SAFE GC Coalition: Understanding Public Health Impacts of Cannabis

According to Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), the greatly increased availability of cannabis over the last two decades has outpaced our understanding of the public-health impacts of the drug. It is now available for medical purposes in most states, and adults may now purchase it for recreational use in nearly half the states. With greater availability has come decreased public perception of harm, as well as increased use. Research on cannabis and cannabis policy is needed to guide individual and public health decision-making.

The National Survey on Drug Use and Health reported that between 2012 and 2019, past-year use of cannabis among people 12 and older rose from 11 percent to over 17 percent, and although trend comparisons aren’t possible because of changes in the survey’s methodology, in 2022, nearly 22 percent of people had used the drug in the past year. Very steep increases are also being seen in the number of people 65 and older who use cannabis.

At the same time, the cannabis industry is producing an ever-wider array of products with varying and sometimes very high concentrations of delta-9-tetrahydrocannabinol (THC). Harms from cannabis use are associated with regular consumption of high-THC doses. And there are many other intoxicating products available to the public, some containing other cannabinoids about which we still know very little.

To create a roadmap for research in this space, NIDA along with the National Center for Complementary and Integrative Health (NCCIH), the National Cancer Institute (NCI), and the Centers for Disease Control and Prevention (CDC), sponsored an independent consensus study by the National Academies of Sciences, Engineering, and Medicine (NASEM) that generated a report that describes in detail the different regulatory frameworks that exist in different states, and it draws on prior research to identify policies that are likeliest to have the greatest impact protecting public health. Those include approaches like restrictions on retail sales, pricing, and marketing; putting limits or caps on THC content in products; and laws about cannabis-impaired driving. They also could include different forms of taxation and even state monopolies. While state monopolies have not yet been tried with cannabis, they have proven effective at reducing the public health impacts of alcohol.

To date, researchers have yet to draw conclusions about the impacts of legalization or the different ways it has been implemented. People are consuming cannabis more and in a wider variety of ways, and there is some evidence of increases in emergency department visits due to accidental ingestion, car accidents, psychotic reactions, and a condition of repeated and severe vomiting (hyperemesis syndrome). Researchers are hindered in their further understanding because policy details vary so much between states and because data are collected and reported in so many different ways, making interpretation difficult.

Consequently, the report enumerates recommendations for research that should be conducted by federal, state, and tribal agencies to provide greater clarity and inform policy, including several domains within the purview of the NIH.

• More detailed information is needed on health and safety outcomes associated with specific policy frameworks.
• More data is needed on outcomes associated with different regulations for how cannabis products are sold and marketed, whether they can be used in public spaces, and whether more restrictive rules about how cannabis can be sold, such as those existing in other countries
• States develop approaches to promote health and social equity, including programs to expunge or seal records of cannabis offenses and preferential licensing for individuals or groups most adversely impacted by the disparities in criminal penalties
• More research is needed on the health effects of cannabis use by specific groups like youth, pregnant women, older adults, and veterans, and on its effects in individuals with various medical conditions for which medicinal cannabis might be used.
• Studies are needed on health effects -positive and negative-of the high-potency and synthetic or semi-synthetic cannabinoid products that are emerging.
• Improved surveillance of cannabis cultivation, product sales, and patterns of use
• Improved tests for detecting cannabis impairment.

Unlike alcohol, THC remains in the body long after its psychoactive effects have worn off. Unlike commonly used alcohol sobriety tests, blood tests for cannabis that are currently widely used in law enforcement and employment screening cannot distinguish between recent or past use. Better surveillance and improved tests can inform research on interventions to mitigate risks to health and safety associated with cannabis use. They can also help inform the development of cannabis product safety and quality standards.

SAFE is the only alcohol and substance use prevention agency in Glen Cove whose mission is to eliminate alcohol and substance use in Glen Cove. Its Coalition is concerned about cannabis use- especially in youth as their brains are developing. The Coalition is conducting a prevention awareness campaign entitled “Keeping Glen Cove SAFE; Underage Cannabis Use,” to educate and update the community regarding cannabis use and its negative consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovecoalition or visit SAFE’s website to learn more about Cannabis/Marijuana use at www.safeglencove.org.