East Asia they increased by 30 per cent from the previous year, record highs in both regions. A record high was also reported for methamphetamine seizures reported from South-West Asia, increasing by 50 per cent in 2020 from 2019.   

Great inequality remains in the availability of pharmaceutical opioids for medical consumption. In 2020, there were 7,500 more doses per 1 million inhabitants of controlled pain medication in North America than in West and Central Africa.

Conflict zones as magnets for synthetic drug production  

This year’s report also highlights that illicit drug economies can flourish in situations of conflict and where the rule of law is weak, and in turn can prolong or fuel conflict.

Information from the Middle East and South-East Asia suggest that conflict situations can act as a magnet for the manufacture of synthetic drugs, which can be produced anywhere. This effect may be greater when the conflict area is close to large consumer markets.  

Historically, parties to conflict have used drugs to finance conflict and generate income. The 2022 World Drug Report also reveals that conflicts may also disrupt and shift drug trafficking routes, as has happened in the Balkans and more recently in Ukraine.

A possible growing capacity to manufacture amphetamine in Ukraine if the conflict persists

There was a significant increase in the number of reported clandestine laboratories in Ukraine, skyrocketing from 17 dismantled laboratories in 2019 to 79 in 2020. 67 out of these laboratories were producing amphetamines, up from five in 2019 – the highest number of dismantled laboratories reported in any given country in 2020.  

The environmental impacts of drug markets

Illicit drug markets, according to the 2022 World Drug Report, can have local, community or individual-level impacts on the environment. Key findings include that the carbon footprint of indoor cannabis is between 16 and 100 times more than outdoor cannabis on average and that the footprint of 1 kilogram of cocaine is 30 times greater than that of cocoa beans.

Other environmental impacts include substantial deforestation associated with illicit coca cultivation, waste generated during synthetic drug manufacture that can be 5-30 times the volume of the end product, and the dumping of waste which can affecting soil, water and air directly, as well as organisms, animals and the food chain indirectly.

Ongoing gender treatment gap and disparities in drug use and treatment  

Women remain in the minority of drug users globally yet tend to increase their rate of drug consumption and progress to drug use disorders more rapidly than men do. Women now represent an estimated 45-49 per cent of users of amphetamines and non-medical users of pharmaceutical stimulants, pharmaceutical opioids, sedatives, and tranquilizers.

The treatment gap remains large for women globally. Although women represent almost one in two amphetamines users, they constitute only one in five people in treatment for amphetamine use disorders.

The World Drug Report 2022 also spotlights the wide range of roles fulfilled by women in the global cocaine economy, including cultivating coca, transporting small quantities of drugs, selling to consumers, and smuggling into prisons.

Further information

The 2022 World Drug Report provides a global overview of the supply and demand of opiates, cocaine, cannabis, amphetamine-type stimulants and new psychoactive substances (NPS), as well as their impact on health.

  • Fraud Alert
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CLB | Criminal Law Brief

The Wider Impact of Drug Legalization on the Criminal Justice System

by aseneviratne | Mar 16, 2021 | All , Criminal Justice Reform , Public Health

drug legalization report

This paper will discuss the effect of legalizing possession of all drugs on the criminal justice system. This paper will begin with a brief history of the modern War on Drugs to establish why drug possession should not be a criminal matter. Discussion of the impact of legalization will primarily focus on reduction in caseload and the resulting benefits.

The modern War on Drugs began during the Nixon presidency with the passage of the Controlled Substances Act of 1970 (“CSA”), which established federal regulatory power over the manufacture, importation, possession, use, and distribution of certain substances. [1] The CSA was ostensibly a public health response to the growing heroin epidemic in the mid-1960s. [2] In 1973, Nixon created the Drug Enforcement Agency (“DEA”) to carry out enforcement of the CSA. [3]

The War on Drugs expanded into a system of mass incarceration under the Comprehensive Crime Control Act of 1984, which increased criminal penalties associated with cannabis possession and established mandatory minimum sentences. [4] From 1980 to 1997, “the number of [individuals incarcerated] for nonviolent drug law offenses [jumped] from 50,000 . . . to over 400,000.” [5] “By 1991, the United States had surpassed the former Soviet Union and South Africa as having the largest prison population in the world.” [6] The racial impact from the ‘Tough on Crime’ approach reared its ugly head as “the sentences of black inmates were 41% longer than that of whites.” [7]

Most critically, the War on Drugs has been ineffective in deterring drug use. [8] In 2000, law enforcement seized over 4.4 million tablets of ecstasy, an increase from 350,000 tablets just two years prior. [9] From 2010 to 2015, the lifetime prevalence of 8th graders who have used illicit drugs consistently hovered around 20%. [10] Over that same period, the number of drug-induced deaths increased from 40,393 to 55,403. [11]

In light of the racial bias stemming from the War on Drugs as well as its failure to achieve its supposed intended purpose, drug possession is a worthy candidate for exploration into forms of treatment outside of the criminal realm. [12]

Legalization v. Decriminalization

For the purposes of this paper, assume that legalization means that the possession, sale, and manufacturing of all drugs would be regulated similarly to alcohol or cigarettes. At the outset, it is important to note why legalization is preferable to decriminalization. Decriminalization of drug possession simply means that possession is not a criminal offense. [13] In 2001, Portugal decriminalized all drugs, and the public health benefits have been palpable. [14] Under a system of decriminalization, however, the manufacturing and sale of drugs is still criminal. [15] As a result, the drug market is still propped up and supplied by drug cartels, just as it is in a system of prohibition. [16] Legalization goes further than decriminalization by legalizing drug production. [17] Allowing companies to manufacture drugs removes the viability of the black market drug trade, such as in Mexico where one cartel alone “had annual earnings calculated to be as high as $3 billion.” [18] In 2018, the DEA spent over $445 million on international enforcement to decrease the impact of these cartels in the United States. [19] Legalization treats the cause of the disease, and the consequent reduction in symptoms would decrease the need for these yearly international enforcement expenditures.

Court Decluttering

In 2017, there were 1,632,921 drug related violations in the U.S., of which 85.4% were for possession; an average of 3,820 possession arrests per day. [20] Under a system of legalization, American courts would no longer be inundated with this entire class of offense. The benefits of legalization on the courts are multifaceted: for the drug possessor, who is no longer a victim of the fruitless War on Drugs; for the judge, who enjoys greater flexibility with a decluttered docket; and most importantly, for the public defender, who can take advantage of the much-needed decrease in workload to provide better counsel to clients. [21]

In 2016, Louisiana had an estimated annual workload of 147,220 total cases to be divided among its 363 public defenders. [22] This meant that “the Louisiana public defense system [could only] handle 21 percent of [its] workload in compliance with [state] guidelines.” [23]

“Unsurprisingly, excessive workloads diminish the quality of legal representation.” [24] With such an enormous caseload, public defenders do not have the time available to conduct basic defense tasks necessary for a trial, creating an incentive for guilty pleas. [25] Guilty pleas based on time constraint rather than merit render “an ethical and constitutional plea bargain . . . impossible.” [26]

Given the sheer number of drug arrests, legalization would likely drastically reduce the public defense system’s case load. [27] With this caseload reduction, public defenders would be able to work towards closing the gap between the actual and necessary amount of time devoted to each client. [28] With more time to evaluate each case, public defenders can more effectively assess the appropriateness of a plea deal on the merits, rather than time constraints. [29] The increased legitimacy and efficiency of the public defense system resulting from legalization will likely lead to broader indirect benefits for all public defense clients, no matter what crime they are accused of. [30 ]

An argument against legalization posits that these reductions in public defense caseload would be offset by an increase in crime, such as petty crime and driving under the influence, due to legalization. [31] This line of reasoning rests on the assumption that if there are no criminal penalties for drug possession or use, then the number of drug users will increase. [32] With more people using drugs, more people will become addicts, who are more prone to committing crimes. [33]

The assumption that the absence of criminal sanctions entails more people using drugs is unsound, as under Portugal’s system of decriminalization, “in almost every category of drug, and for drug usage overall, the lifetime prevalence rates . . . were higher” prior to decriminalization. [34] Cocaine usage in Portugal was significantly lower than usage in the United States, which was head and shoulders above the rest of the world. [35] The heroin usage rate in Portugal from 1999 to 2005 actually decreased from 2.5% to 1.8% among those in the 16-18 age group. [36] Decreased drug use does not necessarily follow from from punitive state response, just as increased drug use does not necessarily follow from rehabilitative state response. [37] If the pool of drug users remains consistent after legalization, then pool of criminal drug users would likely remain consistent as well.

Still, even assuming that the number of drug addicts would increase post-legalization, leading to an increase in the number of petty crime and driving under the influence (“DUI”) cases, these cases differ quantitatively and qualitatively from possession and crimes currently associated with the black market for drugs.

Quantitatively, the increased caseload for petty crime and driving under the influence would still be significantly less the number of possession charges the system currently deals with. [38] Further, under the current system of prohibition, courts and society at large must deal with violent crimes associated with the black market for narcotics: in 2016, 11.2% of all federal prisoners held in state correctional facilities were incarcerated for drug trafficking and drug offenses other than possession. [39] Under a system of legalization, the profitability of the black market is greatly reduced, which would likely result in these arguably more serious crimes becoming less prevalent and further decreasing the caseload related to drugs despite a potential increase in petty crime and driving under the influence cases. [40]

Qualitatively, DUIs directly present significant and real risks of harm to other members of society in a way that drug possession does not. “In 2016, 10,497 people died in alcohol-impaired driving crashes, accounting for 28% of all traffic-related deaths in the United States.” [41] Given the increased culpability and blameworthiness of these crimes, it is not a waste of the public defense system resources to criminalize DUI and bear the associated costs of doing so; rather, these are precisely the crimes which fall under the purview of the criminal justice system. [42]

In conclusion, the War on Drugs has disproportionately impacted minorities [43] and has not effectively reduced drug consumption and usage. [44] In light of this, the United States should take steps to legalize drug possession and emulate the success of other nations who have treated drug use as public health matter, instead a criminal one. [45] Further, the benefits of legalization extend beyond drug users. [46] Globally, legalization helps to curtail the influence of cartels. [47] Domestically, legalization frees up the criminal justice system, permitting more efficient and legitimate legal representation for all individuals. [48]

[1] See Controlled Substances Act of 1970, 21 U.S.C. § 811.

[2] See Pub. Broadcasting Serv., Interview Dr. Robert DuPont , FRONTLINE: DRUG WARS, https://www.pbs.org/wgbh/pages/frontline/shows/drugs/interviews/dupont.html (last visited Mar. 20, 2020).

[3] See History , DRUG ENF’T AGENCY, dea.gov/history (last visited Jun. 29, 2020).

[4] See Comprehensive Crime Control Act of 1984, Pub. L. No. 98-473, 98 Stat. 1976.

[5] A Brief History of the Drug War , DRUG POL’Y ALL., https://www.drugpolicy.org/issues/brief-history-drug-war, (last visited Mar. 23, 2020).

[6] Charles Ogletree, Getting Tough on Crime: Does It Work? 38 Boston B. J. 9, 27 (1994).

[8] See Ross C. Anderson, We Are All Casualties of Friendly Fire in the War on Drugs , 13 Utah B.J. 10, 11 (2000).

[9] Id. at 11.

[10] See OFFICE OF NAT’L DRUG CONTROL POL’Y, NATIONAL DRUG CONTROL STRATEGY: PERFORMANCE REPORTING SYSTEM REPORT 27 (2016); What is Prevalence? NAT’L INST. MENTAL HEALTH (Nov. 2017), https://www.nimh.nih.gov/health/statistics/what-is-prevalence.shtml (explaining that “[l]ifetime prevalence is the proportion of a population who, at some point in life has ever had the characteristic.”).

[11] Id. at 12.

[12] See Anderson, supra note 8, at 11.

[13] See GLENN GREENWALD, DRUG DECRIMINALIZATION IN PORTUGAL: LESSONS FOR CREATING FAIR AND SUCCESSFUL DRUG POLICIES 2 (2009), https://www.cato.org/publications/white-paper/drug-decriminalization-portugal-lessons-creating-fair-successful-drug-policies.

[14] See id. at 14-15 (explaining that since decriminalization, Portugal has experienced a slight decline in drug use, a significant decline in drug related pathologies such as HIV, and a substantial increase in use of treatment programs).

[15] See i d. at 2.

[16] See German Lopez, What People Get Wrong About Prohibition , VOX (Oct. 19, 2015), https://www.vox.com/2015/10/19/9566935/prohibition-myths-misconceptions-facts.

[17] See GREENWALD, supra note 13, at 2.

[18] JUNE S. BEITTEL, CONG. RSCH. SERV., R41576, MEXICO: ORGANIZED CRIME AND DRUG TRAFFICKING ORGANIZATIONS 19 (2019).

[19] DRUG ENF’T ADMIN., FY 2019 BUDGET REQUEST, 4 (2018).

[20] See 2017 Crime in the United States: Persons Arrested , FED. BUREAU INVESTIGATION: UNIFORM CRIME REPORTING, https://ucr.fbi.gov/crime-in-the-u.s/2017/crime-in-the-u.s.-2017/topic-pages/persons-arrested (last visited Aug. 15, 2020).

[21] See Lisa C. Wood et al., Meet-and-Plead: The Inevitable Consequence of Crushing Defender Workloads , 42 LITIG. 20, 23 (2016).

[22] See A.B.A. & POSTLETHWAITE & NETTERVILLE, THE LOUISIANA PROJECT: A STUDY OF THE LOUISIANA DEFENDER SYSTEM AND ATTORNEY WORKLOAD STANDARDS 2 (2017).

[24] Wood et al., supra note 21, at 23.

[25] See id.

[27] See id. at 26.

[28] See id .

[29] See id .

[30] See id.

[31] See Paul Stares, Drug Legalization?: Time for a Real Debate , BROOKINGS INST. (Mar. 1, 1996), https://www.brookings.edu/articles/drug-legalization-time-for-a-real-debate/.

[32] See id.

[33] See id.

[34] GREENWALD, supra note 13, at 14-15 (emphasis added).

[35] See id. at 22-24.

[36] Id. at 14.

[37] See Stares, supra note 31 .

[38] See 2016 Crime in the United States: Table 18 , FED. BUREAU INVESTIGATION: UNIFORM CRIME REPORTING, https://ucr.fbi.gov/crime-in-the-u.s/2016/crime-in-the-u.s.-2016/topic-pages/tables/table-18 (last visited Aug. 15 2020) (illustrating that arrests for drug abuse violations are nearly eight times as high as arrests for burglary – a petty crime that is often related to drugs).

[39 ] JENNIFER BRONSON & E. ANN CARSON, BUREAU OF JUSTICE STATISTICS, NCJ 252156 , PRISONERS IN 2017 21 (2019).

[40] See Lopez, supra note 16 .

[41] Impaired Driving: Get the Facts, CENTERS FOR DISEASE CONTROL AND PREVENTION ( Aug. 24, 2020, 12:00 AM), https://www.cdc.gov/motorvehiclesafety/impaired_driving/impaired-drv_factsheet.html.

[42] See Janine Geske, Achieving the Goals of Criminal Justice: A Role for Restorative Justice , 30 Quinnipiac L. Rev. 527, 530-31 (2012).

