Prices and Purchase Sources for Dried Cannabis Flower in the United States, 2019-2020

Introduction: The price of cannabis has major implications for public health, public safety, social equity, and government revenues. This article examines prices and sources of purchased dried cannabis flower among consumers facing different state laws in the United States. Methods: Repeat cross-sectional survey data were collected from the International Cannabis Policy Study in 2019 and 2020. U.S. respondents were recruited through online commercial panels, ages 16-65, and purchased dried flower in the past year (n=9766). Weighted binary logistic regression models examined legal purchasing in states that had legalized recreational cannabis. Results: Compared with respondents in states with recreational stores, respondents living in "illegal," "medical," and "recreational" states without stores were associated with paying a higher unit price of dried flower (+20.5%, +23.6%, +27.4%, respectively; all p<0.05). The majority of respondents in states with recreational stores last purchased from stores/dispensaries (2019: 66.6%; 2020: 62.0%) and the odds of purchasing legally was greater with each additional year after stores opened (adjusted odds ratio=1.48, 95% confidence interval: 1.37, 1.60). Conclusions: Cannabis prices and purchase behaviors are strongly influenced by its legal status and presence of stores. After states legalize for recreational purposes, it takes multiple years for the legal market to become established as the number of retail stores increase and prices decrease. The findings demonstrate that consumers use sources that they are legally allowed to access, suggesting an increased number of physical retail stores and online delivery services could expand uptake of legal sources in states with recreational cannabis laws.

How much demand for money laundering services does drug selling create? Identifying the key parameters

BACKGROUND

The illegal drug trade is often, and plausibly, asserted to be the largest illegal market, globally and in many individual countries. It is also claimed that a large share of its revenues is laundered, though there are no estimates of that volume. We provide rough estimates of that proportion and its primary determinants.

METHODS AND DATA

This paper presents a model of a multi-tiered drug distribution network that is parameterized with data based on one typical, well-studied case, namely British Colombia's market for illegal opioids, supplemented by a corresponding economic interpretation of what determines the share of drug trade revenues that need to be laundered. Sensitivity with respect to key parameters is analyzed.

FINDINGS

We suggest that less than half and perhaps no more than a quarter of revenues from established drug markets need laundering. Key parameters governing this proportion include the price mark-up across distribution levels, transaction volumes at each market level, and the capacity of market participants to spend cash on daily living expenses.

CONCLUSION

This model permits estimation of the scale of money laundering associated with a particular drug market. It suggests that there are limits on money laundering controls as a way of reducing drug supply - although money laundering investigations may still be an effective way to identify and investigate high-level drug traffickers.

Characteristics that influence purchase choice for cannabis products: a systematic review

Introduction

When non-medical cannabis use became legal, government regulators implemented policies to encourage safer consumption through access to a regulated market. While this market is growing, sales still occur through unregulated channels. This systematic review identifies factors influencing cannabis purchasing to help policymakers understand why consumers still purchase illicit market cannabis (registered with PROSPERO CRD42020176079).

Methods

A comprehensive search strategy included databases in health, business, and social science fields (inception to June 2020). Studies were eligible for inclusion if they were conducted with persons who purchase cannabis and examine at least one attribute that would influence purchase choice and were published in the English language. Studies could be of any methodological design. Two independent reviewers completed two levels of screening, and all extraction was verified by a second reviewer. A qualitative synthesis of the findings was completed. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.

Results

Of the 4839 citations screened, 96 were eligible for full-text review and 35 were included in the final synthesis. Aspects of price were the most common factors (27 studies). Twenty studies measured price elasticity; most studies found that demand was price inelastic. Many other attributes were identified (e.g., product quality, route of administration, product recommendations, packaging), but none were explored in depth. Eleven studies addressed aspects of product quality including demand elasticity based on quality, potency, and aroma. Studies also explored consumer-perceived “quality” but provided no definition; differences in quality appeared to impact consumer choice. Smoking cannabis appeared to be the preferred route of administration but was only examined in three studies. There was insufficient data to understand in the impact of other attributes on choice. There appeared to be preference heterogeneity for different attributes based on the consumer’s experience, reason for use, and gender.

Conclusion

While price influences choices, demand is relatively inelastic. This suggests that consumers may be seeking lowest-cost, unregulated cannabis to avoid reducing consumption. Beyond price, there is a significant gap in our understanding of consumer choices. Perceived quality does appear to impact choice; however, more research is needed due to the lack of a recognized definition for cannabis quality.

Supplementary Information

The online version contains supplementary material available at 10.1186/s42238-022-00117-0.

How Cannabis Users Obtain and Purchase Cannabis: A Comparison of Cannabis Users from European Countries with Different Cannabis Policies

Objective: This study examines the role of cannabis policy in how cannabis users obtain and purchase cannabis. Methods: A survey was conducted in the Dutch coffeeshops among current cannabis users (n = 1255) aged 18-40 from seven European countries with different cannabis policies. This study investigated whether acquisition methods and supply sources were associated with national cannabis policy, controlling for gender, age, and frequency of use. Results: Cross-national differences notwithstanding, cannabis was easily available to current cannabis users in Europe. Within and across countries, users acquired cannabis in various ways and buyers purchased it from various sources, representing a mixture of open, closed, and semi-open retail markets. Buying cannabis was the most common method of acquisition. Among participants who reported buying their cannabis (n = 929), buying from friends was the most common source of supply, followed by street dealers, home dealers, and delivery services. The vast majority of Dutch participants reported buying cannabis from coffeeshops. Contrariwise, French buyers were more likely to buy cannabis from street dealers and delivery services, and Greek buyers to buy it from home dealers and friends. Overall, the Internet played a marginal role in purchasing cannabis. Conclusion: Our findings confirm the significant role of social supply across Europe. Although cross-national differences were rather common in cannabis acquisition and supply, yet they were not unidirectionally linked with the punitiveness of national cannabis policy. Findings suggest a differentiated normalization of the cannabis retail market, with users often preferring to buy cannabis in a regulated or legal market.

Current U.S. State Cannabis Sales Limits Allow Large Doses for Use or Diversion

INTRODUCTION

Legal limits on the amount of cannabis sold per transaction in states with recreational cannabis may promote moderate use and limit diversion. However, state sales limits are heterogeneous and difficult to interpret in terms of tetrahydrocannabinol dose equivalents.

