Associations Between Evolving Cannabis Policies and Cannabis-Related School Discipline Among Secondary School Students in Massachusetts, 2005-2019.

Abstract

The objective of this study was to examine whether cannabis policies, including decriminalization, medical legalization, and recreational legalization, among adults are associated with changes in cannabis-related disciplinary incidents in Massachusetts public schools. This retrospective cohort study utilized 2005-2019 Department of Elementary and Secondary Education data on disciplinary incidents in all public-school districts (N=399). A multilevel time-series model with multiple interruptions was used to examine the relationship between cannabis policy changes and district-level cannabis-related disciplinary incidents per 1,000 students in Massachusetts from 2005 to 2019. There were statistically significant increases in cannabis-related disciplinary incidents during the decriminalization policy period compared with those before decriminalization; the cannabis-related disciplinary incident rate per 1,000 students increased by 34% relative to the time prior (incidence rate ratio=1.34; 95% CI=1.11, 1.60). However, cannabis-related disciplinary incidents decreased during the medical and recreational policy periods; the cannabis-related disciplinary incident rate decreased by 45% during the medical policy period compared with that during the decriminalization period (incidence rate ratio=0.55; 95% CI=0.47, 0.65) and by 20% during the recreational policy period (incidence rate ratio=0.80; 95% CI=0.68, 0.94). The average number of cannabis-related disciplinary incidents per school district ranged from 4.6 during decriminalization (2008-2011), 4.7 during medical (2012-2015), and 5.1 during recreational legalization (2016-2019) periods. There was a modest increase in cannabis-related disciplinary incidents in schools after decriminalization in 2008. However, as state cannabis legalization policies expanded, the cannabis-related disciplinary incident rate per 1,000 students decreased. These findings are encouraging and underscore the need for schools to continue to develop and implement alternatives to exclusionary discipline that employ a harm-reduction approach.