How Has Colorado Changed After Cannabis Legalization

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How Has Colorado Changed After Cannabis Legalization

A heated debate occurred prior to the legalization of cannabis in Colorado, and still today there are disagreements on both sides as to the consequences of the passing of Amendment 64. As the first state to legalize recreational cannabis use, Colorado has been seen as a sort of experiment into broader liberalization measures for the plant both here in the US and around the world.

Proponents said that legalization would decrease crime rates, reduce addiction and injuries due to other drugs, boost the economy, decrease crime and money flowing to cartels, and allow our vets and others to suffer from PTSD easier access to medicine which helps them. Opponents said it would increase use amongst teens, fuel addiction, cause more road accidents, increase the rates of suicide, promote violent crime, and harm local economies. Now, 5 years later, the debate continues. Talk to any cannabis user in the state and they will tell you how much cannabis has helped mental health, jobs, cleaner roads, and better schools.

Talk to anyone that doesn’t use it and they will tell you it is responsible for everything that is wrong with Colorado – from population growth to homelessness, to rising housing and healthcare costs.

After more than half a decade, what is the real story? In this article, we looked to find some of the available statistics regarding these issues, and see how cannabis legalization truly has affected Colorado. Although a little more than 5 years is not long enough to make too many solid conclusions, we can already see some trends, which support some of the claims, and refute others.

Let’s have a look at what the studies have shown so far.


Voters in Colorado approved the sale of medical marijuana in the year 2000, however, it was not until November of 2012 that the recreational use of cannabis was approved by voters through the passing of Amendment 64, which went into effect January 1st, 2014. This has been a major boom to the state, and just in the first year the revenues derived from taxes and licenses on marijuana businesses exceeded 638 million dollars, an amount which has grown to $1.7 Billion dollars in 2019.

And demand seems to be increasing, in 2017, the state produced more than 340 metric tons of cannabis flower, and who is consuming it all? Well, it appears it is not the kids.

Cannabis Exposure Amongst Children

One of the major fears about legalizing cannabis was the message it would send to our children. Are we telling them that the plant is ok, and thus increasing the likelihood of them using it? According to the National Survey on Drug Use and Health, Colorado youth have consistently used cannabis at a rate higher than the national average, however that rate is currently the lowest it has been since 2007-2008, there was no increase in drug use amongst Colorado’s teens following legalization. Furthermore, alcohol, tobacco, and heroin use rates in the state were all down amongst teens in 2015-2016.

Cannabis and Driving Accidents

The results of cannabis legalization on road accidents are less clear, but some interesting statistics have emerged. In 2009 (pre-legalization), 10% of vehicle operators involved in fatal crashes tested positive for cannabis. By 2014 that number had increased to 11.37%, hardly significant. However, marijuana seems to play a role in accidents caused by users of other drugs, with 77% of those crashes that involved marijuana also involving alcohol or other drugs. It should also be mentioned that traffic accidents in general increased by 15% from 2012 to 2014, most likely implicating a third factor other than cannabis. Still, today there is no quick and accurate method to establish whether or not a driver is under the influence of cannabis, so the actual effect of legalization on driving cannot be known.

Drug Combinations for Operators Positive for Marijuana

According to a 2019 study, the perceptions of driving impairment by users of alcohol and cannabis are dramatically different. In that study, 55% of cannabis users thought it was safe to drive under the influence of cannabis, with most of them citing that it made them more cautious, drive slower, and leave more distance between them and the car in front of them. A similar study published in 2019fond that 27% of respondents said marijuana made them drive better due to compensatory behaviors, which intrinsically implies that they are aware that marijuana has impaired their ability to drive.

This is also a growing trend among older drivers, according to a 2019 study in the journal of Accident Analysis and Prevention, 9% of Colorado drivers between the ages of 65-79 used cannabis in the past year, and almost 10% of them had done so within 1 hour of driving. The rate or crashes or citations did not differ between older cannabis users and non-users, but the same study found that older cannabis users were 4 times more likely to drive while impaired by alcohol.

Injuries and Deaths

Another concern was whether or not cannabis legalization would lead to greater incidences of hospital admissions due to physical harm and psychologic episodes. According to a 2018 report by the Department of Environmental Epidemiology, Occupational Health, and Toxicology, the rates of emergency department visits associated with both cannabis and mental health did increase from 2012 to 2014, from 224.5 to 268.4 per 100,000 people, including a large percentage of tourists visiting the state. In another study, it was reported that the rate of emergency department visits by out of state residents involving cannabis rose from 85 per 10,000 visits to 168 per 100 visits from 2013 to 2014. Furthermore, in analyzing data from over 100 hospitals in the state, it was found that hospitalizations specifically related to marijuana doubled after medical marijuana legalization (15 per 100,000 people in 2001-2009 versus 28 per 100,000 from 2010 to 2013), and increased again with the legalization of recreational cannabis (38 per 100,00 people in 2014). However, it should be mentioned that, in general, most of these patients only required a few hours of supportive care before being released with no long-term effects. What is more concerning is the increased prevalence of unintentional exposure by children under 12 years, which was reported to be 0 in 2009 versus 14 in 2014.