[43] See Anderson, supra note 8, at 11 .

[44] See id.

[45] See GREENWALD, supra note 13, at 14-15.

[46] See Stares, supra note 31.

[47] See i d.

[48] See Wood et al., supra note 21, at 23, 26; s ee also Lopez, supra note 16.

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Law enforcement seizures of psilocybin mushrooms rose dramatically between 2017-2022

NIH-supported research highlights need to better understand psilocybin in context of growing psychedelic use

Number of Law Enforcement Seizures of Psilocybin Mushrooms in the United States, 2017-2022

Law enforcement seizures of “ magic mushrooms” or “shrooms ” containing the psychoactive component psilocybin increased dramatically in the United States between January 2017 and December 2022, according to a new study funded by the National Institute on Drug Abuse, part of the National Institutes of Health. The number of law enforcement seizures increased from 402 seizures in 2017 to 1,396 in 2022. In addition, the total weight of psilocybin mushrooms seized by law enforcement increased from 226 kg (498 lbs) seized in 2017 compared to 844 kg (1,861 lbs) in 2022.

The researchers found that most seizures occurred in the Midwest (36.0%), followed by the West (33.5%). The greatest total weight in seizures came from the West (1,864 kg/4,109 lbs, representing 42.6% of all seizures), followed by the South (1,832 kg/4,039 lbs, representing 41.8%). Though there was a significant increase in the total weight of psilocybin mushrooms seized between 2017 and 2022 overall, the investigators found that the total weight seized peaked in 2021 (1,542 kg/3,400 lbs).

This analysis, published in Drug and Alcohol Dependence , was led by researchers at NYU Langone Health, New York City, and the University of Florida, Gainesville. The data used for the analysis were collected through the High Intensity Drug Trafficking Areas (HIDTA) program, a grant program aimed at reducing drug trafficking and misuse administered by the Office of National Drug Control Policy . Though law enforcement seizures do not necessarily reflect prevalence of use, they represent an indicator of the availability of illicit drugs.

Psilocybin mushrooms fall under a broader drug category known as psychedelic and dissociative drugs , which can temporarily alter a person’s mood, thoughts, and perceptions. Self-reported data on the prevalence of their use is limited, though available research suggests that use of drugs like psilocybin that cause hallucinations has increased among adults aged 35-50 in recent years . In addition, research suggests that psilocybin is the most consumed plant-based psychedelic drug in the United States, with 11.3% of individuals aged 12 or older in the United States reporting having ever used psilocybin in 2022 .

“We are in the middle of a rapidly evolving cultural, media, and legal landscape when it comes to psychedelics, and we need data to help shape informed and appropriate public health strategies,” said NIDA Director Nora D. Volkow, M.D. “Moving forward, we must continue to track data on the availability of psychedelics, patterns in use, and associated health effects to guide efforts in promoting accurate education and reducing potential harms among people who do plan to use psychedelic drugs.”

Psilocybin is not currently approved by the U.S. Food and Drug Administration for the treatment of any condition or disease. In recent years, there has been growing research interest in the potential of psychedelic and dissociative drugs to treat medical conditions , including mental health disorders. Importantly, research on psychedelics as a medical treatment is done within a therapeutic structure, which includes a preparatory session with a clinician, a controlled environment and supervision while experiencing the effects of psilocybin, and follow-up sessions.

However, most people who report using psychedelic and dissociative drugs do so outside of medical or research settings for a variety of reasons , including for recreation, or based on the belief that doing so will improve well-being or allow for spiritual or self-exploration. Adverse effects have been associated with use of psilocybin mushrooms, such as “bad trips,” which are marked by distorted thinking, perceptual changes, putting oneself in physical danger, and intense feelings of fear, anxiety, and confusion. People who take psychedelic drugs like psilocybin may also experience short-term side effects such as raised blood pressure and heart rate, agitation, confusion, vomiting, or nausea, which may be severe and require medical attention. In recent years, possession of psilocybin has become increasingly decriminalized throughout the U.S. at the state level. Together, the authors note that these factors may influence nonmedical or recreational use of psilocybin mushrooms in the U.S.

“While psilocybin is by no means the most dangerous drug, recreational use can come with unforeseen risks such as bad trips” said Joseph J. Palamar, Ph.D., M.P.H., associate professor at the NYU Grossman School of Medicine and co-investigator on the NIDA-funded National Drug Early Warning System (NDEWS) , and lead author on the paper. “Research studies suggesting its effectiveness in treating mental health issues and extensive positive media coverage may lead some people to seek shrooms outside of medical contexts. People who use psilocybin outside of medical supervision need to be educated about risks associated with use.”

The authors note that states and regions where seizures are reported don’t necessarily reflect the intended destinations for the seized psilocybin mushrooms. In addition, law enforcement efforts may vary across areas, and a higher number of seizures could be a result of increased vigilance by law enforcement. HIDTA seizures don’t encompass all drug seizures in the US; however, the researchers did observe similar overall increases by region based on data published by the DEA National Forensic Laboratory Information System . The authors also note that it is unknown to what extent psilocybin mushrooms were seized in “wet” or “dry” form, which can significantly impact the recorded weight of each seizure and prevents weight measures from being translated into possible doses.

“Most national surveys and studies don’t capture self-reported data on psilocybin use specifically, so these findings help shed important light on an area where we’ve been largely left in the dark,” said Linda B. Cottler, Ph.D., M.P.H, principal investigator of NDEWS, University of Florida, and author on the paper.

For more information on substance and mental health treatment programs in your area, call the free and confidential  National Helpline  1-800-662-HELP (4357) or visit  FindTreatment.gov . Anyone who needs assistance with the first steps in pursuing help can find guidance at  FindSupport.gov .

  • JJ Palamar, et al. National and Regional Trends in Seizures of Shrooms (Psilocybin) in the United States, 2017-2022 . Drug and Alcohol Dependence . DOI: 10.1016/j.drugalcdep.2024.111086 (2024).

About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov .

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

About substance use disorders: Substance use disorders are chronic, treatable conditions from which people can recover. In 2022, nearly 49 million people in the United States had at least one substance use disorder. Substance use disorders are defined in part by continued use of substances despite negative consequences. They are also relapsing conditions, in which periods of abstinence (not using substances) can be followed by a return to use. Stigma can make individuals with substance use disorders less likely to seek treatment. Using preferred language can help accurately report on substance use and addiction. View NIDA’s online guide .

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As 'magic mushrooms' got more attention, drug busts of the psychedelic drug went up.

Rhitu Chatterjee

drug legalization report

Psilocybin mushrooms jarred and ready for distribution at Uptown Fungus lab in Springfield, Ore. Oregon has decriminalized the use of the psychedelic drug. Craig Mitchelldyer/AP hide caption

Psilocybin mushrooms jarred and ready for distribution at Uptown Fungus lab in Springfield, Ore. Oregon has decriminalized the use of the psychedelic drug.

In recent years, there's been growing interest in psilocybin, the psychoactive ingredient in "magic mushrooms" or "shrooms" as a potentially beneficial therapy for mental health conditions. At the same time, drug busts of mushrooms went way up between 2017 and 2022, and the amount of the psychedelic substance seized by law enforcement more than tripled, according to a new study.

"What I think the results indicate is that shroom availability has likely been increasing," says Joseph Palamar , an epidemiologist at NYU Langone Health and the main author of the new study published in the journal Drug and Alcohol Dependence.

The findings come at a time when there's a "psychedelic renaissance" happening in the country, says Dr. Joshua Siegel of Washington University in St. Louis, who wasn't involved in the new study.

There's growing public and scientific interest in psychedelics' potential therapeutic effects on various mental and behavioral health issues, says Siegel, who also studies how psychedelics affect the human brain. At the same time, a small number of states have already decriminalized psychedelic drugs, and many more are looking into doing the same.

The new study is "an important part of the bigger picture of where we are headed as a nation" with psychedelics, says Siegel. "It's important to understand what's happening in terms of the health care side of things. It's important to understand what's happening recreationally and legally."

The new study found that the total amount of mushrooms seized by law enforcement across the country went from nearly 500 pounds in 2017 to more than 1,800 pounds in 2022. The largest amount (42.6% of total) seized was in the West, followed closely by the Midwest (41.8%).

"The greatest overall weight in seizures was out west," says Palamar. "And I don't think it's coincidental that that's where a lot of the more liberal policies are starting to take effect."

That could be because those liberal policies might not make it legal to sell psychedelics, he explains. "So if you have a store with hundreds of pounds of shrooms, they're probably going against the law somehow. And there's also large growing operations that are being busted."

The results also suggest an "increased demand for the drug," says Dr. Nora Volkow , director of the National Institute on Drug Abuse (NIDA), who wasn't involved in the NIDA-funded study. "The sellers are able to sell the product because more people are using it."

Recent surveys and studies have shown that use of psychedelics like psilocybin, the psychoactive component of shrooms, has been growing in recent years. One study published in 2022, found psilocybin use increased between 2002 and 2019, driven primarily by users 26 years and older. And data from the Substance Abuse and Mental Health Administration suggests that psilocybin is the most popular plant-based psychedelic in the United States, with more than 11% of individuals aged 12 and older reporting that they have used the drug in 2022.

The increasing use of psychedelics and the wave of states decriminalizing the drugs have paralleled a growing investment in research into the potential therapeutic benefits of psychedelics, including psilocybin.

"There's been an enormous amount of attention for the potential use of psychedelic drugs, for the treatment of depression, post-traumatic stress disorder, [and] for the treatment of addictions," says Volkow.

The U.S. Food and Drug Administration has yet to approve the use of psilocybin for therapeutic use. But clinical trials show promising results, says Volkow.

"The clinical trials, as it relates to the use of psilocybin for the treatment of depression in, for example, terminally ill patients or severe depression, are very, very interesting," she adds. "You cannot deny it."

That said, Volkow and Siegel are concerned about the growing number of people using psilocybin, whether it is recreationally or a form of self-medication for mental health symptoms.

"My concern is not about addiction because psychedelic drugs in the classical term of addiction are not addictive," says Volkow.

But, initial research suggest risk of of psychosis and even suicidal ideation.

"It can trigger a full-blown psychosis," says Volkow. "And some of these psychoses can be extremely, extremely scary." Some of the psychoses can lead to suicide or impulsive actions that result in suicide, she says.

Volkow is also concerned about the potential negative impacts of combining psilocybin with other drugs or medications, because it's something that scientists haven't studied yet.

And so, she cautions, "We need to be aware that the use of these drugs comes at a certain cost."

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Mandated Drug Treatment in the Aftermath of Recreational Cannabis Legalization

Marijuana Law

Table of Contents

Katharine neill harris, christopher f. kulesza, share this publication.

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Katharine Neill Harris and Christopher F. Kulesza, “Mandated Drug Treatment in the Aftermath of Recreational Cannabis Legalization: Racial and Ethnic Disparities Persist” (Houston: Rice University’s Baker Institute for Public Policy, December 12, 2023), https://doi.org/10.25613/9shw-gh26.

Executive Summary

Roughly half of the U.S. population now lives in a state that permits recreational cannabis use and sales. Still, the criminal legal system continues to play a primary role in determining who receives treatment for cannabis use. It remains the single largest treatment referral source, and in 2019 more than 100,000 people who were admitted to treatment for cannabis use were referred by a legal entity. [1]

This raises questions regarding the extent to which individuals who interact with the legal system are monitored and punished for cannabis use in the post-legalization era. Moreover, the issue has not been addressed by state legalization measures.

We examined trends in legal system referrals to treatment for cannabis use in legal and nonlegal states from 2007 to 2019. We also tested the relationship between recreational cannabis legalization and legal system treatment referrals for Black, Hispanic, and white adults and juveniles. [2]

Why This Matters

The legal system’s practice of requiring individuals to participate in drug treatment warrants scrutiny because of its potentially negative and long-lasting consequences. While mandated treatment may be appropriate in some cases, the legal system often requires treatment participation from individuals who do not meet the criteria for a substance use disorder, and it does a poor job of connecting those who do have substance use disorders with appropriate care. [3]

The legal system’s limited efficacy in this arena is problematic because mandated treatment carries the possibility of additional legal consequences if program expectations are not met. The harmful effects of legal involvement include fewer education and employment prospects, reduced earning potential, destabilized family structures, negative mental and physical health outcomes, and diminished quality of life. Communities of color are disproportionately targeted by drug enforcement and disproportionately impacted by its collateral consequences.

Recreational cannabis legalization (RCL) is intended to remedy, in part, the harmful and racially disparate effects of cannabis prohibition. However, the continuation of compulsory treatment for cannabis use, and the legal involvement it entails, is a potential pathway through which the systemic harms and inequities of cannabis prohibition can persist. The problematic nature of this arrangement is enhanced when it occurs alongside a commercial cannabis industry that profits from greater levels of cannabis use.

Using data from the Treatment Episode Data Set-Admissions (TEDS-A) for 2007 to 2019, we created variables for state-level rates of legal system-referred cannabis treatment admissions for Black, Hispanic, and white adults and juveniles. We compared rate trends across populations and conducted staggered difference-in-difference and event analyses to determine whether RCL is associated with a decline in legal system referrals to treatment for cannabis use.

In legal states, the average cannabis treatment admissions rate declined 57.19% from 2007 to 2019, compared to a 41.06% decline in nonlegal states over the same period. Admissions rates declined for all populations of study; however, RCL was not associated with these declines when controlling for sociodemographic factors.

Black juveniles had the highest average admissions rate (20.16 per 10,000), followed by Hispanic juveniles (12.35), Black adults (9.18), white juveniles (7.58), Hispanic adults (3.42), and white adults (1.66). On average, juveniles had higher admissions rates and experienced greater percentage declines in these rates compared to their adult counterparts in both legal and nonlegal states.

Black and Hispanic populations experienced smaller percentage declines in admissions rates than their white counterparts. Racial/ethnic disparities in admissions rates increased in both legal and nonlegal states, with greater increases in legal states. In 2019, racial/ethnic disparities were higher in legal states than nonlegal states for all groups except Black juveniles.

Implications

Our findings suggest that RCL has not fundamentally altered the legal system’s practice of requiring defendants who use cannabis to receive drug treatment, nor has it reduced racial and ethnic disparities in referral practices. White adults and juveniles experienced steeper declines in admissions rates than Black and Hispanic adults and juveniles. As a result, racial and ethnic disparities in admissions rates grew in both legal and nonlegal states, with a larger increase in legal states. These findings, coupled with prior research on RCL and cannabis arrest trends as well as evidence of disparate opportunities in nascent cannabis markets, suggest that Black, Hispanic, and youth populations are less likely to benefit from cannabis reform.

Based on our findings and the research to date, we recommend the following:

  • Enact cannabis reform policies that explicitly target legal system features beyond arrest and prosecution.
  • Adopt education reforms that reduce school systems’ reliance on punitive disciplinary measures to respond to students’ use of alcohol and other drugs.
  • Implement regulatory policies that discourage heavy consumption of high-potency THC products to reduce the prevalence of cannabis use disorders in RCL states.
  • Invest resources for addressing substance use, like opioid settlement funds, into school- and community-based initiatives rather than law enforcement programs.