METHODS

This cross-sectional study examined how transaction sales limits on recreational cannabis translate to tetrahydrocannabinol doses among U.S. states allowing commercial cannabis sales as of January 1, 2020. Weight-based quantity limits by cannabis type (flower/bud, concentrates, and edibles) were converted into grams of tetrahydrocannabinol content per transaction using known potency values in 2020.

RESULTS

Weight-based sales limits for flower and concentrate vary considerably across states (range=1.0-2.5 oz for flower and 3.5-15.0 g for concentrate), whereas limits for edible cannabis are heterogeneous. A total of 4 states have independent limits for each product category, and 6 states place limits across all products sold in the transaction. Because no states impose limits on the potency of flower or concentrates, the small differences in the weight-based limits translate into large differences in grams of tetrahydrocannabinol allowed to be sold. Assuming a typical dose of 10 mg of tetrahydrocannabinol, current laws allow for sales of up to 560 (Alaska) to 2,283 (Michigan) doses per transaction on the basis of median product potencies.

CONCLUSIONS

All states allow a large number of tetrahydrocannabinol doses per transaction, larger than what is typically consumed by daily users over a month. States concerned about public health and diversion should consider reducing sales limits and basing them on total tetrahydrocannabinol content across all purchased products.

Assessing New Zealand's Cannabis Legalization and Control Bill: prospects and challenges

BACKGROUND

Few countries have developed detailed legislative proposals for legalizing cannabis. New Zealand recently released the Cannabis Legalization and Control Bill (CLCB) that will be the subject of a referendum in September 2020.

AIMS

To assess the CLCB, drawing on emerging evidence from cannabis legalization overseas, public health research on alcohol and tobacco and the attempt to establish a regulated market for 'legal highs' in New Zealand.

DISCUSSION

The CLCB proposes a strictly regulated commercial cannabis market that resembles the Canadian approach, but notably without on-line sales or regional heterogeneity in retail distribution. The objective of the CLCB of lowering cannabis use over time appears at odds with the largely commercial cannabis sector that will focus on expanding sales. The CLCB includes provision for home cultivation and social benefit operators, but it is not clear what priority these operators will receive. A potency cap of 15% tetrahydrocannabinol (THC) for cannabis plants is included, and this is at the high end of black-market cannabis. The proposed progressive product tax based on THC will be challenging to implement. There is no formal minimum price, but rather discretionary powers to raise the excise if the price drops too much. The CLCB includes a comprehensive ban on advertising, but non-conventional on-line promotion will be difficult to suppress. The central government cannabis authority is tasked with developing local retail outlet policies. We caution against the temptation to employ an interim regulatory regime following a positive referendum result, because a partially regulated market will expose users to health risks and undermine public support.

CONCLUSIONS

New Zealand's Cannabis Legalization and Control Bill's objective of reducing cannabis use via a commercial market will be challenging to achieve. The bill could be strengthened with formal minimum pricing, lower potency cap and greater clarity concerning social benefit operators and the role of local government.

Illicit drug prices and quantity discounts: A comparison between a cryptomarket, social media, and police data

BACKGROUND

Illicit drugs are increasingly sold on cryptomarkets and on social media. Buyers and sellers perceive these online transactions as less risky than conventional street-level exchanges. Following the Risks & Prices framework, law enforcement is the largest cost component of illicit drug distribution. We examine whether prices on cryptomarkets are lower than prices on social media and prices reported by law enforcement on primarily offline markets.

METHODS

Data consists of online advertisements for illicit drugs in Sweden in 2018, scraped from the cryptomarket Flugsvamp 2.0 (n = 826) and collected with digital ethnography on Facebook (n = 446). Observations are advertisements for herbal cannabis (n = 421), cannabis resin, hash (n = 594), and cocaine (n = 257) from 156 sellers. Prices are compared with estimates from Swedish police districts (n = 53). Three multilevel linear regression models are estimated, one for each drug type, comparing price levels and discount elasticities for each platform and between sellers on each platform.

RESULTS

Price levels are similar on the two online platforms, but cocaine is slightly more expensive on social media. There are quantity discounts for all three drug types on both platforms with coefficients between -0.10 and -0.21. Despite the higher competition between sellers on cryptomarkets, prices are not lower compared to social media. Online price levels for hash and cocaine are similar to those reported by police at the 1 g level.

CONCLUSION

Mean prices and quantity discounts are similar in the two online markets. This provides support for the notion that research on cryptomarkets can also inform drug market analysis in a broader sense. Online advertisements for drugs constitute a new detailed transaction-level data source for supply-side price information for research.

Determinants of the retail price of illegal drugs in New Zealand

INTRODUCTION

New Zealand has a number of unusual geographical features that may influence the price of illegal drugs including international isolation, numerous rural communities, and two separate islands (North and South Islands).

AIMS

(1) Collect data on the prices of different drug types from all regions of New Zealand; (2) Identify independent predictors of the reported prices.

METHOD

An online drug survey was promoted via a targeted Facebook™ campaign. A total of 6331 respondents completed the survey. Normal regression models were constructed to identify predictors of the reported price of an ounce of cannabis, gram of methamphetamine, pill of ecstasy and tab of LSD using demographics, drug use frequency, drug market indicators, region, community size, type of seller, and location of purchase as predictor variables.

RESULTS

Higher availability was a predicator of lower prices for cannabis (-3% per higher availability category), methamphetamine (-4%) and ecstasy (-5%). Those living in the North Island (-26%) and buying from gangs (-5%) paid lower prices for methamphetamine. Those living in rural communities reported higher prices for methamphetamine (+5%) but lower prices for cannabis (-3%). Daily cannabis users (+4%) and those on social welfare (+2%) paid higher prices for cannabis.

CONCLUSION

Lower prices for methamphetamine in the North Island may reflect the concentration of methamphetamine manufacture there. The fact that gangs offer lower prices for methamphetamine suggests they do not have monopoly control of this market. Gangs may be able to offer lower prices for methamphetamine due to scale of production/trafficking and lower risk of victimisation. Higher prices for methamphetamine in rural areas may reflect less competitive markets. Lower prices for cannabis in rural communities may be due to proximity to growing locations. Daily cannabis users and those on social welfare may be less able to delay their cannabis purchases to low price harvest months.

