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Building a Learning Marijuana Surveillance System

Sharon Levy, MD, MPH1,2; Elissa R. Weitzman, ScD, MSc1,3
[+] Author Affiliations
1Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
2Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
3Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
JAMA Pediatr. 2016;170(3):193-194. doi:10.1001/jamapediatrics.2015.3489.
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This Viewpoint emphasizes the need for a marijuana surveillance system that augments traditional survey surveillance with novel approaches.

Colorado, Washington, and Alaska have legalized marijuana, thus allowing a commercial industry to develop and market a product that has been, in effect, illegal since 1937. Commercialization of other addictive substances such as alcohol and tobacco created a cascade of negative public health consequences, leading to reactive and ineffective attempts at regulation of a mature industry. Although there are calls to study the effects of marijuana legalization,1 survey data have generated mixed results thus far. For example, Stolzenberg et al2 reported amplified adolescent use in states that legalized marijuana, while Hasin et al3 found no significant changes. These conflicting results highlight the need for a learning marijuana surveillance system that uses varied, robust, and real-time inputs to connect use rates, acute harms, and more subtle prediagnostic indictors of morbidity to changes in policy and product.

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