Do medical marijuana laws increase marijuana use? Replication study and extension

Purpose: To replicate a prior study that found greater adolescent marijuana use in states that have passed medical marijuana laws (MMLs), and extend this analysis by accounting for confounding by unmeasured state characteristics and measurement error.

Methods: We obtained state-level estimates of marijuana use from the 2002 through 2009 National Survey on Drug Use and Health. We used 2-sample t-tests and random-effects regression to replicate previous results. We used difference-in-differences regression models to estimate the causal effect of MMLs on marijuana use, and simulations to account for measurement error.

Results: We replicated previously published results showing higher marijuana use in states with MMLs. Difference-in-differences estimates suggested that passing MMLs decreased past-month use among adolescents by 0.53 percentage points (95% confidence interval [CI], 0.03-1.02) and had no discernible effect on the perceived riskiness of monthly use. Models incorporating measurement error in the state estimates of marijuana use yielded little evidence that passing MMLs affects marijuana use.

Conclusions: Accounting for confounding by unmeasured state characteristics and measurement error had an important effect on estimates of the impact of MMLs on marijuana use. We find limited evidence of causal effects of MMLs on measures of reported marijuana use.