Locating Medical and Recreational Cannabis Outlets for Research Purposes: Online Methods and Observational Study

Background

An increasing number of states have laws for the legal sale of recreational and medical cannabis out of brick-and-mortar storefront locations. Given the proliferation of cannabis outlets and their potential for impact on local economies, neighborhood structures, and individual patterns of cannabis use, it is essential to create practical and thorough methods to capture the location of such outlets for research purposes. However, methods used by researchers vary greatly between studies and often do not include important information about the retailer’s license status and storefront signage.

Objective

The aim of this study was to find methods for locating and observing cannabis outlets in Los Angeles County after the period when recreational cannabis retailers were granted licenses and allowed to be open for business.

Methods

The procedures included searches of online cannabis outlet databases, followed by methods to verify each outlet’s name, address, license information, and open status. These procedures, conducted solely online, resulted in a database of 531 outlets. To further verify each outlet’s information and collect signage data, we conducted direct observations of the 531 identified outlets.

Results

We found that 80.9% (430/531) of these outlets were open for business, of which 37.6% (162/430) were licensed to sell cannabis. Unlicensed outlets were less likely to have signage indicating the store sold cannabis, such as a green cross, which was the most prevalent form of observed signage. Co-use of cannabis and tobacco/nicotine has been found to be a substantial health concern, and we observed that 40.6% (175/430) of cannabis outlets had a tobacco/nicotine outlet within sight of the cannabis outlet. Most (350/430, 81.4%) cannabis outlets were located within the City of Los Angeles, and these outlets were more likely to be licensed than outlets outside the city.

Conclusions

The findings of this study suggest that online searches and observational methods are both necessary to best capture accurate and detailed information about cannabis outlets. The methods described here can be applied to other metropolitan areas to more accurately capture the availability of cannabis in an area.

The price and mark up of pharmaceutical drugs supplied on the black market

BACKGROUND

Research examining illicit drug markets has shown that price affects consumption and mark ups are extremely high. However, the economics of black market pharmaceutical supply remains unknown, despite increasing harms due to pharmaceuticals.

METHODS

Semi-structured, telephone interviews were conducted in Australia with 51 people involved in supplying pharmaceuticals in the previous six months. Interviews were audio-recorded, transcribed and quantitative information on costs, sale price, quantity and frequency of supply were coded and used to calculate the mark up ratio for each drug transaction 'cycle', accounting for distribution via selling, gifting and trading. Mixed effects gamma regressions were used to identify predictors of price and mark up, clustering by participant.

RESULTS

There were 29 drugs supplied over 111 cycles, including hypnotic-sedatives (38%), pharmaceutical opioids (32%), stimulants (18%) and others (12%). Sedatives were sold at lower prices than opioids and there was a negative relationship between unit price and transaction size, consistent with a discount effect. For every dollar spent acquiring the drugs, the supplier earned a median of $3.19. Cycles involving the distribution of drugs sourced via intermediaries (e.g. friends/family) had lower mark up than drugs sourced directly from the medical system.

CONCLUSION

To our knowledge, this is one of few studies to analyse economic aspects of the pharmaceutical black market from a supply perspective. There were a small number of cycles that realised large profits that may warrant different types of policy responses, however for most suppliers in our sample gross revenue and gross profit was modest.

Who's Buying What and How Much? Correlates of Purchase Behaviors From Medical Marijuana Dispensaries in Los Angeles, California

Venue-based distribution of marijuana has become the normative model in the United States to obtain marijuana. This study examines one-time purchase behaviors at medical marijuana dispensaries (MMDs) to identify potential venue- and individual-level targets for prevention. We used a two-stage, venue-based sampling approach to randomly select patrons exiting 16 MMDs in Los Angeles, California during the spring of 2013. Patrons (N = 595) reported their discrete purchase behaviors during their most recent visit to the sampled MMD. We used hierarchical linear modeling to examine the amount spent on marijuana products, regressed on characteristics of the sampled dispensaries and their patrons. We used hierarchical generalized linear modeling to examine the likelihood of purchasing specific types of marijuana products and total grams of loose-leaf buds purchased. Patrons spent US$41.73 on average, with a range of $0-$330. We observed significant variation in purchase behaviors across MMDs and associations between venues located within high median income census tracts and a higher total amount spent and lower odds of purchasing only loose-leaf buds. The networked distance between a patron's home and the sampled MMD was positively associated with the total amount spent and total quantity of buds purchased. We also found significant relationships between medical conditions reported for use in three models: total amount spent, purchase of pre-rolled joints, and total grams of buds purchased. Policy makers may want to explore regulating the availability of specialty items that may be attractive to naïve users, such as pre-rolled joints or edibles, or high-concentration products that may be sought out by regular, heavy users.

When Marijuana Is Used before Cigarettes or Alcohol: Demographic Predictors and Associations with Heavy Use, Cannabis Use Disorder, and Other Drug-related Outcomes

Recent loosening of state and federal policy restrictions on marijuana, along with changes in social norms regarding marijuana use and decreases in prevalence of other types of substance use, may lead to increases in youth initiating marijuana before other types of substances such as alcohol and tobacco. We investigated predictors and potential consequences of initiating marijuana before other drugs for youth aged 12-21-years in the USA. Nationally representative, cross-sectional survey data from the US National Survey on Drug Use and Health supplied self-reported age of first marijuana, cigarettes, alcohol, other tobacco, and other illegal drug use among 12-21-year-old samples from 2004 to 2014 (n = 275,559). We first examined the degree to which initiating marijuana use first was associated with sex, age, race/ethnicity, and survey year. Then, we examined whether using marijuana first predicted heavy marijuana use, cannabis use disorder (CUD), alcohol use disorder (AUD), nicotine dependence (ND), or lifetime use of other illegal drugs. Among all survey youth (substance users and non-users), the proportion using marijuana first increased from 4.8 to 8.8% from 2004 to 2014. Those using marijuana first (vs. alcohol or cigarettes first) were more likely to be male and older and Black, American Indian/Alaskan Native, multiracial, or Hispanic than White or Asian. Among substance users and adjusting for age of onset and the number of substances used, using marijuana first was associated higher odds of heavy current marijuana use and CUD. In recent years, youth have been increasingly likely to use marijuana as their first drug and sequence of initiation is associated with race/ethnicity, gender, and age. Using marijuana first might increase the chance of heavy use and CUD.