Introduction

As of November 2023, 24 states and the District of Columbia have legalized recreational cannabis use for adults 21 and older. [4] Recreational cannabis legalization (RCL) is popular with the American public for many reasons, including its potential to reduce the excessive and racially disparate use of the criminal legal system to enforce cannabis prohibition.

RCL has been accompanied by a significant drop in cannabis possession arrests. This is a welcome development, but it does not mean that legal consequences for using cannabis have disappeared. Individuals are still arrested for violating remaining cannabis laws, and thousands of legal-state residents still have criminal records related to cannabis that create employment and quality-of-life obstacles. Individuals who use cannabis and who become involved in the legal system may also still face legal consequences for their cannabis use.

Historically, the criminal legal system has taken a zero-tolerance approach to cannabis use. Those charged with cannabis-related offenses were typically required to participate in drug treatment as a condition of probation or in lieu of incarceration, even if they did not have a cannabis use disorder. Non-cannabis offenses, like theft or domestic violence, could also trigger mandatory treatment if the individual’s cannabis use was discovered by a court or probation department.

Today, courts and probation departments in RCL states may still require legal system-involved individuals who use cannabis to receive drug treatment. The legalization of cannabis for recreational use and commercial sale warrants a reconsideration of such compulsory treatment requirements. This issue has not been addressed by state legalization initiatives.

At first glance, requiring legal system-involved individuals who use cannabis to participate in drug treatment may appear fairly benign. But the legal system is ill-suited to identify individual treatment needs. It often refers to treatment individuals who do not meet the criteria for a substance use disorder, an error that occurs more often for Black individuals. [5] It is also not effective at connecting those who do have substance use disorders with the appropriate care. [6]

The legal system’s limited efficacy in this area is problematic because mandated treatment, in addition to costing an individual time and money, carries the possibility of further legal consequences if program expectations are not met. The harmful effects of legal involvement include fewer education and employment prospects, reduced earning potential, destabilized family structures, negative mental and physical health outcomes, and diminished quality of life.

Communities of color are disproportionately targeted by drug enforcement and are disproportionately impacted by its collateral consequences. RCL is intended to remedy, in part, the harmful and racially disparate effects of cannabis prohibition. Compulsory treatment, and the legal involvement it entails, is a potential pathway through which the harms and systemic inequities of cannabis prohibition can persist.

This report reviews findings from our analysis of legal system referrals to cannabis treatment in legal and nonlegal states. [7] We find that recreational cannabis legalization has not impacted legal system referral practices or reduced racial and ethnic disparities in referral rates. We conclude with recommendations for policymakers.

The “war on drugs” caused an explosive growth in drug arrests. In 1980, there were an estimated 580,900 drug arrests in the United States. By 2007, this figure had swelled to 1.84 million, nearly half of which were cannabis related. [8] As arrest rates rose, so did referrals to drug treatment. Between 1992 and 2008, the number of adolescents and young adults in treatment for cannabis use increased 344%. [9]

Today, the legal system is the largest referral source to treatment for cannabis use. In 2019, roughly half (49.2%) of the 208,843 individuals admitted to treatment for cannabis were referred through the legal system. [10] Black individuals are overrepresented in cannabis treatment referrals, accounting for 35% of admissions, despite similar use rates across demographic groups. [11]

Several studies have consistently found RCL to be associated with declines in cannabis-related arrests. However, this relationship varies depending on the population and place in question. [12] RCL is associated with a decline in cannabis possession arrests for adults but not for juveniles. [13] While arrests declined for Black and white populations post-legalization, in many cases racial disparities have persisted and, in some states, increased. [14]

Cannabis arrests have also declined in nonlegal states, and a number of factors other than commercial legalization — including macro-level social and political changes and local-level shifts in enforcement patterns and priorities — have likely influenced arrest trends. [15]

Thus, while RCL may be reducing the legal system’s cannabis footprint, features of prohibition endure, most notably the continued racial disparities in remaining cannabis enforcement practices.

We sought to build on research examining the impact of RCL on arrest trends by looking at the relationship between legalization and legal system referrals to treatment for cannabis use. While arrest data measure street-level police responses to cannabis-related activity, “referrals to treatment capture activity of legal system entities, including courtroom actors, diversionary programs, and probation departments, that handle cases after an arrest has been made.” [16] These actors have considerable discretion in determining individual case outcomes and can decide whether to require an individual to participate in a treatment program for cannabis use as a condition of a more lenient sentence. Thus, evaluating trends in legal system treatment referrals “adds to research on arrests to provide a more complete picture of how the criminal legal system as a whole responds to cannabis use post-reform.” [17]

We analyzed data from the Treatment Episode Data Set-Admissions (TEDS-A), compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA) for the period between 2007 and 2019. TEDS-A provides information on admissions to publicly funded substance-use treatment facilities and includes data on treatment referral source, primary substance for referral, and client demographics. We focused on referrals originating from the criminal legal system, for which the TEDS-A includes the following categories: probation and parole, diversionary programs, federal and state courts, the formal adjudication process, DUI courts, prisons, and other recognized legal entities. We examined state-level legal system-referred admissions rates for Black, Hispanic, and white adults (18 years and older) and for Black, Hispanic, and white juveniles (12 to 17 years old).

Methodology

Our independent variable was state legalization of cannabis for recreational use, defined as the removal of all civil and criminal penalties for possession of cannabis (Table 1). This was treated as a dichotomous variable, where “1” denotes legalization and “0” indicates no change. Coding was based on the date that possession became legal. States with limits on the amount of cannabis that is legal to possess and states that had not yet permitted sales or home cultivation were coded as legal states.

Table 1 — State Adult-Use Cannabis Legalization Policies

DP-Harris-Cannabis-120723-Table01

Our dependent variables were the state-level rates of legal system-referred admissions to treatment for cannabis as the primary substance of use. We used TEDS-A data for first-time admissions to treatment for the period 2007 to 2019, for a total of 1,030,185 individual observations. The individual observations were used to create the state rates of legal system-referred treatment admissions for cannabis use by age and race/ethnicity. We calculated separate admissions rates for Black, Hispanic, and white adults (18 years and older) and for Black, Hispanic, and white juveniles (12 to 17 years old). To calculate these rates, we totaled the number of individual observations for each state by year, divided by the relevant state population, and multiplied by 10,000. This produced a total of 551 state-level observations for the period from 2007 to 2019.

We controlled for the following variables: 1) percentage of white population, 2) rate of substance treatment facilities per 10,000 residents, 3) percentage of uninsured population, 4) an index for socioeconomic disadvantage that includes measures for household poverty rate, percentage of female-led households with children, percentage of individuals with a bachelor’s degree or higher, and percentage of owner-occupied housings, 5) state government ideology, 6) state incarceration rates, and 7) a dummy variable indicating whether a state has legalized cannabis for medical use. [18]

We conducted our analysis in five steps. First, we calculated descriptive statistics to understand the nature of our variables (Appendix). Second, we graphically compared average annual admissions trends between legal and nonlegal states by racial/ethnic group and age. Third, to better capture potential disparities, we plotted the relative differences in admissions rates between white and Black adults, white and Hispanic adults, white and Black juveniles, and white and Hispanic juveniles. Fourth, we used staggered difference-in-difference to determine whether legalization had a significant impact on treatment referral trends, with separate models estimated for Black, Hispanic, and white adults and juveniles. [19] The models were carried out using fixed effects with errors clustered at the state level. Lastly, we conducted a series of event panel analyses with fixed effects and clustered errors at the state level.

Like difference-in-difference, event analysis is used to determine the effects of a policy change over time. However, the event analysis better accounts for heterogeneity in policy implementation time by creating a standard baseline around which to test the impact of the treatment variable. This allows us to examine more clearly trends in cannabis admissions in the years preceding and following legalization in states that enacted reforms in different years. All analyses were conducted using the statistical analysis software STATA 16. [20]

Overall Trends

  • For the study period (2007–19), the average legal system-referred admissions (hereafter, “admissions”) rate for the total population was 2.75 per 10,000 residents, with nonlegal states having a higher average rate (2.88) than legal states (2.18).
  • Black juveniles had the highest average admissions rate (20.16 per 10,000), followed by Hispanic juveniles (12.35), Black adults (9.18), white juveniles (7.58), Hispanic adults (3.42), and white adults (1.66).
  • In legal states, the average admissions rates declined 57.19% from 2007 to 2019. Declines started prior to legalization in all states. The size of the decline ranged from 11.5% in Colorado to 99.7% in Washington (Figure 1).
  • In nonlegal states, the average admissions rate declined 41.06% from 2007 to 2019.
  • The size of the decline was greater in legal than nonlegal states for all populations except Black juveniles, for whom average admissions rates declined roughly 59% in both legal and nonlegal states (Figure 2).
  • White juveniles experienced the greatest declines in both legal and nonlegal states, followed by Black juveniles, white adults, Hispanic juveniles, Black adults, and Hispanic adults (Figure 2).
  • Higher uninsured rates were associated with higher admissions rates for all groups (event analysis).
  • Higher levels of socioeconomic disadvantage were associated with higher admissions rates for Hispanic adults and juveniles (event analysis).
  • Higher levels of government conservatism were associated with higher admissions rates for Black juveniles and Hispanic adults and juveniles (difference-in-difference) analysis.
  • Higher incarceration rates were associated with lower admissions rates for Black adults (difference-in-difference) analysis (Appendix).

Figure 1 — Cannabis Treatment Admissions Trends in RCL States

DP-Harris-Cannabis-120723-Figure01

Figure 2 — Size of Decline in Admissions Rates, 2007–19

DP-Harris-Cannabis-120723-Figure02

Age Disparities

  • On average across all states, juveniles had higher admissions rates than their racial/ethnic adult counterparts.
  • Juvenile populations experienced greater percentage declines in admissions rates than their adult counterparts in both legal and nonlegal states (Figure 2).
  • In 2019, white juveniles were admitted to treatment at a rate 2.9 times higher than white adults in legal states and at a rate 2.84 times higher in nonlegal states.
  • In 2019, Black juveniles were admitted to treatment at a rate 1.44 times higher than Black adults in legal states and at a rate 2.14 times higher than Black adults in nonlegal states.
  • In 2019, Hispanic juveniles were admitted to treatment at a rate 2.19 times higher than Hispanic adults in legal states and at a rate 2.82 times higher than Hispanic adults in nonlegal states.
  • The white juvenile/adult disparity decreased 37% in legal states and 46% in nonlegal states. The Black juvenile/adult disparity decreased 29% in legal states and 34% in nonlegal states, and the Hispanic juvenile/adult disparity decreased 26% in legal states and 34% in nonlegal states.

Figure 3 — Change in Age Disparities in Admissions Rates, 2007–19

DP-Harris-Cannabis-120723-Figure03

Racial/Ethnic Disparities

  • On average across all states, Black and Hispanic admissions rates were higher than white admissions rates.
  • Black and Hispanic populations experienced smaller percentage declines in admissions rates than their white counterparts (Figure 2).
  • The Hispanic/white juvenile disparity increased 78% in legal states and 60% in nonlegal states. The Hispanic/white adult disparity increased 51% in legal states and 31% in nonlegal states. The Black/white juvenile disparity increased 58% in legal states and 22% in nonlegal states. The Black/white adult disparity increased 40% in legal states and held stable in nonlegal states (+.79%).
  • In 2019, Black adults were admitted to treatment at a rate 6.67 times higher than white adults in legal states and at a rate 4.97 times higher than white adults in nonlegal states.
  • In 2019, Black juveniles were admitted to treatment at a rate 3.31 times higher than white juveniles in legal states and at a rate 3.75 times higher in nonlegal states.
  • In 2019, Hispanic adults were admitted to treatment at a rate 3.0 times higher than white adults in legal states and at a rate 1.95 times higher in nonlegal states.
  • In 2019, Hispanic juveniles were admitted to treatment at a 2.28 times higher rate than white juveniles in legal states and at a 1.93 times higher rate in nonlegal states.

Figure 4 — Change in Racial/Ethnic Disparities, 2007–19

DP-Harris-Cannabis-120723-Figure04

Figure 5 — Size of Disparity in Admissions Rates by Race and Ethnicity in 2019

DP-Harris-Cannabis-120723-Figure05

We observed a long-term decline in legally mandated cannabis treatment admissions in all states for all populations of study. However, recreational cannabis legalization was not statistically associated with these declines in treatment admissions when controlling for sociodemographic variables. This suggests that legalization does not necessarily alter how the legal system responds to cannabis use among individuals who interact with it. The significance of our control variables in various models — socioeconomic disadvantage, uninsured rates, government ideology — points to the potential for political, economic, and health factors to shape legal system outcomes.

While treatment admissions rates for juveniles declined more sharply than rates for their adult counterparts, adolescents were still referred and admitted to treatment at higher rates after reform. This is not surprising given that all RCL states restrict cannabis use and sales to individuals aged 21 and older. Still, adolescents use cannabis at lower rates than adults, suggesting that other factors contribute to the higher rates of legally mandated treatment admissions for this population, including the existence of additional pathways, like schools, through which juveniles encounter the legal system. [21]

White adults and juveniles experienced steeper declines in admissions rates than Black and Hispanic adults and juveniles. As a result, racial and ethnic disparities in admissions rates grew in both legal and nonlegal states, with a larger increase in legal states. This finding is consistent with prior research demonstrating that racial disparities in cannabis arrests tend to increase after legalization, even as the total number of cannabis arrests declines. [22]

Racial disparities in cannabis enforcement are systemic in the way they endure significant policy reform and manifest at multiple points along the legal system continuum. Black and Hispanic individuals are still more likely to encounter the police and be arrested and charged with cannabis-related offenses post-reform. When arrested and charged with non-cannabis offenses, Black and Hispanic defendants may be more frequently required to participate in legally mandated drug treatment as a condition of probation or deferred adjudication.

To be sure, there are cases in which legally-mandated cannabis treatment is appropriate, such as incidents of impaired driving that directly endanger others. We also do not dismiss the seriousness of cannabis use disorders (CUD), which evidence suggests are on the rise following legalization and increased access to high-potency THC products. [23] Like those with other substance use disorders, a small fraction of people with CUD receive treatment. [24] Unmet treatment needs stem largely from a dearth of effective and affordable care options, and this treatment shortage more severely affects disadvantaged groups, including legal system-involved individuals. [25] Recent evidence of an association between RCL and declines in voluntary cannabis treatment admissions further suggest that legalization could exacerbate the underutilization of treatment for CUD, perhaps by minimizing perceptions of CUD as a serious problem. [26]

Taken together, these trends may lead some to regard the continuation of legally mandated treatment for cannabis use in RCL states as a reasonable effort to connect disadvantaged populations with needed resources. However, the legal system’s efficacy in the treatment process is too limited and its adverse impacts are too severe to justify using it for this purpose. [27] The potential for legal consequences to follow the unsuccessful completion of treatment makes individuals vulnerable to the harms of legal system involvement, from reduced employment prospects to negative health outcomes. Black, Hispanic, and youth populations are more frequently subject to mandated drug treatment and thus are especially at risk of experiencing these harms. The problematic nature of this arrangement is enhanced when it occurs alongside a commercial cannabis industry that profits from greater levels of cannabis use.

