Racial resentment and support for decriminalization of drug possession in the United States

The U.S. population of former prison inmates is large and growing. The period immediately after release may be challenging for former inmates and may involve substantial health risks. We studied the risk of death among former inmates soon after their release from Washington State prisons. We conducted a retrospective cohort study of all inmates released from the Washington State Department of Corrections from July 1999 through December 2003. Prison records were linked to the National Death Index. Data for comparison with Washington State residents were obtained from the Wide-ranging OnLine Data for Epidemiologic Research system of the Centers for Disease Control and Prevention. Mortality rates among former inmates were compared with those among other state residents with the use of indirect standardization and adjustment for age, sex, and race. Of 30,237 released inmates, 443 died during a mean follow-up period of 1.9 years. The overall mortality rate was 777 deaths per 100,000 person-years. The adjusted risk of death among former inmates was 3.5 times that among other state residents (95% confidence interval [CI], 3.2 to 3.8). During the first 2 weeks after release, the risk of death among former inmates was 12.7 (95% CI, 9.2 to 17.4) times that among other state residents, with a markedly elevated relative risk of death from drug overdose (129; 95% CI, 89 to 186). The leading causes of death among former inmates were drug overdose, cardiovascular disease, homicide, and suicide. Former prison inmates were at high risk for death after release from prison, particularly during the first 2 weeks. Interventions are necessary to reduce the risk of death after release from prison. Copyright 2007 Massachusetts Medical Society.

Cannabis is widely used among adolescents and adults. In the U.S., marijuana laws have been changing, and Americans increasingly favor legalizing cannabis for medical and recreational uses. While some can use cannabis without harm, others experience adverse consequences. The objective of this review is to summarize information on the legal status of cannabis, perceptions regarding cannabis, prevalence and time trends in use and related adverse consequences, and evidence on the relationship of state medical (MML) and recreational (RML) marijuana laws to use and attitudes. Twenty-nine states now have MMLs, and eight of these have RMLs. Since the early 2000s, adult and adolescent perception of cannabis use as risky has decreased. Over the same time, the prevalence of adolescent cannabis use has changed little. However, adult cannabis use, disorders, and related consequences have increased. Multiple nationally representative studies indicate that MMLs have had little effect on cannabis use among adolescents. However, while MML effects have been less studied in adults, available evidence suggests that MMLs increase use and cannabis use disorders in adults. While data are not yet available to evaluate the effect of RMLs, they are likely to lower price, increase availability, and thereby increase cannabis use. More permissive marijuana laws may accomplish social justice aims (e.g., reduce racial disparities in law enforcement) and generate tax revenues. However, such laws may increase cannabis-related adverse health and psychosocial consequences by increasing the population of users. Dissemination of balanced information about the potential health harms of cannabis use is needed.