1. Design Considerations for Legal Cannabis: The 12 P’s
Beau Kilmer, PhD
Co-Director, RAND Drug Policy Research Center
Interim Director, RAND’s San Francisco Bay Area Office
Senior Policy Researcher, RAND Corporation
Professor, Pardee RAND Graduate School 1

2. dprc.rand.org 2

3. Also based on interactions with policy makers
Washington State Liquor Control Board
Uruguay’s Junta Nacional de Drogas
State of Vermont
Canada’s Legalization Task Force 3

4. 1.Production
1. Production 4

5. 2. Profit Motive
2.Profit Motive 5

6. Many alternatives to current supply prohibition
Source: Caulkins, Kilmer, Kleiman et al., Considering Marijuana Legalization. RAND 6

7. Commonly-discussed options in the U.S.
Source: Caulkins, Kilmer, Kleiman et al., Considering Marijuana Legalization. RAND 7

8. Middle-ground options (small scale)
Source: Caulkins, Kilmer, Kleiman et al., Considering Marijuana Legalization. RAND 8

9. Middle-ground options (large scale)
Source: Caulkins, Kilmer, Kleiman et al., Considering Marijuana Legalization. RAND 9

10. 3. Power 10

11. 4. Promotion 11

12. 5. Prevention 12

13. 6.Policing & Enforcement13

14. 7. Penalties 14

15. 8. Potency 15

16. In Washington flower dominates, then extracts
Source: Updated from Smart, Caulkins, Kilmer et al., forthcoming. Addiction 16

17. 9. Purity 17

18. 10. Public Use 18

19. 11. Price 19

20. Options to elevate price
Require minimum pricing
Reduce competition Impose regulations
Levy taxes 20

21. 12. Permanency 21

22. Concluding thoughts Be skeptical of those drawing strong conclusions
Overall consequences of cannabis legalization will depend on the use of other substances
Short- and long-run effects could be different
Reasonable people can disagree about legalization 22

23. 23

24. References (1/2)
J. Burgdorf, B. Kilmer, & R. Pacula. (2011). Heterogeneity in the composition of marijuana seized in California. Drug and Alcohol Dependence, 117,
J. Caulkins, B. Kilmer, M. Kleiman, R. MacCoun, G. Midgette, P. Oglesby, R. Pacula, & P. Reuter. (2015). Considering marijuana legalization: Insights for Vermont and other jurisdictions. RR-864. Santa Monica, CA: RAND.
M. Cerdá, M, Wall, T. Feng, M. Keyes, A. Sarvet, J. Schulenberg, P. O’Malley, R. Pacula,
S. Galea. & D. Hasin (2017). Association of state recreational marijuana laws with adolescent marijuana use. JAMA Pediatrics, 171(2),
A. Davis, K. Geisler, & M. Nichols (2016). The price elasticity of marijuana demand:
evidence from crowd-sourced transaction data. Empirical Economics, 50(4), 1171+
W. Hall & R. Pacula. (2003). Cannabis use and dependence: Public health and public
policy. Cambridge University Press. 24

25. References (2/2)
B. Kilmer. (2014). Policy designs for cannabis legalization: Starting with the eight Ps.
American Journal of Drug and Alcohol Abuse, 40,
B. Kilmer. (2015). So you want to legalize weed? Newsweek, June 28.
B. Kilmer. (2017). Recreational cannabis—Minimizing the health risks from legalization.
The New England Journal of Medicine, 376,
R. Pacula, B. Kilmer, A. Wagenaar, F. Chaloupka, & J. Caulkins. (2014). Developing public health regulations for marijuana: Lessons from alcohol and tobacco. American Journal of Public Health, 104,
R. Smart, J. Caulkins, B. Kilmer, S. Davenport, & G. Midgette. (2017). Variation in cannabis potency & prices in a newly-legal market: Evidence from 30 million cannabis sales in Washington state. Addiction. doi: /add.13886 25

26. Extra slides 26

27. What are we learning? It’s still early
Overall, possession arrests decreased
Illicit production and exports still occur
Tax revenues are coming in
Edibles posing challenges 27

28. Nationally, past-month prevalence increasing18 16 14 12 10 8 6 4 2
Source: NSDUH, Ages 12+
USA 28

29. Since 2011/2012, prevalence up 59% in Colorado18 16 14 12 10 8 6 4 2
Source: NSDUH, Ages 12+
USA CO 29

30. Story very different for Washington State18 16 14 12 10 8 6 4 2
Source: NSDUH, Ages 12+
USA CO WA 30

31. Past month prevalence for 12-17 year olds18 16 14 12 10 8 6 4 2
Source: NSDUH, Ages 12-17
USA CO WA 31

32. However, these trend data don’t tell us very much
Care more about quantity consumed, dependence
Increase partially attributable to change in stigma?
Need control groups for rigorous analyses
Will take time
Also need to account for pre-leg medical outlets 32

33. New study attracting a lot of attention
Looked at 8th, 10th, and 12th graders across US
– Cerda et al (JAMA Pediatrics)
After making adjustments, compared past month marijuana use in &
Washington’s 8th and 10th grade students saw an increase in prevalence …
… but Washington’s 12th grade students & Colorado’s students did not see increase 33

