Search

Objectives. To estimate changes in medical cannabis patient activity after Canada's recreational cannabis legalization. Methods. I used linear regressions of interrupted times series models to analyze medical cannabis patient registrations per 10 000 residents, purchases per 100 registrations, and packages per purchase in Canada's 10 provinces between April 2017 and December 2022. I tested relationships between the recreational law's passage in June 2018, recreational sales starting in October 2018, and the arrival of edibles and vapes in December 2019. Results. Medical patient registrations initially increased; they slowed after the law passed and started decreasing after edibles became available. Medical purchasing frequencies initially decreased; they decreased further in proportion to recreational sales but stabilized after edibles became available. Medical purchase sizes were initially stable; they began increasing after edibles became available. Conclusions. Canada saw substantial decreases in medical cannabis patient registrations, but the remaining patients stabilized their purchasing frequencies and increased their purchase sizes. Public Health Implications. Other countries might see significant changes in patient usage of their medical cannabis systems after nationwide recreational cannabis legalization. (Am J Public Health. 2024;114(S8):S673–S680. https://doi.org/10.2105/AJPH.2024.307721) [ABSTRACT FROM AUTHOR]

Lately, there has been massive media coverage of gang-related criminality in 'exposed areas' in Sweden. Politicians have blamed the illegal drugs trade without questioning the country's prohibitionist drug policy. This study analyzes how cannabis is constructed in Swedish newspaper articles that mention both organized crime and cannabis. We ask how the drug and its buyers and sellers are described, what discourses are drawn upon, and discuss the relationship between media coverage and drug policy. We analyzed recent (2021) articles from four newspapers (n = 71) through Critical Discourse Analysis. Cannabis was constructed as a commodity linked to violence and deviance. Agency was attributed to people with power and status (e.g. gang leaders), and recreational cannabis users were described as guilty of feeding organized crime. A combination of economic and moral discourses was used to make the reported events meaningful, and to motivate both prohibition and decriminalization/legalization. The study shows that assumedly neutral journalistic voices emphasized the link between cannabis and violence and problematized cannabis buyers and sellers. This homogenous media coverage will probably contribute to keep the question of cannabis law reform discursively lifeless in Sweden. [ABSTRACT FROM AUTHOR]

Purpose: State-level prevalence data are used to investigate whether recreational cannabis legalization moderates the mediated pathway from the perception of low risk of harm, to cannabis use, to cannabis use disorder (CUD) treatment admissions, among adolescents (age 12–17) in the US. Methods: Annual state prevalence measures of perception of low risk, cannabis use, and CUD treatment admissions between 2008 and 2019 (N = 542 state-year observations) were collected from the National Survey on Drug Use and Health (NSDUH) and the Treatment Episode Dataset – Admissions (TEDS-A). A two-way fixed effects (state and year) moderated mediation model was used to test whether recreational legalization moderated the indirect effect of perception of low risk on treatment admissions via cannabis use. Results: A positive indirect effect of perceiving cannabis as low risk on CUD treatment admissions via cannabis use was observed prior to legalization but not afterwards. After legalization, the positive association of perceiving cannabis as low risk with cannabis use was strengthened, and the positive association of cannabis use with treatment admissions was suppressed, as compared to before legalization. Discussion: Recreational legalization may alter the social acceptability and medical self-administration of cannabis, potentially leading to CUD treatment utilization decline among adolescents even as risk factors for CUD increase. Linking recreational cannabis legalization to advancing awareness of the health risks associated with adolescent cannabis use and promoting adolescent CUD treatment engagement through mHealth approaches and primary care providers are key to addressing potential adolescent health challenges brought about by expanding cannabis legalization. [ABSTRACT FROM AUTHOR]

Few studies of recreational cannabis legalization (RCL) have assessed adolescents both before and after RCL or considered moderators of RCL effects. The present study tested whether RCL was more strongly associated with cannabis use for girls and among youth whose parents had a history of cannabis use during adolescence. Data were pooled from 940 adolescents from three intergenerational studies that began in Washington (where RCL was enacted in 2012), Oregon (RCL year = 2015), and New York (RCL year = 2021). Youth were assessed repeatedly from ages 13 to 18 years (k = 3,650 person–years) from 1999 to 2020 (prior to RCL in New York). Parent cannabis use at or before age 18 years (yes/no) was assessed prospectively during the parent's adolescence. Multilevel models focused on the between-subjects effects of years of youth exposure to RCL on adolescents' mean cannabis use likelihood, and interactions with child sex and parent use history. Child exposure to RCL was associated with a higher likelihood of cannabis use if their parents had a history of adolescent use, (Estimate [SE] = 0.67 [0.25], p = 0.008), versus no such history (Estimate [SE] = −0.05 [0.28], p = 0.855). RCL effects were not moderated by child sex. The effects of RCL on adolescents' cannabis use may depend on their parents' history of using the drug. Identifying other moderators of RCL effects, and understanding the mechanisms of these risks and the ways that parents and communities can offset them, are prevention priorities. (1) Adolescents' use of cannabis may have intergenerational consequences, making it more likely their future offspring will use cannabis. (2) Whether or not recreational cannabis legalization influences adolescents' cannabis use may depend on their parents' cannabis use history. (3) Parenting in a state with liberalized cannabis policies may present new challenges and require that novel prevention resources be developed. [ABSTRACT FROM AUTHOR]

The recently rapidly evolving legal status of recreational cannabis in various countries has triggered international debate, particularly around measures required to minimise resulting harms. The present article argues that mental health nurses should have a key role in promoting safe and appropriate use of recreational cannabis, and minimising harm based on the extant evidence. The article summarises the factors driving legalisation, outlines the evident medicinal benefits of cannabis, and appraises the evidence on the negative mental health impacts associated with use. We go on to discuss research findings on the potentially deleterious mental health effects resulting from legalising recreational cannabis and strategies to minimise these harms, including directions for future research and evaluation. Further, we consider the importance of the implementation of harm minimisation measures that are context‐specific, using Thailand as an example. Finally, we present the key health promotion messages that mental health nurses should aim to convey to people who use or consider using recreational cannabis. Ultimately, we aim to provide a summary of the existing evidence that mental health nurses can draw upon to promote mental health and engage with the policy reform debate. [ABSTRACT FROM AUTHOR]

