To safeguard public health, let science guide marijuana legalization

The lesson we have learned all too well from the COVID-19 pandemic is to “follow the science” when formulating health policy. Yet, science is unfortunately taking a back seat as state houses across the country hastily approve marijuana legalization laws.

Last month, for example, legalization in New York State coincided with the publication of a new study by the National Institute on Drug Addiction (NIDA) showing that, among teenagers, cannabis can be nearly as addictive as prescription opioids — a finding that failed to compel Albany lawmakers to strengthen safeguards. 

As more and more states line up to legalize, a closer look at the New York law reveals how legalization is weighted in favor of the increasingly powerful cannabis industry — rather than protecting vulnerable populations, including young people. While the law does focus on such worthy goals as marijuana decriminalization and achieving social equity and criminal-justice reform — in addition to helping communities disproportionately harmed by the failed War on Drugs — it is weak on regulating the soon-to-boom marijuana market.

Adolescents are particularly at risk: The NIDA study in JAMA Pediatrics shows that nearly 11 percent of children ages 12 to 17 met the criteria for addiction just a year after first trying marijuana. That’s about the same rate as those who try prescription opioids — the drug fueling the opioid epidemic and tragic surge in overdoses. In other words, there’s a growing body of compelling evidence showing that cannabis isn’t as benign as legalization supporters claim. 

Nevertheless, one could argue that legalization measures do more to promote marijuana consumption than hinder its use and keep kids from spiraling into substance misuse. New York, for instance, sanctions home-delivery services — which could open the door for underage purchases — and on-site consumption “lounges,” wherein consumers can seemingly indulge in unlimited quantities. 

Equally troubling is the failure to place any curbs on the high levels of intoxicating THC, the psychoactive component of marijuana found in many of today’s extremely powerful marijuana products. With concentrations rising to as high as 80 percent or more, this can cause hallucinations and blackouts. New York taxes such products at a higher rate, but that’s hardly a disincentive to consumers.

Limits would be prudent, considering what is happening in Colorado, which legalized in 2014. Amid growing concerns in the state, particularly among physicians, about teenage access and the alarming spike in young patients experiencing psychotic episodes after using the drug, lawmakers there are considering a cap on such potent concentrates — a move vehemently opposed by cannabis businesses.

Drugged driving also gets a pass in New York, despite the fact that many legalized states have seen a correlation with increased fatal car crashes involving THC-impaired drivers (in Washington State, the percent of drivers doubled since legalization in 2012). It’s still illegal to drive while high in New York. Yet, lawmakers merely asked state health officials to study the problem and figure out a better way for law enforcement to detect when a driver is drugged, as no breathalyzer-type device as of yet exists. 

The market for medical marijuana is also expanding in New York, following industry complaints that previous rules were too restrictive. The list of conditions under which a person can qualify for a medical marijuana card now includes Alzheimer’s disease, although we are still at a very early stage of clinical research to determine whether pot is an effective treatment for this devastating illness.  

For all these reasons, states that are now considering legalization have an obligation to pay attention to the evolving science of marijuana and craft sensible laws that reduce misuse and harm. Decriminalizing marijuana and advancing restorative justice are of critical importance, but not at the expense of our health and safety. 

Mitchell S. Rosenthal, M.D., is a psychiatrist who founded Phoenix House, the national substance abuse treatment organization, and is now president of The Rosenthal Center for Addiction Studies in New York City.