Vermont marijuana legalization: Asking the right questions

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It's happening. After making medical use of marijuana legal in 2004 and decriminalizing possession of small amounts of marijuana in 2013, this year the Vermont legislature will consider making the recreational use of marijuana legal in the state.

As Colorado and Washington, other states where recreational use of marijuana by adults is legal, have found, legalizing marijuana is complicated. There are many issues to consider: price points, health effects, enforcement, impaired driving, best use of the tax money generated, and more.

It is clear we need answers before legalizing the recreational use of marijuana in Vermont. But what are the right questions?

Here is my question: will the number of people using marijuana increase if it is legal? In public health, we call this prevalence. First of all, I'm not even sure we can answer that question. The effect of legalization on the prevalence of use is unknown. The state of Washington understood this and put prevalence tracking requirements into their legislation. Colorado is also studying the effect of legalization on prevalence of use. We do know, based on self-reported use, that Vermont already has one of the highest prevalence rates for marijuana use, particularly among young adults, in the country. A full 20 percent of those currently using marijuana in Vermont are under 21 years of age. Marijuana use already represents over 60 percent of adolescent substance abuse treatment admissions.

Whether legalization of marijuana in Vermont increases prevalence of use is a very important question to ask, because any increase in marijuana use can have serious health consequences. Related to prevalence, is the frequency and intensity (amount) of use. As with other substances, including alcohol, harmful health effects are increased with more frequent use and at higher consumption.

Health research has shown that frequent high doses of marijuana is associated with increased risk of impaired mental functioning, motor vehicle accidents, psychotic symptoms, chronic lung problems, and poor pregnancy outcomes. Emerging medical evidence is confirming the negative effects of marijuana use on brain development and school performance in young people.

The Vermont Department of Health recently completed a health impact assessment of marijuana legalization in Vermont. They too asked the question about what happens to the prevalence of marijuana use if Vermont were to tax and regulate marijuana. The report refers to a national study of high school students; based on responses from high school seniors, the study concluded there would be an increase in prevalence of marijuana use if it were legal. High school students who were already using marijuana reported they would use it more frequently if it were legal. From this study and many others referenced in the report, the health impact assessment concludes that whether marijuana use in Vermont increases with legalization will depend on the way in which marijuana is regulated and taxed in Vermont.

How marijuana is regulated and taxed in Vermont is very important. The Vermont Public Health Association supports a public health approach to regulation and taxation of marijuana in Vermont. The VtPHA outlines a list of recommendations for legislators to consider. These recommendations prompt a few more questions for Vermont legislators: How will Vermont restrict and enforce the use of marijuana in public places; how will Vermont protect youth from accessing marijuana once it is legal; and how will Vermont insure the public's safety from impaired drivers.

You may have your own questions about the legalization of marijuana in Vermont and now is the time to ask them. More importantly, we need to hold our legislators accountable for the answers before they make marijuana legal in our state.

Laural Ruggles, a resident of Danville , is vice president of marketing and community health improvement at Northeastern Vermont Regional Hospital in St. Johnsbury and a member of the Vermont Public Health Association committee that assisted in developing the Association's policy on marijuana regulation. Ruggles can be contacted at L.Ruggles@nvrh.org or 802-748-7590.


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