Marijuana sources in a medical marijuana environment: dynamics in access and use among a cohort of young adults in Los Angeles, California

While a range of sources exist for marijuana users to acquire marijuana for medical or personal use, prior research on marijuana sources primarily focused on single sources. In this analysis, we longitudinally examined characteristics of multiple sources selected by marijuana users, motivations to use sources, and how a blend of marijuana sources accommodated users' needs. Young adult marijuana users (n=60) in Los Angeles, CA, where marijuana has been legal for medical use since 1996, completed two annual qualitative interviews on marijuana use practices and sources between 2014 and 2016. Approximately two-thirds were medical marijuana patients and one-third were non-patient users. Participants reported acquiring marijuana from the following primary sources across two interviews: dispensaries and delivery services, private sellers in the illicit market, friends and family, and marijuana events/conferences. While patients with legal medical access to marijuana typically purchased marijuana from dispensaries or delivery services, they often supplemented from other illicit sources. Non-patients often accessed marijuana through dispensary diversion but also other sources. As patients became non-patients and vice versa during the study period, source type changed too. Broad access to marijuana via legal and illicit sources in this sample is indicative of societal trends towards normalization of marijuana use.

The Influence of Online-Only Friends on the Substance Use of Young Adults with a History of Childhood Maltreatment

BACKGROUND

Existing research shows that having offline friends that use substances increases risk for individual substance use in adolescence. However, there is little research examining the influence of online social networks on substance use in young adulthood.

OBJECTIVES

This study examined the number of online-only Facebook friends (i.e. those with no in-person contact) that were substance users in relation to the participants' alcohol and marijuana use in the past year.

METHODS

The sample (n = 114) were selected from participants enrolled in a longitudinal study on childhood maltreatment in an urban city within the United States. The mean age of the sample was 21.84 (SD = 1.43), 61% female. With participant permission, data were downloaded from Facebook to obtain the list of online friends. A self-report questionnaire recorded the substance use of each participant. Path analysis and logistic regression were used to examine (a) the number of online-only friends who drink as a predictor of participants' problem drinking, (b) the number of online-only friends who smoke marijuana as a predictor of participants' marijuana use, and (c) moderation by maltreatment status.

RESULTS

The results showed a significant effect of the number of online-only friends who smoke marijuana on the participant's marijuana use. However, after including offline friends this significant effect was no longer present, but offline friends predicted individual marijuana use. Conclusions/Importance: These findings demonstrate that substance use in online social networks may be associated with individual use in young adulthood, but that offline influence is stronger.

Rural and Urban Differences in Nebraskans’ Access to Marijuana, Methamphetamine, Heroin, and Prescription Pills

The ability of a user to access a given type of drug is related to the configuration of the market for that drug, and a range of economic and criminal justice concerns. This study focuses on Nebraskan’s “ready access” to four types of drugs (marijuana, methamphetamine, heroin, and prescription pills) in 2016, using a statewide survey of housed Nebraskan adults. Ready access is defined as a participant knowing at least one person from whom they could obtain a given type of drug if they wanted to. We found that 35% of adult Nebraskans knew at least one person from whom they could obtain marijuana, 8.9% for methamphetamine, 4.5% for heroin, and 17.8% knew at least one source for prescription pills. Relationships between knowing a source for each type of drug and rurality, sex, race, religious attendance, mental health symptoms, and education are explored.

Early Impacts of Marijuana Legalization: An Evaluation of Prices in Colorado and Washington

Following the legalization and regulation of marijuana for recreational purposes in states with medical markets, policymakers and researchers seek empirical evidence on how, and how fast, supply and demand changed over time. Prices are an indication of how suppliers and consumers respond to policy changes, so this study uses a difference-in-difference approach to exploit the timing of policy implementation and identify the impacts on marijuana prices 4-5 months after markets opened. This study uses unique longitudinal survey data of prices paid by consumers and a web-scraped dataset of dispensary prices advertised online for three U.S. medical marijuana states that all eventually legalized recreational marijuana. Results indicate there were no impacts on the prices paid for medical or recreational marijuana by state-representative residents within the short 4- to 5-months window following legalization. However, there were differences in how much people paid if they obtained marijuana for recreational purposes from a recreational store. Further analysis of advertised prices confirms this result, but further demonstrates heterogeneous responses in prices across types of commonly advertised strains; prices either did not change or increased depending on the strain type. A key implication of our findings is that there are both supply and demand responses at work in the opening of legalized markets, suggesting that evaluations of immediate effects may not accurately reflect the long run impact of legalization on consumption.

Police crackdowns, structural violence and impact on the well-being of street cannabis users in a Nigerian city

BACKGROUND

There is abundant literature on the impact of law enforcement on cannabis markets, but scant literature on the effects of law enforcement on cannabis users. This study undertook a qualitative exploration of police crackdowns as a form of structural violence and examined their impact on the well-being of street cannabis users in a Nigerian city.

METHODS

The study was qualitative and descriptive. It was carried out in Uyo, southern Nigeria. Ninety-seven (97) frequent cannabis users (78 males and 19 females) took part. They were aged between 21 and 34 years and recruited from 11 cannabis hot-points in the city. Data were collected through in-depth, individual interviews, conducted over six-months. Data analysis was thematic and data-driven, involving identifying themes, assigning codes, revising codes and verification by independent qualitative methodology experts.

RESULTS

Police crackdowns are commonly experienced by street cannabis users. These do not reduce cannabis use, but displace cannabis markets. Crackdowns are associated with police brutality, confiscation of funds, drugs and belongings, stigma and discrimination, arrest and incarceration, which impacts negatively on the health, livelihoods and well-being of cannabis users. Cannabis users try to escape arrest by running from police, disposing of cannabis, disguising themselves and, when caught, bribing officers to secure release.

CONCLUSION

Crackdowns constitute a form of structural violence in the everyday life of cannabis users, and have negative effects on their health and social and economic well-being. Cannabis use should be decriminalized de facto and arrested users directed to treatment and skills training programmes. Treatment and social services for users should be expanded and legal aid interventions should be mounted to support users in addressing discriminatory practices and human rights violations.