Looking at the larger picture, a 2017 study in the American Journal of Public Health found that deaths due to opioids reduced by 0.7 deaths per month (a 6.5% reduction) in Colorado following legalization, a reversal of the growing trend seen across the rest of the country. That study concluded, that at least in the short term, cannabis legalization had indeed reduced the rates of opioid addiction and overdoses. Including all legal states (not just Colorado), the effect of medical marijuana legalization has been shown to decrease opioid overdose rates by 25% overstates where it is illegal. This is an important observation, as more than 2000 Coloradans have died due to opioid overdoses since 2006, and the costs to the Colorado healthcare system due to tobacco and alcohol have been calculated at almost 2 billion dollars per year, while the effects of cannabis legalization have more or less cost-neutral for state healthcare budgets and led to a drop in chronic pain admissions.


The crime was predicted to either decrease due to less gang and cartel activity or increase due to higher rates of addiction. A 2019 report in Justice Quarterly concluded that, overall, the legalization of cannabis in Colorado and Washington state had “little effect” on crime. That study found that violent crime was unchanged in both states. It did find, however, that in Colorado there was a slight increase in property crime, however, this was only shown in the data for a brief period during 2014, and was not a long-term trend.


One of the major complaints you will hear from most Colorado residents is that Denver is now overrun with homeless people. While a valid observation, what is the trend in homelessness for the state, and can it be proven to be caused by cannabis legalization? A 2017 report by the Metro Denver Homeless Initiative seems to contradict that observation. Their study concluded that homelessness is actually down in Colorado by 7% compared with pre-legalization. Another study focused on the town of Pueblo and found that poverty was unchanged pre- and post-legalization. That study actually cited, counterintuitively, that it was the economic boom that Colorado had experienced over the last 2 decades that resulted in increases in homelessness, as home prices have risen much faster than hourly wages. In analyzing the US government’s data on homelessness there is no indication that legalization increased Colorado’s rates of homelessness. In fact, over the last 10 years, it has declined. Over the period from 2010-2019, homelessness was highest in 2012 (2 years before legalization) with 16,728 individuals or about 0.02325 of the state’s population. Since then, it has been stable or declining, with 9,953 individuals in 2015, and 9,619 individuals in 2019 (0.0167% of the population) that is nearly half of what it was in 2012 both in terms of the real number of individuals and the percentage of the population. Currently, Colorado ranks 16th in the country for homelessness, having 1.7% of the country’s homeless population.

Total People Experiencing Homlessness,2019

Population Growth

Many residents cite Colorado’s being the first state to legalize cannabis with a large boom in population as patients and their families move here to buy weed. However, this is not shown in the data for the state, which shows that Colorado’s population has been steadily growing for some time, and has actually doubled in the last 50 years. In 1970, the state had 2,209,596 residents and now has about 5,758,736 residents. When looking at the yearly rate of population growth, the highest rate in the last two decades occurred in the year 2000 at 6.68%. That rate decreased to an average of 1.28% from 2010 to 2019, with the highest rate in the last decade recorded in 2015 at 1.8%. There appears to be no increase with the legalization of cannabis, and by 2019 the rate reached a two-decade low, at 1.19%.

So, what is the verdict? All in all, it appears that most of the fears about cannabis legalization have not been realized. Many of the observations made by residents and attributed to cannabis have been done so falsely, both the positive and the negative ones. Cannabis has had little to no effect on population growth, homelessness, crime, teen drug use, or traffic accidents.  There have been some increased rates of hospital admissions, but the fact that those are mostly out-of-state residents shows that education can be the key to combating that issue, and should start at the dispensaries. The effect that legalization has on the use and addiction of other drugs is mostly negligible but seems to indicate some positive effects, especially in regards to opioid abuse. Unintentional exposure by children is still a concern, as it is with all substances, and proper labeling and packaging guidelines need to be enforced. As more states, and countries, legalize cannabis the effects of legalization are becoming more apparent, and the major take-home message is that it is neither going to save us nor destroy us.

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Chad Scott is a freelance science writer who specializes in the field of cannabis. He spent over a decade living in Thailand. He was diagnosed with Acute Myeloid Leukemia while living in Thailand in 2016. Upon diagnosis, Chad immediately began chemotherapy at a rural hospital in the country. He continued to use cannabis oil throughout his chemotherapy treatments for almost 1 year, and never again experienced any nausea or vomiting, and was able to sleep and eat normally. From his personal experiences, he has become an advocate for medical cannabis and believes that all cancer patients should have the right to access this natural medicine if they so choose.

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