Associations Between Evolving Cannabis Policies and Cannabis-Related School Discipline Among Secondary School...

The objective of this study was to examine whether cannabis policies, including decriminalization, medical legalization, and recreational legalization, among adults are associated with changes in cannabis-related disciplinary incidents in Massachusetts public schools.

This retrospective cohort study utilized 2005-2019 Department of Elementary and Secondary Education data on disciplinary incidents in all public-school districts (N=399). A multilevel time-series model with multiple interruptions was used to examine the relationship between cannabis policy changes and district-level cannabis-related disciplinary incidents per 1,000 students in Massachusetts from 2005 to 2019.

There were statistically significant increases in cannabis-related disciplinary incidents during the decriminalization policy period compared with those before decriminalization; the cannabis-related disciplinary incident rate per 1,000 students increased by 34% relative to the time prior (incidence rate ratio=1.34; 95% CI=1.11, 1.60). However, cannabis-related disciplinary incidents decreased during the medical and recreational policy periods; the cannabis-related disciplinary incident rate decreased by 45% during the medical policy period compared with that during the decriminalization period (incidence rate ratio=0.55; 95% CI=0.47, 0.65) and by 20% during the recreational policy period (incidence rate ratio=0.80; 95% CI=0.68, 0.94). The average number of cannabis-related disciplinary incidents per school district ranged from 4.6 during decriminalization (2008-2011), 4.7 during medical (2012-2015), and 5.1 during recreational legalization (2016-2019) periods.

There was a modest increase in cannabis-related disciplinary incidents in schools after decriminalization in 2008. However, as state cannabis legalization policies expanded, the cannabis-related disciplinary incident rate per 1,000 students decreased. These findings are encouraging and underscore the need for schools to continue to develop and implement alternatives to exclusionary discipline that employ a harm-reduction approach.