Don’t make a hash of it! A thematic review of the literature relating to outcomes of cannabis regulatory change

Abstract

Globally cannabis regulations are rapidly changing. In recent years social and political pressure, not science, has driven this change. Experience from jurisdictions that have implemented regulatory change, although relatively new, should be used to inform future policy development for other jurisdictions, assisting in addressing the wicked problem that cannabis regulations present. This review aimed to elicit underlying themes from a broad range of literature exploring the effects of regulatory change relating to cannabis. To achieve this a meta-narrative theoretical approach using inductive constant comparative analysis was used to synthesize data until thematic saturation was reached. Following a systematic literature search, 92 papers were analyzed before thematic saturation was complete. Five super-ordinate themes emerged that observed the societal and health effects following legislative and regulatory change: Normalization; Economics; Gatekeeping; Community and Health. These themes, empirically derived through a formal qualitative approach, were considered regarding cultural contexts, providing an understanding of how cannabis regulation is changing the social landscape. Consideration of the themes during future research may provide a focus point for the discussion of legislation and policy, not only relating to cannabis, but also other broad-ranging areas such as social policy, welfare, education and health.

Keywords:

• Marijuana
• cannabis
• legislation
• regulation
• implementation

Acknowledgements

The authors would like to thank the Reference Librarians at the Wellington Medical and Health Sciences Library (University of Otago), for their assistance in the development of the search strategies for this review.

Disclosure statement

Dr Karen Oldfield declares that she has received funding through a Clinical Research Training Fellowship from the Health Research Council of New Zealand (HRC). Dr Irene Braithwaite and Dr Karen Oldfield have undertaken unrelated consultant work for RuaBio, ZHM, Whakaora Pharma and Helius Therapeutics. Dr Irene Braithwaite, Dr Karen Oldfield and Dr Giles Newtown-Howes are members of the Medical Cannabis Research Collaborative. Dr Giles Newton-Howes sits on the New Zealand Pharmacology and Therapeutics Advisory Committee and the international advisory board for the ACRE (The Australian Centre for Cannabinoid Clinical and Research Excellence) and is a Deputy Editor (Reviews) of the British Journal of Psychiatry. Dr Sean Evans has nothing to declare. The Medical Research Institute of New Zealand is funded by the Health Research Council of NZ (HRC) by way of an Independent Research Organization (IRO) grant.

Data availability statement

The data that support the findings are available from the corresponding author, KO, upon reasonable request.

Additional information

Funding

This work was supported by the Health Research Council of New Zealand [Grant numbers 18/002 and 20/057].