Over the past two decades, cannabis policies have liberalized in the United States, culminating in the legalization of recreational cannabis in Colorado and Washington state in 2012. This review will focus on the impact of recreational cannabis legalization in Colorado. While the prevalence of past-year and past-month cannabis use has remained relatively steady among adolescents post-legalization, the prevalence of young adult use has continued to rise. Cannabis products with increased potency have become more prevalent and widely used. There are concerns that the use of products with increased potency will increase risk for cannabis use and comorbid mental health disorders, particularly cannabis-induced psychosis and suicidal behavior, although more research is needed to fully understand the impact of high-potency products. Since the legalization of recreational cannabis, numerous additional public health concerns have emerged: unintentional overdoses requiring acute care visits, electronic vaping-associated lung injury, increased motor vehicle collisions related to cannabis consumption, and higher rates of cannabis use during pregnancy. Lessons learned from the first decade of cannabis legalization emphasize the need for research efforts to provide evidence-based guidelines, inform prevention strategies, and implement selective interventions for at-risk populations including youth, individuals with comorbid mental health disorders, and individuals who are pregnant. [ABSTRACT FROM AUTHOR]

Cannabis legalization policies are rapidly changing in the United States. While there are concerns that recreational legalization will negatively affect young people, previous reviews have not provided clear indication of such effects. The purpose of this rapid systematic review was to examine whether recreational legalization was associated with increases in prevalence of cannabis use and use disorder among adolescents and young adults. PubMed/MEDLINE, Embase, Scopus, PsycInfo, Web of Science, Dissertations & Theses Global, the Trip Database, and OpenGrey were searched from date of inception through Marcy 17, 2022 to retrieve all relevant records. English language and human subject filters were applied. Two reviewers screened abstracts and titles, assessed full text articles, and coded the final included articles. Studies including primarily 10- to 19–year-olds were classified as adolescent, and those between 18 and 26 years as young adult. Our search identified 33 research reports (22 with adolescent samples; 14 young adult). For adolescents, ten studies reported no change in use prevalence associated with legalization, six reported a decrease, and seven reported an increase. Among young adults, most studies (8) showed an increase in at least one prevalence measure, four showed no change, and one showed a decrease. Only two adolescent and one young adult study examined cannabis use disorder, both adolescent studies showed an increase, and the young adult showed no change. The majority of studies had risk of bias. Recreational legalization may be associated with increases in prevalence of cannabis use in young adults while results for adolescents are mixed. Policymakers and practitioners should consider appropriate prevention and treatment options for young people. Trial Registration: PROSPERO #CRD42021276984. [ABSTRACT FROM AUTHOR]

Background: The past two decades have seen significant debate around cannabis legalization globally, including in India. Since there is no data on professionals’ attitudes toward cannabis legalization; we aimed to assess early-career psychiatrists (ECP) views on cannabis legalization. Methods: An online survey consisting of questions regarding personal and socio-demographic details, attitudes toward legalization of medicinal cannabis and recreational cannabis, and potential indications of medicinal cannabis use was distributed to ECPs. Data from 105 respondents were analyzed using descriptive statistics, chi-square test, and t-test. Results: More respondents agreed with the legalization of medical cannabis (55%) as compared to recreational cannabis (23%). More than 80% ECPs considered cannabis to be associated with psychosis and adverse mental health outcomes; however, those in favor of legalization considered cannabis to be less harmful. ECP with past cannabis use was more likely to have a permissive attitude toward the legalization of recreational cannabis (χ2 =6.79, p < .05) but not for medicinal cannabis use (χ² =1.96, p > .05). Conclusion: ECP in India are open to the idea of legalizing cannabis for medicinal purposes but not for recreational purposes. [ABSTRACT FROM AUTHOR]

Background and Aims: Many countries have recently legalized medicinal and recreational cannabis. With increasing use and access come the potential for harms. We aimed to examine the effect of cannabis legalization/decriminalization on acute poisoning. Methods: A systematic review and meta‐analysis registered with PROSPERO (CRD42022323437). We searched Embase, Medline, Scopus and Cochrane Central Register of Controlled Trials from inception to March 2022. No restrictions on language, age or geography were applied. Abstracts from three main clinical toxicology conferences were hand‐searched. Included studies had to report on poisonings before and after changes in cannabis legislation, including legalization and decriminalization of medicinal and recreational cannabis. Where possible, relative risk (RR) of poisoning after legalization (versus before) was calculated and pooled. Risk of bias was assessed with ROBINS‐I. Results: Of the 1065 articles retrieved, 30 met inclusion criteria (including 10 conference abstracts). Studies used data from the United States, Canada and Thailand. Studies examined legalization of medicinal cannabis (n = 14) and decriminalization or legalization of recreational cannabis (n = 21). Common data sources included poisons centre records (n = 18) and hospital presentations/admissions (n = 15, individual studies could report multiple intervention types and multiple data sources). Most studies (n = 19) investigated paediatric poisoning. Most (n = 24) reported an increase in poisonings; however, the magnitude varied greatly. Twenty studies were included in quantitative analysis, with RRs ranging from 0.81 to 29.00. Our pooled estimate indicated an increase in poisoning after legalization [RR = 3.56, 95% confidence interval (CI) = 2.43–5.20], which was greater in studies that focused on paediatric patients (RR = 4.31, 95% CI = 2.30–8.07). Conclusions: Most studies on the effect of medicinal or recreational cannabis legalization/decriminalization on acute poisoning reported a rise in cannabis poisoning after legalization/decriminalization. Most evidence is from US legalization, despite legalization and decriminalization in many countries. [ABSTRACT FROM AUTHOR]

Background: The causal impacts of recreational cannabis legalization are not well understood due to the number of potential confounds. We sought to quantify possible causal effects of recreational cannabis legalization on substance use, substance use disorder, and psychosocial functioning, and whether vulnerable individuals are more susceptible to the effects of cannabis legalization than others. Methods: We used a longitudinal, co-twin control design in 4043 twins (N = 240 pairs discordant on residence), first assessed in adolescence and now age 24–49, currently residing in states with different cannabis policies (40% resided in a recreationally legal state). We tested the effect of legalization on outcomes of interest and whether legalization interacts with established vulnerability factors (age, sex, or externalizing psychopathology). Results: In the co-twin control design accounting for earlier cannabis frequency and alcohol use disorder (AUD) symptoms respectively, the twin living in a recreational state used cannabis on average more often (β w = 0.11, p = 1.3 × 10−3), and had fewer AUD symptoms (β w = −0.11, p = 6.7 × 10−3) than their co-twin living in an non-recreational state. Cannabis legalization was associated with no other adverse outcome in the co-twin design, including cannabis use disorder. No risk factor significantly interacted with legalization status to predict any outcome. Conclusions: Recreational legalization was associated with increased cannabis use and decreased AUD symptoms but was not associated with other maladaptations. These effects were maintained within twin pairs discordant for residence. Moreover, vulnerabilities to cannabis use were not exacerbated by the legal cannabis environment. Future research may investigate causal links between cannabis consumption and outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate the effectiveness of legal analysis in addressing drug abuse in law enforcement within Indonesia. Identifying the barriers to law enforcement and rehabilitation for drug offenders and narcotics abusers in the legal system is also a focus. The research employs sociological and juridical research methods, incorporating a social science approach alongside legal analysis. To identify issues in this study, the researcher employed descriptive analysis research methods by detailing the application of punishment and rehabilitation approaches for drug dealers and individuals involved in drug abuse. [ABSTRACT FROM AUTHOR]

