Environmental strategies are broadly applied in the prevention of substance abuse. Moreover, the strategies are mostly a necessity composition of the program for prevention for beneficiaries of public health aid. The strategies are geared towards fostering personal behavior change. Approaches based on the environment can be applied at the levels of the community as well as national and regional level. The approach involves community mobilization, community connectedness, and neighborhood changes, policy changes, communication campaigns and changes in enforcement (Pettibone et al., 2013).
The existing strategy on enhancing evidence-based approach and policies, and improving the usage of environmental level mechanisms, has influenced leaders of the community to consider direct decision making. The direct decision making should be based on applicable environmental approaches. Also, community leaders should put an effort in matching particular environmental approaches towards the hindrance of specific substances. For example, heroin and cocaine or patterns of substance use for instance conspicuous periodic consumption.
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Though, the lawfulness of production, usage and trade of marijuana for medical as well as non-medical drives differ from nation to nation, as well as States in the United States. Leaders of the community have been steadfast in fighting the not-for-medical consumption of marijuana, specifically among youth, due to its related consequences. The public health effects include severe short-term effects that range from severe psychiatric responses to risks of accidents as well as injury to dependence. Nonetheless, studies are still being conducted to establish ways in which the application of environmental approaches can be efficiently used to decrease non-medical use of marijuana health issues (Friend et al., 2015).
The Need
There is the need for environmental-level risk as well as the non-medical use of marijuana protective factors. Practical application of environmental approaches needs suitable establishment of the elements of environmental-level that are greatly malleable and virulent since they link to the established health issues of the public. The environmental level elements may incorporate accessibility, norms of community-level suitable to use, disorganization in the neighborhood and price or exchange modes. Effective application of environmental approaches as well needs a clear understanding of the targeted population. In this case, the adolescent is the majorly targeted population for non-medical use of marijuana. Also, the accessibility comes up as a steadily related and well-researched environmental-level risk element (Friend et al., 2015).
Hypothetical lower accessibility of marijuana is due to the linkage to both the reduced lifetime as well as the earlier month non-medical use of marijuana among 6th to 10th graders (Pettibone et al., 2013). The increased accessibility of marijuana within and throughout the cities is instrumental in contributing to marijuana consumption among the youth living in city areas. Proof of the effect of norms at community-level on non-medical use of marijuana is steady. Some research indicates that norms at community-level, affect youth marijuana consumption, whereas a section establishes the little effect, even in youths with strong ties to the community (Friese and Grube, 2013). The discrepancy may be due to the difference in operational descriptions of norms at community-level such as those entailing perceptions of adolescents regarding norms of the community and those entailing perceptions of the adults on community norms and norms entailing other contextual variables. Contextual variables may be drug-possession enforcement measurements.
Disorganization in the neighborhood, also known as neighborhood characterized by high population density, high rates of crime, low surveillance, and low neighborhood connection, has varying linkages with youth marijuana consumption (Grucza et al., 2016). Some study has indicated that the higher perceived disorder in the neighborhood is associated with higher risks of marijuana consumption for adolescents whereas other studies establish a lack of linkage after considering several individual-level elements, for instance, poorly modulated impact (Grucza et al., 2016). With regards to model or price of exchange, youths, specifically in the United States, generally, access marijuana through social networks which are a non-economic means. As stated in the United States Countrywide Survey on Drug Usage and Wellbeing (Wu et al., 2015), youths access marijuana for free and irrespective of whether the drug was obtained through purchase or for free, most of the youths access it through relatives or friends (Grucza et al., 2016).
Current Approaches
Some of the current approaches include consideration on prevention efforts at environmental-level for non-medical marijuana usage. Since factors for environmental risks for marijuana vary from those of other forbidden substances, approaches based on the environment for preventing non-medical use of marijuana might also vary from approaches for alternative drugs. For instance, interventions on community space, such as clearing trees, lighting to increase visibility, and transforming patterns of traffic to create drive-by acquisitions rigid have been applied to control the dissemination of other unlawful substances. However, it can have little impact on controlling the rates of non-medical usage of marijuana, specifically in the U. S. since marijuana exchanges are conducted indoors.
