The landscape of marijuana is changing in the United States. According to the Governing Data: State Marijuana Laws Map, 25 states and the District of Columbia have legalized the drug for either medical or recreational use. Also, several states are currently considering legislation that could expand marijuana legalization by the end of 2016.
While recreational marijuana use continues to be illegal in all 50 states for people under the age of 21, the implications of the changing laws on youth perceptions of and attitudes towards marijuana have become a growing concern among prevention practitioners.
To address this concern and equip practitioners in their work to reduce youth marijuana use, SAMHSA’s Center for the Application of Prevention Technologies (CAPT) hosted a webinar that focused on factors and strategies related to the perception of risk and harm of marijuana use among youth ages 12 to 17. The webinar was part of the 5th Annual National Prevention Week, a national observance dedicated to increasing public awareness of substance abuse and mental health issues. The session drew nearly 400 participants, reflecting a strong interest among practitioners in this emerging topic.
To provide context for the upcoming discussion, presenters began the webinar with an overview of national trend data on usage rates, perception of harm, and perception. The data was based on results from three resources: SAMHSA’s National Survey on Drug Use and Health (NSDUH) – 2015 the High School Youth Risk Behavior Survey from the Centers for Disease Control and Prevention (CDC); and Monitoring the Future: National Survey on Youth Drug Use – 2015 (PDF | 3.3 MB) from the National Institutes of Health (NIH).
These data showed that while youth marijuana use has been increasing in recent years, particularly among older youth, their perception of harm has declined precipitously and their perception of availability has remained consistently high.
“As people are using marijuana more, and as youth are seeing it more, it becomes more okay to think about using it,” says Gisela Rots, webinar co-presenter and SAMHSA’s CAPT Northeast Resource Team coordinator. “You could hypothesize that as youth see marijuana as being less harmful, the jump from not using to using just gets closer and closer together. It’s also very relevant that if you can influence perception of harm, you should also be able to reduce use.”
In light of these changes in perception, the presenters went on to explore a variety of factors identified in the research literature that may influence or contribute to these changes, such as:
- Positive attitudes towards marijuana use
- Perception of greater availability of marijuana
- Perceived use of marijuana among friends
They also highlighted factors that have been shown to reduce the likelihood of youth marijuana use, such as intention not to use marijuana and having parents and peers who disapprove of marijuana use.
The presenters emphasized the importance of identifying the priority risk and protective factors at play in a community prior to selecting strategies or interventions, and referred participants to the CAPT decision-support tool Risk and Protective Factors Associated with Youth Marijuana Use – 2014 (PDF | 1.2 MB). According to Rots, the changing landscape of marijuana “requires prevention providers to have a deep understanding of the particular community conditions in which they live [that are] associated with youth marijuana use, and to have the capacity to make really sound decisions about those community conditions they will target, as well as the strategies they will be selecting to address those issues.”
To help practitioners make these sound decisions, the second half of the webinar focused on evidence-based strategies for preventing youth marijuana use that aim to lower youth perception of harm. To increase the likelihood of achieving desired outcomes, presenters recommended taking a comprehensive approach: putting in place a combination of strategies—such as targeting youth and their parents, schools, and/or communities—to ensure depth and reach. But more important than the number of strategies, they cautioned, is selecting strategies with demonstrated outcomes. For guidance in this area, they referred participants to the CAPT tool Strategies and Interventions to Prevent Youth Marijuana Use: An At-a-Glance Resource – 2014 (PDF | 1.6 MB).
Finally, presenters acknowledged that the research on strategies targeting perception of harm is relatively scarce, and broached the question of what to do when there is no relevant evidence-based strategy for a particular risk or protective factor that a community wants to address. In this situation, they suggested that practitioners consider strategies that have been effective for other substance use issues, such as underage drinking, and to think about the lessons learned from the implementation of those strategies that could be applied to preventing youth marijuana use.
Throughout the event, participants were encouraged to exchange ideas in an online “chat” box and pose questions to the presenters. “There’s a huge desire for information on youth marijuana use,” says Rots. “We had a solid stream of questions coming in throughout the event—to better understand the implications of the current context of youth marijuana usage, as well as on what will work to make a difference. We were glad for the opportunity to answer these questions, but they also underscored how far we still need to go to identify the best approach for addressing this growing problem.”