Legalization Uruguay
This study offers the first attempt to estimate the impact of the first non-commercial model of national cannabis legalization on cannabis use outcomes. As analysts have noted (see, for example, Caulkins and Kilmer, 2016), there is a wide range of potential policies regarding cannabis, and it should not be seen as a binary choice between prohibition and for-profit business models. It is therefore crucial to examine and evaluate the different models of legalization and social studies and the many associated North American studies. Many North American studies have also found no significant increase in cannabis use among youth following the introduction of legalization of adult use in U.S. states or Canada. Growers in North America have strengthened, but have often struggled to turn a profit, as access to capital is limited and marijuana prices have been declining since 2019. In the U.S., stocks fell as the pace of legalization slowed and some of the best-known producers threatened bankruptcy. North American producers are also struggling with an unfavorable growth climate, creating additional opportunities for their Uruguayan counterparts. “Everyone wakes up and realizes there`s no point in growing marijuana on the Canadian tundra,” said Lewis, CEO of Fotmer. An international team of researchers from Chile, the United States and Uruguay examined trends in cannabis use in Uruguay among 12- to 21-year-olds after legalization.
Methods: We use a generalization of the synthetic control method (SCM) to estimate the impact of legalization in Uruguay on adolescent cannabis use in the past year and month, the perceived availability of cannabis, and the perceived risk of cannabis use. Every two years, we compare self-reported survey data from high school students in Montevideo and the interior regions of Uruguay after legalization (2014-2018) and after initial implementation (2015-2018) with a synthetic counterfactual basis constructed from a weighted combination of 15 control regions in Chile. Unlike cannabis reform laws in the United States, which were largely passed by popular votes, legalization in Uruguay was enacted through a city effort by the president and his ruling party (Walsh & Ramsey, 2015). In fact, more than 60% of Uruguayans opposed legalization at the time of its entry into force (Cerdá & Kilmer, 2017). In contrast, data from a recent Pew poll suggests that more than 60% of Americans support legalizing recreational use (Geiger, 2018). The explicit motivation for legalizing recreational cannabis in Uruguay was to eliminate illicit drug trafficking and related violence and public health harms (Cruz et al., 2016; Hudak, Ramsey, & Walsh, 2018). Possession of drugs for personal use has been decriminalized in Uruguay since 1974 (Walsh and Ramsey, 2015). This study provides the first empirical evidence of the effects of legalization in Uruguay and examines cannabis use among adolescents. The effect of cannabis legalization on adolescent use is of particular importance, as there is evidence that chronic cannabis abuse among adolescents is associated with an increased risk of developing cannabis-related disorders (Stinson, Ruan, Pickering, & Grant, 2006), cognitive impairment, and neurodevelopmental complications (Batalla et al., 2013); Meruelo, Castro, Cota, & Tapert, 2017).
Although people under the age of 18 are legally allowed to purchase or consume cannabis in Uruguay and no other legalized jurisdiction, there are a number of mechanisms by which legalization can still affect cannabis use among adolescents. Legalization can influence the perception of risk associated with use (Joffe & Yancy, 2004; Khatapoush & Hallfors, 2004) and the social stigma associated with consumption (Cruz, Queirolo & Boidi, 2016) increase youth access through third-party purchase (Cerdá et al., 2017), alter availability in illicit markets (MacCoun, 2011) and/or influence market prices (Hall and Weier, 2015). In addition, legalization may have an even broader effect on adolescent substance use if it influences cannabis use and serves as a substitute or supplement to alcohol and other illicit drugs (Cameron & Williams, 2001; Hopfer, 2014; Subbaraman, 2016; Williams, Liccardo, Pacula, Chaloupka, & Wechsler, 2004).
