Updated Dec. 19, 2024
As medical legalization bill looks likely in upcoming session, here’s what we know about other states’ experiences
It’s likely the debate over whether to legalize marijuana, at least for medical use, will reignite in the Wisconsin Legislature in the new year, now that the minority leader of the state Senate, Dianne Hesselbein (D-Middleton), said this week she would introduce a medicinal cannabis bill in the next session.
Hesselbein said that legalizing recreational use of the drug wouldn’t pass — a bill to do so in 2023 failed to gain bipartisan support. “But let’s get medicinal out there,” she told Wisconsin Public Radio, adding, “I think we’ve got to get the conversation started once again.”
The incoming Senate president, Mary Felzkowski (R-Tomahawk) is a supporter of some form of medicinal legalization, and Republicans, who hold majorities in both Assembly and Senate, offered a medical marijuana legalization in early 2024, but Democrats faulted its high level of regulation. Assembly Speaker Robin Vos (R-Rochester) has mentioned medical marijuana as a long-shot possibility for a bill in the coming session.
With the conversation ready to start once again, the Badger Institute offers for policymakers’ information the series of briefs we have published over the past year exploring the experience of other states and countries that have legalized cannabis to one extent or another.
The focus of our series was not to advocated for or against legalization — we have not taken a stand one way or the other, and it’s possible we won’t — but, rather, to find out what independent researchers have published about the tradeoffs elsewhere.
To summarize our findings:
Public Safety
Research on states that have fully legalized recreational — that is, adult use — cannabis shows a tradeoff: An overwhelming finding of higher traffic fatalities and, by the weight of the evidence, either no increase and possibly a decrease in statewide crime rates.
But when you focus solely on the research related to medical cannabis legalization, you do not see that same tradeoff.
- Medical cannabis legalization in other states has had either no impact or a positive impact on property and violent crime statewide.
- The establishment of medical cannabis dispensaries in other states, a step distinct from but usually occurring at the same time as medical legalization, appears to increase crime in that local neighborhood, particularly property and disorder crime.
- Establishing a medical cannabis market will likely reduce traffic fatalities but will – at worst – have no impact on road safety.
Read more: Marijuana legalization and the impact on public safety (November 2023)
Workforce
Limited available research shows that medical legalization might have positive benefits for a state’s overall economy and for employment.
- Legalizing medical use of cannabis in a state increases the labor force participation of certain groups of individuals.
- Medical cannabis legalization has caused a small reduction in workers’ compensation costs.
Unlike adult-use legalization, the limited nature of existing research does not give us the ability to understand how medical use access will impact unemployment or disability claims at this time.
Read more: Marijuana legalization’s workforce impact looks positive (January 2024)
Cannabis Use
We know from our first report that more than 830,000 Wisconsinites use cannabis every year. The number of adults who do so has been increasing in recent years, while the number of minors doing so has declined to its lowest point in the past decade. The available research shows that a move to legalize medical cannabis will likely not disrupt the downward trend in youth use but will accelerate the trend we see in adult use.
- Allowing the medical use of cannabis in a state will increase adult use of the substance.
- A policy that only allows medical sales and use of cannabis appears to either have no impact or reduce teen use.
Read more: What research shows about marijuana legalization and rates of use (December 2023)
Addiction & Other Substance Use
We found in our prior report that the legalization of cannabis for medical use increases use of the substance. Does that result in increased use of other drugs and addiction because of the frequently cited gateway effect of cannabis?
Here is what we do know:
- The impact of medical cannabis legalization on cannabis use disorder is unclear given an equal split in the findings from research.
- Allowing the medical use of cannabis reduces the use of opioids.
- The research also appears to indicate that it is likely to reduce the use of other illicit drugs among adults.
We still do not have the necessary research to draw strong conclusions on the impact such a policy might have on the consumption of alcohol and tobacco.
Read more: Legalizing cannabis likely means more disordered, harmful use, other states show (February 2024)
Tax Revenue
Research on the topic of taxation reveals that there is a direct relationship between the tax burden states impose on legal marijuana products and the size of the state’s illicit market.
Here is what we know specifically about medical marijuana and taxes:
- 19 out of the 38 states with medical cannabis legalization do not impose a tax on cannabis products intended for medical use.
- The states that do impose a tax on the medical use of cannabis earn approximately $287 million annually in tax revenue.
Read more: Tax rates, state revenue and markets for marijuana (July 2024)
Potency
The potency of cannabis products is much higher today than just a few decades ago. Consumers also prefer higher-potency products today than they have in the past.
Here is what we know specifically about how medical marijuana legalization contributed:
- There is a strong correlation between the medical legalization of cannabis and the potency of illicit cannabis products seized by the Drug Enforcement Administration.
- But research on the topic does not find a causal relationship and concludes that the effect of these laws is on which products are sold rather than the potency of raw cannabis itself.
- Individuals in states that allow medical use of cannabis are more likely to use inherently higher-potency cannabis concentrates.
Read more: Not your grandfather’s weed (July 2024)
Health effects
If legalization increases cannabis use, as research shows happens, the health consequences of cannabis use will, too. Researchers find these principal effects:
- Using cannabis is associated with both psychosis and schizophrenia, different but sometimes related conditions. Much of the evidence points in the direction of causality, but the relationship is not yet indisputable.
- More potent cannabis is associated with a greater risk of psychosis and schizophrenia.
- Using cannabis is associated with a higher risk of depression.
- Research on potential benefits to individual users is uncertain, with some evidence of benefits but with many studies complicated by users’ lack of standard dosage and potency.
- There is evidence that prenatal exposure can have lasting cognitive and mental health effects.
- Heavy or chronic cannabis use can cause severe, days-long bouts of vomiting and pain. This cannabinoid hyperemesis syndrome is sometimes called “scromiting.”
- Evidence shows an association between cannabis use and heart problems and stroke in young people, though it isn’t proved that cannabis causes the problems.
Read more: Legal cannabis’ impact on physical and mental health (August 2024)
Any use or reproduction of Badger Institute articles or photographs requires prior written permission. To request permission to post articles on a website or print copies for distribution, contact Badger Institute President Mike Nichols at mike@badgerinstitute.org or 262-389-8239.
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