The Latin American Marijuana Research Initiative (LAMRI) presents: The Transformation of Drug Policy: The Impact of Marijuana Legalization in Uruguay

2. The Latin American Marijuana Research Initiative
(LAMRI) presents:
The Transformation of Drug Policy:
The Impact of Marijuana Legalization in Uruguay
María Fernanda Boidi
José Miguel Cruz
Rosario Queirolo
Marcelo Gomes Freire
With the support of
Emily Bello-Pardo

3.  Project focuses in four areas:
 Analysis of the enactment and regulation
process
 Public opinion analysis in Uruguay, the United
States, and El Salvador (LAPOP’s 2014
AmericasBarometer)
 The impact on behavior among frequent
consumers (Respondent Driven Sample survey
in Montevideo)
 Profile and membership of Cannabis Clubs

4. Content
 The Legal Framework
Attitudes toward Marijuana
Who Consumes and Who Does Not Consume
Marijuana in Uruguay
The Marijuana Frequent Consumers in
Montevideo

5. The Legal Framework

6. How did marijuana regulation occur in
Uruguay?
 Reasons for regulation very different from the U.S.
experience
 President José Mujica’s initiative
 It was presented as a measure to tackle the increasing
perception citizen insecurity
 It aimed to reduce the leverage of criminal organizations
tied to drug-trafficking
 It regulates production, commercialization, and
consumption in the country

7. Three ways to obtain marijuana
in Uruguay
Home cultivation (autocultivo)
• Six marijuana plants per household
• Annual crop of 480 grams
• Or, 40 grams per month
• People must register
• One location per person

8. Three ways to obtain marijuana in
Uruguay
Cannabis Club
• 15 to 45 members of civil association
• Association must register
• Association is responsible for registering
members
• Allowed to farm up to 99 plants
• Annual crop of 480 grams per person

9. Three ways to obtain marijuana in
Uruguay
Sale through pharmacies
• Registered consumer can buy up to 40 grams
per month
• 480 grams per year
• Marijuana would be produced by a number of
private companies
• Process to select private growers has started,
but not finished yet
• Prices are regulated by the government

10. Three ways to obtain marijuana in
Uruguay
Main debate as of early 2015 is whether the
government may make it compulsory for
pharmacies to sell marijuana
Priorities of Tabare Vazquez government are
different from Mujica’s

11. Attitudes toward Marijuana in Uruguay

12. Congress passed the bill with little
support from the Uruguayan public
Top-down process, although there was
some activist mobilization
Framed as civil rights movement by
activists

13. Strongly agree
9.9%
Agree
24.1%
Neither agree nor disagree
5.2%
Disagree
26.6%
Strongly disagree
34.1%
Other
0.1%
Do you agree with marijuana regulation?
Source: AmericasBarometer, LAPOP
Only a third of Uruguayans approved
the new marijuana regulations

14. Approval for marijuana regulation is
significantly higher in the U.S.
8.2%
34%
51.5%
0%
10%
20%
30%
40%
50%
60%
El Salvador Uruguay United States
SupportforMarijuana
Legalizaion/Regulation
Source: AmericasBarometer by LAPOP

15. 71.8
71.7
71.6
48.5
0.0 20.0 40.0 60.0 80.0
Marijuana is harmful to people's health
Marijuana is the gateway to hard drugs
People will continue buying drugs
Marijuana consumers are a threat to society
Average (0-100)
95 % Confidence Interval
(with Design-Effects)
Source: AmericasBarometer, LAPOP, Uruguay 2014
In fact, as of 2014, most Uruguayans had negative
opinions about marijuana consumption

16. 81.6
71.9
57.7
57.5
53.1
0.0 20.0 40.0 60.0 80.0
Home-grow marijuana will increase
Marijuana consumption will increase
Drug trafficking will increase
Drug consumption will grow
Illicit sales will grow
Average (0-100)
95 % Confidence Interval
(with Design-Effects)
Source: AmericasBarometer, LAPOP, 2014
And most Uruguayans believed that with the law
consumption and illicit trafficking will increase