Recommendations

Our study suggests that RCL has not fundamentally altered the legal system’s practice of requiring defendants who use cannabis to receive drug treatment, nor has it reduced racial and ethnic disparities in referral practices. These findings, coupled with prior research on legalization and cannabis arrest trends as well as evidence of disparate opportunities in nascent cannabis markets, suggest that Black, Hispanic, and youth populations are less likely to benefit from cannabis reform.

  • State lawmakers have begun to recognize the need to address other legal components of cannabis prohibition, as seen in the increased uptake of simplified or automatic record expungement policies for cannabis offenses that occurred prior to legalization. [28]
  • To reduce unnecessary drug treatment requirements, policymakers should establish statutory provisions requiring clear evidence of a relationship between an individual’s cannabis use and the offense in question for probation departments and courtroom actors to mandate treatment participation.
  • Minors who violate low-level cannabis laws and who are diagnosed with a cannabis use disorder may be referred to treatment, but oversight in such cases should be transferred from the legal system to community providers or other nonlegal system entities.
  • Many school districts use alternative education settings for students engaged in alcohol- and other drug-related misconduct. Alternative schools have higher dropout rates than standard schools and some are overseen by juvenile probation departments. Alternative school placements increase the likelihood of legal involvement. [29]
  • Minority students and Black students in particular are disproportionately placed in alternative education settings for nonviolent misconduct.
  • While some states are implementing reforms aimed at ending the “school-to-prison pipeline,” many continue to take an overly punitive approach to substance use. [30]
  • Interventions for adolescent substance use must take place outside of a disciplinary environment and must be attached to comprehensive service offerings that address student mental health, home environments, and other issues that may have led to substance use.
  • Heavy use of high-potency THC products may increase the risk of cannabis use disorder. [31]
  • States may discourage high-potency THC consumption by capping the amount of THC allowed in products or assigning higher tax rates to products containing more THC. [32]
  • State and local jurisdictions may also consider limiting the number of cannabis dispensary locations, as dispensary density is associated with heavier cannabis use among young adults. [33]
  • Public health messaging aimed at cannabis users should provide accurate information and encourage realistic behavioral modifications for using more safely (e.g., taking “tolerance breaks”). [34]
  • Federal leadership via regulating and monitoring the use and sale of cannabis products could significantly aid states in addressing the risks of greater prevalence of cannabis use disorders. [35]
  • Many states are in the process of determining how to allocate funds from large settlement agreements with pharmaceutical companies and drug distributors for their contributory role in the overdose crisis.
  • Strategies to prioritize include overdose prevention, harm reduction, and school- and community-based prevention, treatment, and social assistance programs.
  • Resources for substance use-related services should not be diverted to law enforcement. Police and legal system initiatives, such as enhanced drug enforcement efforts and drug courts, can be supported with already-existing public safety revenue streams.

Study Limitations

The TEDS-A data set relies on the quality of individual state reporting, which is highly variable. TEDS-A only captures publicly funded treatment admissions.

TEDS-A does not include data on offenses that triggered legal system treatment referrals, and our state-level analysis was not able to control for factors relating to the discretion of legal system actors to mandate individuals to cannabis use treatment. Future research should examine the relationship between offense and legal system referral practices surrounding cannabis use in legal states.

  • State-level analyses do not account for local policy change; for example, in some nonlegal states the most populous jurisdictions have implemented de facto decriminalization policies that could affect state-level treatment referral trends.

Acknowledgments

We thank Zachre Andrews, Puneetha Goli, Yea Won Lee, Wendy Olivares, and Bianca Schutz, undergraduate students at Rice University, for their assistance with data collection, organization, and presentation.

[1] Substance Abuse and Mental Health Services Administration (SAMHSA), Treatment Episode Data Set (TEDS) 2019: Admissions to and Discharges From Publicly Funded Substance Use Treatment , Center for Behavioral Health Statistics and Quality (Rockville, MD: Substance Abuse and Mental Health Services Administration, 2021), https://www.samhsa.gov/data/sites/default/files/reports/rpt35314/2019_TEDS_3-1-22.pdf .

[2] This report is adapted from Katharine Neill Harris and Christopher F. Kulesza, “Exploring the Impact of Adult-Use Cannabis Legalization on Legal-System Referrals to Treatment for Cannabis Use: Do Age and Race Have a Moderating Effect?” Clinical Therapeutics 11, no. 39 (2023), https://doi.org/10.1016/j.clinthera.2023.03.006 .

[3] David DeMatteo et al., “Outcome Trajectories in Drug Court: Do All Participants Have Drug Problems?” Criminal Justice Behaviors 36, no. 4 (2009): 354–68, https://doi.org/10.1177/0093854809331547 ; Noa Krawczyk et al., “Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine,” Health Affairs 36, no. 12 (December 2017): 2046–53, https://doi.org/10.1377/hlthaff.2017.0890 .

[4] MJ Biz Daily, “Where Marijuana is Legal in the United States,” updated November 13, 2023, https://mjbizdaily.com/map-of-us-marijuana-legalization-by-state/ .

[5] DeMatteo et al. “Outcome Trajectories in Drug Court”; Ethan Sahker et al., “Efficacy of Brief Intervention for Drug Misuse in Primary Care Facilities: Systematic Review and Meta-Analysis Protocol,” BMJ Open 10, no. 9 (2020): e036633, http://dx.doi.org/10.1136/bmjopen-2019-036633 ; and Karen McElrath, Angela Taylor, and Kimberly K. Tran, “Black-White Disparities in Criminal Justice Referrals to Treatment: Addressing Treatment Need or Expanding the Diagnostic Net?” Behavioral Sciences 6, no. 21 (2016): 1–15, https://doi.org/10.3390/bs6040021 .

[6] Krawczyk et al., “Only One In Twenty Justice-Referred Adults In Specialty Treatment”; Neill Harris and Jay Jenkins, “Diverted Opportunities: Gaps in Drug Treatment for Justice System-Involved Populations in Harris County, Texas” (Houston: Rice University’s Baker Institute for Public Policy, December 10, 2019), https://doi.org/10.25613/XZJH-GX92 .

[7] Neill Harris and Kulesza, “Exploring the Impact of Adult-Use Cannabis Legalization on Legal-System Referrals to Treatment for Cannabis Use.”

[8] Bureau of Justice Statistics, “Law Enforcement,” 2021, https://bjs.ojp.gov/drugs-and-crime-facts/enforcement#arrests .

[9] Lindsay R. Standeven et al., “Trends in Cannabis Treatment Admissions in Adolescent/Young Adults: Analysis of TEDS-A 1992 to 2016,” Journal of Addiction Medicine 14, no. 4 (July/August 2020): 29–36, https://doi.org/10.1097/ADM.0000000000000586 .

[10] COVID-19 impacted treatment admissions and survey collection, making data for 2020 incomparable to other years. That said, while the 2020 TEDS data reports substantial decreases in treatment admissions for all substances, the percentage of cannabis admissions originating with the legal system and the overrepresentation of Black and Hispanic/Latino populations in cannabis admissions remains relatively constant compared to 2019 (SAMHSA, Treatment Episode Data Set [TEDS] 2019 ).

[11] Approximately 13.6% of the U.S. population is Black. Black individuals comprised 20% of total treatment admissions in 2019, meaning they are especially overrepresented in cannabis treatment admissions. Hispanic/Latino individuals account for 19.1% of the U.S. population and made up 19% of cannabis treatment admissions and 14.5% of total treatment admissions in 2019 (SAMHSA, “2021 NSDUH: Detailed Tables,” January 4, 2023, https://www.samhsa.gov/data/report/2021-nsduh-detailed-tables ).

[12] Mike Males and Lizzie Buchen, “Reforming Marijuana Laws: Which Approach Best Reduces the Harms of Criminalization? A Five-State Analysis,” Center on Juvenile and Criminal Justice, September 2014, http://www.cjcj.org/uploads/cjcj/documents/cjcj_marijuana_reform_comparison.pdf ; Andrew D. Plunk et al., “Youth and Adult Arrests for Cannabis Possession After Decriminalization and Legalization of Cannabis,” JAMA Pediatrics 173, no. 8 (2019): 763, https://doi.org/10.1001/jamapediatrics.2019.1539 ; and Mary K. Stohr et al., “Effects of Marijuana Legalization on Law Enforcement and Crime,” National Criminal Justice Reference Service, July 2020, https://www.ojp.gov/pdffiles1/nij/grants/255060.pdf .

[13] Plunk et al., “Youth and Adult Arrests for Cannabis Possession.”

[14] Caislin L. Firth et al., “Did Marijuana Legalization in Washington State Reduce Racial Disparities in Adult Marijuana Arrests?” Substance Use & Misuse 54, no. 9 (May 2019): 1582–7, https://doi.org/10.1080/10826084.2019.1593007 ; Firth et al., “Implications of Cannabis Legalization on Juvenile Justice Outcomes and Racial Disparities,” American Journal of Preventive Medicine 58, no. 4 (February 2020): 562–9, https://doi.org/10.1016/j.amepre.2019.11.019 ; Nguyen K. Tran et al., “The Heterogenous Effect of Marijuana Decriminalization Policy on Arrest Rates in Philadelphia, Pennsylvania, 2009–2018,” Drug and Alcohol Dependence 212 (July 1, 2020): 1–8, https://doi.org/10.1016/j.drugalcdep.2020.108058 ; American Civil Liberties Union, A Tale of Two Countries: Racially Targeted Arrests in the Era of Marijuana Reform , 2020, https://www.aclu.org/report/tale-two-countries-racially-targeted-arrests-era-marijuana-reform ; and Colorado Division of Criminal Justice, Impacts of Marijuana Legalization in Colorado: A Report Pursuant to C.R.S. 24-33.4-516 , July 2021, https://cdpsdocs.state.co.us/ors/docs/reports/2021-SB13-283_Rpt.pdf .

[15] Brynn E. Sheehan, Richard A. Grucza, and Plunk, “Association of Racial Disparity of Cannabis Possession Arrests Among Adults and Youths With Statewide Cannabis Decriminalization and Legalization,” J AMA Health Forum 2, no. 10 (October 29, 2021): e213435, https://doi.org/10.1001/jamahealthforum.2021.3435 .

[16] Neill Harris and Kulesza, “Exploring the Impact of Adult-Use Cannabis Legalization on Legal-System Referrals to Treatment for Cannabis Use.”

[17] Neill Harris and Kulesza, “Exploring the Impact of Adult-Use Cannabis Legalization on Legal-System Referrals to Treatment for Cannabis Use.”

[18] Data sources for control variables include TEDS-A; the U.S. Census American Community Survey; the Kaiser Family Foundation; and Department of Justice, Bureau of Justice Statistics. Government ideology measure from William D. Berry et al., “Measuring Citizen and Government Ideology in the American States, 1960-93,” American Journal of Political Science 42, no. 1 (1998): 327–48, https://doi.org/10.2307/2991759 . Socioeconomic disadvantage measure adapted from Catherine E. Ross and John Mirowsky, “Neighborhood Disadvantage, Disorder, and Health,” Journal of Health and Social Behavior 42, no. 3 (2001): 258–76, https://doi.org/10.2307/3090214 .

[19] Difference-in-difference analysis is a statistical technique used to determine whether a policy change has had an expected impact. This is achieved by comparing a group that experienced the policy change with a group that did not, both before and after the policy change. Difference-in-difference is “staggered” when the policy change in question occurs at different times in different places. For instance, in our analysis here, RCL states implemented the policy change in various years.

[20] Neill Harris and Kulesza, “Exploring the Impact of Adult-Use Cannabis Legalization on Legal-System Referrals to Treatment for Cannabis Use.”

[21] SAMHSA, “2021 NSDUH: Detailed Tables.”

[22] Sheehan, Grucza, and Plunk, “Association of Racial Disparity of Cannabis Possession Arrests”; Firth et al., “Did Marijuana Legalization in Washington State Reduce Racial Disparities in Adult Marijuana Arrests?”

[23] Magdalena Cerdá et al., “Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder from 2008 to 2016,” JAMA Psychiatry 77, no. 2 (November 13, 2019): 165–71, https://doi.org/10.1001/jamapsychiatry.2019.3254 .

[24] SAMHSA, “2021 NSDUH: Detailed Tables.”

[25] Tawandra L. Rowell-Cunsolo and Meghan Bellerose, “Utilization of Substance Use Treatment Among Criminal Justice-Involved Individuals in the United States,” Journal of Substance Abuse Treatment 125 (June 2021):108423, doi:10.1016/j.jsat.2021.108423.

[26] Jeremy Mennis et al., “Recreational Cannabis Legalization Alters Associations Among Cannabis Use, Perception of Risk, and Cannabis Use Disorder Treatment for Adolescents and Young Adults,” Addictive Behaviors 138 (November 2022): https://doi.org/10.1016/j.addbeh.2022.107552 .

[27] DeMatteo et al. “Outcome Trajectories in Drug Court”; Krawczyk et al., “Only One In Twenty Justice-Referred Adults In Specialty Treatment”; and Harris and Jenkins, “Diverted Opportunities: Gaps in Drug Treatment.”

[28] Blair Lozier, Valerie Newberg, and Dakota Thomas, “State Approaches to Marijuana Policy,” The Council of State Governments, February 13, 2023, https://www.csg.org/2023/02/13/state-approaches-to-marijuana-policy/ .

[29] Deborah Fowler et al., “Texas’ School-to-Prison Pipeline: Ticketing, Arrest, and Use of Force in Schools,” Texas Appleseed, December 2010, https://www.njjn.org/uploads/digital-library/Texas-School-Prison-Pipeline_Ticketing_Booklet_Texas-Appleseed_Dec2010.pdf .

[30] For example, Texas recently passed a law that requires students caught vaping to be sent to a Disciplinary Alternative Education Program.

[31] Kat Petrilli et al., “Association of Cannabis Potency with Mental Ill Health and Addiction: A Systematic Review,” The Lancet Psychiatry 9, no. 9 (September 2022): 736–50, https://doi.org/10.1016/S2215-0366(22)00161-4 .

[32] Rosalie Liccardo Pacula et al., “Federal Regulations of Cannabis for Public Health in the United States,” USC Schaeffer Center White Paper Series (July 18, 2022), https://healthpolicy.usc.edu/research/federal-regulations-of-cannabis-for-public-health-in-the-u-s/ .

[33] Eric R. Pedersen et al., “Examining Associations Between Licensed and Unlicensed Outlet Density and Cannabis Outcomes from Preopening to Postopening of Recreational Cannabis Outlets,” The American Journal on Addictions 30, no. 2 (December 30, 2020): 122-30, https://doi.org/10.1111/ajad.13132 .

[34] Days- or weeks-long breaks from cannabis use decrease a person’s tolerance; when they resume use they can consume less to achieve desired effects. For a tolerance break guide, see The University of Vermont Center for Health & Wellbeing, “T-Break: Take a Cannabis Tolerance Break,” https://www.uvm.edu/health/t-break-take-cannabis-tolerance-break .

[35] Liccardo Pacula et al., “Federal Regulations of Cannabis for Public Health.”

