Does a State Legalizing Weed Improve Mental Health?
A recent study found that when states pass recreational cannabis laws, the number of people seeking mental health treatment drops.
The study, published in the journal Health Economics, is notable given the growing question about the effects of cannabis on mental health. Over the past two decades, numerous states have legalized cannabis use for adults. Unfortunately, research on how cannabis affects mental health is mixed.
Some studies have shown that cannabis is helpful for some mental illnesses, while others suggest that cannabis has the potential to worsen certain medical conditions. Because of this complex picture, some fear that legalizing cannabis could lead to worsening mental health in the general population.
However, this study suggests that shortly after recreational cannabis laws, a more positive outcome occurs – fewer admissions for mental health treatment.
Cannabis Laws and Mental Health
Until recently, there was little research into how cannabis laws affect mental health. But Alberto Ortega, a researcher at Indiana University in Bloomington, wanted to know more. “Recreational marijuana laws are becoming increasingly popular, but the impact on mental health treatment is unclear,” explains Ortega. This motivated him to investigate whether the increasing number of states with legal cannabis had a significant impact.
To do this, Ortega analyzed data on psychiatric admissions from the Uniform Reporting System of state psychiatric facilities. This included data from patients ages 13 to 65 over a 12-year period from 2007 to 2019. During that time, 10 states passed recreational cannabis laws. By comparing state-by-state data in the years before and after voters passed the new laws, Ortega discovered a clear pattern. Shortly after a state adopts cannabis legalization, they see a significant decrease in psychiatric admissions.
The results are clear: Legal cannabis leads to fewer psychiatric treatments.
These results proved robust even when accounting for differences between states with and without cannabis laws. For example, states that have passed recreational cannabis laws tend to have broader Medicaid access as well as existing medical cannabis laws. Because these factors could also impact mental health, Ortega took them into account in his analysis. It also included controls for demographic characteristics such as age, race, economics and politics. But even with these controls, the essential findings remained.
This graph shows psychiatric admissions in the years before and after recreational cannabis laws.
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The results differ for some demographic groups
In the first few years after a state passed a recreational cannabis law, states averaged a 37% decrease in psychiatric admissions. Results remained fairly consistent across all age groups under 65 years, with a decrease in admissions even in the youngest group (13-20). The correlation also proved relatively consistent between men and women, who saw a 42% and 37% decrease in admissions, respectively.
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The race caused the biggest difference in results. Mental health admissions for blacks fell by 27%, while for whites there was only a 9% decline. However, other racial demographics showed less consistent results. Who had fewer visitors at one race than another? We need more research to understand this connection and its possible causes.
Medicaid enrollees also had better outcomes. However, this may be due to reporting facilities having high numbers of Medicaid users. Nevertheless, both groups saw a decrease in admissions following cannabis legalization.
These graphs show psychiatric admissions in the years before and after recreational cannabis laws, broken down by race. (a) White (b) Black (c) Hispanic (d) Other race.
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The results show fewer admissions, but not better mental health
You may want to interpret this study as showing that the freedoms of cannabis have a direct impact on individuals’ mental health – and therefore lead to fewer mental health admissions. However, Ortega explains, “What pathways contribute to the decline in treatment admissions remains unclear.” Therefore, the results should not be confused with improved mental health.”
Future research needs to address the causes of this association. Because a number of different theories could explain the data. Cannabis can directly contribute to mental health. But it’s also possible that self-medicating with cannabis may discourage a person from seeking help without actually improving their mental health. Unknown factors could also lead to these results.
One major limitation of this study: It doesn’t really tell us who used cannabis and how their mental health fared. Only large-scale trends at the population level are considered. This cannot replace medical research looking at the effects of cannabis use on mental health. Ortega reminds us that his findings “apply specifically to treatment admissions and should not be equated with improvement or deterioration in mental health.” However, when it comes to the immediate impact of cannabis legalization on the healthcare system, the results are clear: legal cannabis leads to fewer mental health admissions.
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