Navigating the Green Wave and Protecting Youth in the South Southwest Region

Published:
October 23, 2024

By Mariah Flynn, Coalition Director of the Burlington Partnership for a Healthy Community in Burlington, Vermont. Steering Committee Member of Prevention Works! Vermont.

As commercial cannabis continues to expand in the South Southwest PTTC region (Arkansas, Louisiana, New Mexico, Oklahoma and Texas), the prevention field must help to center conversations on addressing youth exposure, high-risk use, and public health disparities. Commercial sales of cannabis were legalized in my home state of Vermont starting in October 2022. In the years before and after the Vermont legislature voted to legalize, our substance use prevention field was a strong advocate for regulation and limits on advertising, potency, and access to reduce the potential for harm. While not everything we advocated for was included in the law, legislators included more protections and resources for youth and public health than many of the other U.S. states that had legalized in prior years.

Across the country, discussions around cannabis legalization have tended to focus on the economics and profit-making system. The South Southwest region can continue to learn from earlier adopting states like Vermont and work to increase the public’s knowledge of the health impacts of cannabis use, particularly for youth, to strengthen support for public health protections.

Why It Matters

In Oklahoma and New Mexico, legal use of cannabis has expanded rapidly, while neighboring states of Texas and Louisiana maintain more restrictive laws. Yet, all states in this region are facing rising concerns about youth access and the normalization of cannabis use. Kids need an environment that supports them to remain substance-free while their brains are still developing. There is a lot cooking in the adolescent brain, and the increasing promotion and growth of new cannabis markets expose young people to more addictive products, intensive marketing, and confusing messaging causing things to “boil over.” Youth cannabis use has reached historic highs nationwide (1) and the frequency with which people are using cannabis daily has increased (2). That, coupled with the interchangeable use of cannabis and tobacco vape products, may be contributing to the youth vaping epidemic the US is experiencing (3).

Community normalization of use, as well as promotion and easy access to substances in communities, has been shown to increase high-risk use and the development of substance use disorders. The earlier people start using any substance the more likely they are to develop problem use (4), so it is our collective responsibility to make sure the community policies and programs prevent youth use to help youth thrive. Additionally, when the availability and promotion of cannabis, alcohol, or tobacco retail is denser in economically disadvantaged neighborhoods, it can exacerbate existing health inequalities, such as poor mental health outcomes (5) and lower high school graduation rates (6).

Below are some of the prevention strategies that can help protect youth and support public health and health equity:

  • Increase public education. Public knowledge has not caught up with newer research on cannabis. Efforts to increase awareness of health-related harms and requiring health warnings on cannabis products is important prevention work.
  • Reduce normalization of use. Regulations to prohibit cannabis use in public or at community events can help reduce the risk factors associated with normalizing use. Strong enforcement of these regulations is key to ensuring success.
  • Align policies with youth protections. States/communities can limit youth exposure to ads and substances by creating buffer zones for adult-only product growing, sales and/or advertising near schools and other places youth gather.
  • Limit outlet density. Establish density maximums to prevent the clustering of outlets in economically vulnerable areas, which may face higher public health risks.
  • Increase taxes. Youth have shown to be particularly sensitive to price. Additional costs, such as state or local taxes, can help deter teenage access.
  • Include a public health voice in decision-making. Communities should include public health experts on cannabis control boards and decision-making bodies to help ensure considerations for health and youth protections.
  • Monitor and respond. As policies change, states and communities should collect data to evaluate the impact so that adjustments can be made as necessary to mitigate negative effects.

As the cannabis industry expands in the South Southwest region, prevention professionals have an opportunity to learn from other regions and create responsible retail environments that support public health, equity, and the well-being of youth.

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REFERENCES

  1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. 2022. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report.
  2. Jonathan P. Caulkins. Changes in self‐reported cannabis use in the United States from 1979 to 2022. Addiction, 2024; DOI: 10.1111/add.16519
  3. Centers for Disease Control and Prevention. More than 2.5 million youth reported e-cigarette use in 2022. https://www.cdc.gov/media/releases/2022/p1007-e-cigarette-use.html
  4. Feinstein, E. C., Richter, L., & Foster, S. E. (2012). Addressing the critical health problem of adolescent substance use through health care, research, and public policy. Journal of adolescent health, 50(5), 431-436.
  5. National Academies of Sciences, Engineering, and Medicine. 2017. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Washington, DC: The National Academies Press. doi: 10.17226/24625
  6. E. Silins et al., Adolescent substance use and specificity of association with educational attainment in young adulthood, Drug and Alcohol Dependence 156 (2015) 90–9.; Previous research: Esch et al., 2014; Macleod et al., 2004; Maggs et al., 2015; Silins et al., Lancet Psychiatry, 2014; Townsend et al., 2007)
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