Six policy lessons relevant to cannabis legalization

ABSTRACT

Background: Cannabis (marijuana) has been legalized for recreational and/or medicinal use in many US states, despite remaining a Schedule-I drug at the federal level. As legalization regimes are established in multiple countries, public health professionals should leverage decades of knowledge from other policy areas (e.g., alcohol and tobacco regulation) to inform cannabis policy.

Objectives: Identify policy lessons from other more established policy areas that can inform cannabis policy in the United States, Canada, and any other nations that legalize recreational cannabis.

Methods: Narrative review of policy and public health literature.

Results: We identified six key lessons to guide cannabis policy. To avoid the harms of “a medical system only in name,” medical cannabis programs should either be regulated like medicine or combined with the recreational market. Capping potency of cannabis products can reduce the harms of the drug, including addiction. Pricing policies that promote public health may include minimum unit pricing or taxation by weight. Protecting science and public health from corporate interest can prevent the scenarios we have seen with soda and tobacco lobbies funding studies to report favorable results about their products. Legalizing states can go beyond reducing possession arrests (which can be accomplished without legalization) by expunging prior criminal records of cannabis-related convictions. Finally, facilitating rigorous research can differentiate truth from positive and negative hype about cannabis’ effects.

Conclusion: Scientists and policymakers can learn from the successes and failures of alcohol and tobacco policy to regulate cannabis products, thereby mitigating old harms of cannabis prohibition while reducing new harms from legalization.

KEYWORDS:

• Public health
• policy
• legalization

Financial disclosures and funding information

The authors report no conflicts of interest. The authors were supported by the National Institute on Drug Abuse, the Veterans Health Services Research and Development Service, and Stanford Neurosciences Institute. Research reported in this publication was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Number DA035165. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Funding

Chelsea L. Shover was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number T32 DA035165. Research reported in this publication was supported by the National Institute The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Keith Humphreys was supported by a Senior Career Research Scientist Award from the Veterans Health Administration, Stanford Neurosciences Institute, and the Esther Ting Memorial Professorship at Stanford University. Any views expressed are the responsibility of the authors and do not necessarily reflect policy positions of their employers. The authors report no relevant financial conflicts.