Unemployment, drugs and attitudes among European youth

This paper studies changes in the patterns of drug consumption and attitudes towards drugs in relation to sky-high (youth) unemployment rates brought about by the Great Recession. Our analysis is based on data for 28 European countries that refer to young people. We find that the consumption of cannabis and 'new substances' is positively related to increasing unemployment rates. An increase of 1% in the regional unemployment rate is associated with an increase of 0.7 percentage points in the ratio of young people who state that they have consumed cannabis at some point in time. Our findings also indicate that higher unemployment may be associated with more young people perceiving that access to drugs has become more difficult, particularly access to ecstasy, cocaine and heroin. According to young Europeans, when the economy worsens, anti-drug policies should focus on the reduction of poverty and unemployment, and not on implementing tougher measures against users.

Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state

AIMS

To (1) assess trends and variation in the market share of product types and potency sold in a legal cannabis retail market and (2) estimate how potency and purchase quantity influence price variation for cannabis flower.

DESIGN

Secondary analysis of publicly available data from Washington State's cannabis traceability system spanning 7 July 2014 to 30 September 2016. Descriptive statistics and linear regressions assessed variation and trends in cannabis product variety and potency. Hedonic regressions estimated how purchase quantity and potency influence cannabis flower price variation.

SETTING

Washington State, USA.

PARTICIPANTS

(1) A total of 44 482 176 million cannabis purchases, including (2) 31 052 123 cannabis flower purchases after trimming price and quantity outliers.

MEASUREMENTS

Primary outcome measures were (1) monthly expenditures on cannabis, total delta-9-tetrahydrocannabinol (THC) concentration and cannabidiol (CBD) concentration by product type and (2) excise tax-inclusive price per gram of cannabis flower. Key covariates for the hedonic price regressions included quantity purchased, THC and CBD.

FINDINGS

Traditional cannabis flowers still account for the majority of spending (66.6%), but the market share of extracts for inhalation increased by 145.8% between October 2014 and September 2016, now comprising 21.2% of sales. The average THC-level for cannabis extracts is more than triple that for cannabis flowers (68.7% compared to 20.6%). For flower products, there is a statistically significant relationship between price per gram and both THC [coefficient = 0.012; 95% confidence interval (CI) = 0.011-0.013] and CBD (coefficient = 0.017; CI = 0.015-0.019). The estimated discount elasticity is -0.06 (CI = -0.07 to -0.05).

CONCLUSIONS

In the state of Washington, USA, the legal cannabis market is currently dominated by high-THC cannabis flower, and features growing expenditures on extracts. For cannabis flower, both THC and CBD are associated with higher per-gram prices, and there are small but significant quantity discounts.

Place over traits? Purchasing edibles from medical marijuana dispensaries in Los Angeles, CA

OBJECTIVES

To examine discrete purchasing behaviors of marijuana-infused edibles from medical marijuana dispensaries with the aim to identify potential venue- and individual-level targets for prevention.

METHODS

Two-stage, venue-based sampling approach was used to randomly select patrons exiting 16 medical marijuana dispensaries in Los Angeles, California during Spring 2013. Hierarchical generalized linear modeling was used to examine the likelihood of purchasing edibles among 524 patrons reporting a discrete purchase regressed on characteristics of the sampled dispensaries and their patrons.

RESULTS

At a venue level, patrons were more likely to purchase edibles from dispensaries located within Census tracts with higher median incomes or in close proximity to a higher number of dispensaries. At an individual level, patrons who identified as Black or Hispanic were associated with a lower likelihood of purchasing edibles when compared to patrons who identified as other non-White, non-Hispanic race/ethnicity.

CONCLUSIONS

Place-based policies focused on regulating edible sales through dispensaries may be fruitful in influencing access to edibles. Additionally, social marketing campaigns may benefit from targeting both locations where edible purchases are more likely and populations who are more likely to purchase edibles.

Understanding and learning from the diversification of cannabis supply laws

BACKGROUND AND AIMS

Prohibitions on producing, distributing and selling cannabis are loosening in various jurisdictions around the world. This paper describes the diversification of cannabis supply laws and discusses the challenges to and opportunities for learning from these changes.

METHODS

We document changes in cannabis supply laws that de jure legalized cannabis production for medical and/or non-medical purposes (excluding industrial hemp) in Australasia, Europe, North America and South America. We also highlight challenges to evaluating these legal changes based on our experiences studying cannabis laws and policies in the United States.

FINDINGS

As of August 2016, two countries have passed laws to legalize large-scale cannabis production for non-medical purposes at the national (Uruguay) or subnational level (four US states). At least nine other countries legally allow (or will soon allow) cannabis to be supplied for medicinal purposes. Most of the changes in cannabis supply laws have occurred since 2010. The data available in most countries are inadequate for rigorously evaluating the changes in cannabis supply laws.

CONCLUSION

The evidence base for assessing changes in cannabis supply laws remains weak. Efforts should focus upon collecting information about quantities consumed and market transactions as well as validating self-report surveys.

Cannabis retail purchases in a low-risk market: Purchase size and sex of buyers

Aim

To analyse the composition of cannabis retail purchases in a representative sample of purchases made in Christiania, Copenhagen in 2004.

Material

Transactions (n=1,123) were registered along four variables; type (loose resin or joints), quantum (n=957, grams or number of joints), sex (n=559, female or male) and payment (n=707, notes or coins).

Results

We found that more than half of all transactions were for joints only. The median transaction quantum was small, at two joints or three grams of resin, valued at DKK 100. Of the resin transactions, 88% were three grams or below. Women made 11% of the purchases. There was no statistically significant difference in the preferences for quantum or type between males and females.

Conclusions

Buyers prefer joints over loose resin despite the higher price, which is interesting. The small median transactions size is consistent with findings in the international literature. Illicit drug buyers appear to prefer small acquisitions across drugs and social context. The share of purchases made by women is 11%, which is similar to the estimated proportion of women among daily cannabis users. This finding suggests an interesting question for future research. At what point in a cannabis-using career do users purchase their drugs? These findings contribute to the existing research by documenting the proportion of female buyers, and preferences for type and quantum in a sample that is representative of a market and is not based on self-reported purchases.