Cannabis is one of the oldest psychoactive substances in India and worldwide. Many developed countries like Canada, Netherlands and few states of the USA have legalized the use of recreational cannabis. However, In India, the recreational use of cannabis and its various forms such as ganja, charas, hashish, and its combination is legally prohibited. There have been several discussions and public interest litigations in India regarding the legalization of recreational cannabis use and its benefits. With this background, this article addresses the various implications of legalizing recreational use of cannabis, a multibillion dollar market and its impact on mental health, physical health, social, cultural, economic, and legal aspects with the lessons learnt from other countries that have already legalized recreational cannabis use. It also discusses whether India is prepared for the legalization of recreational cannabis, given the current criminal justice and healthcare systems. The authors conclude that, India is perhaps not enough prepared to legalize cannabis for recreational use. India's existing criminal justice and healthcare systems are overburdened, finding it challenging to control medicinal use, which is often the first contact point for cannabis-related concerns. [ABSTRACT FROM AUTHOR]

Aims: To measure the impact of Canada's recreational cannabis legalization (RCL) in October 2018 and the subsequent impact of the coronavirus disease 2019 (COVID‐19) lockdowns from March 2020 on rates of emergency department (ED) visits and hospitalizations for traffic injury. Design: An interrupted time series analysis of rates of ED visits and hospitalizations in Canada recorded in population‐based databases from January/April 2010 to March 2021. Setting: ED visits in Ontario and Alberta and hospitalizations in Ontario, Alberta, British Columbia, the Prairies (Manitoba and Saskatchewan) and the Maritimes (Nova Scotia, New Brunswick, Newfoundland and Prince Edward Island). Participants: Monthly counts of presentations to the ED or hospital for motor vehicle injury or pedestrian/cyclist injury, used to calculate monthly rates per 100 000 population. Measurements An occurrence of one or more International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD‐10‐CA) code for motor vehicle injury (V20–V29, V40–V79, V30–V39 and V86) and pedestrian/cyclist injury (V01–V09 and V10–V19) within the National Ambulatory Care Reporting System and Discharge Abstract Database. Findings There were no statistically significant changes in rates of ED visits and hospitalizations for motor vehicle or pedestrian/cyclist injury after RCL after accounting for multiple testing. After COVID‐19, there was an immediate decrease in the rate of ED visits for motor vehicle injury that was statistically significant only in Ontario (level change β = −16.07 in Ontario, 95% CI = −20.55 to −11.60, P = 0.000; β = −10.34 in Alberta, 95% CI = −17.80 to −2.89, P = 0.008; α of 0.004) and no changes in rates of hospitalizations. Conclusions: Canada's recreational cannabis legalization did not notably impact motor vehicle and pedestrian/cyclist injury. The rate of emergency department visits for motor vehicle injury decreased immediately after COVID‐19 lockdowns, resulting in rates below post‐recreational cannabis legalization levels in the year after COVID‐19. [ABSTRACT FROM AUTHOR]

To determine the effect of recreational cannabis legalization (RCL) and/or recreational cannabis commercialization (RCC) on emergency department (ED) visits, hospitalizations, and deaths due to substance use, injury, and mental health among those aged 11 years and older. A systematic review of six electronic databases up to February 1, 2023. Original, peer-reviewed articles with interrupted time series or before and after designs were included. Four independent reviewers screened articles and assessed risk of bias. Outcomes with 'critical' risk of bias were excluded. Protocol registered on PROSPERO (# CRD42021265183). After screening and risk of bias assessment, 29 studies were included which examined ED visits or hospitalizations for cannabis use or alcohol (N = 10), opioid mortality (N = 3), motor vehicle fatalities or injury (N = 11), and intentional injury/mental health (N = 5). Rates or number of cannabis-related hospitalizations increased after RCL in Canada and the USA. Immediate increases in rates of cannabis-related ED visits were found after both RCL and RCC in Canada. Rates of traffic fatalities increased after RCL and RCC in certain jurisdictions in the USA. RCL was associated with increased rates of cannabis-related hospitalizations. RCL and/or RCC was associated with increased rates of cannabis-related ED visits, consistently shown across sex and age groups. The effect on fatal motor vehicle incidents was mixed, with observed increases found after RCL and/or RCC. The effect of RCL or RCC on opioids, alcohol, intentional injury, and mental health is not clear. These results inform population health initiatives and international jurisdictions considering RCL implementation. [ABSTRACT FROM AUTHOR]

The article explores the potential impact of drug decriminalization and gun criminalization on the African American population with regard to racial justice issues in the U.S. Topics discussed include the history and enforcement of drug laws in the country, the prosecution and conviction of African Americans for drug offenses, and the way gun control measures may help promote safer interactions between law enforcement personnel and African Americans.

Copyright of International Journal of Legal Studies ( IJOLS ) is the property of International Institute of Innovation Science-Education-Development in Warsaw and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Recreational cannabis legalization has become more prevalent over the past decade, increasing the need to understand its impact on downstream health-related outcomes. Although prior reviews have broadly summarized research on cannabis liberalization policies (including decriminalization and medical legalization), directed efforts are needed to synthesize the more recent research that focuses on recreational cannabis legalization specifically. Thus, the current review summarizes existing studies using longitudinal designs to evaluate impacts of recreational cannabis legalization on cannabis use and related outcomes. Method: A comprehensive bibliographic search strategy revealed 61 studies published from 2016 to 2022 that met criteria for inclusion. The studies were predominantly from the United States (66.2%) and primarily utilized self-report data (for cannabis use and attitudes) or administrative data (for health-related, driving, and crime outcomes). Results: Five main categories of outcomes were identified through the review: cannabis and other substance use, attitudes toward cannabis, health-care utilization, driving-related outcomes, and crime-related outcomes. The extant literature revealed mixed findings, including some evidence of negative consequences of legalization (such as increased young adult use, cannabis-related healthcare visits, and impaired driving) and some evidence for minimal impacts (such as little change in adolescent cannabis use rates, substance use rates, and mixed evidence for changes in cannabis-related attitudes). Conclusions: Overall, the existing literature reveals a number of negative consequences of legalization, although the findings are mixed and generally do not suggest large magnitude short-term impacts. The review highlights the need for more systematic investigation, particularly across a greater diversity of geographic regions. [ABSTRACT FROM AUTHOR]

The author comments on the article "The implementation and public health impacts of cannabis legalization in Canada: a systematic review" by W. Hall and colleagues. Topics discussed include origin of legal access to medical cannabis in Canada, perspectives of stakeholders on the effectiveness of legal market, and significance of a mandatory legislative review of the federal Cannabis Act.