Appendix Table 1 — State-Level Variables, Descriptive Statistics

DP-Harris-Cannabis-120723-Appendix-Table01

Appendix Table 2 — Individual Level Descriptive Statistics, TEDS-A Data

DP-Harris-Cannabis-120723-Appendix-Table02

Appendix Table 3 — Difference-in-Difference Results

DP-Harris-Cannabis-120723-Appendix-Table03

Appendix Table 4 — Event Panel Analysis Results

DP-Harris-Cannabis-120723-Appendix-Table04A

Appendix Table 4 — Event Panel Analysis Results Continued

DP-Harris-Cannabis-120723-Appendix-Table04B

Appendix Figure 1 — Results of Event Analysis

DP-Harris-Cannabis-120723-Appendix-Figure01

This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s), and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.

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Gorilla in the Room: The Expert View on Drug Legalization

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As the debate over drug prohibition develops, InSight Crime reviews the positions of leading thinkers on drug decriminalization and legalization, finding that the debate is often more nuanced than a simple yes or no.

When Guatemalan President Otto Perez Molina said in January 2012 that he would support a debate over drug decriminalization , he ignited a conversation that has drawn the attention of the entire region. Even the message from Washington has shifted, with Vice President Joe Biden reiterating that the US opposes legalization, but acknowledges that it is a legitimate topic for discussion. As the sixth Summit of the Americas approaches, to be held April 14 and 15 in Cartagena, Colombia, Western Hemisphere leaders are preparing for the next stage of the debate, even though drug policy reform is not an official item on the event’s agenda.

This article is part of a series on drug policy and legalization in the region. See the full series her e or download the full report .

InSight Crime has prepared a map detailing the positions of every country in the region on legalization and decriminalization. While it is useful to understand how these policies are viewed throughout the region, some experts advocate more nuanced views than the current state of the debate has allowed.

The differing positions of three leading US-based thinkers who have spent their careers studying drug policy speak to the degree of complexity of the issue.

Peter Reuter , University of Maryland professor in the School of Public Policy and the Department of Criminology, said during a 2009 speaking engagement he was skeptical of decriminalization but noted that overall consumption has not risen significantly in Portugal since it decriminalized possession of small quantities of all drugs in 2001. Later, he expressed qualified support for decriminalization, but said that in regard to cannabis, consumption was more influenced by popular culture than by government policy.

In the preface to his 2001 book “Drug War Heresies: Learning from Other Vices, Times, and Places,” co-authored with Robert MacCoun, Reuter notes that the publication “does not reach a strong conclusion about what should be done.” Later, he says full-scale marijuana legalization would produce “no major additional gains to counterbalance the increase in prevalence.”

Regarding the prohibition of cocaine and heroin, Reuter and MacCoun note, “The extraordinary prices of cocaine and heroin, the massive involvement of young minority males in center cities, foreign corruption, and the violence of the drug trades are all plausibly much increased by the nation’s decision to be highly punitive toward these drugs. Prohibition might be implemented differently with much less of this specific collateral damage.”

Mark Kleiman , UCLA Professor of Public Policy, advocates the decriminalization of marijuana (but not its commercial legalization) and the continued prohibition of hard drugs. Kleiman also suggests more specific policy reforms like adapting enforcement and sentencing to mitigate the harmful effects of the drug trade, which he says are, “Violence, neighborhood disruption, and the recruitment of juveniles.” Kleiman suggests a variety of policies to overhaul the approach to all recreational drugs, not just illegal ones: much higher cigarette and alcohol taxes, eliminating the drinking age but targeting kids with anti-alcohol abuse advertisements, and better incorporating drug addiction treatment into the health care system, to name a few.

While Kleiman and Reuter argue for a different kind of prohibition, Ethan Nadelmann , executive director of the Drug Policy Alliance , advocates prohibition be discarded altogether, at least for marijuana. In a radio interview from March 2012 Nadelmann suggests marijuana be legalized commercially . Nadelmann also suggested hard drugs be provided to addicts — but still a step short of a commercially legal regime like those that currently govern the sale of alcohol and tobacco. In addition to these steps toward a legal regulatory framework, Nadelmann’s organization advocates a host of reforms aimed at harm reduction, like supervised injection facilities (currently illegal in the US), drug replacement therapy, and clean needle access.

For each of these leading experts, legalization and decriminalization are complex issues. Beyond the difference between commercial legalization and decriminalization, a key distinction exists between the kind of drug under consideration. Each of these scholars considers that marijuana deserves a different treatment, as its use has very different public health consequences than cocaine, heroin, and methamphetamine use.

While these experts hold differing positions on drug policy, they all acknowledge the opportunity for reform. They all hold positions more complex than blanket support for decriminalization or legalization of all drugs. As the hemisphere’s leaders prepare for the Summit of the Americas, the incredible complexity of both the drug policy issue and its potential solutions ensures that the process of region-wide reform will be lengthy and controversial.

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World Drug Report 2023

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For the first time since its conception, this year the World Drug Report consists of two products, a web-based element and a set of booklets. The latest global, regional and subregional estimates of and trends in drug demand and supply are presented in a user-friendly, interactive  online segment . While  Special points of interest  include key takeaways and policy implications,  booklet 1  takes the form of an executive summary based on analysis of the  key findings of the online segment  and the  thematic booklet 2  and the conclusions that can be drawn from them. In addition to providing an in-depth analysis of key developments and emerging trends in selected drug markets, including in countries currently experiencing conflict, booklet 2 focuses on a number of other contemporary issues related to drugs. 

A research brief titled the Drugs-Crime Nexus in the Amazon Basin , first published in the World Drug Report 2023 , focuses on the countries affected by drug trafficking and related crime issues, hosting the largest share of the Amazon Basin rainforest- Brazil, Peru, Plurinational State of Bolivia and Colombia.

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The Legalization of Drugs: For & Against

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Douglas Husak and Peter de Marneffe, The Legalization of Drugs: For & Against , Cambridge University Press, 2005, 204pp., $18.99 (pbk), ISBN 0521546869.

Reviewed by William Hawk, James Madison University

In the United States the production, distribution and use of marijuana, heroin, and cocaine are crimes subjecting the offender to imprisonment. The Legalization of Drugs , appearing in the series "For and Against" edited by R. G. Frey for Cambridge University Press, raises the seldom-asked philosophical question of the justification, if any, of imprisoning persons for drug offenses.

Douglas Husak questions the justification for punishing persons who use drugs such as marijuana, heroin, and cocaine. He develops a convincing argument that imprisonment is never morally justified for drug use. Put simply, incarceration is such a harsh penalty that drug use, generally harmless to others and less harmful to the user than commonly supposed, fails to justify it. Any legal scheme that punishes drug users to achieve another worthy goal, such as creating a disincentive to future drug users, violates principles of justice.

Peter de Marneffe contends that under some circumstances society is morally justified in punishing persons who produce and distribute heroin. He argues a theoretical point that anticipated rises in drug abuse and consequent effects on young people may justify keeping heroin production and distribution illegal. According to de Marneffe's analysis, however, harsh prison penalties currently imposed on drug offenders are unjustified.

The points of discord between Husak's and de Marneffe's positions are serious but not as telling as is their implicit agreement. Current legal practices and policies which lead to lengthy incarceration of those who produce, distribute and use drugs such as marijuana, heroin, and cocaine are not, and cannot be, morally justified. Both arguments, against imprisoning drug users and for keeping heroin production illegal, merit a broad and careful reading.

The United States has erected an enormous legal structure involving prosecution and incarceration designed to prohibit a highly pleasurable, sometimes medically indicated and personally satisfying activity, namely using marijuana, heroin, and cocaine. At the same time, other pleasure-producing drugs, such as tobacco, alcohol, and caffeine, though legally regulated for the purposes of consumer safety and under-age consumption, can be purchased over the counter. As a result, while the health and safety risks of cigarettes may be greater than those proven to accompany marijuana, one can buy cigarettes from a vending machine and but go to prison for smoking marijuana. A rational legal system, according to Husak, demands a convincing, but as yet not forthcoming, explanation of why one pleasurable drug subjects users to the risk of imprisonment while the other is accommodated in restaurants.

Drug prohibitionists must face the problem that any "health risk" argument used to distinguish illicit drugs and subject offenders to prison sentences runs up against the known, yet tolerated, health risks of tobacco, as well as the additional health risks associated with incarceration. "Social costs" arguments targeting heroin or cocaine runs up against the known, yet tolerated, social costs of alcohol, as well as the additional social costs of incarceration. Even if one were to accept that illicit drugs were more harmful or exacted greater social costs than tobacco and alcohol (and the empirical studies referred to in the text do not generally support this thesis), that difference proves insufficient to justify imprisoning producers, distributors or especially users of illicit drugs.

Decriminalizing Drug Use. Douglas Husak presents a very carefully argued case for decriminalizing drug use. He begins his philosophical argument by clarifying the concepts and issues involved. To advocate the legalization of drugs calls for a legal system in which the production and sale of drugs are not criminal offenses. (p. 3) Criminalization of drugs makes the use of certain drugs a criminal offense, i.e. one deserving punishment. To argue for drug decriminalization, as Husak does, is not necessarily to argue for legalization of drugs . Husak entertains, but cautiously rejects the notion of a system where production and sale of drugs is illegal while use is not a crime. De Marneffe advocates such a system.

Punishing persons by incarceration demands justification. Since the state's use of punishment is a severe tool and incarceration is by its nature "degrading, demoralizing and dangerous" (p. 29) we must be able to provide "a compelling reason … to justify the infliction of punishment… ." (p. 34) Husak finds no compelling reason for imprisoning drug users. After considering four standard justifications for punishing drug users Husak concludes that "the arguments for criminalization are not sufficiently persuasive to justify the infliction of punishment."

Reasons to Criminalize Drug Use . 1) Drug users, it is claimed, should be punished in order to protect the health and well being of citizens . No doubt states are justified in protecting the health and well being of citizens. But does putting drug users in prison contribute to this worthy goal? Certainly not for those imprisoned. For those who might be deterred from using drugs the question is whether the drugs from which they are deterred by the threat of imprisonment actually pose a health risk. For one, Husak quotes research showing that currently illicit drugs do not obviously pose a greater health threat than alcohol or tobacco. For another, he quotes a statistic showing that approximately four times as many persons die annually from using prescribed medicines than die from using illegal drugs. In addition, one-fourth of all pack-a-day smokers lose ten to fifteen years of their lives but no one would entertain the idea of incarcerating smokers to further their health interests or in order to prevent non-smokers from beginning. In sum, Husak accepts that drug use poses health risks but contends that the risks are not greater than others that are socially accepted. Even if they were greater, imprisonment does not reduce, but compounds the health risks for prisoners.

2) Punishing drug users protects children . Husak here responds to de Marneffe's essay which focuses on potential drug abuse and promotes the welfare of children as a justification for keeping drug production and sale illegal. Husak finds punishing adolescent users a peculiar way to protect them. To punish one drug-using adolescent in order to prevent a non-using adolescent from using drugs is ineffective and also violates justice. Punishing adult users so that youth do not begin using drugs and do not suffer from neglect -- which is de Marneffe's position -- is not likely to prevent adolescents from becoming drug users, and even if it did, one would have to show that the harm prevented to the youth justifies imprisoning adults. Husak contends that punishing adults or youth, far from protecting youth, puts them at greater risk.

3) Some, e.g. former New York City mayor Guiliani, argue that punishing drug use prevents crime . Husak, conceding a connection between drug use and crime, turns the argument upside-down, showing how punishment increases rather than decreases crime. For one, criminalization of drugs forces the drug industry to settle disputes extra-legally. Secondly, drug decriminalization would likely lower drug costs thereby reducing economic crimes. Thirdly, to those who contend that illicit drugs may increase violence and aggression Husak responds that: a) empirical evidence does not support marijuana or heroin as causes of violence and b) empirical evidence does support alcohol, which is decriminalized, as leading to violence. Husak concludes "if we propose to ban those drugs that are implicated in criminal behavior, no drug would be a better candidate for criminalization than alcohol." (p. 70) Finally, punishing drug users likely increases crime rates since those imprisoned for drug use are released with greater tendencies and skills for future criminal activity.

4) Drug use ought to be punished because using drugs is immoral . In addition to standard philosophical objections to legal moralism, Husak contends that there is no good reason to think that recreational drug use is immoral. Drug use violates no rights. Other recreationally used drugs such as alcohol, tobacco or caffeine are not immoral. The only accounts according to which drug use is immoral are religiously based and generally not shared in the citizenry. Husak argues that legal moralism fails, and with it the attempts to justify imprisoning drug users because of health and well-being, protecting children, or reducing crime. Husak concludes, "If I am correct, prohibitionists are more clearly guilty of immorality than their opponents. The wrongfulness of recreational drug use, if it exists at all, pales against the immorality of punishing drug users." (p. 82)

Reasons to Decriminalize Drug Use. Husak's positive case for decriminalizing drug use begins with acknowledgement that drug use is or may be highly pleasurable. In addition, some drugs aid relaxation, others increase energy and some promote spiritual enlightenment or literary and artistic creativity. The simple fun and euphoria attendant to drug use should count for permitting it.

The fact that criminalization of drug use proves to be counter-productive provides Husak a set of final substantial reasons for decriminalizing use. Criminalizing drugs proves counter-productive along several different lines: 1) criminalization is aimed and selectively enforced against minorities, 2) public health risks increase because drugs are dealt on the street, 3) foreign policy is negatively affected by corrupt governments being supported solely because they support anti-drug policies, 4) a frank and open discussion about drug policy is impossible in the United States, 5) civil liberties are eroded by drug enforcement, 6) some government corruption stems from drug payoffs and 7) criminalization costs tens of billions of dollars per year.

Douglas Husak provides the conceptual clarity needed to work one's way through the various debates surrounding drug use and the law. He establishes a high threshold that must be met in order to justify the state's incarcerating someone. Having laid this groundwork Husak demonstrates that purported justifications for drug criminalization fail and that good reasons for decriminalizing drug use prevail. For persons who worry about what drug decriminalization means for children, Husak counsels that there is more to fear from prosecution and conviction of youth for using drugs than there is to fear from the drugs themselves.

Against Legalizing Drug Production and Distribution. Peter de Marneffe offers an argument against drug legalization . The argument itself is simple. If drugs are legalized, there will be more drug abuse. If there is more drug abuse that is bad. Drug abuse is sufficiently bad to justify making drug production and distribution illegal. Therefore, drugs should not be legalized. The weight of this argument is carried by the claim that the badness of drug abuse is sufficient to justify making drug production and sale illegal.

