Recreational Cannabis

Minimizing the Health Risks from Legalization

Published in: The New England Journal of Medicine, , v. 376, no. 8, Feb 2017, p. 705-707. DOI: 10.1056/NEJMp1614783

by Beau Kilmer

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This article was published outside of RAND. The full text of the article can be found at the link above.

Research Question

  1. What public health and regulatory decisions should policymakers be aware of when considering whether to legalize recreational marijuana?

The cannabis-policy landscape is undergoing dramatic change. Although many jurisdictions have removed criminal penalties for possessing small amounts of cannabis and more than half of U.S. states allow physicians to recommend it to patients, legalizing the supply and possession of cannabis for nonmedical purposes is a very different public policy. Since the November 2016 election, 20% of the U.S. population lives in states that have passed ballot initiatives to allow companies to sell cannabis for any reason and adults 21 or older to purchase it. Although other states may move toward legalization, uncertainty abounds because of the federal prohibition on cannabis. The Obama administration tolerated these state laws; it’s unclear what the Trump administration will do.

Key Findings

  • Jurisdictions thinking about legalizing recreational marijuana use will need to decide who will be allowed to sell marijuana, and to what extent the jurisdiction will be involved in that sale.
  • Limits on production, placing regulations on suppliers, requiring a minimum price, or levying an excise tax are methods to ensure marijuana doesn’t become too cheap.
  • Prevention messaging could provide a counterbalance to commercial promotion, and placing some limits on access (to high-potency products, for example) could help soften the transition to legal availability.
  • Marijuana regulation is new territory for all, so building in flexibility to changes at a later date may help with implementation.

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