Following landmark legislation in 2013, Uruguay became the first country to regulate the legal production, distribution and sale of recreational cannabis. While broader debates anticipated the significance of the UN drug conventions, the extent to which Uruguay's drug treaty obligations shaped regulation is unclear and the relevance of finance norms has been neglected. Drawing on institutionalist and governance theories, this study explores how international drug and finance regulations limited Uruguay's policy space to implement cannabis regulation, and how this was perceived by policy actors. Policy documents and 43 semi-structured interviews were thematically analysed. The analysis demonstrates how Uruguay's drug treaty obligations were less directly constraining to policy space compared to international finance norms, including the US Patriot Act, anti-money laundering standards and financial inclusion practices. Such norms exerted powerful influence over Uruguay's ability to implement aspects of cannabis supply that interact with broader financial systems, allowing banks to terminate business relationships with clients deemed as high risks for money laundering. The Uruguayan case suggests that financial regulations at diverse levels are likely to constrain policy space in other contexts where the market-based policies of cannabis regulation raise tensions with a narrowly constructed risk management principle in approaches to financial supply. [ABSTRACT FROM AUTHOR]

There has been heightened public concern about the implications of recreational marijuana legalization to public safety. Prior research on this issue has primarily focused on Colorado and Washington State—the two states that first legalized recreational marijuana in the U.S.—and on legalization's impact on major crimes. This study extends this line of research to Oregon (OR, legalized in late 2014) and examines the impact of legalization on a less serious form of violent crime—simple assault. Using Uniform Crime Reporting (UCR) Program data from 2007 to 2017 and a quasi-experimental research design, this study found that counties in OR have experienced increases in simple assault rate following legalization, relative to rates in the 19 non-legalized states. Findings suggest the need for more scholarly efforts to explore the potential impact of marijuana legalization on different subtypes of violent crime in other legalized states. [ABSTRACT FROM AUTHOR]

Background and Aims: In 2013, Uruguay became the first country to legalize and regulate the production and distribution of cannabis for recreational use. We measured whether Uruguay's non‐commercial model of recreational cannabis legalization was associated with changes in the prevalence of risky and frequent cannabis use among secondary school students. Design: We used data from repeated cross‐sectional surveys of secondary students in Uruguay and Chile (2007–2018). Using a difference‐in‐difference approach, we evaluated changes in the prevalence of past‐year, past‐month, any risky and frequent cannabis use following enactment (2014) and implementation (2016) of cannabis legalization among the full sample of secondary students and among students who reported past‐year/month use. We examined changes separately for students ages 12 to 17, and students for whom cannabis became legally accessible, ages 18 to 21. Setting: Uruguay and Chile (2007–2018). Participants: Secondary school students in 8th, 10th and 12th grade (n = 204 730). Measurements Past‐year and past‐month cannabis use; any risky cannabis use measured with the Cannabis Abuse Screening Test (CAST); and frequent cannabis use (10+ days in the past‐month). Findings We found a decrease in past‐year and past‐month use following enactment or implementation. Among students ages 18 to 21, post‐enactment, we observed a transitory increase in 2014 that decreased thereafter for: any risky use among those who reported past‐year use (prevalence difference [PD] = 13.5%; 95% CI: 2.0, 24.9), frequent use in the full sample (PD = 4.5%; 95% CI: 1.0, 8.1), and frequent use among those who reported past‐month use (PD = 16.8%; 95% CI: 1.9, 31.8). Conclusion: The legalization of recreational cannabis in Uruguay was not associated with overall increases in either past‐year/past‐month cannabis use or with multi‐year changes in any risky and frequent cannabis use among young people. [ABSTRACT FROM AUTHOR]

Aims: This study estimated the likelihoods of individuals transitioning to different cannabis use status following recreational cannabis legalization (RCL) in the United States. Design: Secondary analysis of a nationally representative longitudinal cohort in the United States. We used propensity score matching to balance individual characteristics between RCL and comparison states and generalized mixed regressions to estimate behavioral transitions in matched samples. Participants: A longitudinal cohort of 21 863 individuals (6925 youths and 14 938 adults) participating in the Population Assessment of Tobacco and Health waves 3 and 4. Setting: Four RCL states that implemented RCL between waves 3 and 4 (California, Massachusetts, Nevada and Maine) and comparison states in the United States. Measurements Transitions in cannabis use over the two waves: (1) from non‐users to users; (2) from non‐users to weekly users; (3) from users to non‐users. Individuals in RCL states were compared with matched individuals in (1) states with medical cannabis legalization (MCL), (2) states not legalizing cannabis (non‐legalizing) and (3) MCL and non‐legalizing states combined. Findings Among youths, the association between RCL and greater odds of transition from non‐users to users was seen in comparison with non‐legalizing states [odds ratio (OR) = 2.18, 95% confidence interval (CI) = 1.37–3.45] and combined states (OR = 1.73, 95% CI = 1.23–2.42). Evidence was lacking regarding the associations between RCL and transitions from non‐users to weekly users and from users to non‐users. Among adults, RCL was associated with greater odds of transitions from non‐users to users and non‐users to weekly users if RCL states were compared with non‐legalizing states (OR = 1.68, 95% CI = 1.15–2.46; OR = 1.82, 95% CI = 1.00–3.31, respectively) or combined states (OR = 1.51, 95% CI = 1.11–2.07; OR = 2.09, 95% CI = 1.19–3.66, respectively). RCL was also associated with lower odds of transition from users to non‐users if RCL states were compared with non‐legalizing states (OR = 0.54, 95% CI = 0.35–0.81). Conclusions: There appears to be some evidence that recreational cannabis legalization in the United States is associated with elevated odds of transition to cannabis use among both youths and adults. [ABSTRACT FROM AUTHOR]

Background: Canadians seeking medical cannabis (MC) may encounter difficulties in finding a healthcare provider (HCP) who authorizes their access to it. Barriers that HCPs face in authorizing MC are unclear. The objectives of this study were to evaluate HCP opinions, knowledge, comfort, and practice in MC prescribing and counseling on recreational cannabis use, and whether the COVID-19 pandemic affected MC prescribing practices. Methods: Eligible participants included HCPs (e.g., attending physicians, nurses, pharmacists) in Canada. A questionnaire evaluating their knowledge, comfort, and practice in medical and recreational cannabis was designed based on instruments developed in previous studies. Between April 13th-December 13th 2021, ninety-one healthcare associations were asked to distribute the survey to their members, and an advertisement was placed in the online Canadian Medical Association Journal. Descriptive statistics were used to analyze the results. Results: Twenty-four organizations agreed to disseminate the survey and 70 individuals completed it. Of respondents, 71% were attending physicians or medical residents, while the remainder were nurses, pharmacists or other HCPs. Almost none (6%) received training in MC in professional school but 60% did receive other training (e.g., workshops, conferences). Over half (57%) received more questions regarding MC since recreational cannabis was legalized, and 82% reported having patients who use MC. However, 56% felt uncomfortable or ambivalent regarding their knowledge of MC, and 27% were unfamiliar with the requirements for obtaining MC in Canada. The most common symptoms for recommending MC were pain and nausea, whereas the most common conditions for recommending it were cancer and intractable pain. The strongest barrier to authorizing MC was uncertainty in safe and effective dosage and routes of administration. The strongest barrier to recommending or authorizing MC was the lack of research evidence demonstrating its safety and efficacy. During the pandemic, many respondents reported that a greater number of their patients used cannabis to relieve anxiety and depression. Conclusions: Our results suggest that HCPs across Canada who responded to our survey are unfamiliar with topics related to MC. The strongest barriers appear to be lack of clinical research, and uncertainty in safe and effective MC administration. Increasing research, training, and knowledge may help HCPs feel more equipped to make informed treatment/prescribing decisions, which may help to improve access to MC. [ABSTRACT FROM AUTHOR]

