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Are cannabis policy changes associated with alcohol use patterns? Evidence for age-group differences based on primary
Natalia Van Doren1,2, Felicia W Chi2, Kelly C Young-Wolff1,2
1Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
Adult cannabis legalization in California was associated with moderate reductions in alcohol use, especially among middle-aged adults. These changes in drinking patterns were observed following policy changes, with varying effects across age groups.
Area of Science:
- Public Health
- Substance Use Research
- Health Policy Analysis
Background:
- California enacted adult cannabis legalization (ACL) in 2016, with legal sales beginning in 2018.
- This study investigates the association between ACL and changes in adult alcohol consumption patterns.
- The research specifically examines age-related differences in alcohol use following policy changes.
Purpose of the Study:
- To determine if adult cannabis legalization in California influenced alcohol use behaviors.
- To explore variations in alcohol use changes across different adult age demographics.
- To analyze trends in exceeding alcohol limits and heavy episodic drinking post-legalization.
Main Methods:
- Utilized interrupted time series and ARIMA models to analyze monthly alcohol screening data (2015-2019).
- Examined data from over 3.5 million adult primary care patients in California.
- Controlled for seasonality and autocorrelation, evaluating changes at ACL passage and implementation dates.
Main Results:
- Gradual declines in exceeding weekly alcohol limits and frequent heavy episodic drinking (HED) were observed post-ACL passage.
- Young adults (21-34) showed an initial HED increase followed by a decline; older adults (50-64) had an initial increase in exceeding weekly limits.
- Middle-aged adults (35-49) exhibited consistent HED declines, while older adults (65+) showed small, gradual decreases in alcohol use metrics.
Conclusions:
- Cannabis policy changes in California are associated with age-specific shifts in alcohol consumption.
- Moderate reductions in alcohol use were noted, particularly among middle-aged adults.
- The study highlights associative findings, emphasizing that causality cannot be definitively determined.
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