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A new report by the National Academies of Sciences, Engineering, and Medicine calls for urgent federal action to address U.S. marijuana policy, warning that state legalization efforts prioritise commercial interests over public safety.

The government-sponsored research found that cannabis consumption has increased in many population groups as a result of the public perception of risk decreasing and availability increasing. In 2022, more individuals reported daily or almost daily cannabis use than alcohol use.

The THC content in products has also increased significantly. Researchers identified this as one of the biggest public health concerns related to cannabis. This is where policies often fall short.

“Cannabis policies often focus on regulating sales and revenues first, and then protecting public health,” said Steven Teutsch. He is the chair of the committee that authored the report and a senior fellow at University of Southern California’s Schaeffer Center for Health Policy and Economics.

Setting standards

The vast majority of U.S. States have legalized cannabis, whether for adult use or medical purposes. However, due to the federal prohibition and lack of options for interstate commerce, this industry has developed under a patchwork regulation.

The report states that the federal government could “assist those states that have decided to legalize.”

The study stated that the Centers for Disease Control and Prevention (CDC) should use existing tobacco and alcohol policies in order to develop best practices for protecting the public health in states where cannabis is legal. This includes “marketing restrictions and age restrictions, physical retailers and retail operating restrictions as well as taxation, price limitations, product design and measures to restrict youth access.”

The recommendations also urge state cannabis regulators adopt and enforce quality standards being developed for product safety by the U.S. Pharmacopeia.

The report states that “once the Centers for Disease Control and Prevention have developed their best practices, they should be integrated into the model legislation.”

The study also addresses hemp industry and recommends Congress refine the definition to close loopholes which have led to a “booming industry” for largely unregulated products derived from hemp, which competes against legal cannabis markets.

The committee proposed a definition that clearly states no form of tetrahydrocannabinol, or semisynthetic derived cannabinoid is exempted from the Controlled Substances Act.

Establishing safeguards

“A federal campaign to promote public health that targets those at greatest risk of negative effects of cannabis would be a great way to support public health,” said Yasmin HURD, vice chair of the committee and director of Mount Sinai’s Addiction Institute.

The study also highlights a lack in safeguards against lobbying, and raises concern about “revolving door practices” and financial entanglements that regulators and industry have in some states. Researchers cited Washington State and Colorado as examples where lobbying efforts blocked attempts to restrict pesticide usage and limit THC concentration.

Boyoung Seo is an economist who has studied the cannabis markets in Colorado, Washington and Colorado. Green Market Report States must balance generating revenue with mitigating negative social effects.

Seo said that the fact that each state has its own regulatory bodies or authorities that regulate the marijuana market likely also shaped marijuana regulation.

The report stated that due to the vast differences in state markets, the CDC should make efforts to track the effects of state legalization. The committee recommended that a public surveillance system be created to monitor cannabis sales and use patterns, as well as health impacts. The committee also stressed the need for more cannabis research and more federal support to assess how state-local cannabis regulations impact public health outcomes and equity.

The report was sponsored and funded by several federal agencies, including the Centers for Disease Control and Prevention and National Institute on Drug Abuse.