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Drug Alcohol Depend. 2019 Jan 1;194:178-183. doi: 10.1016/j.drugalcdep.2018.09.028. Epub 2018 Nov 6.

Greater risk for frequent marijuana use and problems among young adult marijuana users with a medical marijuana card.

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RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, USA. Electronic address:
RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, USA.
RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, USA.



This study compared young adults with and without a medical marijuana (MM) recommendation from a provider ("MM card") on their developmental trajectories of frequent marijuana use and marijuana-related problems in young adulthood.


The analytic sample consists of young adult past month marijuana users (N = 671) who were part of a larger, diverse, and predominantly California cohort. Analyses are based on data from seven surveys completed from ages 13-19.


At age 19, 28% of participants reported having an MM card to legally purchase marijuana from an MM dispensary. A multiple group latent growth model indicated that young adults who had an MM card showed steeper increases in frequent marijuana use (i.e., 20-30 days of use in the past month) from ages 13-19 compared to young adults who did not have an MM card. Logistic regression models that matched MM cardholders and non-MM cardholders on individual sociodemographic characteristics found that MM cardholders were more likely to report marijuana negative consequences, selling marijuana/hashish, and driving under the influence of marijuana in the past year. In addition, MM cardholders were more likely to have tried cutting down or quitting in the past 3-months.


Among young adult marijuana users, those with an MM card had a higher risk profile for marijuana use and related problems compared to those without an MM card. Given expanding state legalization of MM, this issue warrants further attention.


Medical marijuana; Negative consequences; Problem behaviors; Trajectories; Young adults

[Available on 2020-01-01]

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