The evolving story about marijuana and public health

Last month, Scioto Analysis released a cost-benefit analysis looking at the recreational marijuana ballot initiative that passed on election day. Our goal with this analysis was to hopefully offer some insight into what the impacts of legalization would be so Ohio voters could make an informed decision. 

Overall, we found that the ballot initiative as written would likely generate over $250 million in social benefits for the state. One notable exclusion from our analysis was the lack of a monetized health impact. In other words, we did not explore what increased marijuana use would mean for public health. 

There are a few reasons we chose to exclude this particular impact. The most important reason was the uncertainty that surrounded it. Specifically, we were unsure of the effect that recreational marijuana legalization would have on alcohol use. Some studies have found that states with recreational marijuana use see decreases in their alcohol consumption, and if that is true then we might expect some of the negative health outcomes associated with marijuana use to be balanced out by positive health outcomes associated with less alcohol use.

Evidence of the negative impact of recreational marijuana legalization on health was presented last week at the Association for Public Policy Analysis and Management conference during a session about the impacts of recreational marijuana laws. One presenter in particular was able to measure the impact that recreational marijuana legalization had on asthma hospitalizations.  

Taking this new information into account, our final results probably would not change substantially. Doing some back-of-the-envelope math, I figure these added asthma cases would have a monetized value somewhere in the tens of millions. Certainly a major cost and an important consideration, but not enough to change a margin in the hundreds of millions.

Another consideration is the fact that this research was being presented as a work in progress. The researchers’ estimates were preliminary, with more questions that need to be addressed in order to fully understand the connection between recreational marijuana legalization and asthma hospitalizations. 

This situation highlights the differences between academic research and policy analysis. Academics need lots of time to carefully estimate each individual effect, while policy analysts need to provide useful information quickly. The goal of academic research is to poke holes and see how solid an argument can be made. This is with the goal of advancing “knowledge” writ large. Policy analysis, on the other hand, is focused on improving the knowledge policymakers have when they make decisions. This is usually on a shorter timeline than academic publishing.

As more states legalize recreational marijuana, there will be more high quality research about the associated health impacts of the legalization of the sale and purchase of marijuana for recreational purposes. I especially hope some academics are up to the challenge of measuring net health benefits, including any impact these laws have on alcohol use.

Either way, according to the evidence we have now, Ohio’s economy will be better off from a social perspective as a result of this vote (assuming the legislature doesn’t reallocate the tax dollars currently allocated by the program for employment and drug abuse treatment). In the event there is groundbreaking research about the negative health effects of marijuana use, then most of the country is going to have to reevaluate their laws. This is the purpose of the laboratories of democracy, though: to test policies and see what happens when policy changes.