Marijuana Legality: Changing Policies and Paradigms

Background & Purpose: Marijuana legalization has been well researched, for its effects on medical innovation and its economic benefits.  However, there is little exploration of this changing policy from the context of homeless youth service providers. These agencies are in a unique place in the homeless services community because of their provision of low-barrier access to services and basic needs.  We administered surveys to staff at transition aged youth (TAY) homeless service agencies in states located on the West Coast of the United States because they are in different stages of marijuana legalization and have varying local responses and policy pressures. Surveys and interviews were geared to understand the impact of changing marijuana policies, the role that marijuana plays in the access to services, and the potential use of marijuana as part of mental health interventions.

Methods: Using a case study mixed-methods design, staff of 26 TAY homeless service providers participated in a brief marijuana policy focused questionnaire with follow up semi-structured interviews with key agency staff.  We hypothesized that there would be a great degree of variability in the responses by geographic location and little interest or understanding of the use of marijuana as a therapeutic tool for mental health. Responding agencies ranged in their services focus with agencies primarily providing drop in services (66%) and transitional/permanent supportive housing (57%).   Responding agencies were from California (34%), Oregon (53%), and Washington (13%) additionally respondents were primarily located in urban areas (76%).  Descriptive analyses were conducted using Stata (v14).  Qualitative thematic analysis were conducted using Dedoose.

Results: Results primarily showed a lack of clarity of the legal status of marijuana and a lack of coherent strategy to the regulation of marijuana on an agency level.  Respondents stated agency policy was largely unaffected by the change in policy (80%).  Myriad agencies reported using marijuana as a tool to reduce more problematic drug use (78%), and use of marijuana as a coping mechanism (81%) – regardless of local legal status. Additionally, less than half (45%) of the agencies have formal marijuana programing.  However, counter to this roughly half agencies (53%) held a zero-tolerance policy towards marijuana use and only 20% embracing a harm-reduction policy.  Agencies in states with legalized marijuana cited increased external pressures to enforce a zero-tolerance policy (funding sources, local influences).

Conclusions & Implications: Agencies are left in limbo regarding how to manage and/or treat clients’ and residents’ marijuana use. Given the high rates of marijuana use in this population this is a troubling finding.  Agencies universally reported an overall anxiety around creating formal policies and interventions involving marijuana.  This uncertainty is not new, but in a rapidly changing policy landscape it is preventing agencies from implementing the most effective interventions.  It is paramount that local and state level law-enforcement to educate and collaborate with TAY homeless service agencies on the changing legal landscape.  Moreover, agencies should look to collaborate across states to develop a nationally coherent policy for best practices around marijuana use treatment and marijuana use a therapeutic tool.