On the heels of a new government-commissioned report that calls on federal agencies to take a more active role in providing guidance to state-level marijuana markets, authors said in an online presentation on Thursday that officials need not wait for Congress to enact any cannabis reform legislation to start taking steps to better protect public safety and minimize harm.
“Most of the recommendations that we make…are not regulatory in nature,” Steven Teutsch, a public health researcher and professor in Southern California who co-edited the report, said in response to a question from Marijuana Moment.
“They require getting information, they require the funding to provide the research resources to do the work that we’ve identified,” he said—but most don’t require any action from federal lawmakers.
“Basically these agencies need to take up these roles, and they need to be allowed to do that,” Teutsch explained, urging what he described as “a change in the basic approach to the federal role in cannabis.”
Teutsch and others spoke as part of an event publicizing a new, 341-page report by the National Academies of Sciences, Engineering, and Medicine (NASEM) that takes a broad look at the U.S. marijuana market. It lays out a number of policy recommendations around health and safety matters, research, criminal justice and social equity.
For example, it calls on the U.S. Centers for Disease Control and Prevention (CDC) to develop both targeted public health campaigns and establish “best practices for protecting public health” in states that have legalized marijuana.
It also advises that CDC begin centrally tracking state-level marijuana information more closely with “an adaptable public health surveillance system for cannabis, capturing a range of data from cannabis cultivation and product sales to use patterns and public health impacts,” and calls for a shift in research priorities to focus more on public health outcomes related to legalization, including efficacy of tests to determine cannabis impairment and health effects of new and emerging products.
“States have received little federal guidance on how to proceed regarding the health impact of cannabis on the public and communities,” the NASEM report says. “Other than two memoranda deferring to states”—guidance that was rescinded under the Trump administration—“the federal government has been noticeably missing from this dialogue.”
In fact, the federal government’s position on cannabis has actually set back state-level attempts to protect safety, the NASEM report asserts.
“Because cannabis is illegal federally, the federal government has had minimal involvement in cannabis policies within the states,” it notes. “The limited federal guidance on cannabis has focused on its sale—not on public health. Further, federal policies have complicated the efforts of state governments to develop cannabis policies that protect public health.”
At Thursday’s webinar, authors drew attention to highlights of the report’s findings as well as top-level recommendations. In response to a question from Marijuana Moment, Teutsch noted that nearly all of the advised actions can be taken now, without waiting for rulemaking processes action by Congress.
One exception is action the NASEM report advises changes around federal control of intoxicating hemp-derived cannabinoids. Authors said federal lawmakers should take action to close so-called “loopholes” in federal law around the products, which exploded onto the market—even in states where marijuana remains illegal—following the 2018 Farm Bill’s legalization of hemp.
Notably, the NASEM panel wasn’t tasked with taking a position on legalization or cannabis rescheduling, nor was it charged with comprehensively evaluating the health effects of marijuana consumption.
One main takeaway from the report is that most regulatory focus has been around sales and commerce rather than on public health. Rosalie Pacula, a University of Southern California health policy professor and a member of the NASEM committee behind the report, emphasized that the federal illegality of cannabis may be a contributing factor.
“Due probably to the federal prohibition,” Pacula said during the webinar, “the federal government has not provided adequate guidance on public health issues related to cannabis legalization within the states, leading to inconsistent state-to-state regulations that often prioritize commerce over public health objectives.”
“Other countries,” she added, “have adopted centralized regulatory approaches to cannabis that do a better job of prioritizing public health through stricter controls on access, availability and products safety while still enabling commerce.”
Pacula and others also spoke about the report’s findings that legalization has diminished illegal cannabis sales—at least in some jurisdictions.
“There’s a trend away from the illicit market in states that have legalized cannabis either medically or for adult purposes,” Pacula said, but data on this are not entirely conclusive.” While consumers in legal states are significantly less likely to buy marijuana from an illegal source, she explained, there’s also “some evidence that illicit production has grown in legalized states, although it’s unclear if it’s uniquely in particular states or a consistent trend.”
Beau Kilmer, a member of the NASEM committee that authored the report as well as the co-director of the RAND Corporation’s Drug Policy Research Center, noted that some states are still dealing with illegal retailers despite having a legal system.
“California’s been dealing with this,” Kilmer noted, and “at one point it was estimated that there were over 1,000 illegal cannabis retailers in New York City alone.”
Another market trend Pacula pointed to was the steady fall in price for marijuana products—a dynamic that both can provide benefits and raise concerns.
There’s been a “significant decline in the price per unit of delta-9 THC,” Pacula said, “and it’s been declining over the entire period of liberalization policies, with a slight exception of during COVID-19.”
“Declining prices have important implications for many of the topic discussed in legalization debates,” she added, “whether you’re concerned about cannabis consumption, purchases made in the illicit market, tax revenue that is available from legal markets, as well as the profitability of cannabis businesses, which has important implications for social equity considerations.”
The report, Cannabis Policy Impacts Public Health and Health Equity, was commissioned by CDC and the National Institutes of Health (NIH), which asked the committee “to recommend a harm reduction approach to cannabis policy and set a policy research agenda for the next 5 years.”
Earlier this year, a NASEM meeting convened state and local regulators from across the country to discuss social equity efforts. It was the third meeting of the Committee on Public Health Consequences of Changes in the Cannabis Policy Landscape following a pair of earlier gatherings to discuss other policy issues.
An earlier meeting, held in November, took up a variety of other regulatory matters around local control, the persistence of the illicit market, gaps that have allowed unregulated businesses to thrive, market trends in countries where cannabis is legal and corporate and celebrity backing of legal marijuana.
The committee’s first meeting, in September, featured representatives of several federal agencies who weighed in on evolving cannabis policies.
Meanwhile at the federal level, some lawmakers are beginning to consider a number of possible actions to rein in largely unregulated sales of intoxicating hemp-derived cannabinoids. This week Sen. Ron Wyden (D-OR) introduced a new bill that would create a federal regulatory framework for hemp-derived cannabinoids, for example, allowing states to set their own rules for products such as CBD while also empowering the Food and Drug Administration (FDA) to ensure that certain safety standards are met in the marketplace.
On the heels of a new government-commissioned report that calls on federal agencies to take a more active role in providing guidance to state-level marijuana markets, authors said in an online presentation on Thursday that officials need not wait for Congress to enact any cannabis reform legislation to start taking steps to better protect public Read More