As the marijuana legalization movement has expanded—and psychedelics policy has increasingly entered the mainstream conversation—a new survey shows that Americans don’t view cannabis and LSD as harmful as they once did.
A new analysis of the National Survey of Drug Use and Health (NSDUH), conducted annually by the federal Substance Abuse and Mental Health Services Administration (SAMHSA), found broadly that “perceptions of harm associated with substance use have been steadily declining for most substances since 2015.”
That’s especially true of marijuana, the review from the consulting firm Carnevale Associates, LLC explains. While risk perception has declined across multiple substances over the past decade, it was down “considerably” for cannabis—though the survey revealed “slightly more variability from year to year.”
“From 2015 to 2023, the NSDUH shows steady (i.e., regular, yearly) declines in perceptions of harm across ‘frequent’ and ‘less frequent’ use for cigarettes, heroin, LSD, and cocaine,” the firm, which was founded by a former top staffer in the White House Office of National Drug Control Policy, said. “Marijuana’s decline was the largest of any substance over the period (-30 percent for both types of use), though it showed very slight variability by year.”
Notably, perceptions of harm for the psychedelic LSD “experienced the largest decline over the period for more frequent use (-14 percent) and less frequent use (-20 percent),” it said. “For cigarettes, heroin, LSD, and cocaine, diminishing perceptions of harm were slightly more pronounced among youth and young adults.”
“The changing perceptions of harm associated with LSD illustrate the pattern,” the report continued. “For trying LSD once or twice, overall perception of harm decreased -20 percent. By age group, perception of harm declined by 19 percent among adults aged 26+, 23 percent among youth aged 12-17, and by 31 percent among young adults aged 18-25.”
For marijuana, risk perceptions for monthly and weekly use both decreased by 30 percent from 2015 to 2023.
“Perceptions of harm associated with substance use have been steadily softening for many years. This softening is apparent across most substances and age groups,” Carnevale Associates said. “Since perceived risk of harm is often considered a leading indicator of substance use trends, policymakers and practitioners should continue to monitor substance use trends closely.”
While it is the case that risk perception is often associated with usage trends, it should be noted that, for cannabis at least, that hasn’t always borne out in the data.
Despite prohibitionist warnings about lower perceptions of harm potentially leading more underage people to use marijuana, multiple national surveys have found that, even as that sense of concern about health impacts has declined, rates of cannabis use have been stable, or even declined, among teens—including in states that have enacted legalization.
To advocates, that isn’t an especially surprising finding, as supporters of legalization have long argued that establishing a regulatory framework for marijuana sales where there are safeguards in place (e.g. age restrictions and ID checks at licensed retailers) would mitigate youth access.
A study published in the journal Pediatric Reports in October revealed a “significant decrease” in youth marijuana use from 2011 to 2021—a period in which more than a dozen states legalized marijuana for adults—detailing lower rates of both lifetime and past-month use by high-school students nationwide.
In Washington State—the second state in the country to launch an adult-use marijuana market—data from a recent survey of adolescent and teenage students found that perceived ease of access to cannabis among underage students has generally dropped since the state enacted legalization for adults in 2012. That survey also showed overall declines in both lifetime and past-30-day marijuana use since legalization, with striking drops in recent years that held steady through 2023.