Evolution of the United States Marijuana Market in the Decade of Liberalization Before Full Legalization

The past decade has seen a remarkable liberalization of marijuana policies in many parts of the United States. We analyze data from the National Survey on Drug Use and Health (NSDUH) for coinciding changes in the marijuana market from 2002 to 2013, including market size, number and demographics of customers, and varying means of acquiring the drug. Results suggests that (a) the national market has grown, especially in terms of the number of daily users; (b) marijuana users remained economically “downscale” over this period, and in many ways resemble cigarette users; (c) distribution networks appear to be professionalizing in a sense, as fewer users obtain marijuana socially; (d) the typical purchase has gotten smaller by weight but not price paid, suggestive of a trend toward higher potencies; (e) marijuana expenditures vary by user group; and (f) respondents with medical marijuana recommendations differ from other users in systematic ways.

Using Respondent-Driven Sampling to Recruit Illegal Drug Purchasers to Evaluate a Drug Market Intervention

BACKGROUND

Violent drug markets are not as prominent as they once were in the United States, but they still exist and are associated with significant crime and lower quality of life. The drug market intervention (DMI) is an innovative strategy that uses focused deterrence, community engagement, and incapacitation to reduce crime and disorder associated with these markets. Although studies show that DMI can reduce crime and overt drug activity, one perspective is prominently missing from these evaluations: those who purchase drugs.

OBJECTIVES

This study explores the use of respondent-driven sampling (RDS)-a statistical sampling method-to approximate a representative sample of drug users who purchased drugs in a targeted DMI market to gain insight into the effect of a DMI on market dynamics.

METHODS

Using RDS, we recruited individuals who reported hard drug use (crack or powder cocaine, heroin, methamphetamine, or illicit use of prescriptions opioids) in the last month to participate in a survey. The main survey asked about drug use, drug purchasing, and drug market activity before and after DMI; a secondary survey asked about network characteristics and recruitment.

CONCLUSIONS

Our sample of 212 respondents met key RDS assumptions, suggesting that the characteristics of our weighted sample approximate the characteristics of the drug user network. The weighted estimates for market purchasers are generally valid for inferences about the aggregate population of customers, but a larger sample size is needed to make stronger inferences about the effects of a DMI on drug market activity.

Correlates of Amount Spent on Marijuana Buds During a Discrete Purchase at Medical Marijuana Dispensaries: Results from a Pilot Study

Marijuana purchasing behaviors vary by the purchaser's individual characteristics; however, little is known about patients' purchasing behaviors when buying from medical marijuana dispensaries (MMDs). Our objective was to explore whether patient characteristics were associated with amount spent during one financial transaction at medical marijuana dispensaries. We conducted a pilot study of four purposively sampled MMD locations in Long Beach, California, in 2012. A total of 132 medical marijuana patients (33 patients per dispensary) participated in an exit survey about their demographic characteristics, conditions for their medical marijuana recommendation, amount spent at the dispensary, and cross-streets of where they lived. The sample reported amounts spent on discrete purchases of marijuana buds averaging $40.82 (ranging from $10 to $255). Multivariate regression analyses indicated average amount spent differed significantly by patient age and condition. An increase in 10 years of age was associated with a 10% higher amount spent. Receiving a recommendation for anxiety and/or sleeping problems or other nonspecified conditions was related to higher discrete purchase amounts than chronic pain. This pilot suggests that variations in patient purchasing behaviors from MMDs exist. These purchase behaviors can provide insight into variations in how patients use dispensaries, consume products, and allocate personal resources.

Assessing the effects of medical marijuana laws on marijuana use: the devil is in the details

This paper sheds light on previous inconsistencies identified in the literature regarding the relationship between medical marijuana laws (MMLs) and recreational marijuana use by closely examining the importance of policy dimensions (registration requirements, home cultivation, dispensaries) and the timing of when particular policy dimensions are enacted. Using data from our own legal analysis of state MMLs, we evaluate which features are associated with adult and youth recreational and heavy use by linking these policy variables to data from the Treatment Episode Data Set (TEDS) and National Longitudinal Survey of Youth (NLSY97). We employ differences-in-differences techniques, controlling for state and year fixed effects, allowing us to exploit within-state policy changes. We find that while simple dichotomous indicators of MML laws are not positively associated with marijuana use or abuse, such measures hide the positive influence legal dispensaries have on adult and youth use, particularly heavy use. Sensitivity analyses that help address issues of policy endogeneity and actual implementation of dispensaries support our main conclusion that not all MML laws are the same. Dimensions of these policies, in particular legal protection of dispensaries, can lead to greater recreational marijuana use and abuse among adults and those under the legal age of 21 relative to MMLs without this supply source.

Blurred Boundaries

This article examines particular features of the bottom level of the U.K. cannabis market and the overlap between supply–supplier and use–user within that market. An Internet survey was completed by 464 adult regular cannabis users residing in the United Kingdom. Results indicate that over a quarter of the sample had bought large amounts (9 ounces [252 g] or more) of cannabis at one time, a third had been involved in selling cannabis for profit and over two fifths had been involved in intentionally taking cannabis across internal European Union borders. These findings are discussed in relation to both Parker, Aldridge, and Measham’s (1998) thesis of normalization and South’s (1999) theory of the “everyday” nature of drug taking. We suggest that the boundaries between users and suppliers within the U.K. cannabis market are far from clear, and that attempts to conceptually separate these behaviors, whether for legal, policy or academic purposes, are therefore problematic.

The effects of medical marijuana laws on illegal marijuana use

More and more states have passed laws that allow individuals to use marijuana for medical purposes. There is an ongoing, heated policy debate over whether these laws have increased marijuana use among non-patients. In this paper, I address that question empirically by studying marijuana possession arrests in cities from 1988 to 2008. I estimate fixed effects models with city-specific time trends that can condition on unobserved heterogeneities across cities in both their levels and trends. I find that these laws increase marijuana arrests among adult males by about 15-20%. These results are further validated by findings from data on treatment admissions to rehabilitation facilities: marijuana treatments among adult males increased by 10-20% after the passage of medical marijuana laws.

Are users' most recent drug purchases representative?