17. Why did the government enacted
the marijuana law?
Motives %
Public security, tackle crime and trafficking 45.8
To regulate a phenomenon already occurring 13.6
To make money, to get richer 12.3
For public health 8.1
To get political support, votes 6.8
To divert attention from truth 3.4
To grant more freedoms 2.2
Other reasons 7.7
Source: AmericasBarometer by LAPOP

18. 55.3
51.2
41.6
38.3
38.0
0.0 10.0 20.0 30.0 40.0 50.0 60.0
Country's fight agaisnt drug-trafficking
Country's individual freedoms
Country's health care system
Country in general
Country's security situation
Average
95 % Confidence Interval
(with Design-Effects)
Source: AmericasBarometer, LAPOP, 2014
Uruguayans believed that the law would have a positive
impact in the fight against trafficking and advancing
individual freedoms

19. Then, what are the variables associated
with regulation approval?

20. Most important predictors support
for the regulation law
• President’s job approval

21. 61.3
31.4
0.00
20.00
40.00
60.00
80.00
NoYes
Have tried marijuana?
95% Confidence interval
Source: © AmericasBarometer by LAPOP
Most important predictors support
for the regulation law
• Previous experiences with marijuana

22. Most important predictors support for
the regulation law
• Number of relatives & friends who use
marijuana
29.4
37.2
49.6
25
30
35
40
45
50
55
None One Two or more
Family or friends consume marijuana
Predicted values 95% Confidence Interval
Source: AmericasBarometer by LAPOP

23. Variables associated to regulation
approval in the United States
Most important predictors to favorable
opinions toward marijuana regulation
• Previous experiences with marijuana
• President’s job approval
• Ideology: Being a liberal
• Support for the political system (negative)
• Age: young people

24. 10.0
20.0
30.0
40.0
50.0
60.0
2 3 4 5 6 7 8 9Left Right
Ideology (left / right)
Source: AmericasBarometer LAPOP
40.0
50.0
60.0
70.0
80.0
90.0
Agreewithregulation/legalization?(%)
2 3 4 5 6 7 8 9Liberal Conservative
Ideology (liberal / conservative)
Source: AmericasBarometer LAPOP
Ideological orientations play an important role
in both Uruguay and the U.S.
 Uruguay  United States
But it is crucial in Uruguay…

25. In sum
The President’s popularity played a key role in
the regulation of marijuana in Uruguay
Although people have mixed feelings toward
marijuana regulation, the law did not find
significant popular opposition because it was
not salient to the general public, even as it was
framed as an alternative to tackle increasing
problems of security

26. Who Consumes, Who Does not
Consume Marijuana in Uruguay

27. Prevalence evolution in Uruguay
• Marijuana consumption has been increasing in
Uruguay since we have reliable measures of
prevalence
• Life prevalence has quadrupled from 2001 to 2014
• Annual prevalence increased by six times from 2001
to 2011
• Monthly prevalence increased by ten during the
same period

28. Prevalence Evolution in Uruguay
0
5
10
15
20
25
2001 2006 2011 2014
Life Prevalence Year Prevalence
Month Prevalence
Source: Encuesta Nacional sobre Consumo de Drogas en Hogares, Observatorio Uruguayo de Drogas &
AmericasBarometer 2014

29. Marijuana Prevalence in Youth
• Starting age: in 2011 was 18.3
• But, the results of the National Survey of
High School Students (from 13 to 17
years old) indicate that year prevalence
has doubled in ten years:
– 8.4% in 2003 and 17% in 2014

30. Year Prevalence Evolution in
Secondary Students (%)
0
2
4
6
8
10
12
14
16
18
2003 2005 2007 2009 2011 2014
Year
Prevalence in Students
Source: Encuesta Nacional sobre Consumo de Drogas en Hogares, Observatorio Uruguayo de Drogas

31. Marijuana Year Prevalence and Daily
Consumers
In 2011, year prevalence was 8.3%
Daily consumers: 14.6% of 8.3%,
approximately 18,700 Uruguayans
Around 11,000 more uncovered by the
household survey

32. Yes
Should we trust this data on
prevalence?

33. Evidence from a List Experiment
List experiment rationale
It is a technique used to measure sensitive
topics while avoiding social desirability
effect
It has been used to measure racism,
clientelism and drugs consumption.
It works comparing the percentage
obtained from a direct question with the
one obtained with an indirect question.

