The limited relevance of drug policy: cannabis in Amsterdam and in San Francisco

Am J Public Health. 2004 May;94(5):836-42. doi: 10.2105/ajph.94.5.836.


Objectives: We tested the premise that punishment for cannabis use deters use and thereby benefits public health.

Methods: We compared representative samples of experienced cannabis users in similar cities with opposing cannabis policies-Amsterdam, the Netherlands (decriminalization), and San Francisco, Calif (criminalization). We compared age at onset, regular and maximum use, frequency and quantity of use over time, intensity and duration of intoxication, career use patterns, and other drug use.

Results: With the exception of higher drug use in San Francisco, we found strong similarities across both cities. We found no evidence to support claims that criminalization reduces use or that decriminalization increases use.

Conclusions: Drug policies may have less impact on cannabis use than is currently thought.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Drug and Narcotic Control*
  • Humans
  • Illicit Drugs / legislation & jurisprudence*
  • Marijuana Abuse / epidemiology*
  • Netherlands / epidemiology
  • San Francisco / epidemiology


  • Illicit Drugs