Rates of cannabis initiation, use and abuse are not necessarily higher in communities which have decriminalized, in part or full, the possession or use of illicit substances (21, 43, 44), nor are rates lower, in countries such as the United States, which have severe penalties for possession and use (45). Cannabis use in the Netherlands, where possession of small amounts is legal, is lower than in neighbouring countries with stricter laws. In 2000, the lifetime prevalence among young adults was 45% in Denmark, 40% in France, 31% in Germany, and 43% in the UK compared to 32% in the Netherlands (46). Similar to the US general population (47, 48) lifetime cannabis use among Virginian twins is 50% to 56% in males (49) and 46% to 53% among females (37).