Background and aims: Recreational cannabis was legalized in Canada in October 2018. Initially, the Government of Ontario (Canada's largest province) placed strict limits on the number of cannabis retail stores before later removing these limits. This study measured changes in cannabis‐attributable emergency department (ED) visits over time, corresponding to different regulatory periods. Design Interrupted time–series design using population‐level data. Two policy periods were considered; recreational cannabis legalization with strict store restrictions (RCL, 17 months) and legalization with no store restrictions [recreational cannabis commercialization (RCC), 15 months] which coincided with the COVID‐19 pandemic. Segmented Poisson regression models were used to examine immediate and gradual effects in each policy period. Setting: Ontario, Canada. Participants: All individuals aged 15–105 years (n = 13.8 million) between January 2016 and May 2021. Measurements Monthly counts of cannabis‐attributable ED visits per capita and per all‐cause ED visits in individuals aged 15+ (adults) and 15–24 (young adults) years. Findings We observed a significant trend of increasing cannabis‐attributable ED visits pre‐legalization. RCL was associated with a significant immediate increase of 12% [incident rate ratio (IRR) = 1.12, 95% confidence interval (CI) = 1.02–1.23] in rates of cannabis‐attributable ED visits followed by significant attenuation of the pre‐legalization slope (monthly slope change IRR = 0.98, 95% CI = 0.97–0.99). RCC and COVID‐19 were associated with immediate significant increases of 22% (IRR = 1.22, 95% CI = 1.09–1.37) and 17% (IRR = 1.17, 95% CI = 1.00–1.37) in rates of cannabis‐attributable visits and the proportion of all‐cause ED visits attributable to cannabis, respectively, with insignificant increases in monthly slopes. Similar patterns were observed in young adults. Conclusions: In Ontario, Canada, cannabis‐attributable emergency department visits stopped increasing over time following recreational cannabis legalization with strict retail controls but then increased during a period coinciding with cannabis commercialization and the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Legalization has increased cannabis availability in Canada. Research shows complex relationships between cannabis use and mental health, and a need for health care providers to engage with patients about cannabis use. Providers have noted gaps in knowledge and research on the medical effects of cannabis as barriers to service delivery. It is unclear how providers and patients in mental health care settings have been impacted by legalization. From June 1 to July 2, 2021, we conducted a qualitative study involving semi-structured interviews with 20 health care providers in a range of roles (e.g., physicians, pharmacists, nurses) within a psychiatric hospital setting. Participants responded to open-ended questions with follow-up probes on various topics related to cannabis legalization. Topics included impacts on patient mental and physical health, clinical impacts, education and training, legal cannabis retail system and the medical cannabis access system. Thematic analysis identified several themes in the data. Participants reported that legalization has had some positive impacts relating to clinical care and cannabis safety. They also expressed concerns with increased rates of cannabis use, risks to mental health and ongoing challenges engaging with patients about cannabis. Participants made recommendations for medical educators and regulators (e.g., updated curriculums, clinical guidelines), the mental health care sector (e.g., implementation of standardized screening), government (e.g., public health campaigns, safe use guidelines), the medical cannabis access system (e.g., increased regulation, research), and the legal cannabis system (e.g., zoning changes, point-of-sale information). This study begins to address the paucity of data on impacts of legalization from mental health service delivery settings. Findings show that although legalization has had some positive impacts, there are ongoing patient concerns and unmet provider needs. More research is needed to understand the experiences of providers delivering care to populations experiencing mental health and/or substance use concerns who use cannabis in the post-legalization era. • Health care providers report positive impacts of legalization on clinical care and safety • They also expressed concerns with increased cannabis use and risks to mental health • They made recommendations for educators, regulators, government, health care sector, and medical and legal cannabis systems [ABSTRACT FROM AUTHOR]

The opioid crisis has steadily killed Americans for twenty years. In total, we have lost more than 500,000 American lives since the 1990s, and countless more suffer from chronic addiction. After years of piecemeal efforts to address this massive loss of life and health, the opioid litigation, largely centralized in Ohio federal district court, has brought significant hope for change. But there is a notable divide between the popular sense of the litigation and its reality. A full 57% of Americans believe that opioid companies should be held accountable for precipitating a public health crisis. However, the litigation, has been dedicated to a quick but modest monetary settlement, and scholars have generally been hostile to corporate accountability. This paper, together with its companion piece,' seeks to resurrect the idea of tort accountability. The U.S. has experienced several opioid crises over the last 150 years, yet we have never held opioid corporations accountable. Meanwhile, it is fairly standard in other areas of law, such as administrative law, to hold an agency accountable for legal violations. This paper articulates a double standard between tort and administrative law and makes a strong call for corporate accountability in tort. Accountability is a form of ex post incentive-based liability, which has potent ex ante effects on actors choosing how to market dangerous products. Accountability has the power to change incentive structures and to support the rule of law. If we hope to prevent recurrence of mass harms, we must hold the actors who perpetrate them accountable. Current proposals to hold only agencies accountable for the opioid crisis risk kneecapping regulators and further liberating defendant companies from essential public health regulations. Instead, we must embrace corporate accountability in tort as a necessary check on corporate power. Beyond accountability, this paper makes several suggestions to maximize the public health benefits of the opioid litigation. [ABSTRACT FROM AUTHOR]

