Effects of cannabis legalization on the use of cannabis and other substances : Current Opinion in Psychiatry

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ADDICTIVE DISORDERS: Edited by John Saunders and Linda Cottler

Effects of cannabis legalization on the use of cannabis and other substances

Assanangkornchai, Sawitria; Kalayasiri, Rasmonb; Ratta-apha, Woraphatc; Tanaree, Athipd

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Current Opinion in Psychiatry 36(4):p 283-289, July 2023. | DOI: 10.1097/YCO.0000000000000868


Purpose of review 

As more jurisdictions legalize cannabis for non-medical use, the evidence on how legalization policies affect cannabis use and the use of other substances remains inconclusive and contradictory. This review aims to summarize recent research findings on the impact of recreational cannabis legalization (RCL) on cannabis and other substance use among different population groups, such as youth and adults.

Recent findings 

Recent literature reports mixed findings regarding changes in the prevalence of cannabis use after the adoption of RCL. Most studies found no significant association between RCL and changes in cannabis use among youth in European countries, Uruguay, the US, and Canada. However, some studies have reported increases in cannabis use among youth and adults in the US and Canada, although these increases seem to predate RCL. Additionally, there has been a marked increase in unintentional pediatric ingestion of cannabis edibles postlegalization, and an association between RCL and increased alcohol, vaping, and e-cigarette use among adolescents and young adults.


Overall, the effects of cannabis legalization on cannabis use appear to be mixed. Further monitoring and evaluation research is needed to provide longer-term evidence and a more comprehensive understanding of the effects of RCL.

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