Background: Uruguay marks a decade since the legalization of cannabis, a milestone in its regulatory framework. Its implementation has been phased and is functioning adequately. The legal cannabis market is estimated to have grown since the implementation of the law. By 2023, the legal market covers nearly 50% of cannabis users, according to the "real" market estimation by IRCCA. While this represents a significant achievement of the law, the territorial and socioeconomic coverage remains uneven. The regulation represented an innovative policy grounded in a state-controlled model that yielded both intended and unintended effects.
Objective: This study focuses on the implications for equity in the continuity and expansion of this public policy: the unequal coverage across regions (cities vs. rural areas) and between neighborhoods with middle to upper socioeconomic status versus those with lower socioeconomic status, as one of the unintended effects of the law implementation. The relationship between these inequalities and contact with the illegal market is also explored.
Methods: Using a mixed-methods research design, we describe the access barriers that remain a challenge for cannabis regulation in Uruguay. We conducted 23 interviews with key informants and 25 interviews with frequent cannabis consumers, and a survey with frequent cannabis users (n= +400).
Results: We found that that legal cannabis does not reach the less urbanized areas and users from lower socioeconomic levels. This is partly due to the characteristics of the rigid legal framework and, additionally, to the specific traits of lower socioeconomic users, which we describe in this paper.