A recent study highlights the urgent need for cannabis policies to transition from a punitive stance to one that focuses on public health education. As cannabis legality expands across many U.S. states, the authors emphasize that the current policies, which often promote abstinence over informed use, must evolve.
Millions of individuals in the U.S. rely on cannabis for various health issues, often without adequate guidance from healthcare professionals or access to reliable information about what they are using and the possible risks involved.
In a paper released today in the American Journal of Public Health, the official publication of the American Public Health Association, researchers from the University at Buffalo underscore this troubling situation, which they attribute to a policy landscape historically influenced by political motives rather than scientific understanding.
The authors argue that a public health-oriented approach to cannabis policy is needed, contrasting it with the current enforcement-led strategies that prioritize abstinence instead of education. With the legality of cannabis advancing, they assert that the urgency for reform is growing.
“Legal cannabis is like a train barreling down the tracks, and if public health continues to just say ‘no,’ it will be left behind,” states Daniel J. Kruger, PhD, the paper’s senior author and a research associate professor in UB’s Jacobs School of Medicine and Biomedical Sciences. He is also affiliated with the university’s Clinical and Research Institute on Addictions.
Kruger advocates for a move towards harm reduction and health promotion, applying existing public health strategies to cannabis policy.
The researchers propose using the social ecological model (SEM) of public health to shape comprehensive cannabis policies. This model examines individual behaviors across various levels—such as the types of cannabis products available, their health impacts, the behaviors of users, and the social and regulatory systems surrounding them.
Distinction from tobacco and alcohol
According to the researchers, formulating cannabis policies that promote public health differs significantly from those for tobacco or alcohol.
“Unlike alcohol, which is a singular substance, cannabis contains hundreds of psychoactive compounds, each with unique effects,” Kruger explains. “It’s crucial to assess cannabinoids individually, as our understanding of their differences is still in its infancy.”
The presence of inconsistent regulations across different states complicates matters further.
“It would be beneficial to see federal policies governing cannabis that move beyond criminalization,” Kruger notes. “Currently, each of the 50 states and territories has a patchwork of rules that lack coordination. This leads to complications, such as importing products across state lines that are regulated differently.”
Even with state-regulated dispensaries, like those in New York, many cannabis users continue to acquire their products through illegal channels.
At the federal level, cannabis is categorized as a Schedule I controlled substance, suggesting a high potential for abuse and no accepted medical use, a classification that contradicts available evidence.
The researchers point out that cannabis users frequently lack accurate information regarding its effects and methods for minimizing risks. They often rely on informal advice from peers and do not typically share their cannabis use with healthcare providers.
Importance of public education
This highlight’s the necessity of public education, a point supported by a recent report from the National Academies of Sciences, Engineering, and Medicine regarding cannabis.
Kruger elaborates that essential knowledge—such as the THC content in cannabis products and appropriate dosages—needs to be conveyed to consumers. He explains that users might start with low doses and subsequently increase their intake, which can lead to adverse reactions like anxiety or panic due to the delayed effects of edibles.
The study discusses THC-O as an example where finding reliable information is challenging. Despite recommendations for safer consumption methods like vaporizing or edibles, vaporizing THC-O may emit ketene, a harmful gas linked to lung injuries similar to those from vaping.
The authors view potential shifts by U.S. regulatory bodies to reclassify cannabis from Schedule I to Schedule III as a positive development that could lead to more uniform cannabis policies across the nation.
“We need policies that are informed by scientific evidence,” concludes Kruger, “and for that, robust research and clinical trials are crucial, alongside other studies to assess cannabis usage and its impacts, aiming to enhance its benefits while minimizing risks and costs for individuals and society.”
Co-authors include Jessica S. Kruger, PhD, a clinical associate professor at UB’s School of Public Health and Health Professions, and Carlton CB Bone from Portland State University.
This research was not funded.