Moreover, in Australia, the Great Britain, the United Sates together with other several other nations, there are many political and social controversies about farming, distribution, and consumption of marijuana (Marcoux et al., 2013; Rubens, 2014). The aftermath consideration marijuana gets due to countrywide debates may affect elements of the environment like sensitivity to harm, norms sensitivity on the acceptability of usage as well as enforcement perception. This would possibly make prevention of non-medical use of marijuana varied than the deterrence of other consumable drugs. Therefore, intended variations indicate a necessity for an examination of whether and the ways deterrence sector can be reflexively implementing what has been learned from environmental approaches. The examination may incorporate some health problems to the non-medical use of marijuana, and the applications should be appropriate.
This study highlights on the documented proof for environmentally based non-medical use of marijuana prevention approaches with the goal of guiding decision-making for applicability. As a result of the variation of norms, legality, and enforcement of the non-medical use of marijuana globally, the nations incorporated in the study sample, established whether they were a representation of the country (Marcoux et al., 2013). Also, as a result of the changes in different nationwide policies regarding the legalization of marijuana custody, its farming and usage have changed the contexts in which actions of prevention take place. The population on target is clearly noted as well; since the effective establishment of the population on focus is a vital element of design as well as the provision of environmental approaches.
Recommended Approaches
Media Interventions
Countrywide Campaigns
Seven peer reviewed journals focused on describing the analysis of media approaches to preventing marijuana usage among the youth. Four articles described the outcomes of marijuana usage in the United States countrywide campaigns dubbed “My Anti-Drug’ and ‘Above the Influence” with the countrywide sample (McHale et al., 2016). One article evaluated the results of the United State-based countrywide campaign dubbed “My Anti-Drug” through the usage of two community sample (Alvaro et al., 2013). Besides, an extra journal assesses the concurrent impact of United State-based campaigns as well as interventions of the local media, that is, “Be Under Your Own Influence” regarding marijuana usage (Slater et al., 2011).
The movement began in 1999 through to 2004 and focused on marijuana come 2002. It encompassed advertisements about three themes including resistance skills as well as self-efficiency, normative education coupled with positive substitutes and adverse outcomes of drug usage. The behavioral and cognitive impacts of “My Anti-Drug” were assessed by use of four years information on an in-home-based study of youths and parents. Outcomes established less proof that revelation to the advertisement of anti-drug affected lifetime, earlier year and earlier 30-day marijuana usage. Particularly, certain proof proposed the probability of impacts due to marijuana in reaction to anti-marijuana messaging, more so for younger adolescents between the ages of 12 to 14 years. Thus, to understand the reasons why the Countrywide Anti-Drug Campaign by Media in the U.S. was unproductive, a study by Alvaro et al. (2013) on adolescents’ perceptions of anti-marijuana advertisement on television; as used in the campaigns along with their relation to the future use of marijuana is elaborated.
In this study, youths who positively analyzed the advertisements at the beginning of the first study were unlikely to explain consuming marijuana at follow-up. Besides, they were unlikely to explain forthcoming intents of consuming marijuana. Vulnerable consumers such as individuals who showed they might consume marijuana in the subsequent 12 months and current users of marijuana preferred the advertisements than determined non-consumer. That is those individuals who showed no intent to consume the drug. Though the campaign reach was high, the advertisements were disliked by the targeted population on the risk which incorporated users and vulnerable non-users.
Another study based on the United States Countrywide Media Campaign on Anti-Drug observed particularly at the foray of the movement into marijuana-particular messaging throughout 2002. It aimed at risks and high-perception pursuing adolescents with advertisements highlighting contents on the negative outcomes of marijuana consumption. Before the campaign, high-perception pursuant indicated an increasing tendency in usage. The tendency was interfered with by a statistically substantial decrease in the usage after the campaign began. The diminution further maintained across the dimension time. Effects on the tendency of usage were not showed for low-sensation pursuant. The results show that whereas the advertisements might not have been effective in producing behavior change for the overall population of adolescent, they might have been effective in decreasing the usage in the high-sensation pursuant youths (Comello, 2013).
