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December 2017

Changing Physician Approaches to Marijuana Use in a New Era of Legalization

Author Affiliations
  • 1Department of Pediatrics, School of Medicine, University of California, San Diego
  • 2Division of Academic General Pediatrics, Developmental Pediatrics, and Community Health, Department of Pediatrics, School of Medicine, University of California, San Diego
JAMA Pediatr. 2017;171(12):1137-1138. doi:10.1001/jamapediatrics.2017.3030

Seven states in the United States and the District of Columbia have legalized the recreational use of marijuana. The push for legalizing recreational marijuana is rapidly gathering momentum; 4 of the 7 states legalized recreational marijuana use in November 2016, and the Canadian federal government has announced its intent to do the same by 2018.

Supporters of legalizing use argue that it will lead to increased regulatory capacity, which can restrict its sale to minors while permitting adults to use small amounts without fear of legal consequence. However, critics raise concerns that legalization will promote more permissive attitudes toward marijuana among minors, which may increase their rates of use. In a 2017 study, adolescents in states that had legalized recreational marijuana had lower perceptions of harm associated with marijuana use and higher past-month use compared with prelegalization rates.1 These trends appeared to be more pronounced in regions that experienced a larger increase in marijuana commercialization and advertising over the study period.1 It is unclear whether legalizing recreational use of marijuana itself promotes more lenient approaches toward marijuana or if a preexisting culture of permissive attitudes is the impetus for legalizing recreational use. However, 10% of non–marijuana using high school students state that they intend to initiate use specifically if and when marijuana becomes legal,2 suggesting that legalizing the use of marijuana does influence adolescent behavior.

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