In November 2016, California voters passed the Adult Use of Marijuana Act making recreational cannabis sales legal to adults aged 21and older starting January 1st, 2018. This study aims to understand the relationship of cannabis use and cigarette smoking with serious psychological distress (SPD) in California in light of the legalization of recreational cannabis sales. This cross-sectional study included 42,313 adult participants from the 2017 to 2018 California Health Interview Surveys. We used the Kessler-6 (K6) scale to measure psychological distress in the past 30 days. Multiple logistic regression models were used to examine the association between cannabis/cigarette use and SPD. Cannabis use was positively associated with SPD (AOR = 2.48, 95% CI = 1.57, 3.91), but this association was not significantly different before and after recreational cannabis sales legalization in California (AOR = 0.82, 95% CI = 0.72, 2.05). Cigarette smoking was also positively associated with SPD (AOR = 2.76, 95% CI = 2.05, 3.71). Compared to those who used neither cannabis nor cigarettes, sole cannabis users (AOR = 2.51, 95% CI = 1.75, 3.60), sole cigarette smokers (AOR = 3.23, 95% CI = 2.28, 4.60), and dual users of cannabis and cigarettes (AOR = 5.65, 95% CI = 4.04, 7.89) were more likely to report SPD. Dual users were also more likely to report SPD than sole cannabis users (AOR = 2.25; 95% CI = 1.48, 3.43) and sole cigarette smokers (AOR = 1.75; 95% CI = 1.18, 2.59). These findings provide evidence for the need to develop effective cessation intervention strategies targeting individuals with SPD to reduce their cannabis use and dual-use of cannabis and cigarettes. [ABSTRACT FROM AUTHOR]

Alaska and Hawaii, the only two noncontiguous states in the United States, have different marijuana policy environments. Alaska enacted recreational marijuana legalization (RML) in 2014, whereas recreational marijuana is still illegal in Hawaii. This study analyzed how RML affects adolescents' marijuana use (MU) by comparing two states. We used data from 2 states (Alaska and Hawaii) from the Youth Risk Behavior Survey, 2009 to 2019 years (N = 35 467). The trends of lifetime MU and current MU were examined. Using difference-in-differences analysis models, this study investigated whether RML increased lifetime and current MU in Alaska compared with Hawaii after adjusting for socioeconomic characteristics. Both lifetime and current MU prevalence among adolescents in Alaska increased after RML, while both rates in Hawaii gradually decreased. The rate of lifetime MU in Alaska was significantly increased after RML (odds ratio [OR] = 1.29) compared with Hawaii. Similarly, the current MU among adolescents in Alaska was significantly increased compared with that in Hawaii (OR = 1.34). Both lifetime and current MU were increased following RML in Alaska, suggesting that RML may affect the increase of MU among adolescents. [ABSTRACT FROM AUTHOR]

The government of Washington state legalized recreational cannabis consumption in December 2012. We used data on all drivers involved in fatal crashes in Washington in the years 2008–2019 (n  = 8,282) to estimate prevalence in fatal crashes of drivers with ∆9-tetrahydrocannabinol (THC; the main psychoactive compound in cannabis) in their blood before and after legalization. However, nearly half of the drivers were not tested for drugs; we therefore used multiple imputation to estimate THC presence and concentration among them. We used logistic regression followed by marginal standardization to estimate the adjusted prevalence of THC-positive drivers after legalization relative to what would have been predicted without legalization. In the combined observed and imputed data, the proportion of drivers positive for THC was 9.3% before and 19.1% after legalization (adjusted prevalence ratio: 2.3, 95% confidence interval: 1.3, 4.1). The proportion of drivers with high THC concentrations increased substantially (adjusted prevalence ratio: 4.7, 95% confidence interval: 1.5, 15.1). Some of the increased prevalence of THC-positive drivers might have reflected cannabis use unassociated with driving; however, the increased prevalence of drivers with high THC concentrations suggests an increase in the prevalence of driving shortly after using cannabis. Other jurisdictions should compile quantitative data on drug test results of drivers to enable surveillance and evaluation. [ABSTRACT FROM AUTHOR]

Background and aim: New Zealand has recently legalized medicinal cannabis and has explored the possibility of legalizing large‐scale recreational cannabis supply. In the process, concerns have emerged regarding whether corporations involved in the large‐scale production and sale of legalized cannabis will invest in tactics of influence with policymakers and the public. This paper aimed to examine the various ways a legalized cannabis industry could seek to influence governments and the public in the New Zealand reform context. Method: Based on the study of industry tactics with alcohol, tobacco and gambling, we applied a three‐chain model of industry influence that breaks tactics into the 'public good', 'knowledge' and 'political' chains. Results: Exploratory analysis of the nascent cannabis industry's activity in New Zealand provided signs of industry influence strategies related to all three chains. The medicinal cannabis industry has associated the establishment of a legal cannabis sector with regional economic development and employment, supported lobbying for recreational law reform, funded NGOs involved in lobbying for law reform, established research partnerships with universities, invited ex‐politicians on advisory boards, and participated in government public sector partnerships. Conclusion: There is emerging evidence that the legal cannabis industry is using strategies to influence the regulatory environment in New Zealand. [ABSTRACT FROM AUTHOR]

Background: Increasing prenatal cannabis use over recent years has been associated with changes in state-level cannabis policies. Yet, how correlates of prenatal cannabis use differ by recreational cannabis legality has not been examined. We aim to estimate prenatal cannabis use prevalence and examine how maternal factors associated with use vary across states with and without recreational cannabis legalization. Methods: In 2020, we performed a cross-sectional analysis using 2018 Pregnancy Risk Assessment Monitoring System data, providing population-level estimates of prenatal cannabis use among included states. Across 14 states, we examined characteristics of prenatal cannabis users via chi-square tests and multivariate logistic regression models. We present odds ratios (ORs) of prenatal cannabis use, stratified by recreational cannabis legality. Results: Self-reported prenatal cannabis use in states with and without legalized recreational cannabis were 6.29% and 5.22%, respectively. Adjusted analyses found that regardless of recreational cannabis legalization, women who were unmarried, reported Medicaid as their prenatal care insurer, did not receive first trimester prenatal care, or reported having prenatal depression or anxiety were 1–4 times more likely to report prenatal cannabis use. Women residing in states where recreational cannabis was legal were significantly more likely to report concurrent cannabis and tobacco use while pregnant (OR: 8.66, 95% confidence interval [CI], 5.40–13.86) compared with women in states yet to legalize (OR: 5.49, 95% CI, 3.97–7.59). Conclusions: Our findings suggest a need for focused cannabis prevention efforts for nonpregnant women of reproductive age to stop initial uptake of the drug. Additionally, as women in these states were three times more likely to report concurrent cannabis and tobacco use during pregnancy, we recommend that states with recreational cannabis focus on prevention and intervention of cosubstance use among pregnant women. [ABSTRACT FROM AUTHOR]

