Boston University, 715 Albany St., Boston, MA 02118, USA.
University of Southern California, 650 Childs Way, Los Angeles, CA 90089, USA.
Int J Drug Policy. 2022 Aug;106:103744. doi: 10.1016/j.drugpo.2022.103744. Epub 2022 May 25.
Cannabis policy is developing faster than empirical evidence about policy effects. With a panel of experts in substance use policy development and research, we identified key cannabis policies and their provisions enacted by U.S. states; rated their theoretical efficacy in a restrictive form for reducing problematic use and impaired driving in the context of a recreational cannabis market as judged by experts; and rated the strength of evidence for each policy.
Using a modified Delphi approach, 9 panelists rated the comparative efficacy of 18 state cannabis policies for reducing youth use of cannabis, excessive cannabis use among the general population, and cannabis-impaired driving. Each outcome was rated separately using a Likert scale, and panelists also rated the strength of evidence supporting each efficacy rating. Investigators provided descriptions of each policy so that the nine panelists had similar conceptions of each policy.
State monopoly (state owns all production, manufacturing, wholesale, and retail operations) was rated as the most effective policy for all three outcome areas. Restrictions on retail physical availability, taxes, retail price restrictions, and retail operations restrictions were also highly rated for all three outcomes. Policies regulating cannabis businesses and products were judged more effective than policies targeting consumer use and behavior. Panelists reported there was little or no direct evidence from the cannabis policy literature for most of the included policies.
These ratings can facilitate research as well as policy-making decisions. A relatively small number of policies were judged to be highly effective across all three domains, indicating that for the most part adult excessive use, youth use, and impaired driving can all be reduced with the same set of policies; these policies tended to target the behaviors of businesses rather than consumers. The low levels of direct evidence available to inform policy ratings, as reported by the policy panelists, makes clear the need for ongoing and sustained cannabis policy research.
大麻政策的发展速度超过了政策效果的经验证据。我们组织了一个由物质使用政策制定和研究方面的专家组成的小组，确定了美国各州颁布的关键大麻政策及其规定；根据专家判断，在娱乐大麻市场背景下，以限制形式评估这些政策在减少问题性使用和驾驶障碍方面的理论效果；并对每项政策的证据强度进行了评级。
使用改良 Delphi 方法，9 名小组成员对 18 项州大麻政策在减少青少年大麻使用、普通人群中过度使用大麻和大麻影响驾驶方面的相对效果进行了评估。每个结果都使用李克特量表进行单独评估，小组成员还对每项效果评估的证据强度进行了评级。调查人员对每项政策进行了描述，以便 9 名小组成员对每项政策都有类似的理解。
州垄断（州拥有所有生产、制造、批发和零售业务）被评为所有三个结果领域最有效的政策。对零售物理可用性、税收、零售价格限制和零售业务限制的限制也被高度评价，适用于所有三个结果。监管大麻企业和产品的政策被认为比针对消费者使用和行为的政策更有效。小组成员报告说，大多数纳入的政策在大麻政策文献中几乎没有或没有直接证据。
这些评级可以促进研究和决策。少数几项政策被评为在所有三个领域都非常有效，这表明在大多数情况下，成年人过度使用、青少年使用和驾驶障碍都可以通过同一套政策来减少；这些政策往往针对企业的行为，而不是消费者的行为。政策小组成员报告说，可用于为政策评级提供信息的直接证据水平较低，这清楚地表明需要持续进行和维持大麻政策研究。
