What was once broadly accepted for its diverse uses and cultural value has lately dramatically changed in terms of the perception and use of cannabis on a global scale.
Weed was long consigned to the fringes by the pressure of stringent regulations and rigid societal norms. Finally, a new narrative has come forth as legislation begins to shift the tides toward decriminalization and legalization.
While framed as a question of legal status, this is a transformation that contains much more than wider cultural acceptance and recognition of its potential medicinal and recreational benefits
The debate about cannabis has been hot over the last few years, emanating from the confluence of advocacy, science, and economic opportunity from nearly all corners of the globe.
From continent to continent, many countries are revisiting their stance on cannabis, which is probably an unparalleled rise in usage.
This increase is not homogeneous in its extent but very much region-specific due to the effect of local laws and regulations, cultural attitudes, and access to cannabis products.
The main objective of this systematic review and meta-analysis is to thoroughly review the available estimates of cannabis use globally for the period between 2000 and 2024.
Drawing on data extracted from studies, the result is an overview of how cannabis use has changed across different regions and legal contexts.
Paradigm Shifting. Growing Cannabis Acceptance in Europe
Perhaps the most interesting case is that of Europe, the continent with the most extended history and various cultural attitudes toward cannabis use.
The prevalence of cannabis use differs quite spectacularly on the Continent of Europe. Indeed, according to the data from systematic reviewers, the prevalence is between 0.42% and 43.90% for cannabis use across 33 European countries.
The highest prevalence was in the Netherlands, often considered to be a forerunner in liberal cannabis policies, amounting to 43.90% in 2013. This high prevalence might be explained by the country’s long-term policy of de facto decriminalization of cannabis selling and consumption through the regulated “coffee shops.”
In contrast, the country with the strictest drug laws and a zero-tolerance policy toward illicit drugs was Sweden, which had the lowest prevalence at 0.42% in 2016.
Data proves the tendency for countries with more permissive regulations on cannabis to report higher prevalence rates of use.
For example, Switzerland and Spain, with their relatively liberal laws concerning cannabis, had 2010 prevalence rates equal to 28.14% and 25.72%, respectively.
On the other side of the scale are countries strictly regulating anti-cannabis policies, like Romania and Estonia, showing meager rates of 4.31% and 6.60%, respectively, in the same period.
Another example is the trends in data from 19 countries that have deregulated cannabis. In most of those countries, the prevalence rate is higher compared to countries where it is still illegal.
This underlines the impact of legal status on consumption patterns of cannabis due to increased usage associated with legal access.
North and South America. A Tale of Two Continents
The Americas hold a wide schizophrenic range of cannabis use prevalence, which was influenced by both various degrees of legalization and cultural acceptability.
In the United States, one of the global forerunners in the cannabis movement to legalization, an overall increasing trend in cannabis use can be observed after the legalization of medical and recreational cannabis in several states.
As recently as 2021, the highest recorded prevalence was 38.12%, putting a face to how much to raise the usage rate based on regularization alone.
South American countries, such as Brazil and Uruguay, depict the same upward trend since their legalization. The prevalence rate of Brazil was 23.10% in 2019, while that of Uruguay, which first fully legalized cannabis in a country, was reported to be at 20.78% in 2018.
Even these data epitomize more diffused acceptance and access to cannabis in countries with liberal policies.
As a clear contrast, nations that actively forbid the legality of cannabis indicate prevalent rates to be relatively meager.
For example, Bolivia reported a 2.60% prevalence in 2012 and Peru 2.90% in 2010. The understanding behind these lower rates is that legal and social barriers inhibit the event and wide use of cannabis in these regions.
Data from the Americas indicate pretty clearly that the view that legalization policies play an essential role in shaping cannabis consumption patterns.
Since most countries in this region are moving toward legalizing Cannabis, the results might continue to rise in prevalence rates under the stressful tides of influence derived from the normalization and acceptance of the global trend of cannabis use.
Oceania and Africa. New Cannabis Consumption Trends
In New Zealand, the highest prevalence was 19.00% in 2012, with a definite tendency for decline over time.
The situation in Africa, however, is considerably complex.
Of all the African states, only South Africa legalized cannabis for personal use; its reported prevalence in 2017 was 7.80%.
Other nations in Africa, sharply contrasting to the heavy, illicit drug users, had much lower prevalences: Benin and Tanzania were at 1.30% and 2.30%, respectively, in 2017.
Data from these regions support that legalizing policies play an essential role in cannabis use patterns.
Counties with legal frameworks for cannabis generally reported higher prevalence rates in comparison with countries that implemented strict prohibition laws. This trend is consistent with the global pattern observed in other regions.
Asia. A Continent of Contrasts
The Asian continent represents a unique view of cannabis use, with many diverse cultures and legal regimes.
Prevalence rates of cannabis use in Asia range from 0.30% to 19.10%, with considerable variations occurring across the region.
Israel recorded a prevalence of 19.10% in 2017, guiding the way forward in progressive medical cannabis legislation that typifies wider acceptance and use of cannabis for medicinal purposes more generally.
In contrast, countries with stringent anti-cannabis laws, like Japan and Vietnam, report some of the lowest prevalence rates. Taking the case of Japan, that has rigorous control policies for cannabis, the nation reported a 0.30% prevalence in 2004, making it among the world’s lowest rates.
Similarly, Vietnam reported a prevalence rate of 0.60% back in 2013. Data shows that, in countries where the use of cannabis is illegal, prevalence rates are meager.
This would point toward legal status and enforcement intensity as the two principal determinants in the cannabis use patterns for this region. It will be exciting to see how these trends may evolve, with some Asian countries currently looking into possible benefits of cannabis.
Global Cannabis Consumption Trends
The landscape of cannabis use worldwide is changing at an extremely rapid rate on account of shifting legal frameworks and evolving cultural attitudes.
This systematic review and meta-analysis bring out the fact that significant regional variations exist in cannabis prevalence rates, underlining the role that changes in legalization policies can play in consumption patterns.
Consequently, with more countries moving towards decriminalization and legalization, global cannabis use will grow. In such complex terrains, policymakers will have to tread carefully regarding the potential implications of increased cannabis use for public health and society.
These developments will be of importance to appreciate in understanding the future landscape that cannabis use, as well as its regulation, will unfold as this plant continues to enjoy the acceptance it deserves worldwide.