Background and Aims: Cannabis use among parents may be increasing with legalization, but perception of associated risk has declined. The study investigated the association between cannabis legalization and cannabis use among adults with children in the home over time in the United States (US). Design A difference‐in‐difference approach was applied to public and restricted‐use data from the 2004–2017 National Survey on Drug Use and Health (NSDUH), an annual cross‐sectional survey. Setting: A representative sample of the United States. Participants/Cases: Respondents ages 18+ with children living in the home drawn from the NSDUH (n = 287,624), which is administered to non‐institutionalized civilians in the 50 states and District of Columbia. Measurements Exposures were year and state‐level cannabis policy in state of residence annually. Outcomes were past‐30‐day cannabis use and daily cannabis use. Sociodemographic variables included age, gender, marital status, annual family income, race/ethnicity, educational attainment, and strength of state‐level tobacco control. Findings In 2017, past‐month cannabis use (11.9%, 9.3%, and 6.1%) and daily cannabis use (4.2%, 3.2%, and 2.3%) were more common in states with recreational marijuana laws (RML), followed by states with medical marijuana laws (MML) and without legal cannabis use, respectively. RML and MML were associated with significantly higher prevalence of past‐month cannabis use (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [CI] = 1.12–1.46; AOR = 1.12, 95% CI = 1.03–1.22) and daily cannabis use (AOR = 1.25, 95% CI = 1.03–1.51; AOR = 1.16, 95% CI = 1.02–1.32), respectively. The impact of MML was particularly salient among adults ages 50+ and the highest income and education subgroups. Conclusions: Among adults with children living in the home, cannabis use appears to be more common in US states with legalized cannabis use compared with states with no legal cannabis use. Recreational legalization appears to increase use among adults with children in the home broadly across nearly all sociodemographic groups, whereas the effect of legalization for medical use is heterogeneous by age and socioeconomic status. [ABSTRACT FROM AUTHOR]

This consensus statement is an update of the 1987American College of SportsMedicine (ACSM) position stand on the use of anabolic-androgenic steroids (AAS). Substantial data have been collected since the previous position stand, and AAS use patterns have changed significantly. The ACSMacknowledges that lawful and ethical therapeutic use of AAS is now an accepted mainstream treatment for several clinical disorders; however, there is increased recognition that AAS are commonly used illicitly to enhance performance and appearance in several segments of the population, including competitive athletes. The illicit use of AAS by competitive athletes is contrary to the rules and ethics of many sport governing bodies. Thus, the ACSMdeplores the illicit use of AAS for athletic and recreational purposes. This consensus statement provides a brief history of AAS use, an update on the science of how we now understand AAS to be working metabolically/biochemically, potential side effects, the prevalence of use among athletes, and the use of AAS in clinical scenarios. [ABSTRACT FROM AUTHOR]

With the recent introduction of recreational marijuana retail stores throughout the United States and other jurisdictions, research is warranted on whether responsible sales practices are implemented. We assessed store practices/policies in the first two US states to legalize recreational marijuana, Colorado and Washington. We surveyed a random sample of store managers (25 per state) and observed store practices in the largest city in each state (22 in Denver; 24 in Seattle). We analyzed many practices/policies with a focus on underage access (

• We used publicly available data from 2010 to 2012 to predict which counties in the US would allow legal cannabis sales in 2014 using multiple methods. • The ensemble method produced the best results, as measured by a macro f1 average score of 0.61. • The main factors associated with legalizing county-level recreational cannabis sales were the prevalences of past-month cannabis use and past-year cocaine use. There is substantial geographic variability in local cannabis policies within states that have legalized recreational cannabis. This study develops an interpretable machine learning model that uses county-level population demographics, sociopolitical factors, and estimates of substance use and mental illness prevalences to predict the legality of recreational cannabis sales within each U.S. county. We merged data and selected 14 model inputs from the 2010 Census, 2012 County Presidential Data from the MIT Elections Lab, and Small Area Estimates from the National Surveys on Drug Use and Health (NSDUH) from 2010 to 2012 at the county level. County policies were labeled as having recreational cannabis legal (RCL) if the sale of recreational cannabis was allowed anywhere in the county in 2014, resulting in 92 RCL and 3002 non-RCL counties. We used synthetic data augmentation and minority oversampling techniques to build an ensemble of 1000 logistic regressions on random sub-samples of the data, withholding one state at a time and building models from all remaining states. Performance was evaluated by comparing the predicted policy conditions with the actual outcomes in 2014. When compared to the actual RCL policies in 2014, the ensemble estimated predictions of counties transitioning to RCL had a macro f1 average score of 0.61. The main factors associated with legalizing county-level recreational cannabis sales were the prevalences of past-month cannabis use and past-year cocaine use. By leveraging publicly available data from 2010 to 2012, our model was able to achieve appreciable discrimination in predicting counties with legal recreational cannabis sales in 2014, however, there is room for improvement. Having demonstrated model performance in the first handful of states to legalize cannabis, additional testing with more recent data using time to event models is warranted. [ABSTRACT FROM AUTHOR]

Cannabis prohibition and its subsequent enforcement have yielded an epic societal tragedy. The decision to criminalize cannabis was a paradigm-shifting moment in legal history because it converted lawful medicinal or intoxicantseeking conduct into criminal activity, inviting government intrusion into matters previously self-controlled. Scholars increasingly recognize that prohibition was built upon a decadeslong, false, media-driven narrative that "marijuana" was one of society's worst menacing enemies. Using overtly racist propaganda, the narrative successfully captured the audience, fomenting public anxiety and unfairly demonizing cannabis and its users. This misinformation campaign ultimately led to its current status as prohibited under the federal Controlled Substances Act ("CSA") because it ostensibly has (1) a high potential for abuse, (2) no currently accepted medical use in treatment in the United States, and (3) a lack of accepted safety for use under medical supervision. While the consequences of cannabis prohibition are still unfolding, unfortunately, one sobering conclusion may confidently be drawn: criminal enforcement of cannabis prohibition has been, and continues to be, irreparably marred by enforcement injustice. Prohibition has led, and continues to lead, to arrests and disproportionately harsh punishments when compared to the severity of the underlying behavior. Moreover, as Michelle Alexander and the ACLU documented early on, enforcement has been disproportionately exercised against a discrete subset of the larger cannabis-using population. Specifically, enforcement has been disparately borne by individuals of color, particularly Black and Latinx individuals, and by those of lower socioeconomic means. Society is just beginning to recognize, define the scope of, and process this injustice. The vestiges of this unjust enforcement persist through its lingering trail: an individual's cannabis criminal enforcement record. Known as "collateral consequences," these negative effects linger--some for long periods that might last generations--without some form of mitigating criminal "record relief." Expungement is widely hailed as the most fulsome of the record-relieving options because it offers complete erasure of the record. This Essay agrees, yet posits that while expungement is a laudable and necessary remedy to mitigate individual cannabis criminal record-based harm, expungement also yields an outcome paradox: to further justice by expunging criminal records, society is erasing evidence of historic enforcement injustice. Because society needs to balance individual relief with the need to maintain a historical account of this legal enforcement era, this Essay suggests that expunging entities maintain a curated record--one that eliminates, to the extent possible, sensitive personally identifying information, while maintaining other important information of historic and legal value. Policy makers will still need to considert the (1) expungement recipients' potential future need for their criminal records, (2) data privacy principles to protect any retained expungment records, and (3) mechanisms to incentivize and fund large-scale expungement efforts. Erase the individual's record without erasing history. [ABSTRACT FROM AUTHOR]