34. New study attracting a lot of attention
• Looked at 8th, 10th, and 12th graders across US
– Cerda et al (JAMA Pediatrics)
• After making adjustments, compared past month marijuana use in &
• Washington’s 8th and 10th grade students saw an increase in prevalence …
• … but Washington’s 12th grade students &
But the authors note:
“A greater number of schools would have been advantageous, and the sample design may lead to discrepancies between MTF results and those found in other large-scale surveillance efforts”
--Cerda et al., 2017 (emphasis added)
Colorado’s students did not see increase 34

35. Adjusted MTF prevalence data for WA 10th graders from Cerda et al
Pre Post
25%
20%
15%
10% 5% 0%
MTF Adjusted vs 35

36. Raw trend different for WA Healthy Youth Survey (N = ~8,000 10th graders each wave)
Pre Post
25%
20%
15%
10% 5% 0%
MTF Adjusted vs
HYS Sample & 2012 vs
2014 & 2016 36

37. Youth data from general population survey do not suggest an increase, but cover different population
Pre Post
25%
20%
15%
10% 5% 0%
MTF Adjusted vs
HYS Sample & 2012 vs
2014 & 2016
NSDUH (12-17)
2010 & 2011 vs
2014 & 2015 37

38. What about traffic safety?
Two studies find that auto fatalities involving THC- positive drivers doubled after legalization
– CO (RMHIDTA 2015); WA (AAA 2016)
Testing positive for THC not the same as impairment 38

39. 39

40. American Journal of Public Health (Aydelotte, Brown et al., 2017)
Study 1
Source
American Journal of Public Health
(Aydelotte, Brown et al., 2017)
Outcome
Motor vehicle crash fatality rates
Years considered
When did legalization start?
2012
Control states
Alabama, Indiana, Kentucky, Missouri, South Carolina, Tennessee, Texas, & Wisconsin
Finding
“Motor vehicle crash fatality rates for WA and CO were not statistically different from those in similar states” 40

41. American Journal of Public Health (Aydelotte, Brown et al., 2017)
Study 1
Study 2
Source
American Journal of Public Health
(Aydelotte, Brown et al., 2017)
Highway Loss Data Institute
(HLDI Bulletin, 2017)
Outcome
Motor vehicle crash fatality rates
Auto insurance collision claim rates
Years considered
When did legalization start?
2012
2014 (CO, WA)
2015 (OR)
Control states
Alabama, Indiana, Kentucky, Missouri, South Carolina, Tennessee, Texas, & Wisconsin
Idaho, Montana, Nevada, Utah and
Wyoming
Finding
“Motor vehicle crash fatality rates for WA and CO were not statistically different from those in similar states”
“This analysis yielded a significant
2.7 percent increase in collision claim frequency for states that are currently legally selling recreational marijuana” 41

42. American Journal of Public Health (Aydelotte, Brown et al., 2017)
Study 1
Study 2
Source
American Journal of Public Health
(Aydelotte, Brown et al., 2017)
Highway Loss Data Institute
(HLDI Bulletin, 2017)
Outcome
Motor vehicle crash fatality rates
Auto insurance collision claim rates
Years considered
When did legalization start?
2012
2014 (CO, WA)
2015 (OR)
Control states
Alabama, Indiana, Kentucky, Missouri, South Carolina, Tennessee, Texas, & Wisconsin
Idaho, Montana, Nevada, Utah and
Wyoming
Finding
“Motor vehicle crash fatality rates for WA and CO were not statistically different from those in similar states”
“This analysis yielded a significant
2.7 percent increase in collision claim frequency for states that are currently legally selling recreational marijuana” 42

43. American Journal of Public Health (Aydelotte, Brown et al., 2017)
Study 1
Study 2
Source
American Journal of Public Health
(Aydelotte, Brown et al., 2017)
Highway Loss Data Institute
(HLDI Bulletin, 2017)
Outcome
Motor vehicle crash fatality rates
Auto insurance collision claim rates
Years considered
When did legalization start?
2012
2014 (CO, WA)
2015 (OR)
Control states
Alabama, Indiana, Kentucky, Missouri, South Carolina, Tennessee, Texas, & Wisconsin
Idaho, Montana, Nevada, Utah and
Wyoming
Finding
“Motor vehicle crash fatality rates for WA and CO were not statistically different from those in similar states”
“This analysis yielded a significant
2.7 percent increase in collision claim frequency for states that are currently legally selling recreational marijuana” 43

44. American Journal of Public Health (Aydelotte, Brown et al., 2017)
Study 1
Study 2
Source
American Journal of Public Health
(Aydelotte, Brown et al., 2017)
Highway Loss Data Institute
(HLDI Bulletin, 2017)
Outcome
Motor vehicle crash fatality rates
Auto insurance collision claim rates
Years considered
When did legalization start?
2012
2014 (CO, WA)
2015 (OR)
Control states
Alabama, Indiana, Kentucky, Missouri, South Carolina, Tennessee, Texas, & Wisconsin
Idaho, Montana, Nevada, Utah and
Wyoming
Finding
“Motor vehicle crash fatality rates for WA and CO were not statistically different from those in similar states”
“This analysis yielded a significant
2.7 percent increase in collision claim frequency for states that are currently legally selling recreational marijuana” 44