Essays on Marijuana Use in Older Adults Restricted; Files Only

Abstract

 This dissertation examines the effects of marijuana access on marijuana demand, pain relief, health outcomes, and labor market participation among adults aged 45 and older. While the literature on marijuana has expanded, most research has focused on younger populations, leaving a gap in understanding how older adults, who increasingly report using marijuana as a pain reliever, are affected by marijuana legalization. With the older adult population expected to outnumber children by 2032, it is crucial to understand the impact of marijuana laws on this group, both for their individual health and broader societal outcomes.

Using public state trend data from the National Survey on Drug Use and Health (2002-2014), I analyze the impact of medical marijuana dispensaries on marijuana consumption among older adults. My findings indicate that the opening of medical marijuana dispensaries leads to increased marijuana use in this population. I then explore the effects of marijuana laws on health outcomes—such as self-reported health status and pain levels—and labor market outcomes, utilizing restricted data from the Health and Retirement Study.

The results suggest that the opening of recreational marijuana dispensaries is associated with significant reductions in pain and improvements in labor market outcomes, such as increased employment. These findings support the notion that marijuana use can alleviate pain, which may improve the quality of life and economic productivity of older adults. Additionally, I investigate the potential link between access to cannabis and suicide rates, finding a decline in suicide rates among older adults following the opening of recreational marijuana dispensaries, particularly among older White adults, men, and those with lower levels of education.

This research contributes to the expanding literature on marijuana use by focusing on the effects of marijuana policies on an often-overlooked demographic. It provides valuable insights into how marijuana laws can impact pain management, health, and labor market outcomes for older adults, offering important implications for policymakers considering the broader effects of marijuana legalization on public health and the economy.

Table of Contents

1 Effect of Medical Marijuana Dispensaries on Marijuana Consumption in Older Adults 1

1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

1.2 Demand for Marijuana . . . . . . . . . . . . . . . . . . . . . . . . . . 3

1.2.1 Marijuana Stigma . . . . . . . . . . . . . . . . . . . . . . . . . 4

1.2.2 Effect of Medical Marijuana on Consumption . . . . . . . . . 5

1.2.3 Access to Cannabis . . . . . . . . . . . . . . . . . . . . . . . . 6

1.3 Demand Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.3.1 Dependent Variable . . . . . . . . . . . . . . . . . . . . . . . . 8

1.3.2 Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

1.3.3 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

1.4 Demand Estimation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

1.4.1 Two-Way Fixed Effects . . . . . . . . . . . . . . . . . . . . . . 13

1.4.2 Event Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

1.5 Demand Results and Discussion . . . . . . . . . . . . . . . . . . . . . 15

1.6 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

2 Pain in the Hash: Effect of Marijuana Legislation on Health and Labor Market Outcomes in Older Adults 22

2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

2.2 Marijuana Background . . . . . . . . . . . . . . . . . . . . . . . . . . 24

2.2.1 What is Marijuana . . . . . . . . . . . . . . . . . . . . . . . . 24

2.2.2 History of Marijuana Legalization . . . . . . . . . . . . . . . . 25

2.2.3 Marijuana in Older Adults . . . . . . . . . . . . . . . . . . . . 27

2.2.4 Not All Legislation is Created Equal . . . . . . . . . . . . . . 28

2.3 Literature Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

2.3.1 Decriminalization . . . . . . . . . . . . . . . . . . . . . . . . . 35

2.3.2 Legalization . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

2.3.3 Pain and Marijuana . . . . . . . . . . . . . . . . . . . . . . . . 39

2.3.4 Older Adults and Labor Market Decisions . . . . . . . . . . . 42

2.4 Theoretical Framework . . . . . . . . . . . . . . . . . . . . . . . . . . 43

2.4.1 Production Function . . . . . . . . . . . . . . . . . . . . . . . 43

2.4.2 Time Constraint . . . . . . . . . . . . . . . . . . . . . . . . . 44

2.4.3 Budget Constraint . . . . . . . . . . . . . . . . . . . . . . . . 44

2.4.4 Utility Maximization . . . . . . . . . . . . . . . . . . . . . . . 45

2.5 Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

2.5.1 Dependent Variables . . . . . . . . . . . . . . . . . . . . . . . 47

2.5.2 Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

2.5.3 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

2.6 Empirical Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

2.6.1 Two-Way Fixed Effects . . . . . . . . . . . . . . . . . . . . . . 51

2.6.2 Threats to Validity . . . . . . . . . . . . . . . . . . . . . . . . 52

2.6.3 Event Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

2.6.4 Discrete Time Hazard Model . . . . . . . . . . . . . . . . . . . 55

2.7 Results and Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . 57

2.7.1 Pain Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

2.7.2 Health Status . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

2.7.3 Work Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

2.8 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

3 Marijuana Legalization and Suicides Among Older Adults 72

3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

3.2 Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

3.3 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

3.4 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

3.5 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

Appendix A Pain in the Hash: Effect of Marijuana Legislation on Health and Labor Market Outcomes in Older Adults 85

A.1 Dependent Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

A.2 Control Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Bibliography 88

About this Dissertation

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School	Laney Graduate School
Department	Economics
Degree	Ph.D.
Submission	Dissertation
Language	English
Research Field	Economics, General
Keyword	Cannabis Labor market participation Marijuana Health outcomes Older Adults
Committee Chair / Thesis Advisor	Sara Markowitz, Emory University
Committee Members	Ian McCarthy, Emory University Stephen O'Connell, Emory University

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