Despite fears by critics that marijuana legalization would lead to sharp increases in problematic use, newly published data from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) shows that states where cannabis sales remained illegal typically had the highest rates of treatment admissions for the drug.
States with the highest admissions rates where marijuana was the primary substance, on a per capita basis, the top 10 states were South Dakota (151 per 100,000 residents), Iowa (144), Connecticut (141), South Carolina (119), Minnesota (110), New York (95), Wyoming (85), Georgia (84), North Dakota (81) and New Jersey (80). While all those states except South Carolina and Wyoming permitted medical marijuana use, none of the top 10 states had legal recreational sales at the start of 2021. New York, New Jersey and Connecticut all legalized adult-use cannabis at some point in 2021, but retail sales didn’t begin until subsequent years.
As noted by the prohibitionist group Smart Approaches to Marijuana (SAM), admissions for cannabis treatment in 2021 fell by more than 10,000 since the year before, dropping from 141,091 to 129,343—even as more states enacted legalization. Overall Treatment admissions overall were down nationally between 2020 and 2021, during the height of the coronavirus pandemic.
