In 2012, Colorado became one of the first states to legalize recreational marijuana through Amendment 64, setting a precedent that Missouri followed with its own legalization in 2022. While proponents of marijuana legalization promised economic boosts and social progress, Colorado’s experience reveals a more troubling reality. As Missouri navigates its early years of legal cannabis, data from Colorado highlights significant health risks, economic challenges, and social consequences that demand attention. This article explores the negative impacts of marijuana legalization in Colorado, offering critical lessons for Missouri residents, policymakers, and communities like Chariton County.
Health Risks: Rising Hospitalizations and Mental Health Concerns
One of the most alarming outcomes of marijuana legalization in Colorado is the surge in health-related issues, particularly in emergency departments and hospitals. According to the Colorado Department of Public Health and Environment (CDPHE), marijuana-related hospitalizations skyrocketed from 575 per 100,000 in 2000 to 2,413 per 100,000 by 2014–2015, a fourfold increase following legalization. Emergency room visits for cannabis-related issues, including acute intoxication and cannabis hyperemesis syndrome (CHS), tripled in the same period, straining healthcare systems. CHS, characterized by severe nausea and vomiting, saw a near-doubling of cases in Denver-area hospitals, with patients often requiring costly diagnostic tests and treatments.
“Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado,” notes a 2019 study published in the Western Journal of Emergency Medicine.
Mental health impacts are equally concerning. A 2022 CDPHE report found an 89% increase in ER visits for cannabis-related psychosis since legalization, with the largest spike among 15–19-year-olds. Studies, including one from the University of Colorado Boulder, link heavy cannabis use to increased risks of psychosis, depression, anxiety, and suicidality, particularly among adolescents and young adults whose brains are still developing. A 2019 study of 49,321 Swedish men showed that frequent cannabis use correlated with a 38% higher risk of welfare dependence and unemployment, suggesting long-term mental health and social impacts.
For Missouri, these trends raise red flags. Legalization has increased access to high-potency THC products, such as edibles and vapes, which are linked to cannabis use disorder (CUD). A 2023 study from Johns Hopkins noted that CUD affects up to one-third of near-daily users, with six million Americans experiencing symptoms ranging from mild to severe. Missouri’s rural communities, like those in Chariton County, may face heightened risks as access to potent cannabis grows, potentially overwhelming local healthcare resources.
Economic Costs: A Modest Gain with Hidden Expenses
Proponents of marijuana legalization often tout tax revenue as a major benefit, but Colorado’s experience suggests the economic picture is far from rosy. While the state collected $2.38 billion in marijuana tax revenue from 2014 to 2023, this accounts for only 0.98% of the state’s 2021 budget, a modest contribution dwarfed by associated costs. A 2020 report by the Centennial Institute at Colorado Christian University estimated that for every dollar in tax revenue, Colorado spends approximately $4.50 mitigating legalization’s effects, including healthcare, law enforcement, and regulatory expenses.
“Marijuana tax revenue represent approximately nine-tenths of one percent of Colorado’s FY 2018 budget,” according to the Rocky Mountain High Intensity Drug Trafficking Area (RMHIDTA) report, underscoring the limited fiscal impact.
The economic benefits, such as job creation, are also nuanced. The marijuana industry supports about 40,257 jobs across 1,686 licensed businesses, contributing 5.4% of Colorado’s employment growth since 2014. However, this represents just 0.7% of total state employment, and many jobs are low-wage or part-time. Meanwhile, federal illegality creates banking challenges, forcing businesses to operate in cash, increasing risks of theft and fraud. Missouri, with its smaller economy, may struggle to replicate even these modest gains while facing similar regulatory and enforcement costs.
The persistence of the illicit market further undermines economic benefits. RMHIDTA reported a 1,042% increase in seizures of Colorado marijuana in the U.S. mail system from 2009–2012 to 2013–2017, indicating a thriving black market despite legalization. This illegal activity diverts potential tax revenue and burdens law enforcement, a concern for Missouri as it grapples with regulating its nascent cannabis industry.
Social Impacts: Crime, Youth, and Inequities
Legalization was pitched as a way to reduce crime and address social injustices, but Colorado’s data paints a mixed picture. While marijuana-related arrests dropped 68% from 2012 to 2019, racial disparities persist. In 2019, Black individuals faced arrest rates more than double those of Whites (160 vs. 76 per 100,000), a disparity that has not meaningfully improved since legalization. A 2019 Denver study found neighborhoods near marijuana dispensaries experienced 84.8 more property crimes annually, suggesting localized crime increases.
“This disparity has not changed in any meaningful way since legalization,” states a Colorado Department of Public Safety report, highlighting ongoing racial inequities.
Traffic safety is another pressing issue. Traffic deaths involving drivers testing positive for marijuana rose 138% from 2013 to 2020, from 55 to 131, with marijuana-related fatalities increasing from 11% to 20% of total traffic deaths. This trend raises concerns for Missouri, where rural roads in counties like Chariton are already prone to accidents, and increased cannabis use could exacerbate risks.
Youth impacts are particularly troubling. While adolescent marijuana use has remained stable (19.7% in 2013 to 20.6% in 2019 per the Healthy Kids Colorado Survey), the use of high-potency products like edibles and vapes has surged. These products, often indistinguishable from regular snacks, led to a 185% increase in marijuana-only exposures among children from 2013 to 2020. A 2021 Cato Institute study noted that heavy adolescent cannabis use is linked to impaired cognitive functioning, increased school dropout rates, and higher risks of psychotic illnesses. Missouri’s schools, already facing resource challenges, may see similar issues as legal cannabis becomes more accessible.
Homelessness also emerged as a concern in Colorado, with a 13% increase in the homeless population from 2015 to 2016, compared to a 3% national decrease. While a direct causal link to legalization is unclear, the correlation suggests social costs that Missouri communities, particularly in rural areas, may not be prepared to address.
Lessons for Missouri: A Call for Caution
As Missouri navigates its third year of recreational marijuana legalization, Colorado’s experience serves as a cautionary tale. The health risks—rising hospitalizations, mental health issues, and youth exposure—highlight the need for robust public health campaigns and stricter regulations on high-potency products. Economically, Missouri should temper expectations of a fiscal windfall, as costs for healthcare, enforcement, and regulation may outweigh tax revenue. Socially, persistent racial disparities, increased traffic fatalities, and localized crime near dispensaries underscore the need for targeted policies to protect vulnerable communities.
For rural areas like Chariton County, the stakes are high. Limited healthcare infrastructure and law enforcement resources could be strained by increased cannabis-related issues, while the allure of tax revenue may not deliver meaningful economic relief. Missouri policymakers must prioritize data collection to monitor these impacts, as Colorado’s experience shows that long-term consequences may take years to fully emerge.
“The connections between marijuana use and consequences to mental and physical health, and brain development, among other risks are often lost in conversations on legalization,” warns a 2020 study in Current Opinion in Psychology.
Missourians, especially those who opposed legalization, have reason to remain vigilant. By learning from Colorado’s challenges, the state can implement safeguards to mitigate the negative effects of marijuana legalization. For more information on cannabis impacts, visit the Colorado Division of Criminal Justice’s website or contact local health officials to stay informed.
