Activity ID



October 11, 2022

Format Type


CME Credit




CME Provider: JAMA Pediatrics

Description of CME Course

Civil liberty advocates typically support legalization of cannabis, which targets adult use, rather than decriminalization, which can affect both adults and youths. However, it is unknown how arrests of youths for cannabis possession change when adult use of cannabis is legalized.

To model changes in arrest rates of adults and youths after decriminalization and legalization of cannabis.

Design, Setting, and Participants:
This quasi-experimental study used the publicly available Uniform Crime Reporting Program Data: Arrests by Age, Sex, and Race administrative data set to examine arrest rates in 38 states from January 1, 2000, to December 31, 2016. Adult (age, =18 years) and youth (age, <18 years) arrests for possession of cannabis were examined. States were excluded if they did not report complete arrest data or if a policy was implemented that reduced penalties for possession of cannabis but fell short of decriminalization. Fixed-effects regression was used in an extended difference-in-differences framework. The analyses in their final form were conducted between January 17 and February 28, 2019.

Living in a state with a cannabis decriminalization policy (ie, making the penalty for cannabis possession similar to the small fine for a traffic violation) or legalization policy (ie, creating a legal supply of cannabis along with the removal of penalties for possession of a small amount of cannabis for recreational use).

Main Outcome and Measures:
State cannabis possession arrest rate per 100?000 population.

Data from 38 states were examined, including 4 states with cannabis legalization policies and 7 states with cannabis decriminalization policies. The adult arrest rate decreased by 131.28 (95% CI, 106.23-154.21) per 100?000 population after the implementation of decriminalization and 168.50 (95% CI, 158.64-229.65) per 100?000 population after the implementation of legalization. The arrest rate for youths decreased by 60 (95% CI, 42-75) per 100?000 population after decriminalization but did not significantly change after legalization in a state (7 per 100?000 population; 95% CI, -15 to 30).

Conclusions and Relevance:
Legalization, as implemented through 2016, did not appear to reduce arrests for cannabis possession among youths, despite having benefited adults. The study’s findings suggest that decriminalization reduces youth arrests in most cases, but these findings also suggest that any benefit for youths could be lost when adult use has also been legalized. To address this problem, it appears that state decriminalization policies should take the additional step to explicitly describe when youths can be arrested for possession of small amounts of cannabis.


1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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NOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.

Educational Objectives

To review if arrests of youths for possession of cannabis change when cannabis policy focuses on adults.


Adolescent Medicine, Pediatrics, Substance Use and Addiction


Medical Knowledge

CME Credit Type

AMA PRA Category 1 Credit



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