The performance of the wider United States-based Countrywide Media Campaign on Anti-Drug, “My Anti-Drug” by Lacklustre, gave rise to substantial revision as well as re-proclamation in 2005. The new movement dubbed “Above the Influence” applied advertisements focusing on the needs of an adolescent for individual self-sufficiency and the affirmative outcomes of drug usage abstinence, for instance, exciting activities and pursuing goals of one’s career (Comello, 2013). “Above the Influence” impacted on girls of 8th grade, as there was increased revelation to advertisements of anti-drugs which was substantially related to the earlier month usage of marijuana or a lifetime of lower odds. Disappointingly, advertisements of anti-drugs did not seem to have any effect on the boys of eighth grade nor neither gender of both grades 10th and 12th.
Community Campaigns
Whereas the initial United States countrywide Campaign of the Media on Anti-Drug was taking place, “My Anti-Drug,” applied an in-school as well as media intervention based on community, dubbed ‘Be Under Your Own Influence’ that aimed at the autonomy goal of an adolescent. Initial interventions occurred in 16 identified communities in the U.S. and included a design of four-group (Quinlan et al., 2015). First, community-delivered media endeavors as well as in-school media emphasis of messages coupled with prevention program based on the curriculum. Second, community-delivered media endeavors together with in-school media emphasis with the lack of program based on the curriculum. Third, curriculum based on prevention program only. Fourth, Lack of treatment. The community-based campaign of the media was identified to substantially lower lifetime youth usage of marijuana at the last stage of data collection, and marijuana treatment impact became greater throughout the time (Cohn et al., 2016).
Policy Interventions
Medical laws on marijuana
Using two countrywide, United States datasets, established that states with marijuana medical laws were comprised of the earlier tear, adult marijuana consumption rates than states applying medical marijuana laws after regulating for different state-level demographics (Cerda et al. 2012). Particularly, persons above 18 inhabiting one of the states with the laws on medical marijuana before 2004 were only 1.92 folds vulnerable to have been involved in earlier year marijuana consumption when likened to adults inhabiting the states lacking the laws on medical marijuana. However, researchers never warned in contrast to concluding a causal linkage (Cerda et al., 2012). Remarkably, there were no countrywide datasets in this research to distinguish between non-medical and medical usage of marijuana in levels of usage. Thus, it indicates the outcomes, for instance, more persons can be consuming marijuana for medical reasons in those states with medical marijuana laws.
Employing data from NSDUH on a population of 23,000 and over among 12 to 17 years old, a comparison of the earlier month marijuana usage in states that have implemented medical marijuana laws and those without was analyzed. The outcomes showed that high intensities of usage characterized countries with medical marijuana laws and lower intensities of sensitivity to harm compared to states that lack these laws. Besides, using similar statistics, a reproduction and postponement established that the moment state-level impacts were accounted for in the study, adolescent marijuana consumption appeared to lower due to the passage of medical marijuana laws (Harper et al., 2012). However, medical marijuana laws had no influence on the sensitivity of harm. According to the researchers, the earlier outcomes that medical marijuana laws increase the rates of adolescent marijuana usage were due to the confounding results. Thus, those states that pass medical marijuana laws vary in some unmeasured means linked to marijuana usage from the states that do not (Wall et al., 2016).
Criminalization as well as other National Policies
With regards to multicultural examination of marijuana usage trends and usage courses among veteran marijuana users, there is no substantial variation between Netherlands (Amsterdam) and United States (San Francisco) in age of earlier usage, age of starting steady usage or time for regular usage or usage patterns among experienced users of marijuana (Volkow et al., 2014). However, according to the researchers, if decriminalization against criminalization policy is instrumental in limiting the usage, then experienced marijuana users would have long-term usage courses in Amsterdam as opposed to San Francisco. The researchers proposed that unofficial etiquette such as use mostly with friends and in moderation as well as usage for relaxation can be a major influence of marijuana trends of usage and courses than federal or state guidelines. The verdicts are almost similar to that of (Li et al., 2016) who established that the rates of usage of marijuana could be linked to the rigidness of the national rules among the youths in a comparison done in Netherlands, Canada, and U.S. (Volkow et al., 2014).
