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Impact evaluations of drug decriminalisation and legal regulation on drug use, health and social harms: a systematic review
Journal article   Open access   Peer reviewed

Impact evaluations of drug decriminalisation and legal regulation on drug use, health and social harms: a systematic review

Ayden Scheim, Nazlee Maghsoudi, Zack Marshall, Siobhan Churchill, Carolyn Ziegler and Dan Werb
BMJ open, v 10(9), pp e035148-e035148
01 Jan 2020
DOI: https://doi.org/10.1136/bmjopen-2019-035148
PMID: 32958480
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1136/bmjopen-2019-035148View
Published, Version of Record (VoR)CC BY-NC V4.0,  Open

Abstract

General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology
Objectives To review the metrics and findings of studies evaluating effects of drug decriminalisation or legal regulation on drug availability, use or related health and social harms globally. Design Systematic review with narrative synthesis. Data sources We searched MEDLINE, Embase, PsycINFO, Web of Science and six additional databases for publications from 1 January 1970 through 4 October 2018. Inclusion criteria Peer-reviewed articles or published abstracts in any language with quantitative data on drug availability, use or related health and social harms collected before and after implementation ofde juredrug decriminalisation or legal regulation. Data extraction and synthesis Two independent reviewers screened titles, abstracts and articles for inclusion. Extraction and quality appraisal (modified Downs and Black checklist) were performed by one reviewer and checked by a second, with discrepancies resolved by a third. We coded study-level outcome measures into metric groupings and categorised the estimated direction of association between the legal change and outcomes of interest. Results We screened 4860 titles and 221 full-texts and included 114 articles. Most (n=104, 91.2%) were from the USA, evaluated cannabis reform (n=109, 95.6%) and focussed on legal regulation (n=96, 84.2%). 224 study outcome measures were categorised into 32 metrics, most commonly prevalence (39.5% of studies), frequency (14.0%) or perceived harmfulness (10.5%) of use of the decriminalised or regulated drug; or use of tobacco, alcohol or other drugs (12.3%). Across all substance use metrics, legal reform was most often not associated with changes in use. Conclusions Studies evaluating drug decriminalisation and legal regulation are concentrated in the USA and on cannabis legalisation. Despite the range of outcomes potentially impacted by drug law reform, extant research is narrowly focussed, with a particular emphasis on the prevalence of use. Metrics in drug law reform evaluations require improved alignment with relevant health and social outcomes.

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44 citations in Web of Science
47 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Substance Abuse
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