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Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map

BACKGROUND: Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabi...

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Autores principales: Sevigny, Eric L., Greathouse, Jared, Medhin, Danye N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10616541/
https://www.ncbi.nlm.nih.gov/pubmed/37915420
http://dx.doi.org/10.1002/cl2.1362
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author Sevigny, Eric L.
Greathouse, Jared
Medhin, Danye N.
author_facet Sevigny, Eric L.
Greathouse, Jared
Medhin, Danye N.
author_sort Sevigny, Eric L.
collection PubMed
description BACKGROUND: Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy‐relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms. OBJECTIVES: This evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps. SEARCH METHODS: We comprehensively searched for eligible English‐language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020. SELECTION CRITERIA: The conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population‐level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer‐term consequences (health, safety, and socioeconomic outcomes) of these laws. DATA COLLECTION AND ANALYSIS: Both dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2. MAIN RESULTS: The EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws—including CBDLs, IHLs, and DCLs—are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid‐related harms (3), and alcohol‐related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality. AUTHORS’ CONCLUSIONS: More primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer‐term—and arguably more salient—health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions.
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spelling pubmed-106165412023-11-01 Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map Sevigny, Eric L. Greathouse, Jared Medhin, Danye N. Campbell Syst Rev Evidence and Gap Map BACKGROUND: Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy‐relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms. OBJECTIVES: This evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps. SEARCH METHODS: We comprehensively searched for eligible English‐language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020. SELECTION CRITERIA: The conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population‐level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer‐term consequences (health, safety, and socioeconomic outcomes) of these laws. DATA COLLECTION AND ANALYSIS: Both dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2. MAIN RESULTS: The EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws—including CBDLs, IHLs, and DCLs—are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid‐related harms (3), and alcohol‐related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality. AUTHORS’ CONCLUSIONS: More primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer‐term—and arguably more salient—health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions. John Wiley and Sons Inc. 2023-10-30 /pmc/articles/PMC10616541/ /pubmed/37915420 http://dx.doi.org/10.1002/cl2.1362 Text en © 2023 The Authors. Campbell Systematic Reviews published by John Wiley & Sons Ltd on behalf of The Campbell Collaboration. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Evidence and Gap Map
Sevigny, Eric L.
Greathouse, Jared
Medhin, Danye N.
Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map
title Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map
title_full Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map
title_fullStr Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map
title_full_unstemmed Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map
title_short Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map
title_sort health, safety, and socioeconomic impacts of cannabis liberalization laws: an evidence and gap map
topic Evidence and Gap Map
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10616541/
https://www.ncbi.nlm.nih.gov/pubmed/37915420
http://dx.doi.org/10.1002/cl2.1362
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