Colorado, Washington state, Alaska and Washington, D.C., don’t allow home delivery of marijuana. Oregon, California and Nevada do, but services are not universal Colorado, Washington state, Alaska and Washington, D.C., don’t allow home delivery of marijuana. Oregon, California and Nevada do, but services are not universal. Colorado Governor John Hickenlooper stated one of chief concerns surrounding marijuana delivery services; that “delivery service offers more opportunity for that marijuana to get into the hands of kids.” . Another key concern for delivery services is enforcement. Many are based in cities where marijuana businesses are not permitted and it is impossible to monitor how often they deliver to cities in which MMDs are banned; even though some delivery business have put protocols in place that allow them to identify areas where delivery is prohibited and refuse to deliver to those jurisdictions , they represent only a handful of the hundreds of the businesses available to choose from for marijuana delivery. For example, neither medical or recreational marijuana business are currently legal in the cities shown in the screenshot below, but dozens of marijuana delivery businesses are based there and ready to service those regions. The results presented in Chapter 6 refuted Hypothesis 1.2, and established that dispensary bans do not have a direct effect on high school students’ marijuana use when controlling for student and school characteristics known to be associated with adolescent marijuana use. This diverged from findings from the trend analysis which found that over time a more restrictive dispensary policy in Los Angeles was followed by decline in lifetime marijuana use among the City’s 9th and 11th grade students. Before concluding that dispensary bans had no relevance to adolescent marijuana use, however, I investigated if a more complex relationship was masking an association.
By investigating indirect effects,drain trays for plants I hoped to learn identify indirect mediators of a relationship between dispensary bans have an impact on adolescent marijuana use, for example if their effect is dependent on them having a significant effect on another variable that has a significant influence on student marijuana use. This kind of hypothetical relationship is called indirect mediation . Often, the researcher’s interest switches to the variable with the direct effect once it is identified, but in the case of civic policies regulating dispensaries, learning more about these dependent relationships could also elucidate the mechanisms by which restrictive city regulations on legal, adult-use products might be effective in preventing substance use among adolescents. For example, if these analyses had demonstrated that the density of dispensaries was significantly correlated with adolescent marijuana use by city, policies that strictly limit the number of dispensary bans could pursued in lieu of dispensary bans. Recent studies have demonstrated that dispensary density is positively associated with higher prevalence of use and more frequent use among adults but their influence has not been studied among youth. Prevention research supports the idea that more convenient access to substances that are legal for adults, such as tobacco or alcohol, often has the end result of creating easier access for youth . This finding implies that youth living in or attending school in a city that allows dispensaries might obtain cannabis more easily or more often from adults in their social network. Considering that adolescents report older relatives and the illicit market as their primary sources of cannabis , a dispensary ban making access less convenient for adults could have the additional effect of making it less conveniently obtained by teens. The number of dispensaries in a community makes sense as a measure of convenience of access but could also be a marker for ineffective enforcement if it is larger than the number a city allows. Dispensary bans were significantly negatively associated with lower density of dispensaries, among the cities of LA County , which supported H2.2.
This means that the average city with a dispensary ban had less dispensaries operating there the average city that allowed dispensaries. I expected the number of dispensaries in a city to be positively correlated with the prevalence of marijuana use among students but instead found that there was not a statistically significant association . This finding refuted H2.2 and ruled out the rate of dispensaries per 10,000 residents as an indirect mediator that carries the effect of dispensary bans on students’ rates of lifetime and recent marijuana use. Included as a measure of the actual exposure to dispensaries in communities, the number of dispensaries per 10,000 had surprisingly little influence on the outcomes of interest for this study. As youth are not able to access these storefront outlets directly, the presence of dispensaries in their city may have little impact on the availability of marijuana within their social circles. That the number of dispensaries in a community normalized by population had no effect on high school students’ marijuana use was in line with research indicating that adolescents generally do not get marijuana directly from dispensaries, but rather from social sources like relatives or friends. I hypothesized that a greater number of dispensaries located within a city would create more convenient access for the adults that act as a conduit of marijuana to adolescents. However, creating easy access for adults through legitimate sources like dispensaries may have also shrunk the illicit market as a source for adolescents. One possibility is that the adults and adolescents that formerly supplied marijuana through the illegal market pursued other activities after losing a large proportion of their adult customers when access to dispensaries became legal. The finding that the rate of dispensaries per 10,000 population had no effect on high school students’ marijuana lifetime or recent use or perceptions of how easy it was to get marijuana was in line with research indicating that adolescents generally do not get marijuana directly from dispensaries, but rather from social sources like relatives or friends . It’s also possible that the predictions of marijuana legalization advocates are correct; that allowing easier access to marijuana through legitimate sources like dispensaries has starved the illicit market as a source.
