As more and more states move to legalize marijuana, colleges and universities struggle to understand what the new legislation means for their prevention efforts. Research has identified the impact that broader availability of the substance has had on public health outcomes in the states where it is medically and recreationally legal, but what are the implications for institutions of higher education in those states?

It is important to point out that any discussion about this issue on campus must include the recognition that marijuana is still a Schedule I drug under federal law. This means that regardless of changes to state laws, institutions of higher education are expected to follow the regulations outlined in the Drug Free Schools and Campuses Act (Edgar Part 86). This includes upholding federal laws and statutes prohibiting marijuana possession, use, or distribution by students, staff, and faculty. Not doing so puts an institution at risk of losing or being required to repay federal funds. Some mistakenly believe that exceptions are made for medical marijuana, but that is not the case. Those with a legitimate prescription in a state where it is medically legal still cannot use or possess the substance on campus.

Although the federal law leaves little room for doubt as to the expectations for how a campus should respond to marijuana use and possession, the reality is more complex. Because the federal prohibition on marijuana includes even medicinal use, schools are grappling with how to work with students who have a legitimate prescription but are unable to possess the substance on campus. Another challenge is working with students in the recovery community who may use marijuana to minimize the debilitating side effects of opioid withdrawal. These types of situations require schools to work within the law to identify creative solutions, such as assisting students with locating appropriate off-campus housing options or helping students find alternative solutions to address withdrawal without creating further stigma for those experiencing a substance use disorder.

For schools in states where marijuana is still illegal, the policy conversation is, or should be, pretty straightforward. However, that isn’t the case when it comes to primary prevention programs, problem identification, and referral resources. Schools’ efforts to educate students and treat marijuana-related substance use disorders should not be guided by assumptions about how the laws of the state they occupy impact student use. Doing so has put many institutions behind the curve when it comes to addressing this issue. That is because students’ attitudes and behaviors related to marijuana appear to be shaped more by the legislative landscape and resulting environmental impact of where they went to high school than where they attend college.

Studies of states where marijuana is legal in some form have shown a connection between perception of risk and rates of marijuana use. In a study examining the impact of changing laws in Washington state, researchers found that there was a significant decrease in perceptions of marijuana’s harmfulness and increase in past-month marijuana use among eighth and tenth graders following the legalization of recreational marijuana. This supports a 2014 report from the Substance Abuse and Mental Health Services Administration (SAMHSA) identifying that while about 23% of adolescents nationally perceived a great risk of harm from monthly marijuana use, rates among individual states varied. Specifically, states reporting the lowest rates of perceived risk (15% to 20%) also happened to be among the 20 states with some type of established medical or recreational marijuana law at the time of the survey. States with the highest perceived risk of harm, ranging from 26% to 33%, were found in states where marijuana was, and still is, illegal.

When it comes to college students, data from EVERFI’s AlcoholEdu for College survey (n=122,450) administered in the fall of 2016 showed no differences in the use patterns of students attending college in states where marijuana is recreationally or medically legal versus those in other states. However, differences do appear across the national sample, with the percentage of students who have ever smoked or ingested marijuana being highest among those who graduated from high school in states where marijuana was recreationally legal (46%) or medically legal (43%) compared to states where it is illegal (34%). Rates of more frequent use showed similar trends, with students from recreationally and medically legal states reporting past 30 day use rates of 24% and 22%, respectively, while only 15% of students from states where cannabis is illegal have used in the past 30 days.

The implications of these findings are that schools in states where marijuana is still illegal cannot afford to take a “wait and see” approach to education on this issue. The broadening national availability of cannabis means that even states where it is illegal are growing less insulated from the impact of marijuana use and colleges in those states can no longer rely on their state border to serve as a protective barrier. While federal laws have a number of implications and considerations for policy development that must be addressed, effective and thoughtful prevention efforts to address marijuana use should already be happening, regardless of where a campus is located.