Since the 1960s, celebrity drug trials have usually involved actors or musicians. The first drug prosecution of a Canadian "celebrity" took place in 1985 after the Royal Canadian Mounted Police (RCMP) found a small amount of marijuana in the luggage of New Brunswick Premier Richard Hatfield at the airport in Fredericton. He was charged with simple possession and, aided by a team of lawyers, pleaded not guilty. Although Hatfield was the most successful premier in the province's history, he was facing challenges over the economy and language policy, and a finding of guilt would have devastated both his political career and the fortunes of his party. This article examines the Hatfield drug prosecution, which was followed by revelations of drug use with university students in 1981, as a chapter in Canadian legal and political history. It involved not only a privileged defendant, but also the independence of judges, the role of the RCMP, the relationship between the courts and the media, federal-provincial relations and an internal RCMP probe. Hatfield, the political celebrity, won his 1985 court battle but, with his lifestyle impugned, lost in the court of public opinion. In 1987, his party was crushed by the landslide victory of Frank McKenna's Liberals. [ABSTRACT FROM AUTHOR]

The article discusses that the Earp and colleagues (2021) make a strong case for the complete decriminalization and even the legalization of recreational drug use based on the negative impact of the "War on drugs" on racialized persons. It mentions that the authors desire to remain neutral regarding the positive and negative contributions of recreational drug use to wellbeing.

The production of child pornography using Artificial Intelligence is poised to potentially evade current laws protecting child abuse. Artificial Intelligence "DeepFakes" can be used to create indistinguishable videos and images of child abuse, without actual child abuse ever occurring. This Note proposes two solutions for curbing this inevitable dilemma. First, Artificial Intelligence should fall under the "computer‐generated" terminology found in the 18 U.S.C. § 2256(8) definition of child pornography. Second, if Artificial Intelligence cannot be considered to fall under that definition, then 18 U.S.C. § 2256(8) should be amended to include "Artificial Intelligence‐generation." Key Points for the Family Court Community: The United States is one of the largest producers and consumers of child abuse content in the world.In 2018, technology companies reported over 45 million images and videos of child abuse.The National Center for Missing and Exploited Children has to review 25 million images of child abuse annually, amounting to 480,769 images a week.Currently, there are no laws regulating Artificial Intelligence in the United States.DeepFake technology has progressed to allow even the most rudimentary computer user to create a pornographic DeepFake in just a few hours. [ABSTRACT FROM AUTHOR]

The substance of marijuana is becoming legal in an increasing number of states. With the rise in legallity of marijuana comes a question of how will child protective agencies treat marijuana use by a parent or guardian. Family courts have continued to use the "actual harm" standard to determine child abuse and neglect. In addition to that standard, this Note proposes the adoption of "conduct specific" language into state marijuana statutes in order to further clarify for such agencies when investigations warrant a child neglect or abuse petition to be filed against parents. Key Points for the Family Court Community: Marijuana's illegal status has been subject to change in over thirty states over the last two decades.The substance has survived a long history of punitive treatment from both federal and state governments, and it remains the nation's most popular psychoactive drug.Only six out of the thirty‐three states contain "conduct specific" language in their marijuana statutes which do not presume child abuse or neglect for parental marijuana use alone.Adopting "conduct specific" language into marijuana statutes will make it clear that a parent cannot have a child abuse or neglect case brought against them solely for using marijuana. [ABSTRACT FROM AUTHOR]

Objective: We investigated whether recreational marijuana legalization (RML) in Oregon in 2015 and recreational marijuana and alcohol retail outlet density levels in Oregon counties were associated with increased alcohol and marijuana co-use and beliefs supportive of alcohol and marijuana use among adolescents. Method: We conducted secondary analyses of biennial data collected from 11th graders who participated in the Student Wellness Survey (SWS) in 36 Oregon counties from 2010 to 2018 (N = 71,870). Multi-level logistic regression analyses assessed changes in past-30-day co-use of alcohol and marijuana, and alcohol- and marijuana-related beliefs after RML in counties with low, medium, and high densities of licensed recreational marijuana and alcohol retail outlets. We used post-RML 2016 and 2018 SWS data to examine whether beliefs accounted for any relationship of recreational marijuana and alcohol outlet density with alcohol and marijuana co-use. Results: We found a significant post-RML increase in past-30-day alcohol and marijuana co-use in 2016 in counties with the highest density of recreational marijuana and alcohol retail outlets. There were significant post-RML increases in perceived risk and parent approval of alcohol and marijuana use. Analyses with 2016 and 2018 SWS data indicated that the relationship between level of recreational marijuana and alcohol retail outlet density and past-30-day alcohol and marijuana co-use was accounted for beliefs about marijuana and alcohol availability, approval by parents, and risk. Conclusion: RML and greater retail availability of recreational marijuana and alcohol were positively associated with alcohol and marijuana co-use among adolescents, and with beliefs favorable to alcohol and marijuana use. [ABSTRACT FROM AUTHOR]

An editorial is presented on nerve conduction and peripheral neurophysiology clinics seeing an assortment of patients. Topics include increasing number of young patients encountered with subacute, peripheral sensorimotor deficits with or without neuropsychiatric complications due to excessive inhaled nitrous oxide (N2O) use; and rarer being asphyxiation and frostbite injuries from cooling discharging N2O cylinders.

Background: Despite its controversial nature, the use of recreational marijuana and cannabis-derived products continue to increase in popularity. Cannabis consumption is currently legal in certain American states as well as Canada, and it is also frequently used by Canadian youth. However, cannabis use during childhood and adolescence can contribute to significant harm. Materials andMethods: A review of current literature regarding the impacts of cannabis consumption among Canadian youth was conducted. Medline, Cochrane, Embase and PubMed databases were utilized to identify journal articles published within 10 years that highlighted the impacts of cannabis consumption in its different forms among the North American pediatric population. Results: Our review identified harms include structural and functional impairments in the developing brain, the development of mental health conditions such as depression and anxiety, impaired road safety while driving under the influence of cannabis, and the significant consequences of accidental ingestion of cannabis products by children. We also ascertained that cannabis cessation strategies that employed an affective model, which explores the root causes of adolescents turning to cannabis, are most effective in reducing substance use among adolescents. Conclusions: In light of the recent legalization of cannabis in Canada, the purpose of this article was to provide background on cannabis consumption and its legalization in Canada, the impacts of cannabis on Canadian youth, and evidence-based strategies to help mitigate them. [ABSTRACT FROM AUTHOR]