De Marneffe centers his argument on heroin. Heroin, he contends, is highly pleasurable but sharply depresses motivation to achieve worthwhile goals and meet responsibilities. Accordingly, children in an environment where heroin is legal will be subjected to neglect by heroin using parents and, if they themselves use heroin, they will be harmed by diminished motivation for achievement for the remainder of their lives. It is this later harm to the ambition and motivation of young people that, according to de Marneffe, justifies criminalizing heroin production and sale. As he puts it:

… the risk of lost opportunities that some individuals would bear as the result of heroin legalization justifies the risks of criminal liability and other burdens that heroin prohibition imposes on other individuals. The legalization of heroin would create a social environment -- call it the legalization environment -- in which some children would be at a substantially higher risk of irresponsible heroin abuse by their parents and in which some adolescents would be at a substantially higher risk of self-destructive heroin abuse. (p. 124)

Are the liberties of individual adult drug producers, distributors and users sacrificed? Yes, but this may be justified by de Marneffe's "burdens principle." According to the burdens principle, "the government violates a person's moral rights in adopting a policy that limits her liberty if and only if in adopting this policy the government imposes a burden on her that is substantially worse than the worst burden anyone would bear in the absence of this policy." (p. 159) According to this, de Marneffe claims that burdens on drug vendors or users may be justified by the prevention of harms to a particular individual or individuals. As he puts it:

What I claim in favor of heroin prohibition is that the reasons of at least one person to prefer her situation in a prohibition environment outweigh everyone else's reasons to prefer his or her situation in a legalization environment, assuming that the penalties are gradual and proportionate and other relevant conditions are met. (p. 161)

According to this view, the objective interest of a single adolescent in not losing ambition, motivation and drive justifies the imposition of burdens on other youth and adults who would prefer using drugs. Although Johnny might choose heroin use, his objective interest is for future motivation and ambition that is not harmed by heroin use.

De Marneffe's "burdens principle" seems to hold the whole society hostage to the objective liberty interests of one individual. Were this principle applied to drug producers or distributors who faced imprisonment it seems that imprisonment could not be justified. I suspect a concern for consistency here gives de Marneffe reason to make drug production and distribution illegal but without attaching harsh prison sentences for offenders. He advocates an environment where drugs are not legal, in order to protect youth against both abuse and their own choices that may cause them to become unmotivated, but recognizes that prison sentences are unjustified as a way to support such a system.

In The Legalization of Drugs the reader gets two interesting arguments. Douglas Husak makes a compelling case against punishing drug users. His position amounts to drug decriminalization with skepticism toward making drug production and sale illegal. On the other side, Peter de Marneffe justifies making drug production and sale illegal based upon the diminishment of future interests of young people. De Marneffe introduces a "burdens principle" which is likely much too strong a commitment to individual interests than could ever be realized in a civil society. In both instances, the reader is treated to arguments that effectively undermine current drug policy. The book provides philosophical argumentation that should stimulate a societal conversation about the justifiability of current drug laws.

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The Effects of Drug Legalization

With an increasing number of states legalizing marijuana and other drugs, the debate continues on whether the negative effects of drug decriminalization outweigh the positives. Researchers, policymakers, and public health officials provide arguments on both sides. For mental health experts, however, the most relevant question is how drug legalization will impact rates of substance abuse and addiction.

Let’s take a closer look at the drug legalization debate, the pros and cons of legalizing drugs, and what research says about how the decriminalization of drugs will affect young adults in particular.

All calls are always confidential.

States and Countries Where Drugs Are Legal

Recreational marijuana use is now legal for adults in 15 states and the District of Columbia, including five that legalized the drug in the November 2020 election. States where recreational marijuana is legal include:

  • South Dakota—the first state ever to legalize medical and recreational cannabis at the same time, beginning July 1, 2021
  • Montana, with recreational sales beginning in 2022
  • Arizona, where regulations are still being developed
  • New Jersey—the first state in the mid-Atlantic region to legalize marijuana
  • California—the first state to legalize medical marijuana
  • Massachusetts
  • Colorado, which became the first state to legalize marijuana in 2012.

In addition, marijuana use is legal in the US territory of Guam, and medical marijuana is legal in 34 states. And experts predict that more states will move toward drug legalization under a Democratic president and Congress, paving the way to federal legalization of marijuana.

Furthermore, in 2020, Oregon became the first state to decriminalize hard drugs, including heroin, cocaine, MDMA, and LSD. The Oregon Nurses Association, the Oregon chapter of the American College of Physicians, and the Oregon Academy of Family Physicians supported the measure, stating, “Punishing people for drug use and addiction is costly and hasn’t worked. More drug treatment, not punishment, is a better approach.” Oregon residents arrested with small amounts of hard drugs will be able to pay a $100 fine and attend a substance abuse program rather than facing jail time. In addition, revenue from legalized marijuana sales will fund the treatment centers.  

Portugal: A Case Study in the Decriminalization of Drugs

The Oregon drug legalization followed in the footsteps of countries like Portugal, the Netherlands and Switzerland, which have decriminalized possession of small amounts of hard drugs. In 2001, Portugal became the first country in the world to decriminalize the acquisition, possession, and use of small quantities of all illicit drugs. However, the country did not decriminalize drug trafficking, involving larger quantities of drugs. Moreover, while individuals caught using drugs are not incarcerated, they may be fined, given community service, or referred to treatment programs.

According to Portugal drug decriminalization statistics, drug overdose deaths declined after decriminalization, drug usage did not go up, and prison overcrowding decreased. However, stats supporting a Portugal drug decriminalization failure show an initial increase in drug experimentation and a 41 percent spike in homicides, which fell after the first five years.

Hence, the results appear to be mixed. But perhaps most important, the number of people in drug treatment increased by 20 percent in the first seven years after drug legalization in Portugal, and has held steady since.

Discharging patients ‘quicker but sicker’ may have the unintended consequence of fueling revolving-door hospitalization, a pattern that disrupts mental health recovery and increases treatment costs.

Austin Frakt, research scientist with the Harvard T.H. Chan School of Public Health

The Pros and Cons of Legalizing Drugs

Even as the country moves toward more widespread decriminalization of drugs, drug legalization continues to be a contentious topic. For every argument for why drugs should be legal, there’s one focusing on why drugs should not be legalized. And there are drug legalization statistics to support both sides of the issue.

Supporters of drug legalization argue that incarceration is not an effective deterrent to drug use, and that decriminalization allows the marijuana industry to be regulated, like tobacco and alcohol. In addition, they say, more people can receive treatment if revenue and taxes from legal marijuana sales are funneled into prevention and recovery programs, as in Oregon and Arizona. Moreover, activists maintain that decriminalization will help address the disproportionately high jail time and number of drug-related arrests among Black and brown people. A statewide study found that the new Oregon drug legalization will reduce drug convictions for Black and Native people by nearly 95 percent. Supporters also argue that drug legalization and regulation would make marijuana and other drugs safer for users.

drug legalization report

Those on the other side of the drug legalization debate maintain that mainstream acceptance of marijuana will lead to an increase in use and thus an increase in marijuana addiction, particularly because marijuana potency has steadily increased over the past 30 years. They also believe that marijuana is a gateway drug , and consequently a rise in marijuana use would lead to increases in the use of harder drugs. Opponents also express concern regarding the potential increase in hospitalizations related to legalizing drugs, and they forecast increases in impaired driving and fatal car crashes as a result of recreational marijuana legalization. As with most issues in the drug legalization debate, there is research both supporting and opposing the latter thesis.

How Drug Legalization Impacts Young Adult Substance Abuse

The question young adult mental health experts are asking is, What does decriminalizing drugs mean for this age group? Will drug legalization result in increased substance abuse and marijuana addiction for Generation Z?

Research does confirm that marijuana use among young adults has reached all-time highs, particularly rates of marijuana vaping . The annual Monitoring the Future (MTF) survey found that one in four young adults uses marijuana, and close to one in 10 uses marijuana daily. One survey found that Gen Z uses marijuana at twice the rate of the national average. But are these increases due to the decriminalization of drugs? Studies show that drug legalization has increased marijuana use among adults, but not among adolescents , as many feared would be the case. Young adults span these two age groups.

In addition, drug legalization has changed young adults’ perception of cannabis. The MTF survey found that only about 25 percent of those surveyed thought that regular marijuana use was potentially dangerous. In addition, only about 6 percent of young adults perceived a “great risk of harm” associated with occasional marijuana use.

Know the Facts

21% of 18- to 24-year-olds who have never tried cannabis before would use it if it was legal, according to a 2020 survey conducted by Cowen research.

Ultimately, mental health professionals are concerned that an increase in young adult marijuana use due to drug legalization will result in an increase in what’s known as cannabis use disorder. According to the National Institute on Drug Abuse, as many as 30 percent of those who use marijuana may have cannabis use disorder. And the risk may be greater right now, because research indicates that young adults are suffering more than any other age group from pandemic-related stress, anxiety, and virtual isolation . Hence, they are using marijuana as a coping mechanism.

It’s too soon to tell whether the positive or the negative effects of drug decriminalization will have the most significant impact on this age group and on society as a whole. However, for young adults who are suffering from cannabis use disorder caused by underlying trauma, depression , and anxiety, comprehensive mental health treatment can help change their trajectory.

At Newport Institute, our approach to substance abuse treatment addresses the root causes of maladaptive behaviors. We guide young adults to process difficult emotions, learn healthy coping skills, and build the authentic connections that create thriving. Contact us today to find out more about clinical model of care and our residential and outpatient treatment programs .

Front Psychol. 2020 Dec;11:10.3389.

J Pos Psych. 2018 Jan;14(2).

Am J Lifestyle Med. 2017 Nov-Dec; 11(6): 466–475.

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  • “Drug Legalization Handbook” Urges Individual ...
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“Drug Legalization Handbook” Urges Individual Reparations, Repealing CSA

drug legalization report

  • by Ben Adlin November 1, 2023

drug legalization report

I t’s time to end prohibition and instead legalize and regulate all drugs, according to a new Reason Foundation report from a coalition of analysts and advocacy groups. Authors say the nearly century-long drug war has failed.

The new 84-page report, released on October 31, was produced in partnership with the National Coalition for Drug Legalization (NCDL), Students for Sensible Drug Policy and Law Enforcement Action Partnership (LEAP). It covers a range of drug-related issues, but it argues broadly that “a legal and regulated market for drugs is likely to produce less dangerous outcomes for both society at large and the individuals who choose to consume drugs.”

“I think America is at a crossroads,” Geoffrey Lawrence, the lead author of the report and the research director for the Reason Foundation, told Marijuana Moment . “The drug war has failed to achieve any of the goals espoused by the key interest groups, whether it’s keeping drugs out of the hands of kids or preventing overdoses or just increasing human freedom.”

“Much work has been done to detail why  we should legalize drugs, but not enough shows people how we can successfully legalize in the current regime.”

“All of those metrics have gone the wrong way under the current approach to drugs,” Lawrence added, “and so maybe there’s an appetite for discussing how a regulated market might work better at achieving all those things.”

Described in the foreword by NCDL founder Veronica Wright as a “living document” that will change “as new information and data arrive,” the report discusses the many facets that would go into drug legalization, from repealing the federal Controlled Substances Act (CSA) to various regulatory, financial, restorative justice and medical considerations.

“Much conversation and work has been done to detail  why  we should legalize drugs,” Wright says, “but not enough effort has been done to show people how  we can successfully legalize drugs in the current regime.”

Of particular note in the report is its prescription to end prohibition by, as one chapter proposes, “eliminating” the CSA. Written by two authors from the Cato Institute, the chapter argues that advocates get it wrong by trying to craft excessive policy.

“As illustrated by recent state-level debates over marijuana legalization, people worry a lot about  how to legalize drugs,” it says. “They suggest regulation, taxes, new state agencies and more in an effort to convince voters—and themselves—that they are serious about getting it ‘right.’ But this focus on legalizing drugs the ‘right way’ misses the mark.”

“Repealing the federal laws that treat drugs differently than other products is the best way forward,” Jeffrey Miron and Erin Partin, the Cato authors, conclude. “There is no need for government to design rules and regulations for the sale of drugs: Markets arise when needed. Letting the market solve a problem created by the government is the best possible outcome.”

While the new report follows the theme of drug legalization, Lawrence at the libertarian-minded Reason Foundation said it represents “a compilation of opinions” from contributing authors. Not every author, he acknowledges, would necessarily agree with such a laissez-faire approach.

“[Cannabis] regulatory components could be replicated and extended to other drugs to create a safe and secure supply channel.”

The following section, for example—written by Lawrence himself and LEAP co-founder Howard Wooldridge—suggests state medical and adult-use marijuana laws as a sort of blueprint for how regulation of other drugs might work, pointing to best practices around production, lab testing, packaging and labeling, advertising, product-tracking and preventing sales to minors.

“Each of these regulatory components could be replicated and extended to other drugs to create a safe and secure supply channel for those individuals who will seek out drug use regardless of its legality,” they write. “As with cannabis, states could license suppliers, conduct extensive background checks of those who own or work for these licensees, and require training where appropriate.”

Some changes might have to be made, they note. For some drugs, regulators might set purchase or possession limits by taking into account the amount of a substance that they believe could cause overdose, or even require that drugs be consumed on-site rather than allow retail sales.

The chapter notes that Oregon’s commercial psilocybin market, for instance—which they describe as “one model for other states that choose to facilitate a commercial supply chain for safe consumption”—requires that the substance “only be administered by a trained and licensed professional in a clinical setting” and that “consumers are never permitted to take psilocybin home for unsupervised use.”

“In a free society, [drug use] should be approached like other lifestyle choices, with respect for autonomy and an emphasis on harm reduction.”

Jeffrey Singer, an Arizona surgeon and senior fellow at the Cato Institute, writes in a section on drug therapy that substance use is a personal choice that carries risks and should be dealt with accordingly.

“Clinicians commonly recommend harm reduction strategies, including medications, to their patients whose lifestyle choices may cause them harm,” Singer says. Similarly, people who use drugs should be able to access harm reduction resources such as syringe service programs and safe consumption sites.

“Drug use [involves] personal choices,” Singer concludes. “In a free society, they should be approached like other lifestyle choices, with respect for autonomy and an emphasis on harm reduction.”

Lawrence and Wright both anticipate that state governments will continue to act ahead of the federal government to create regulated markets for currently illicit drugs. They recommend establishing regulatory boards “with authority to govern licensed businesses” for the sake of public health and safety. The section advises against governments manufacturing or selling products directly, however, citing risk of federal prosecution or asset seizure.

“In communities that the drug war has disproportionately devastated, individual-level compensation actually serves as a community investment.”

The pair also call for strict product manufacturing and testing standards to be sure that products contain listed ingredients and no adulterants. “All batches should be held in quarantine with the wholesale manufacturer until it has obtained clean testing results assuring users the batch is free of potentially harmful contaminants,” they write, recommending that the results be summarized on product labels.

As for restorative justice to repair harms inflicted by the drug war, authors Wright and Jacob James Rich, a Reason Foundation policy analyst, push back against the approach taken by many states with cannabis legalization. Specifically, they advise against using revenue from cannabis taxes, for example, to fund community reinvestment programs and other restorative justice initiatives.

“This approach simply drives up the price for consumers legally purchasing cannabis,” they write, “discouraging people from participating in the legal and regulated market.”

Instead, they suggest a form of individual reparations. “Following tort law traditions, it is arguably appropriate to compensate the victims of these actions through payment of financial damages,” they write, but say that it’s “not clear yet how policymakers should approach this compensation.” The goal should nevertheless be “to target specific individuals who were directly harmed by drug enforcement policies, giving cash transfers to victims in almost all situations.”

“In communities that the drug war has disproportionately devastated, individual-level compensation actually serves as a community investment,” the pair reason, “because the residents who benefit will in turn spend money locally and build a stronger neighborhood. To the extent the drug war was executed in a racially discriminatory way, granting damages directly to the harmed individuals is most equitable and will help bring about racial justice.”

