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In late August, the results of two national surveys identified and underlined increased cannabis use, especially among young adults. But at the same time, more stories emerged exploring harms caused by cannabis &mdash; to individuals, communities and the environment. The cannabis market evolved in a way that exacerbates rather than mitigates these dangers, these stories argue. Yet additional survey results that reveal favorable views of cannabis, at least relative to alcohol, suggest that many Americans remain untroubled. "Historic Highs": Near 30% of Young Adults Use Cannabis Monthly, +11 Pts in 10 Yrs Young adults use cannabis and hallucinogens more than ever before, authors of the annual Monitoring the Future study proclaimed when releasing the results last month. Use among 19-30 yr olds "increased significantly in 2021 compared to five and 10 years ago, reaching historic highs in this age group since 1988," when they began monitoring, the NIH wrote in its press release about the annual study. That contrasts with alcohol, which "remains the most used substance" studied by MTF, but for which a number of key consumption measures "have been decreasing over the past decade" (see Aug 29 issue).In 2021, 19-30 yr olds were nearly 2x more likely to have used cannabis in the past 30 days than 35-50 yr olds, MTF results show. While 28.5% of all 19-30 yr olds said they used cannabis in the last mo, up from 20.6% in 2016 and 17.1% in 2011, consumption peaks among mid-20-somethings. Prevalence ranges from 26-27% among 19-20 and 29-30 yr olds to 31% among 25-26 yr olds. "Just" 15.8% of 35-50 yr olds said they use cannabis monthly in 2021, up 7 pts in the last 5 yrs and more than double the figure in 2011. Ref 1"Daily" drinking (consumption on 20+ occasions in 30 days) is far less common among 20-somethings than daily cannabis use, too. About 4% of 19-30 yr olds said they drink so frequently, MTF results show, compared to almost 11% who use cannabis that often. Furthermore, only 6% of monthly drinkers aged 19-30 also drink "daily," while almost 38% of monthly cannabis users are "daily" users, up from about 1/3 a decade ago. Around half of college-aged cannabis users vape, according to MTF, with very little difference among men and women and only slightly higher prevalence among non-college youth compared to full-time college students.Under 20% of Adults Use Cannabis, But 1/2 See Its Impacts as Positive The MTF results confirmed findings of Gallup polls, released the prior wk, also showing greater cannabis use among younger adults. But Gallup raised the stakes, revealing broadly-held positive views of cannabis. Almost 1/2 of 18+ adults told Gallup they've tried cannabis, while 16% said they "smoke" it, each up 9-10 pts since 2013. Yet 30% of 18-34 yr olds smoke cannabis, making them almost twice as likely to do so as 35-54 yr olds, who are in turn more than twice as likely to smoke as 55+ adults, Gallup showed. "Eating" cannabis edibles was reported by 22% of 18-34 yr olds and 16% of 35-54 yr olds.Despite the fact that less than 20% of adults currently use cannabis and around 2/3 drink alcohol, Americans are considerably more likely to think cannabis impacts users and society positively. Recall, 70-75% of American adults and even around 2/3 of drinkers think that alcohol's effect on society and drinkers is negative (see Aug 12 issue). But views are more evenly split on cannabis: just over 1/2 of Americans think it positively affects most users and just under 1/2 say it positively affects society.Unsurprisingly, a greater proportion of those who've tried cannabis see its impact as positive and, again, younger respondents are the most likely to view cannabis' effects positively: 2/3 say so. The results remind of the so-called "Cali sober" trend, or folks who have given up alcohol, but use cannabis instead. (That was among the threads picked up by the lengthy Washington Post piece about "neo-moderation" shared in our Aug 12 issue.) While future research could impact legalization efforts, the "greater tolerance" of cannabis among young people "may be destined to prevail over time," Gallup wrote.Personal, Societal, Environmental Harms Largely Unseen The positive views captured by Gallup's questions reflect little awareness that cannabis is causing harm to at least some users, their communities and beyond. A damning series of stories about the fallout from legalization in California, published by the LA Times earlier this mo, exposed the complexities of the problems, while portraying them as clear and devastating government failings. It follows a June NY Times