34. Evidence from a List Experiment:
Indirect question
 AmericasBarometer 2014, Uruguay
 MAREX1 and MAREX2
 Now I am going to give you a card in which you will
find several products, and I want you to tell me
HOW MANY do you use. Please, do not tell me which
ones, tell me HOW MANY: 0 1 2 3 4 5
 Options:
- Alcohol
- Yerba mate
- Tabacco
- Shark cartilage
- Marijuana

35. Evidence from a List Experiment:
Direct question
AmericasBarometer 2014, Uruguay
Some people use or have at least experimented
with marijuana. Have you ever tried marijuana?
(1) No, never
(2) Yes, one time
(3) Yes, two or more times
(88) DK
(98) DA

36. List Experiment Analysis
Compare control group mean with treatment
group mean
The prevalence is obtained by subtracting the
mean of the control group, from the mean of
the treatment group
Finally, compare that number with the one
from the direct question

37. No underreporting
At least in March 2014, with the new law
of marijuana legalization, no
underreporting of marijuana
consumption existed in Uruguay
22.7% vs 22.1%

38. Life Prevalence of Marijuana in
Uruguay, El Salvador and US (2014)
 Data follow similar distribution of
support for marijuana legalization
URUGUAY EL SALVADOR UNITED STATES
Have tried 22.1% 11.2% 57.9%
Haven’t tried 77.9% 88.8% 42.1%

39. Uruguayan Consumer Profile

40. Probability of Marijuana Consumption
in Uruguay by Age

41. U.S. Consumer Profile

42. In Sum
Data are reliable
– Long series and different measures
All prevalence types have increased
– Specially among youth and those under 18
Red flags about law implementation
– Need to focus on prevention

43. Frequent Marijuana Consumers in
Montevideo
Respondent Driven Sample Survey Results

44. How did we reach frequent
consumers in Montevideo?
Respondent Driven Sample survey- RDS
RDS
Developed by Douglas Heckathorn (1997)
Participants in the study and recruited by
other participants
Snowball sample + weight system to
compensate for non-random sampling
Ideal sampling method for hard to reach
populations

45. Our study: RDS frequent
marijuana consumers
Target group
Individuals age 18 or more
Who live in Montevideo or Montevideo
metropolitan area
Who consume marijuana at least once a week
Data collection: Nov 14 – Dec 28, 2014
294 effective cases
Data analysis conducted with RDS Analyst*
* Mark S. Handcock, Ian E. Fellows, Krista J. Gile (2014) RDS Analyst: Software for the
Analysis of Respondent-Driven Sampling Data, Version 0.42, URL http://hpmrg.org.

46. Recruitment process
Five seeds with diverse backgrounds in
terms of age, gender, consumption
patterns and SES
Each participant was given three
coupons to recruit new participants
Each participant was given gift cards:
USD 25 for attending the interview
USD 20 for each valid referee (up to three)

47. Recruitment chain
(Theoretical example)
Seed 1
11
111
1111
1112
1113112
113
12
121
122
1221
1222
12221
12222 122221
1222211
1222212 1222211
112231223123
13
131
132
133
1331
1332 13321 133211

48. Actual Recruitment Chain

49. Settings for the analyses
Data analysis using RDS Analyst
Population Parameters using:
Giles ‘SS
1000 iterations
95 % Confidence interval
500 Bootstraps
Assuming population size of 15.000 (for
Montevideo and Metro area)
Homophily tests (for recruiters) show no
problematic results
Tested for gender and method of obtaining
marijuana

50. Respondents are really high-frequency
users
8.5
16.9
21.8
7.8
13.4
2.7
29.1
1 2 3 4 5 6 7
Number of days that consumes
marijuana in a week

