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Co-use was relatively stable across the different periods. Writing in the journal of Addictive Behaviors, the researchers said that the evolving trends in use of the two substances could be evidence of a substitution effect amid changing harm perceptions, evolving legislation, and shifting norms. The rising cannabis-only use across groups parallels the expanding state-level recreational cannabis legalization, increasing accessibility and normalization, the paper says

46 Strengths and Limitations In terms of strengths, a systematic approach was used in the two reviews that we synthesized, with extensive searches carried out to identify relevant studies

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