More than half of all states in the United States have legalized marijuana, whether for medical, recreational, or both purposes. Cannabis dispensaries have an ever-growing selection of gummies, drinks, and joints on their shelves.
Meanwhile, the federal government still considers most types of cannabis to be illegal.
A new report released this week by the National Academies of Sciences, Engineering, and Medicine finds that this disconnect between states and the federal government has led to policy fragmentation and risks to the public.
As states created new commercial markets for cannabis, they initially focused on regulating sales and revenue. “As a result, the public health aspect has often been left on the back burner, and we're now trying to pick that up,” said the National Academies, which authored a report on cannabis' public health impacts. said Dr. Stephen Teutsch, chairman of the committee.
The report calls for federal leadership and national standards on cannabis quality and potency to protect public health.
Here are five takeaways.
1. People consume more cannabis than alcohol on a regular basis in the United States
More U.S. adults reported using marijuana than alcohol most days in 2022, according to the National Survey on Drug Use and Health. It was the first time that regular marijuana use exceeded regular alcohol use.
Regular cannabis use has skyrocketed over the past 30 years, from fewer than 1 million people reporting near-daily use in 1992 to more than 17 million in 2022.
Cannabis has become more accessible as it has gained legal status in many states. About two-thirds of people over the age of 12 think it is “fairly easy” or “very easy” to obtain cannabis. And prices have also fallen in terms of the price per unit of delta-9-tetrahydrocannabinol (THC), the main compound responsible for psychoactive effects.
2. Cannabis and e-cigarettes can be very potent, but it's not always disclosed
The concentration of THC in cannabis flower has increased over time. “I think most people are aware of the phenomenon of, 'This isn't your grandfather's marijuana'…I always talk about this,” Stacey Gruber of Harvard McLean Hospital told NPR in 2019. “I listen to it,” he told NPR.
And while smoking dried cannabis flower remains the way most people consume cannabis, cannabis edibles, vape oils and other products are on the rise, says director of Mount Sinai's Institute of Addiction Research. said Dr. Yasmin Hurd, vice chair of the NASEM committee. .
“There are now concentrates like dabs, waxes, and shatters that contain very high concentrations of THC, even in the 60% to 90% range,” she says. Hurd spoke Thursday at a press conference announcing the release of the report.
Higher THC levels make it more likely that people will ingest more THC than they intended, which has led to an increase in car accidents and hospital visits related to cannabis use, Hurd said.
Many states where cannabis use is legal have limits on the amount of THC in gummies and other edibles, but those rules do not apply to other cannabis products, according to the report. It is said that there are many
3. Psychoactive hemp products are available even in states where marijuana is illegal.
Cannabis is classified as a Schedule I substance by the U.S. Drug Enforcement Administration, meaning the federal government considers it to be a drug with a high potential for abuse and no accepted medical use.
Thanks to the 2018 Farm Bill, which defined a portion of cannabis as hemp and exempted it from the Controlled Substances Act, products containing hemp-derived chemicals are experiencing a boom. These contain CBD and delta-8 THC, a psychoactive compound extracted and synthesized from CBD, and can be sold even in states that have not legalized cannabis.
Some of these chemicals are processed to enhance their psychoactive properties, but these evade regulation. U.S. health officials from the CDC and FDA have warned of health and safety risks.
The report recommends that Congress close this loophole by specifying that all intoxicating forms of cannabis, including those derived from marijuana, are subject to regulation.
4. Cannabis research is being suppressed
Scientific research into the health effects of cannabis has made little progress in recent years due to significant barriers to research into this drug.
Because cannabis is classified as a Schedule I substance, researchers often cannot obtain it for their studies. Even if they could do that, they would have to deal with all sorts of strict regulations.
The White House Office of National Drug Policy is not authorized to study the effects of marijuana legalization, even though many states have already legalized it.
Earlier this year, the DEA proposed reclassifying marijuana as a Schedule III drug, similar to ketamine. It is a drug with accepted medical uses, low to moderate potential for abuse, and few restrictions.
The report also recommends that Congress remove restrictions on the Office of National Drug Policy's research.
5. Cannabis can be dangerous, but people hear more about its benefits than its risks
Once cannabis is legalized, Hurd says, people tend to think it's less dangerous.
However, many people are not fully informed about the potential harm. “The risks associated with THC intake, including psychosis, suicidal ideation, and cannabis use disorder, increase as the dose increases,” Hurd says.
Now that more children and young people are exposed to pro-cannabis messages through advertising, the cannabis industry lobby is becoming increasingly influential, such as efforts to limit THC levels in Washington and cannabis farms in Colorado. has been successful in crushing efforts to limit the use of pesticides. According to the report.
“We really need to address cannabis in a public health framework,” Dr. Pamela Ring, director of the UCSF Center for Tobacco Control Research and Education, wrote in an email after reviewing the report at NPR's request.
“The good news is we don’t have to start from scratch. We have developed tobacco control and alcohol best practices that can be applied to cannabis, particularly with regard to marketing restrictions, age restrictions, retail environments, taxes, and ways to reduce youth access.” I have models from,” she says.
The report also recommends public health campaigns to explain the risks, especially to children, young people, pregnant people and the elderly. It also requires training cannabis retail staff to speak knowledgeably about the risks and benefits to customers.
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