BACKGROUND

Various surveys now ask respondents to describe their most recent purchase of illicit drugs, as one mechanism through which market size can be estimated. This raises the question of whether issues surrounding the timing of survey administration might make a sample of most recent purchases differ from a random sample of all purchases. We investigate these issues through a series of questions which ask about the three most recent purchases, and about drug use.

METHODS

Data were drawn from 688 respondents in the Melbourne Injecting Drug User Cohort Study across the period 2008-2013 and 2782 respondents to the Washington Cannabis Consumption Study in 2013. Responses to questions about the most recent purchases were compared to larger subsets of all recent purchases.

RESULTS

For heroin, methamphetamine and cannabis no differences were found between the amount spent by participants on their most recent purchase and the average amount spent on three or more recent purchases. There were also no differences concerning the locations and types of deals, and the duration between consecutive cannabis purchases was the same for first and second most recent, and second and third most recent.

CONCLUSIONS

Asking about the most recent purchase appears to be an economical way to learn about purchases more generally, with little evidence of substantial variation between the most recent purchase and other recent purchases reported by participants. In spite of consistent findings across our two surveys, further replication of the work reported in this paper involving other populations of users is warranted.

The Drugs–Violence Nexus

Research on drug use often fails to account for drug dealing in most analyses of violence and other systemic risks associated with illegal drugs. The current study examined whether drug dealing, independent of its connection to drug use, increases involvement with delinquent peers, violence, weapons, and other drug-related conflicts. Data were drawn from the first two waves of the Toledo Adolescent Relationships Study ( N = 1,148). Hierarchical linear models were used to investigate changes in these behaviors that resulted from the respondents’ involvement in drug dealing and drug use. Results indicate that involvement in drug dealing, controlling for drug use, increases violence and other systemic risks to a level that drug use alone is not likely to achieve. Findings also show, however, that drug use among dealers may reduce violence and limit contact with delinquent peers.

Why Changes in Price Matter When Thinking About Marijuana Policy: A Review of the Literature on the Elasticity of Demand

Recent debates regarding liberalization of marijuana policies often rest on assumptions regarding the extent to which such policy changes would lead to a change in marijuana consumption and by whom. This paper reviews the economics literature assessing the responsiveness of consumption to changes in price and enforcement risk and explicitly considers how this responsiveness varies by different user groups. In doing so, it demonstrates how most of the research has examined responsiveness to prevalence of use, which is a composite of different user groups, rather than level of consumption among regular or heavy users, which represent the largest share of total quantities consumed. Thus, it is not possible to generate reliable estimates of the impact of liberalizing policies on either tax revenues or harms, as these outcomes are most directly influenced by the amounts consumed by regular or heavy users, not prevalence rates.

Exploring the Spread of Methamphetamine Problems within California, 1980 to 2006

BACKGROUND

The introduction and spread of high potency methamphetamine has led to dramatic increases in drug-related problems in California. Prior research suggests that drug abuse rates are related to local demographic and economic characteristics, law enforcement activities, and sentencing practices. Methamphetamine abuse in particular has been shown to be reduced by laws regulating the raw materials needed for its production. This research models the regional effects of such laws on the spatio-temporal patterns of growth of methamphetamine-related problems across California from 1980 to 2006.

METHODS

Amphetamine-related arrests and hospital discharges related to amphetamine abuse / dependence were assembled for California counties over the years 1980 through 2006. Varying-parameter Bayesian space-time models were used to relate the implementation of major laws controlling the distribution of methamphetamine precursors to observed patterns of arrests and discharges and to allow such associations to vary by location. The models used conditionally autoregressive (CAR) Bayesian spatial priors to allow spatial correlation in estimation of county-specific growth in these measures over three distinct time periods: before the 1989 law, between the 1989 and 1997 laws, and after the 1997 law. Growth of arrests and discharges were related to demographic and economic indicators to determine geographic areas more or less susceptible to the spread of methamphetamine problems.

RESULTS

Although both problem measures increased during all three periods, each of the precursor laws was associated with short-term reductions in the growth of arrests and discharges. Growth was greatest in central California counties prior to 1989 and increased in coastal counties in later years. From 1980 to 1989 growth was highest for counties with low incomes and high proportions of white residents, while 1989-1997 growth was highest in counties with fewer whites and more Hispanics. Growth after 1997 was not significantly associated with county characteristics.

CONCLUSION

This research demonstrates that the precursor laws did suppress the growth of methamphetamine related arrests and hospital discharges. It also demonstrates specific geographic patterns in the growth of methamphetamine arrests and abuse across California during this time. Early patterns of growth were related to economic and demographic characteristics, while later patterns were not. This suggests that some counties were uniquely susceptible to the early spread of the methamphetamine epidemic, although problems eventually grew dramatically in all California counties.

Childhood predictors of first chance to use and use of cannabis by young adulthood

AIMS

To prospectively examine the linkage between childhood antecedents and progression to early cannabis involvement as manifest in first chance to try it and then first onset of cannabis use.

METHODS

Two consecutive cohorts of children entering first grade of a public school system of a large mid-Atlantic city in the mid 1980s (n=2311) were assessed (mean age 6.5 years) and then followed into young adulthood (15 years later, mean age 21) when first chance to try and first use were assessed for 75% (n=1698) of the original sample. Assessments obtained at school included standardized readiness scores (reading; math) and teacher ratings of behavioral problems. Regression and time to event models included covariates for sex, race, and family disadvantage.

RESULTS

Early classroom misconduct, better reading readiness, and better math readiness predicted either occurrence or timing of first chance to try cannabis, first use, or both. Higher levels of childhood concentration problems and lower social connectedness were not predictive.

CONCLUSIONS

Childhood school readiness and behavioral problems may influence the risk for cannabis smoking indirectly via an increased likelihood of first chance to use. Prevention efforts that seek to shield youths from having a chance to try cannabis might benefit from attention to early predictive behavioral and school readiness characteristics. When a youth's chance to try cannabis is discovered, there are new windows of opportunity for prevention and intervention.