“We should return to a society that respects the freedom and independence of all.”

The section doesn’t specifically mention social equity licensing programs, which have been adopted in some form by many state marijuana licensing systems, though it does include a footnote referencing an April study by Lawrence at the Reason Foundation that found social equity programs “aren’t helping victims of the drug war” but have instead “unintentionally created new versions of the war on drugs.”

In the  report’s conclusion, Lawrence and Wright urge a compassionate approach to drug use that emphasizes the autonomy of consumers. “We should return to a society that respects the freedom and independence of all individuals to live as they see fit as long as they don’t harm others,” they write. “This includes respecting others’ choices to experiment with drugs.”

Education about substances, for example, should “balance the relative risks and potential benefits or cultural contexts of their use,” the section says.

“We cannot ignore human nature,” the authors write. “If enough individuals wish to purchase any commodity, someone will find a way to supply that commodity even if the government calls it contraband.”

In October, a separate report from the International Coalition on Drug Policy Reform and Environmental Justice  attacked the global drug war from an entirely different perspective, arguing that prohibition has ravaged critical ecosystems, undermined efforts to combat climate change and caught up vulnerable populations in a cycle of poverty and prosecution.

A UN report urged member states to shift from punitive drug-control policies to an approach rooted in public health.

Affiliated organization with the environmental justice coalition include Health Poverty Action, LEAP Europe, SOS Amazônia, the Transnational Institute (TNI) and the Washington Office on Latin America (WOLA). While the new Reason report focuses on the United States, the other paper represents Bolivia, Brazil, Colombia, Myanmar, the Netherlands and the United Kingdom.

Both reports come amid a changing global mindset about controlled substances, even as the drug war rages on. A United Nations agency report in September  highlighted human rights concerns raised by the drug war , urging member states to shift from punitive drug-control policies to an approach rooted in public health. Dealing with drugs as a legal issue, it said, is causing further harm.

UN experts and global leaders  echoed those points in June as part of World Drug Day .

In 2019, the UN Chief Executives Board, which represents 31 UN agencies including the UN Office on Drugs and Crime, adopted a position stipulating that member states should pursue science-based, health-oriented drug policies “including the decriminalization of drug possession for personal use.”

Latin American and Caribbean countries  also recently agreed to rethink the drug war . Under the current, punitive approach, “the expected results have not been obtained when combating the world drug problem, leaving in many cases the underlying problems to be solved and exploiting and exacerbating vulnerabilities of our territories and societies,” according to a joint statement issued by 19 nations.

Nevertheless, a recent report by the organization Harm Reduction International found that  wealthy countries gave nearly $1 billion to further the global drug war .

Photograph via United States Drug Enforcement Administration

LEAP was formerly the fiscal sponsor of The Influence Foundation, which operates Filter.

This story was originally published by  Marijuana Moment , which tracks the politics and policy of cannabis and drugs. Follow  Marijuana Moment  on  Twitter  and  Facebook , and sign up for its  newsletter .

Ben is a writer and editor covering cannabis since 2011, including as a senior news editor for Leafly. He is currently senior editor at Marijuana Moment . He lives in Seattle.

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New ACLU Report: Despite Marijuana Legalization Black People Still Almost Four Times More Likely to Get Arrested

A tale of two countries: racially targeted arrests in the era of marijuana reform details millions of racially targeted marijuana arrests made between 2010-2018.

NEW YORK – The American Civil Liberties Union today released a new report showing that Black people are 3.64 times more likely than white people to be arrested for marijuana possession despite comparable marijuana usage rates. Additionally, although the total number of people arrested for marijuana possession has decreased in the past decade, law enforcement still made 6.1 million such arrests over that period, and the racial disparities in arrest rates remain in every state.

The report , A Tale of Two Countries: Racially Targeted Arrests in the Era of Marijuana Reform , details marijuana possession arrests from 2010 to 2018, and updates our unprecedented national report published in 2013, The War on Marijuana in Black and White . The disturbing findings of this new research show that despite several states having reformed marijuana policy over the last decade, far too much has remained unchanged when it comes to racial disparities in arrests.

Key findings include:

  • Law enforcement made more than 6.1 million marijuana-related arrests form 2010-2018. In 2018 alone, there were almost 700,000 marijuana arrests, which accounted for more than 43 percent of all drug arrests . In 2018, law enforcement made more marijuana arrests than for all violent crimes combined.
  • Despite legalization in a number of states, it is not clear that marijuana arrests are trending downward nationally. Arrest rates have actually risen in the past few years, with almost 100,000 more arrests in 2018 than 2015.
  • In every state, and in over 96 percent of the counties examined, Black people were much more likely to be arrested than white people for marijuana possession. Overall, these disparities have not improved. On average, a Black person is 3.64 times more likely to be arrested for marijuana possession than a white person, even though Black and white people use marijuana at similar rates. In 10 states, Blacks were more than five times more likely to be arrested.
  • In states that legalized marijuana, arrest rates decreased after legalization, however racial disparities still remained .

A Tale of Two Countries: Racially Targeted Arrests in the Era of Marijuana Reform comes at a time when the criminal legal system is overwhelmed by the public health crisis presented by COVID-19 that demands expedited decarcercal action to safeguard the lives of those incarcerated in and employed by jails and prisons. The reforms recommended in this report provide a roadmap for reducing marijuana arrests and criminalization as governors, prosecutors, judges, and other stakeholders across the country grapple with the harms presented by the public health crisis and take steps to release people from jails and prisons.

“Many state and local governments across the country continue to aggressively enforce marijuana laws, disproportionately targeting Black communities,” said Ezekiel Edwards, director of the Criminal Law Reform Project at the ACLU and one of the primary authors of the report. “Criminalizing people who use marijuana needlessly entangles hundreds of thousands of people in the criminal legal system every year at a tremendous individual and societal cost. As a matter of racial justice and sound public health policy, every state in the country must legalize marijuana with racial equity at the foundation of such reform.”

To combat the racial disparities rampant in marijuana-related arrests, the ACLU is calling not only for an end to racialized policing, but also for full legalization of marijuana use and possession and specific measures to ensure legalization efforts are grounded in racial justice. This includes pressing for passage of the MORE Act , which aims to correct historical injustices of the failed War on Drugs that has terrorized Black communities by decriminalizing marijuana at the federal level, reassessing marijuana convictions, and investment in economically disadvantaged communities.

The full report is available here .

State level data is available here .

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  • Criminal Law Reform
  • Marijuana Law Reform
  • Drug Law Reform

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Drug Legalization: Myths vs. Reality

drug legalization report

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(Archived document, may contain errors)

1/25/90 122

DRUG LEGALIZATION: MYTHS VS. REALITY

(Updating Backgrounder No. 656, "Why America is Losing the Drug War," June 9,1988, and Backgrounder No. 672, "Strategy for a Drug-Free America: A Symposium," September 12, 1988.) The case for drug legalization continues to be made by some intellectuals and politicians. For the most part, they contend that it has become futile to fight the widespread use of drugs in America, and that legal prohibitions against drug use simply have triggered a crime wave. Like the prohibition of alcohol use in the 1920s, they argue, legal penalties against drug use cannot succeed and thus should be ended. The American people disagree with this line of reasoning, opposing drug legalization by margins of three or four to one. Indeed, a September 1989 Washington Post poll found 88 percent opposed to legalizing cocaine and only 10 percent in favor; the last marijuana de . . . on measure, in Oregon in 1986, lost by more than three to one. They are right to do so, because the case for drug legalization rests on myths and misconceptions. Among them: Myth #1: Current policies are failing to reduce drug use. Fact: Drug use fell by 37 percent between 1985 and 1988, the last year for which accurate figures are available, from 23 million regular drug users to 14 million. It is true that current policies aimed at keeping drugs out of the United States have not worked - and probably cannot be made to work. But this merely underscores the importance and effectiveness of the new emphasis on "user accountability" and reducing demand. Myth #2: Drugs always have been a part of American society and always will be; attempts to prohibit drug use thus are doomed to fail. Fact: Drugs have not always been part of American society. Most Americans today can remember a time when drugs were not in the workplace or discussed casually on television, and when schools were free of drugs. The explosion of drug use during the 1960s and 1970s was the result of a misguided acceptance of drugs and the defacto legalization policies of the time. While alcohol prohibition ultimately failed the test of public approval, it was effective in significantly reducing consumption, which dropped by 50 percent during prohibition and rose 50. percent with its repeal. Cirrhosis deaths for men dropped from 29.5 per 100,000 in 1911 to 10.7 per 100,000 in 1929. Myth #3: Drug legalization would eliminate drug-related crime. Fact: Drug prohibition is related to inner city crime. But much crime associated with drugs is a function of drug use itself. For example, 32 percent of men in prison for rape admit they were using illegal drugs at thetime of the crime. These are not addicts stealing to support a habit or dealers shooting each other in territorial disputes. Moreover, drug use destroys the effectiveness of

criminal penalties as a deterrent to crime; a person high on cocaine is unlikely to think much about the consequences of his actions. Myth #4: Current policies and proposals under discussion infringe on civil liberties. Fact: Concerns about civil liberties do and should influence policy toward drug use. But the government has a legitimate role in curbing the use and supply of poisonous substances. Tle notion that curbing drug use implies America is striding toward a police state is nonsense. Myth #5: Illegal drugs are not significantly more harmful (and may be less harmful) than legal drugs. If alcohol and tobacco are legal, marijuana and cocaine should be too, Fact: To be sure, more Americans die from alcohol and cigarettes than from illegal drugs. But that is because far more use them. About 110 million Americans use alcohol; about 60 million smoke; by contrast, 14 million use drugs. Illegal. drugs, however, are much more dangerous than alcohol and tobacco. While 10 percent of alcohol users consume to excess, 50 percent of marijuana users suffer from excessive use of the drug, as do 90 percent of cocaine users, and 95 percent of those using opiates. Myth #6: Drug use is a "victimless crime." Americans have a right to do what they want with their own bodies. Fact: Drug use is not victimless. Not only do individuals commit crimes under drug influence, but drug users are involved in 10 percent to 15 percent of highway fatalities, are two to three times more likely to be involved in workplace accidents (injuring others as well as themselves), and give birth to 100,000 cocaine addicted infants each year. Myth #7: Drug prohibition creates drug dealers, who proselytize drug use. Drug use would decline (or at least not go up) if drugs were legalized. Fact: If drug legalization works at all, it works by lowering prices - "taking the profit out of drugs" as proponents of legalization put it. Lowering the price, however, surely would lead to increased demand. After prohibition, alcohol consumption increased 50 percent. In Britain, where addicts get heroin from the government, the number of "registered" addicts has risen from 2,800 in 1980 to 80,000 today. T'hus, both economic theory and actual experience strongly suggest drug legalization would increase drug use, perhaps as drastically. Myth #8: Current policies are too costly, money would be better spent on education, rehabilitation and economic development. Fact: The U.S. spends less than 3 cents of every federal, state, and local government dollar on criminal justice of all kinds - of which only a tiny fraction goes for drug law enforcement. Even with recent funding increases for drug enforcement, the federal government spends five times as much on agricultural subsidies, four times as much on highway and mass transit subsidies, and three times as much on foreign aid. Moreover, rehabilitation and treatment can only help those who have already fallen prey to drugs and, regrettably, the best studies indicate that only 10 percent to 30 percent of those who enter these programs are successful in kicking their habits. Thus, enforcement is essential as a means of deterring drug use before it starts. Alternatives to Legalization It is possible to make America drug-free'. Drug use already has fallen by more than a third since 1985. Drug use among 18- to 25-year-olds is down 53 percent for marijuana and 52 percent for cocaine since 1977. This is hardly the time to run up the white flag.

With the moral climate moving decisively against drug use, even talk of drug legalization is dangerous. The percentage of high school seniors who believe marijuana is hazardous to health bottomed out in 1978 (at 35 percent) and their rate of drug use peaked (at 39 percent in 1988). Today, 77 percent of high school seniors believe marijuana use is damaging to health, and only 21 percent use drugs. Proponents of legalization should ponder the message that would be sent to young Americans if prohibitions against drug use were to be withdrawn. The drug legalization argument ultimately rests on the dual proposition that current policies have failed and that there are no alternatives to a complete surrender. But as the recent drop in drug use indicates, the claim that current policies have failed is at least open to question. More important, there are alternatives to current policies that promise to achieve a sharp reduction in drug use in America. Among the policies that need to be adopted: 1) Give greater incentives for current and potential drug users not to use drugs. In the military, in schools, and in the private workplace, the use of drug testing combined with "measured response" penalties (such as mandatory participation in a drug treatment program) have been effective in reducing dramatically the extent and costs of drug use. Yet such "user accountability" programs, which work by identifying drug users and imposing certain relatively mild penalties for first-time offenders, still have been applied in fewer than half the private workplaces in America and in very few schools at either the elementary and secondary or post-secondary levels. In many states, the law enforcement system itself still has not even adopted user accountability, leaving drug users free to commit their crimes without serious fear of punishment, even if they are arrested. If user accountability programs are expanded, as seems likely, drug use can be expected to decline dramatically. Senator Phil Gramm, the Texas Republican, and Representative Newt Gingrich, the Georgia Republican, have introduced legislation authorizing private employers to test for drug use in the workplace. This would override several state statutes that have sought to limit such testing. 2) Institute long-tenn incarceration of career drug traffickers to reduce the availability of drugs and increase their street price. While there can be little doubt that dfugs win continue to be available in America as long as there is a demand for them, the law enforcement system today is doing far too little to make drug trafficking as a career unattractive to young Americans. The recent conviction on cocaine dealing charges of Rayful Edmond in Washington, D.C, dre%;r wide attention simply because it was so exceptional. Most career drug dealers either escape punishment, receive light sentences, or are let out on early release or parole. Ile message young Americans are receiving is: "If you deal drugs, you can live a luxurious lifestyle with minimal risk of punishment." Stronger and more certain penalties can change this equation and reduce the supply of drug dealers. This goal means more police officers, prosecutors, and courts. Even more important, it needs more prison spaces, so that the thousands of Rayful Edmonds still on the loose in America can be convicted and put behind bars. 3) Focus on underclass neighborhoods, where the drug war still is being lost. The suffocating liberal welfare state policies of the past 25 years have eliminated legitimate opportunity for the very Americans they were intended to help, causing many to forsake hope altogether and drift outside of mainstream society. Rather than providing a cheap "opiate for the masses," as legalization would do, government must create an environment of hope and opportunity in which citizens can solve their problems instead of trying to escape them through drugs. Restoring order and opportunity to America's inner cities is a daunting challenge, but the drug war will not be won until anti-poverty programs in the inner city become centered on economic opportunity and independence, not welfare and dependence on the government.

nose who argue for legalization are expressing the pessimism that has dominated American culture since Vietnam: the problem is too big, the resources too limited, and the country's resolve too weak to win the war against drugs. Yet this pessimism is based on myths and falsehoods regarding the nature of the drug problem and America's ability to deal with it. Moreover, if the pessimists win the argument over drug legalization, it may not be long before running up the white flag becomes a proposal for "dealing" with other chronic problems facing the nation, such as declining education standards and inner city poverty. If lawmakers continue to improve on current policies, however, the drug problem can be overcome, along with the sense of pessimism that spawned the ill-conceived proposal to legalize drugs.