51. With mostly moderate consumption
patterns
26.0
37.4
26.3
5.3
2.5 2.5
Less than 1
gr
One gram Between 1
and 3 grams
More than 3
and up to 5
More than 5
and up to 10
More than 10
grams
Amount consumed per day (during the days
they actually consume)

52. Individuals use several methods for acquiring
marijuana, many of them still illegal
61.8
36.7
59.0
37.9
27.4
14.0
73.9
81.2
5.8
Bought pressed mj directly
Bought flowers directly
Someone bought pressed mj for them
Someone bought flowers for them
Self-grow (individual)
Self-grow (group)
Gifted pressed mj
Gifted flowers
Other ways
Methods used to acquire marijuana in the
past 12 months (%)

53. “Palancas” and “25s”

54. Pressed marijuana is the most popular
method of acquisition
40.6
3.5
20.9
7.6
5.5
4.3
10.3
6.9
Bought pressed mj directly
Bought flowers directly
Someone bought pressed…
Someone bought flowers for…
Self-grow (individual)
Self-grow (group)
Gifted pressed mj
Gifted flowers
Method of acquisition in most recent
acquisition

55. Respondents consume marijuana in a
variety of forms
92.5
84.5
39.9
26.4
15.7
9.4
6.9
2.2
Joint (self)
joint (other)
Pipe
Edibles
Vaporizers
Drinks
Tinctures
Creams or lotions
Ways of consuming marijuana in the past 12
months (%)

56. And joint is, by far, the most popular
67.2
26.3
5.5
0.7
0.3
Joint (self)
joint (other)
Pipe
Tinctures
Vaporizers
Most frequent way of consuming marijuana (%)

57. Risk Behavior: Individuals perform a
variety of activities under the influence
of marijuana
11.2
21.4
28.4
54.0
98.6
Operated heavy equipment
Drove a care
Rode a motorbike
Rode a bike
Walked in public areas
Percentage of individuals who report having done
these activities under the influence of marijuana

58. Including going to work and to class
under the influence
55.4
62.7
Consumed mj before
going to work
Consumed mj before
going to class
Percentage who consumed marijuana
before going to work and to class

59. Attending classes under the influence clearly affects
performance negatively but there is no consensus on
impact at work
33.5
30.1
36.1
63.8
21.6
14.2
Diminishes Same Increases
Reported performance under the influence of
marijuana (versus going sober) (%)
Performance at work Performance in class

60. The Marijuana Law is highly popular among
frequent consumers
88.9% agree with Marijuana Law
52.1% agree
36.8% agree a lot
Attitudes toward the Marijuana
Law among frequent consumers

61. The registry system required by the law
not quite so…
31.1
26.9
19.6 19.6
0.6 2.1
Surely Probably Probably
NO
Surely NO Already
registered
DK
Will you register as a marijuana user?
(%)

62. Individuals see a high opportunity cost
in registering
20.9
18.8
36.6
0.1
22.9
0.7
Lack of trust
in the
registry
Rejection to
the idea of
registry
Don’t see
any gains in
being
registered
Don’t want
to limit ways
of access
Other
reasons
DK
Reasons for not registering
(Percentage among those who say they will surely or
probably not register)

63. But the controversial pharmacy-selling
is the preferred method for those who
plan to register
30.1
12.8
55.9
1.3
Self-grow Cannabis Clubs Pharmacies DK
Preferred form of access
(% those who will register)

64. Law implementation will face many challenges,
especially:
– Individuals rely in more than one method to
acquire marijuana despite the provisions of the law
– Rejection to the registry
There is little perception of risk among
consumers
Previous points illustrate challenges that
marijuana law is facing:
– Poor communication strategy
– Lack of prevention strategies
In Sum

65. Maria Fernanda Boidi
fernandaboidi@gmail.com
José Miguel Cruz
jomcruz@fiu.edu
Rosario Queirolo
rosario.queirolo@ucu.edu.uy
Marcelo Gomes Freire
marcelogomesfreire@live.com
Thanks!