Assessing correlates of the growth and extent of methamphetamine abuse and dependence in California

Using aggregate-level data, this study performed cross-sectional analyses on all 1,628 populated California zip code areas and longitudinal analyses on 581 consistently defined zip codes over six years (1995-2000), relating place and population characteristics of these areas to rates of hospital discharges for amphetamine dependence/abuse using linear spatial models. Analyzing the data in two ways, spatial time series cross-sections and spatial difference models, amphetamine dependence/abuse were greatest in rural areas with more young low-income whites, larger numbers of retail and alcohol outlets, and smaller numbers of restaurants. Growth rates of these problems were greater in areas with higher income and larger non-White and Hispanic populations. This suggests that there was some change in the penetration of the methamphetamine epidemic into different population groups during this time. Study implications and limitations are discussed.

Drug Policy and the Public Good: a summary of the book

Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence.

Patterns of Youth Participation in Cannabis Cultivation

The current study examines the patterns of youth participation in cannabis cultivation by developing a typology among a sample of young offenders (n=175) in a rural region of Quebec, Canada known for its extensive outdoor cultivation industry. A hierarchical cluster analysis approach is used to group participants on various dimensions: motivation, substance use, delinquency and type of participation in cannabis cultivation. We also explore the role that criminal networks have in structuring the nature of youth involvement in the cultivation industry. Two general categories of participants emerged: participants for which cultivation is mainly a money generating activity (Entrepreneurs and Generalists), and participants who grow for personal use and intangible rewards (Hobbyists). Further, we found another group, the “helpers”, who qualify as “participants” to the cultivation industry, but not as “growers” per se. For generalists, participation to the cultivation industry is found among a portfolio of other crimes, while entrepreneurs tend to specialize in cultivation and are rewarded by achieving a higher level of success. Our results also suggest a correlation between the intensity of involvement in cultivation and the size of a youth's criminal network.

Cannabis and crime: findings from a longitudinal study

AIM

To examine the association between cannabis use during adolescence and young adulthood, and subsequent criminal charges.

METHODS

Data were obtained from the Young in Norway Longitudinal Study. A population-based sample (n = 1353) was followed from 13 to 27 years of age. Data were gathered on cannabis use, alcohol consumption and alcohol problems, and use of other illegal substances such as amphetamines, cocaine and opiates. In addition, extensive information on socio-demographic, family and personal factors was collected. This data set was linked to individual-level information from official Norwegian crime statistics.

FINDINGS

We found robust associations between cannabis use and later registered criminal charges, both in adolescence and in young adulthood. These associations were adjusted for a range of confounding factors, such as family socio-economic background, parental support and monitoring, educational achievement and career, previous criminal charges, conduct problems and history of cohabitation and marriage. In separate models, we controlled for alcohol measures and for use of other illegal substances. After adjustment, we still found strong associations between cannabis use and later criminal charges. However, when eliminating all types of drug-specific charges from our models, we no longer observed any significant association with cannabis use.

CONCLUSIONS

The study suggests that cannabis use in adolescence and early adulthood may be associated with subsequent involvement in criminal activity. However, the bulk of this involvement seems to be related to various types of drug-specific crime. Thus, the association seems to rest on the fact that use, possession and distribution of drugs such as cannabis is illegal. The study strengthens concerns about the laws relating to the use, possession and distribution of cannabis.

Convenient labour: the prevalence and nature of youth involvement in the cannabis cultivation industry

BACKGROUND

The emergence of cannabis cultivation in industrialised countries may offer adolescents, especially those living in regions suitable for outdoor cultivation, new opportunities to participate in the drug trade. The current study examines the prevalence and the nature of youth involvement in cannabis cultivation in an important agricultural region of Quebec, Canada.

METHODS

A self-report delinquency survey was administered to 1262 adolescents between 13 and 17 years who were attending one of four secondary schools in that region. The study location was not chosen arbitrarily. The region was known for having a larger than average outdoor cannabis industry, and various media reports suggested that a substantial number of students missed school days during the cannabis harvest season, in October.

RESULTS

A first set of findings show that 12% of respondents reported having participated in the cannabis cultivation industry in the past year. Such a prevalence rate is higher than for any other type of crime found in the survey (except for the general category of mischief)--including assault and theft, and is comparable to the prevalence rates found for drug dealing. Such a high prevalence rate comes in part out of need for labour in this low population density region: 35% of respondents who reported having participated in the industry in the past year, were "labourers", while many others only participated in small sites, destined for personal use. Another set of findings suggest that growers are a very diverse group: although cultivation is the most prevalent money-generating crime for gang members in the region, girls and otherwise conventional adolescents are also involved in high numbers.

CONCLUSION

These results emphasise the need to design policies that concern not just the prevention of drug use among youth, but also youth involvement in the supply of drugs. In addition, it underlines the difficulty of planning general interventions in what appears to be a very heterogeneous population of growers.

Civic norms and etiquettes regarding marijuana use in public settings in New York City

This paper shows that active police enforcement of civic norms against marijuana smoking in public settings has influenced the locations where marijuana is smoked. It has subtly influenced the various marijuana etiquettes observed in both public and private settings. The ethnographic data reveal the importance of informal sanctions; most marijuana consumers report compliance with etiquettes mainly to avoid stigma from nonusing family, friends, and associates-they express limited concern about police and arrest.

How much for a dime bag? An exploration of youth drug markets

Relatively little is known about how youth obtain marijuana and other drugs. The Drugs, Alcohol and Violence International (DAVI) study explored youthful drug markets among samples of school students, detained youth, and school dropouts (ages 14-17 years) in the greater metropolitan areas of Philadelphia, Toronto, Montreal, and Amsterdam. Students frequently reported sharing drugs, either getting them from others or giving them to others for free. Sharing was less common among the more drug-involved detainees and dropouts. Marijuana was typically obtained either outdoors or in a house or apartment. Few youth reported getting marijuana at school. In Amsterdam, where marijuana can be purchased in small quantities in coffeeshops, this was the most common place to get marijuana, even though 18 is the legal age for purchase. Alcohol was also most likely to be obtained in stores or restaurants across all the sites, even though none were of legal age except those in Amsterdam age 16 or older. Youth most often reported purchasing marijuana in nickel, dime or other small bags, which are not standardized units. The exception again was Amsterdam, where youth most often reported quantities in grams or joints, which is how it is sold in coffeeshops. The lack of standardization of units makes economic cost estimates suspect. Even standardized units such as alcohol present problems since youth report a wide range of 'typical purchases.' Survey data can, however, more aptly describe drug market characteristics such as general location of purchase, and relationship with the seller.