A new study from the Substance Abuse and Mental Health Services Administration provides an in-depth examination of marijuana use in the United States, as well as data regarding the public’s perception of the risks associated with the drug.

Using data collected by the National Survey on Drug Use and Health from 2012 to 2014, SAMHSA analyzed various regions around the country and within states to determine the rates of marijuana use and “perceptions of risks of harm” associated with the drug’s use in different parts of the U.S.

“This report provides a very detailed understanding of marijuana use and perception patterns in communities across the nation,” said Fran Harding, Director of SAMHSA’s Center for Substance Abuse Prevention. “This information can help public health officials and others better gauge the marijuana-related prevention and treatment needs in their communities and fine-tune their programs and services to best address them.

“What really is the strongest message that we hope people take from this is the connection between perception of risk and how that, in turn, dictates the use rates,” she said. “Our prevention programming is through what we call a ‘risk and protection framework.’ So if there is high perception of risk there is going to be a lower use rate. The lower the perception of risk, the higher the use rates are."

According to the study, 20.3 million people age 12 or older used marijuana in the past month, or approximately 1 in 13 people over the age of 12.

Although the federal government still classifies marijuana as a Schedule I drug, many states have begun to make changes to their cannabis laws. Alaska, Colorado, Oregon, Washington and the District of Columbia are currently the only states with legalized recreational marijuana, but 23 states and the District of Columbia have legalized forms of medical marijuana while an additional 14 have taken measures to decriminalize the drug.

The report comes several months ahead of the November elections, where eight states will have the option to legalize either recreational or medical cannabis. Five states — Arizona, California, Maine, Massachusetts and Nevada — are pursuing recreational marijuana, while three more — Arkansas, Florida and Missouri — could legalize medicinal cannabis.

Breaking their study into several regions — West, Northeast, Midwest and South — SAMHSA identified several states with multiple high use substate regions. Among those identified were Alaska, California, Colorado, Maine, Massachusetts, Oregon, Rhode Island, Vermont, Washington and the District of Columbia. Rhode Island and Vermont are the only two of those states to have either not legalized recreational marijuana or not have it on the ballot in 2016.

In spite of the increasingly relaxed marijuana laws, the SAMHSA study also found that approximately 74.9 million people aged 12 or older “perceived great risk of harm” from using marijuana once a month, or approximately 2 out of every 7 people above the age of 12.

The states with the highest percentages of perception of risk were all from the South — Alabama, Arkansas, Florida, Kentucky, Louisiana, Mississippi and Texas. Alabama, Louisiana and Texas were among the states with the lowest use rate. The states with the lowest perception of risk include high marijuana use areas like Oregon, Washington and the District of Columbia.

“In the area of the country where they are reporting a high perception of risk, the data for use is very low,” said Harding. “It makes sense. If you are in a high-risk area for tornados, for instance, you are going to be well prepared for those kind of tragedies.”

According to Art Hughes, a statistician with the Center for Behavior Health Statistics and Quality with SAMHSA and one of the author's of the report, the numbers are fairly in line with previous incarnations of this study.

“We do this study every two years and update it. Every other year, we put together three years of data…We didn’t really see any surprises.”

As the drug laws and marijuana use rates continue to evolve and fluctuate on a state-by-state basis, SAMHSA hopes to provide specialized tools and programs for people to inform themselves about the drug and how to obtain help if need be. The educational resources they are developing would be available to parents, teens, schools, behavioral health professionals and more. The information would cover a variety of topics and would cover more substances than just marijuana.

“In our business, if we can bring more education and awareness to the dangers of marijuana and the dangerous effects on developing young people’s brains, the use rate should go down,” explained Harding.

“We don’t advise one specific program, but we do argue for a strategic prevention framework,” she continued. “It is a process where you do an assessment and find your areas of risk and low-risk, you implement the program that is made specifically for the area you are targeting, then you examine it and do it again.”

“It almost doesn’t matter what drug we are targeting. We just need people to know the facts.”