Interventions based on Supply/Demand Reductions (Incorporating Price)
With the use of data from adolescents reaching 80,000 and beyond from 31 nations, Piontek et al., (2013) established that national level endeavors at regulating distribution and demand could affect personal-level usage of marijuana over as well as above the effect of personal-level programs of prevention. However, applying non-user viewpoints of accessibility as an alternative regulation for supply as well as non-user viewpoint of detriment as an alternative regulation for demand, the authors established that inhabiting in a nation where majority of non-users see great levels of accessibility and decreased levels of harm; raises the probability of personal marijuana usage, irrespective of the personal-level viewpoints. Nonetheless, national level policies on supply and demand can affect usage; the effect of price particularly on the earlier year marijuana usage has shown unreliable outcomes. But, a meta-analysis usage of price elasticity approximates, as stated by Kilmer and Burgdorf (2013) resolved that marijuana usage is largely less reactive to price fluctuations, with a forecasted elasticity of price which is almost half rest of other illicit substances for instance heroin and cocaine.
Resources to Implement Strategies
The relevant resources to assist in the non-medical usage of marijuana include the Web sites of NIDA, private organizations, and Federal agencies where vital information on the non-medical use of marijuana can be obtained. The resources are important sources of data to assist communities to design and implement a research-based prevention program on the non-medical use of marijuana.
Challenges
The treatment of medical marijuana laws as a dichotomous measure that is the states accepting medical marijuana usage or disallowing medical marijuana usage complicates significant policy differences. Such policies include patient Archives, permission for home farming, permission of medical marijuana as recommended for control of medical dispensaries and general diagnosis of pain that can affect recreational usage (Pacula et al., 2013). Thus, medical marijuana laws should consider the quantity and types of regulations the state channels on the supply, cultivation and possession of marijuana for medical purposes. When accounting for medical marijuana laws, communities and states have applied different extra policies, laws, and ordinances to inhibit accessibility locally. For instance, zoning limitations including controlling dispensaries to commercial or industrial zoning districts, distancing dispensaries from schools and places those below the age of 21 meet as well as developing policies for the dispensaries (Quinlan et al., 2015).
Research using NSDUH information to analyze the effect of medical marijuana laws are obliged to apply two-year approximations that disallow for exact analysis of the effect of the law, and the timeframe in which associated rules are applied (Harper et al., 2012). Though the value and accessibility of prevailing information are usually a distress when examining environmental approaches (Pettibone et al., 2012). Prospective studies should consider the usage of substitute sources of information to triangulate outcomes and add extra views, for instance, marijuana associated arrests for cultivation, treatment admission information, distribution as well as usage and emergency room information (Harper et al., 2012).
Maybe just as important as what is available in the existing literature is what is lacking. Due to the wide difference in norms of the culture, laws of the country and local policies regarding marijuana usage, the prevention sector is lacking some consensus on what method of non-medical usage of marijuana is challenging, for whom as well as on what basis. Rates of marijuana usage and relationships of marijuana usage resulting from certain countrywide research do not justify for marijuana usage as lawfully recommended for medical reasons, for instance, the Countrywide Survey on Drug Consumption and Wellbeing. Thus, it results to confound in an attempt to scrutinize the effect of laws on medical marijuana and other related policies regarding medicinal usage on rates of general consumption.
Contradicting operational descriptions create a substantial difficulty in the logical criticism of works about the non-medical usage of marijuana. Thus, this area of research would much benefit from addressing the challenges. Available literature is affected by the absence of information on protective elements linked to the non-medical use of marijuana and an equivalent lack of data on intercessions intended to enhance such elements. Besides, the literature has majorly depended on the dichotomous usage of regulations, for instance, lifetime usage, which can prevent linkage between environmental approaches and the regularity of marijuana usage and advancement onto addiction. Lastly, few journals explain for the probably distinguishable impacts of approaches on non-users against users. Assessment study is as well required for policies beyond medical marijuana laws; other environmental approaches applied at the local or state level and strategies for enforcing marijuana. In the case of United States policy, future study should be conducted beyond a mere assessment of whether either have or not have medical marijuana laws to assess the variations in medical marijuana laws.
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