Although this could be a factor, local research indicates that it could not be completely responsible for the results seen here. Two recent local studies have indicated that although use of dispensaries as a source for marijuana is preferred by the adult marijuana users in LA County, most of this population continues to access marijuana from illicit sources in addition to dispensaries . For example, a September 2018 community assessment published by the LA County Department of Public Health Substance Abuse and Prevention Program titled “Marijuana Use and Public Perceptions in Los Angeles County” indicates that dispensaries are still not the most common marijuana source for adult users. Instead, 58% of the LA County marijuana users surveyed cited friends as the primary source for their marijuana ,dry rack for plants whereas only 21% of respondents reported dispensaries as their primary source. However, only approximately 6% of the respondents in the 2018 study reported a “dealer” as their primary source, i.e., the illicit market. This is less than half of the proportion of marijuana users surveyed for a qualitative study of dispensary users conducted by SAPC and UCLA in 2014, which found that although dispensary customers unanimously preferred to get marijuana from dispensaries as compared to the illicit market, 13% also continued to get marijuana from the illicit market . Even if city ordinances do not have an effect on the supply of marijuana available to youth or ultimately impact their marijuana use behaviors, could they have an effect on their perceptions of risk and on youth social norms surrounding marijuana use? Attitudes toward drugs and alcohol are known to be powerful predictors of adolescent substance use , and changing attitudes to perceive cannabis use as more acceptable and less risky have been noted among youth populations . For example, qualitative research with at-risk youth in LA County indicates that many view marijuana use as having fewer negative consequences than drinking . A community assessment conducted in LA County also found that the risks of cannabis use were rated much lower among cannabis users than among non-users, indicating a potentially important relationship between perceptions of the risk of marijuana use and the willingness to use it. The results of the perceived mediation analysis indicate that while perceived risk has a strong association with the prevalence of students’ lifetime and recent marijuana use , it is not determined by their city’s dispensary policy . Perceiving great risk from frequent marijuana perceived risk could not therefore mediate the relationship between dispensary bans and student marijuana use . Perceived risk having a strong association with student marijuana use is consistent with well-known theoretical models like the Health Belief Model but it is outside of the scope of this analysis to determine what is determining students’ perception of the risks of marijuana use other than to note that it is not the dispensary ordinance in the city where they attend school and likely live.
For Research Question 4 I tested the mediating effect of the continuous distance from the study participants’ schools to the nearest dispensary in LA County. I hypothesized that dispensary bans would be associated with a greater average distance compared to cities that allowed dispensaries. I used the distance to the nearest unlicensed dispensary as the mediating variable based on a sub-analysis finding that unlicensed dispensaries had a stronger association with student marijuana use and because there were more unlicensed dispensaries located near schools. I found that dispensary bans were indeed associated with a significantly longer average distance between schools and the nearest unlicensed dispensary , and that a greater distance was in turn associated with lower rates of lifetime and recent marijuana use among students. Including the distance between schools and the nearest dispensaries in the regression equation greatly improved the model fit and the strength of the association between dispensary bans and student use, although it fell just short of statistical significance . This result indicated that to the extent that dispensary bans are effective, their effectiveness is partially determined by being associated with unlicensed dispensaries being located further from schools. The distance between schools and the nearest unlicensed dispensary has a powerful association with students’ marijuana use as well as the relationship between dispensaries and student use, suggesting that the usefulness of dispensaries in in keeping unlicensed outlets further away from schools. It’s important to note that a dispensary ban is not required to do this, but different approaches among cities that allow dispensaries may be required A sensitivity analysis using progressively smaller distances within a mile and testing for significant associations with rates of lifetime and recent marijuana use among students found that there was a statistically significant relationship between both lifetime and recent marijuana and having the nearest dispensary located within a mile. A mile is equivalent to 5,280 feet, which is more than 8 times the minimum distance the State of California requires dispensaries to be located away from schools. Interestingly, the presence of licensed dispensaries within a mile was not associated with greater likelihood of marijuana use among the study participants, but was instead significantly associated with lesser likelihood of both lifetime and recent marijuana use. The disparate effects of licensed and unlicensed dispensaries at distances within a mile of schools merits much more detailed study. How do licensed dispensaries prevent diversion to youth so much more effectively than unlicensed dispensaries, if indeed that that is the cause of the opposite effect on youth use? Could licensed dispensaries shrink the illicit market on such a localized level? Recent premise surveys conducted by the LA County Department of Public Health indicate that ID checks were nearly universal among both unlicensed and licensed dispensaries , so it’s unlikely that youth are buying it directly from unlicensed dispensaries themselves. Perhaps less easily observable differences occur with unlicensed dispensaries circumventing other regulations intended to prevent diversion to youth and the illicit market, like quantity limits on the amount customers can buy in a single transaction. Research on dispensaries business practices and compliance with state and city regulations to date is sparse but supports this possibility. For example, recent observational research among dispensaries in LA County indicates that unlicensed outlets were more likely to have violated several regulations designed to prevent youth harm, such as displaying products designed to be attractive to youth, displaying products outside of their original child resistant packaging .