UK legislators are being urged to recognise the health and economic benefits of cannabis as findings from the US highlight a myriad of positive public health outcomes.
A recent review of existing studies has linked medical cannabis legalisation to a number of positive public health outcomes, including a reduction in crime, traffic fatalities, suicides and alcohol and tobacco consumption.
Researchers analysed studies published between 2013 and 2020 on the public health effects of cannabis legalisation in the US. To date 36 states have legalised cannabis for medicinal purposes, with 18 having legalised it for recreational or adult-use.
One of the major concerns by regulators, public health bodies and those who are generally opposed to the introduction of more liberal cannabis laws, is that it will increase consumption among young people.
However, ‘almost without exception’ the authors found ‘little credible evidence’ that legalisation of medical marijuana led to an increase in use among teenagers.
Instead they found ‘convincing evidence’ that legalisation resulted in young adults consuming less alcohol. A number of studies have concluded that alcohol and cannabis are often treated as substitutes.
Post-legalisation research has highlighted the reduction in past-month alcohol use and binge drinking, a decrease in alcohol sales and ‘large reductions in alcohol-related hospital admissions among males aged 15-24-years-old.
“These studies… have, in our opinion, gone a long way towards settling the debate over whether alcohol and marijuana are complements or substitutes, at least among young adults,” the authors say.
Positive health impacts
This reduction in alcohol use may also improve mental health and potentially lead to less suicides.
One paper estimated that medical cannabis legalisation was associated with an 11% reduction in suicides in men aged 20-29 and a 9% reduction in suicides among male 30-39-year-olds. Effects on female suicide rates were of similar magnitude but less precise.
“There is accumulating evidence that restricting where and when alcohol is sold can reduce suicides, the paper states.
“If, as most studies based on well-defined natural experiments suggest, alcohol and marijuana are treated as substitutes then legalising marijuana could improve mental health and ultimately reduce suicides.”
The review also found ‘little evidence’ that legalisation of medical cannabis has encouraged tobacco smoking. If anything, the authors say, it has ‘discouraged its use’.
Legal access to medical cannabis was also associated with reductions in prescription medications for conditions including depression, anxiety, and epilepsy. It appears to reduce sickness-related absences and workplace injuries, although further studies are needed in this area.
While some studies have found that medical cannabis is linked with a reduction in opioid use, the authors were less confident when it came to making conclusions in this area.
“For other public health outcomes such as mortality involving prescription opioids, the effect of legalising medical marijuana has proven more difficult to gauge,” they state.
Reducing crime and improving road-safety
Another area which has gathered significant attention with the adoption of legal cannabis access is its impact on road safety.
When exploring the relationship between medical cannabis legalisation and traffic fatalities, the review found evidence that ‘road safety improves when medical marijuana is legalised’. It also may discourage drunk driving which is deemed to be ‘unequivocally dangerous’.
In addition, studies that examined both the effect of medical and adult-use cannabis found ‘strong evidence’ that legalisation reduces non-drug related crimes.
One found that the introduction of medical cannabis laws led to fewer homicides and assaults, while another suggested that recreational legalisation was associated with a reduction in rapes and thefts.
There was less data on the public health impacts of legalising recreational cannabis.
“It is not yet clear how legalising marijuana for recreational purposes will affect these and other important public health outcomes,” they conclude.
“We will be able to draw stronger conclusions when more post-treatment data are collected in states that have recently legalised recreational marijuana.”
Cannabis could have significant health and economic benefits for the UK
In the week that the UK Chancellor has announced the Treasury’s spring budget, the review’s findings have led to calls for the government to get behind a sector which could save significant sums in public health funding and boost economic growth.
An ongoing health economic analysis research project is expected to show the cost-effectiveness of prescribing cannabis through the NHS for chronic pain.
“The Cannabis Industry Council and Drug Science have commissioned some independent research into the health-economic impact from expanding the treatment of chronic pain with cannabis medicines,” said Mike Morgan-Giles, CEO of the CIC.
“We hope this study will find that boosting prescriptions for cannabis medicines will reduce opioid usage and addiction, as well as bringing a raft of other savings across the NHS and the wider health economy.”
The organisation is also calling for wider public awareness of the legality of medicinal cannabis in the UK to increase patient numbers.
Morgan-Giles added: “Boosting public awareness of the legal medical market will lead to an increase in cannabis prescriptions, resulting in decreased revenues for criminal gangs, as well as significant health and economic benefits.”
In 2021, Maple Tree Consultants published 10 government recommendations for the establishment of a successful medical cannabis sector which highlighted how the industry could help grow the economy after the impacts of Brexit and the pandemic.
Among other recommendations, the report called for the government to streamline the licensing process to make it easier for companies to set up cultivation facilities and carry out research and development into cannabis-based medicines in the UK. It argues that this, along with a review of the NICE guidelines and allowing GPs to prescribe, would allow more patients to access the treatment.
The report estimates that if just half of the 1.4 million people who are believed to be self-medicating with cannabis were able to obtain a medical prescription, the potential value would be somewhere in excess £2 billion.
Hannah Deacon, director of Maple Tree and co-author of the report, told Cannabis Health: “The changes to regulations highlighted in our report would result in wider access to this medication for patients who are currently either having to pay privately or use the illegal market.
“But not only do patients benefit from medical cannabis prescriptions through a reduction in their symptoms and improvement in their quality of life, the industry actually has the potential to bring significant benefit to the economy. “
She added: “At a time when the government is focused on economic growth, in my opinion it is missing a huge opportunity by not backing a sector which could see the creation of around 100,000 new jobs and a potential £2 billion a year in tax revenue for the Treasury.”
