Colorado marijuana industry sets sales records in early '17

Medical marijuana in Iowa is currently restricted to CBD oil

These laws "seem to send a message that use of this drug is safe and acceptable in some way", said lead researcher Deborah Hasin of Columbia University's Mailman School of Public Health.

"Just as the case for alcohol, not everybody who uses it is harmed but there are some risks", Hasin told Reuters Health.

"The laws may not be too relevant and salient to teenagers so we thought it was important to look at adults", said Hasin.

The research, published by JAMA Psychiatry on Wednesday, is the first to do a comprehensive review of data stretching from before laws came in until now.

The bill will allow medical marijuana patients under 21 who suffer from PTSD legal access to marijuana for the first time.

Illicit use was generally defined as illegal use of marijuana without a prescription at least 12 times during the past year. In the DSM IV, cannabis abuse and dependence were separate disorders and neither withdrawal nor craving were criteria for a dependence diagnosis.

Twenty-nine states now have medical marijuana laws, and eight states - Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington - have legalized both medical and recreational cannabis use.

The increase in cannabis use disorders could stem from the increasing potency of pot that has occurred under legalization, Hasin said. The rise in illicit use ranged from 3.5 percent in states without MMLs to 7 percent in states that had legalized medical marijuana.

States with medical marijuana laws also saw an increase in people who can't stop using pot even though it's interfering with many aspects of their lives, researchers said.

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To investigate, the authors of the new study consulted data from three studies: the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey, the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions and the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III.

The Colorado Board of Health, which oversees the state medical marijuana program, has not added any new qualifying conditions since the program began in 2001. But Republican Gov. Greg Abbott said then that doing so "does not open the door to marijuana in Texas".

"I think all of these things can contribute to increases, but we can't pinpoint them for sure because it's not what the study was created to address", said Hassin.

The analysis also revealed that in remaining early-MML states, the prevalence of use and disorders increased.

For example, she said, research has tied medical marijuana laws to fewer opioid overdose deaths.

Attorney General Jeff Sessions, a stanch opponent of legalization, is now reviewing the Cole Memorandum, a set of guidelines established in 2013 that direct DOJ to focus marijuana enforcement efforts on violent crimes and distribution in states without legalization laws.

Dr. Wilson Compton, deputy director of the U.S. National Institute on Drug Abuse, agreed that differences in state laws matter, including how many dispensaries are allowed under the law and how tightly they are regulated.

"In the meantime, it is clear that a robust system of education, prevention, and treatment is needed to minimize the negative consequences that might arise if cannabis use continues to increase", they write.

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