article pointing out the dangers of high-potency cannabis products to teens and other users (see Jul 1 issue), a thread picked up elsewhere recently. Additional questions about the safety of cannabis drinks, specifically, appeared in the NY Times late last month.Instead of hindering the illegal trade in California, legalization fueled it, lowering costs for illicit operators and challenging enforcement, the LA Times lays out in many thousands of words. The paper focused on the expansion of illicit cultivation, leading to a glut of product that slashed wholesale prices, endangered legal operators and fed out-of-state black markets. Illegal grows overran rural communities, leading locals to lease their land under threat of violence, and encroached on larger private properties used by legal growers.And illegal operators often treat their workers and the land terribly, the Times points out, listing instances of deaths by carbon monoxide poisoning and violence. They've also preyed on immigrant communities who see few alternatives, according to the stories. Illegal growers will also use and leave behind remnants of pesticides and other products banned in the US, in addition to sucking water from the state's drought-ridden system.While the LA Times explores the social and economic toll of mismanaging the legalization of a psychoactive drug, the NY Times scrutinizes the wellness marketing of cannabis drinks and the health effects of the high-potency products that are now the norm. Most research supporting therapeutic uses of THC have only looked at the kind of low-potency flower (10% THC or less) that is far less common in the modern cannabis market, an article published last mo by Tablet reminded, pointing to 2020 research. It paints cannabis as "the new OxyContin," focusing on the rise of psychosis and addiction among teens and highlighting investments by "industries that pioneered the addiction business: tobacco, alcohol and pharmaceuticals."CA Social Equity Measures Under-Used, Over-Burdensome "Social equity" programs, designed to "boost the chance of success for hopeful Black and Latino cannabis entrepreneurs," targeting aid for "communities disproportionately criminalized by the 'war on drugs,'" are just a "pipe dream," the LA Times wrote early in 2022. Few CA municipalities have adopted the programs and the ones that have set standards too complicated to meet, it argues. LA, for instance, instituted a policy that's fairly standard when seeking an alcohol license: requiring applicants to secure property before applying. But "bureaucratic delays" drain applicants' funding before they can open, according to the paper. So folks with "dreams and hopes of building generational wealth" (often explicitly supported by promises made during the legalization process) instead find "just the opposite. It's ruining lives at this point," said founder of the Natl Diversity and Inclusion Cannabis Alliance.Generally speaking (and unsurprisingly), a familiar set of well-funded companies are winning in the market, the Times pointed out. Separately, the constitutionality of some social equity programs have been challenged in courts elsewhere. And these provisions now play key roles in both state and federal debates about legalizing cannabis.Some Conclusions, Mostly Questions In sum, many continue to view cannabis as healthier than alcohol or at least without the same short- and long-term risks that alcohol carries. Yet emerging stories of harm suggest that folks are either unaware, unmoved or unwilling to accept those outcomes. These thorny issues and efforts to mitigate future harm could impact future federal and state legalization efforts, while attempts at atoning for past harms clearly complicate both the politics and the policies.Closely considering cannabis consumption and policy naturally raises a host of parallel questions about alcohol. Here are just a few: How might the policy and competitive landscape shift if questions about social equity, like those being asked about cannabis (and especially its previous or current prohibition) are asked about alcohol? How do concerns about the increased risk of high-potency, high-dosage cannabis products &mdash; and policies designed to mitigate that risk &mdash; translate to alcohol? And how will attitudes about each substance (continue to) impact future consumption and policy? Cheers,References1 Patrick, M. E., et al, "Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 60, 1976-2021," University of Michigan Institute for Social Research, 2022

Mo' Cannabis, Mo' Questions: a Thicket of Issues Grows Alongside Consumption

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