Jeffrey A. Eisenach Visiting Fellow

Senior Policy Analyst on International Economics

Americans are less safe today than they were a decade ago due to failed models of criminal justice reform, rogue prosecutors, and politicized unequal law enforcement. 

LEGAL MEMO About an hour read

REPORT 17 min read

COMMENTARY 4 min read

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Biden administration examining role of supply chain middlemen in generic drug shortages

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  • The Federal Trade Commission said it is examining the role drug wholesalers and companies that purchase medicines for U.S. health-care providers play in shortages of generic drugs.
  • The move follows an unprecedented shortfall of crucial medicine over the last year, which has forced hospitals to ration drugs ranging from injectable cancer therapies to pain treatments.
  • In a joint request for information, the FTC and the Department of Health and Human Services are seeking public comment on the contracting practices, market concentration, and compensation of two types of middlemen: group purchasing organizations and drug wholesalers.

The Federal Trade Commission on Wednesday said it is examining the role that drug wholesalers and companies that purchase medicines for U.S. health-care providers play in shortages of generic drugs, which account for the majority of Americans' prescriptions.

The move follows an unprecedented shortfall of crucial medicine ranging from injectable cancer therapies to generics, or cheaper versions of brand-name medicines, over the last year, which has forced hospitals and patients to ration drugs. Problems from manufacturing quality control to demand surges can drive supply issues.

But the Biden administration is zeroing in on other players in the drug supply chain to uncover the "root causes and potential solutions" to ongoing shortages. 

In a joint request for information, the FTC and the Department of Health and Human Services are seeking public comment on the contracting practices, market concentration and compensation of two types of middlemen. They are group purchasing organizations, which broker drug purchases for hospitals and other health-care providers, and drug wholesalers, which buy medicines from manufacturers and distribute them to providers. 

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The request for information will examine whether those middlemen have misused their market power to cut the prices of generic drugs to the point that manufacturers can't profit and have to stop production, and rival suppliers are discouraged from competing in the generic drug market. 

"The FTC is interested in looking at this market because on one side of the market, you have patients that are desperate for the right drug and would pay a very high price for that drug if they could. And on the other side of the market, you have manufacturers that can't get more than a few dollars per dose of that same drug," Doug Farrar, director of the FTC's Office of Public Affairs, told CNBC.

"So that negative outcome for patients is what caused the FTC to want to study this market," he added.

The FTC and HHS did not name specific companies. But Vizient, Premier and HealthTrust are among the biggest group purchasing organizations for hospitals, while Cencora , Cardinal Health and McKesson are responsible for roughly 90% of prescription drug distribution in the U.S..

The public will have 60 days to submit comments at Regulations.gov, the FTC said. 

Group purchasing organizations and wholesalers have gotten limited attention on Capitol Hill, even as reining in high drug costs has become a key priority among lawmakers in both chambers.

As part of the effort to cut the cost of medications, lawmakers have sought greater transparency from pharmacy benefit managers , which negotiate drug discounts on behalf of insurance companies and other payors, about their business practices.

PBMs contend that manufacturers are responsible for high drug prices, while drugmakers say rebates and fees collected by those middlemen force them to increase list prices for products.

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comscore

Honolulu KHNL

New reaction on state’s push to legalize recreational marijuana

H ONOLULU (HawaiiNewsNow) - Community leaders and law enforcement officials from across the state take a unified stand against efforts to legalize recreational marijuana.

Honolulu Prosecutor Steve Alm said two bills intended to legalize recreational marijuana would not get rid of the black market.

“We’re looking at what Marijuana is today, and it is nothing like it is today,” said Alm. “And in fact, states that have legalized have a bigger black market because you’re gonna get more users.”

The pushback comes a day after Gov. Josh Green, who’s also a physician, said he would approve the drug for adult use as a lesser evil than cocaine and meth.

“I also have some thoughts that marijuana might blunt the effect, if you will, of people on these heavy drugs, these horrible drugs, it is a relative sedative, people are far less violent, they are much hungrier,” said Green. “But they, aside from the snacking and stealing Cheetos, will probably do less harm.”

However, the CDC said three out of 10 people who use marijuana will develop a disorder.

And the health aspects are only part of the equation.

Today, a broad range of state and county leaders took a stand against legalization, including the police chiefs of Maui and Kauai counties who worked in Nevada when cannabis became legal there seven years ago.

“During our law enforcement careers in Las Vegas, Chief Pelletier and I witnessed firsthand how criminals exploited marijuana legalization to expand their criminal enterprises,” said Kauai Police Chief Todd Raybuck.

“You will have violent crime more than you have now, you will have homeless more than you have now,” said Maui Police Chief John Pelletier. “You are not prepared to do this.”

Former governor Linda Lingle feels so strongly about the issue that she spoke publicly on Wednesday for the first time in 14 years.

“The bottom line is it’s a risk we just can’t take,” said Lingle. “We have big issues to solve here.”

“This would make those big issues almost impossible to ever solve.”

However, those in the marijuana industry said the issues are all solvable, and legalization isn’t as scary as it may appear.

Supporters include The Drug Policy Forum of Hawaii.

“Adult use cannabis legalization also has great upside potential for creating an economy that, that where Hawaii will have significant advantages,” said Nikos Leverenz of the Drug Policy Forum of Hawaii.

“And so, it’s really about a balance of harm, and how do we reduce the issues that face children?” said Ty Cheng, President of Aloha Green Apothecary. “By legalizing and putting strict rules in place and good regulation, we have a much better chance of protecting public safety.”

A joint legislative hearing for the bill is set for 9 a.m. next week on Tuesday at the Capitol.

Honolulu Prosecutor Steve Alm said two bills intended to legalize recreational marijuana would not get rid of the black market.

IMAGES

  1. New NCCI Report: 2021 Marijuana Legalization Update

    drug legalization report

  2. Maps reveal how each U.S. state enforces drug laws differently

    drug legalization report

  3. A Timeline of the Federal Legality of 12 Drugs in the United States

    drug legalization report

  4. Election Day results: Marijuana legalization, drug decriminalization

    drug legalization report

  5. Drug Legalization: 17 Main Pros and Cons (You Must Know)

    drug legalization report

  6. Report: Marijuana Legalization Could Generate $28B in Tax Revenue

    drug legalization report

COMMENTS

  1. From Prohibition to Progress: What We Know About Marijuana Legalization

    A new report by the Drug Policy Alliance, From Prohibition to Progress: A Status Report on Marijuana Legalization, demonstrates how and why marijuana legalization is working so far. On Tuesday, January 23 at 1pm (ET) / 10am (PT), DPA will host a press teleconference to discuss the report's findings with key policymakers and elected officials:

  2. Oregon pioneered a radical drug policy. Now it's reconsidering

    Kristyna Wentz-Graff/OPB. Oregon voters passed the most liberal drug law in the country in November 2020, decriminalizing possession for small amounts of hard drugs. Under Ballot Measure 110 ...

  3. UN drug report shines light on cannabis, cocaine and methamphetamine

    27 June 2022 Health Legalized cannabis use in some countries and states appears to have accelerated daily use and related health impacts, the UN Office on Drugs and Crime (UNODC) revealed in a...

  4. Drug Legalization and Decriminalization Beliefs Among Substance-Using

    Drug Legalization and Decriminalization Beliefs Among Substance-Using and Non-using Individuals. Alexis S. Hammond, MD, PhD, Kelly E. Dunn, ... (36.1%), or no substances (37.7%). Similarly, those who identified with a religion were significantly less likely to report primary marijuana use (23.7%) than those who did not (38.6%). However, those ...

  5. UNODC World Drug Report 2022 highlights trends on cannabis post

    Vienna (Austria), 27 June 2022 - Cannabis legalization in parts of the world appears to have accelerated daily use and related health impacts, according to the UN Office on Drugs and Crime (UNODC)'s World Drug Report 2022.

  6. The Federal Status of Marijuana and the Expanding Policy Gap with States

    The rate of past-month marijuana use among youth (ages 12-17) initially declined during this time period—from 7.0% in 2008 to 6.5% in 2017 and 2018—before rising to 7.4% in 2019 and then dropping to 5.8% in 2021, while adult (ages 18 and older) use steadily increased—from 6.3% in 2008 to 13.7% in 2021.

  7. The Wider Impact of Drug Legalization on the Criminal Justice System

    This paper will discuss the effect of legalizing possession of all drugs on the criminal justice system. This paper will begin with a brief history of the modern War on Drugs to establish why drug possession should not be a criminal matter.

  8. Law enforcement seizures of psilocybin mushrooms rose dramatically

    Law enforcement seizures of "magic mushrooms" or "shrooms" containing the psychoactive component psilocybin increased dramatically in the United States between January 2017 and December 2022, according to a new study funded by the National Institute on Drug Abuse, part of the National Institutes of Health. The number of law enforcement seizures increased from 402 seizures in 2017 to ...

  9. Drug busts of 'magic mushrooms' went way up in recent years ...

    The new study found that the total amount of mushrooms seized by law enforcement across the country went from nearly 500 pounds in 2017 to more than 1,800 pounds in 2022. The largest amount (42.6% ...

  10. The Evolution of Marijuana as a Controlled Substance and the Federal

    Marijuana is a psychoactive drug that generally consists of leaves and flowers of the cannabis ... Many observers voice apprehension over possible negative outcomes of marijuana legalization, including, but not limited to, (1) potential increases in marijuana use, particularly among youth; (2) potential increases in traffic accidents involving ...

  11. Drug Legalization Handbook

    October 31, 2023 Foreword The Drug Legalization Handbook is a living document. As new information and data arrive, the words on these pages will change. The intent of this handbook is simply to provide a framework for how to legalize all drugs.

  12. The Budgetary Effects of Ending Drug Prohibition

    Legalization can reduce government spending, which saves resources for other uses, and it generates tax revenue that transfers income from drug producers and consumers to public coffers....

  13. PDF STATE AND TERRITORY REPORT ON ENDURING AND EMERGING THREATS

    January 2024. NIIP-012-24. 500,000. Incidents of fentanyl misuse and drug. 450,000. poisonings, and law enforcement. 400,000. seizures of to produce fentanyl in both powder form and pressed into fake pills. Fentanyl is increasingly being mixed with other illicit drugs, such as methamphetamine, heroin, and cocaine.

  14. New 'Drug Legalization Handbook' From Coalition Of Advocacy Groups

    Ben Adlin It's time to end prohibition and instead legalize and regulate all drugs, according to a new Reason Foundation report from a coalition of analysts and advocacy groups. Authors say the nearly century-long drug war has failed to rein in overdose deaths, reduce substance use disorders or decrease violent crime.

  15. PDF Impacts of Marijuana Legalization in Colorado: A Report Pursuant to C.R

    A Report Pursuant to C.R.S. 24-33.4-516 July 2021 Colorado Department of Public Safety Division of Criminal Justice Office of Research and Statistics 700 Kipling St., Denver, Colorado 80215 https://ors.colorado.gov/ Impacts of Marijuana Legalization in Colorado A Report Pursuant to C.R.S. 24-33.4-516

  16. Mandated Drug Treatment in the Aftermath of Recreational Cannabis

    In legal states, the average admissions rates declined 57.19% from 2007 to 2019. Declines started prior to legalization in all states. The size of the decline ranged from 11.5% in Colorado to 99.7% in Washington (Figure 1). In nonlegal states, the average admissions rate declined 41.06% from 2007 to 2019.

  17. Drug Legalization?: Time for a real debate

    Besides undermining the black-market incentives to produce and sell drugs, legalization could remove or at least significantly reduce the very problems that cause the greatest public concern:...

  18. Gorilla in the Room: The Expert View on Drug Legalization

    This article is part of a series on drug policy and legalization in the region. See the full series her e or download the full report. InSight Crime has prepared a map detailing the positions of every country in the region on legalization and decriminalization. While it is useful to understand how these policies are viewed throughout the region ...

  19. World Drug Report 2023

    World Drug Report 2023. For the first time since its conception, this year the World Drug Report consists of two products, a web-based element and a set of booklets. The latest global, regional and subregional estimates of and trends in drug demand and supply are presented in a user-friendly, interactive online segment . While Special points of ...

  20. The Legalization of Drugs: For & Against

    The Legalization of Drugs: For & Against Douglas Husak and Peter de Marneffe, The Legalization of Drugs: For & Against, Cambridge University Press, 2005, 204pp., $18.99 (pbk), ISBN 0521546869. Reviewed by William Hawk, James Madison University 2006.08.09

  21. The Effects of Drug Legalization

    The Effects of Drug Legalization Reading Time: 5 minutes With an increasing number of states legalizing marijuana and other drugs, the debate continues on whether the negative effects of drug decriminalization outweigh the positives. Researchers, policymakers, and public health officials provide arguments on both sides.

  22. Drug Legalization: Pro and Con

    Drug Legalization: Pro and Con NCJ Number 154383 Author (s) H L Hogan Date Published 1988 Length 19 pages Annotation This paper presents arguments for and against the legalization of drugs whose use and trafficking is currently criminalized. Abstract

  23. "Drug Legalization Handbook" Urges Individual Reparations, Repealing CSA

    The new 84-page report, released on October 31, was produced in partnership with the National Coalition for Drug Legalization (NCDL), Students for Sensible Drug Policy and Law Enforcement Action Partnership (LEAP). It covers a range of drug-related issues, but it argues broadly that "a legal and regulated market for drugs is likely to produce ...

  24. PDF Drug legalization handbook

    The National Coalition for Drug Legalization is a nonprofit 501(c)3 focused on the legalization of all drugs. Our mission is to advance the conversation about the legalization of all drugs through community service and research. We are a direct-action organization guided by the principle of love. We recognize love is an action

  25. New ACLU Report: Despite Marijuana Legalization Black People Still

    In 2018 alone, there were almost 700,000 marijuana arrests, which accounted for more than 43 percent of all drug arrests. In 2018, law enforcement made more marijuana arrests than for all violent crimes combined. Despite legalization in a number of states, it is not clear that marijuana arrests are trending downward nationally.

  26. Colorado Division of Criminal Justice Publishes Report on Impacts of

    (July 19, 2021) - The Colorado Division of Criminal Justice's Office of Research and Statistics has published the latest " Impacts on Marijuana Legalization in Colorado " report, which presents data on marijuana-related topics including crime, impaired driving, hospitalizations, ER visits, usage rates, effects on youth, and more.

  27. Drug Legalization: Myths vs. Reality

    Myth #3: Drug legalization would eliminate drug-related crime. Fact: Drug prohibition is related to inner city crime. But much crime associated with drugs is a function of drug use itself. For ...

  28. FTC, HHS examining cause of generic drug shortages

    The Federal Trade Commission said it is examining the role drug wholesalers and companies that purchase medicines for U.S. health-care providers play in shortages of generic drugs. The move ...

  29. New reaction on state's push to legalize recreational marijuana

    "Adult use cannabis legalization also has great upside potential for creating an economy that, that where Hawaii will have significant advantages," said Nikos Leverenz of the Drug Policy Forum ...