Explaining the strictness of medical marijuana regulations in states

While 33 states and the District of Columbia have adopted laws legalizing medical marijuana, no studies have considered explaining how and why state requirements and restrictions vary, including eligibility requirements, the amount of legal marijuana permitted, sanctions for abuse, and other provisions in state laws that range from more permissive laws to stricter and more limited laws. This study explains the strictness or extent of medical marijuana laws (MMLs) adopted by states from 1996 to 2013, developing hypotheses based on states' economic conditions, political structures, user demands, criminal justice demands, and the impact of neighboring states. We develop an index score that captures state statute strictness by analyzing and coding the statutes of MMLs in each state. Our findings show (1) that factors that influence adoption of MMLs are not the same as the factors that influence the strictness of policies and (2) that the regulation of users and what they are allowed to have for medical marijuana treatment are associated with different variables than the regulation of dispensaries. Overall, the leniency of MMLs is associated with liberal government ideology, poor state fiscal health, unemployment, the size of the state's criminal justice bureaucracy, numbers of AIDS/cancer patients, and number of neighboring states that have adopted MMLs. Laws regarding users tend to become more lenient over time in states.