[image_credit]REUTERS/Anthony Bolante[/image_credit][image_caption]It is possible to move toward a correction of criminal injustices for communities that were harmed by marijuana laws, but we are charged with completing that task with eyes wide open to the known and unknown risks of marijuana use.[/image_caption]
A new job in California provided me an opportunity to observe the first year of legalization. The first day of legal sales of recreational use coincided with my arrival, this followed 20 years of medicinal marijuana in the state. In this essay I provide my observations of what should be front of mind for Minnesota policymakers.
These observations are provided through my own biases as a public health scientist with a background in tobacco control.
1. Any legislation should provide a net benefit for the population.
At the very top of my agenda is the inclusion of public health in the discussion of legalization. And while we can agree prohibition has created huge injustices, let us not pretend that consuming marijuana has no risks. There should be a hard distinction against any assumption that legalization is an endorsement of freedom from risk.
We know enough to be cautious. Cannabis use disorder is a harmful consequence of compulsive use; addiction is a real concern for 1 of every 10 users, with increased risk for those who start using in their teens. In addition, there are adverse side effects and the risk of psychosis, perhaps linked to high levels of THC.
What should Minnesota do? If legalization is a net benefit, then strict regulations should be created to manage the marijuana industry. Minnesota should also adapt and update policies over time.
2. A plan should be created to reduce harms and unknown consequences.
For the past year, marketing messages on billboards have promoted cannabis products as wellness for the whole family. In this case the sell was for Cannabidiol oil or CBD, the non-intoxicating industrial extract from hemp plants. This was followed by online ordering and delivery; next up will be indoor cannabis lounges similar to the Amsterdam coffee shops with pot for sampling.
What should Minnesota do? If marijuana prohibition was a disaster because minorities were the target of detention and jail for marijuana offenses, the course correction of unfettered business marketing is not the answer. A plan should imagine future needs for drug treatment, for stronger prevention programs in schools, and research needs — for example, how to test driving under the influence.
3. Just like Big Tobacco, the marijuana industry cannot be trusted.
There will be an even bigger flood to market of products as the industry establishes the use of CBD/THC as routine and personalized with brand endorsement from celebrities. To create a level of respectability, the marijuana industry will cultivate a language of cannabis designed to ease our concerns (see Thomas Fuller’s piece in the New York Times, October 2018).
What should Minnesota do? Minnesota should carefully consider whether the market should be wide open to all possible products despite limited evidence. Descriptions like CBD-rich therapeutic products should be challenged.
4. Just like tobacco, marijuana cannot be smoked or vaped in public places.
In California you can consume marijuana on private property but smoking, eating or vaping is banned in public places. Anywhere tobacco is prohibited applies to marijuana. As I commute from Berkeley to Oakland, there are hotspots where the distinctive smell is omnipresent, much like the other big cities where marijuana use is legal.
What should Minnesota do? Public policy should be on the side of the greater public good and resist a wide open normalization of cannabis use. Trading marijuana smoking as a replacement for tobacco smoking would be a poor policy solution. Smelling secondhand marijuana smoke is a common complaint that can be prevented. All smoking should be banned in public places and there should be significant enforcement.
5. Products must be sold in marijuana-only retail stores.
If legal cannabis businesses are following state regulations and paying their taxes, then illegal operations cannot be allowed. To ensure that only legal entities can promote themselves to consumers a business state-issued license number must be included in ads.
What should Minnesota do? Minnesota should manage the location, type, and density of retail locations. Sampling should not be permitted, and other locations — such as liquor stores and convenience stores — cannot sell marijuana.
6. Preventing sales to under 21 must be strictly enforced.
There is significant consensus in the public health community and likely in the general public that young people should avoid trying tobacco and marijuana. Age 21 has emerged as the preferred age that prevents younger age use.
What should Minnesota do? Minnesota should harmonize tobacco and marijuana laws to restrict use to those 21 and older.
7. A portion of excise taxes should be appropriated for treatment (1 percent), research (1 percent), and prevention (1 percent).
California has a marijuana excise tax of 15 percent, but additional local taxes could increase to 45 percent. A segment of California adults and tourists appear content to stay in the legal market (reported first year marijuana tax revenue was $345 million), but a large illegal market remains.
What should Minnesota do? Tax policy must consider not just revenue, but also preventing young people from starting, encouraging substitution for more dangerous drugs, and reducing the illegal market. Minnesota should be pragmatic and start with a tax similar to Oregon with a cap on excise taxes of 10 percent for the state and 10 percent for local tax. But the real need is dedicated taxation for treatment, prevention, and research. The law should allocate a modest 1 percent to each of these areas as a part of the plan to mitigate expected harms from increased use of marijuana.
8. THC potency should be limited to reduce harm.
One of the tough decisions will be potency, which is a measurement of Δ9-tetrahydrocannabinol (Δ9-THC; or THC), and ultimately the concern is the rising ratio of THC/CBD. Current THC levels continue to increase as cultivators breed strains with higher levels (eg. THC/CBD ratio 18:1). New research suggests potency is a significant concern with increased admissions to drug treatment associated with increasing THC levels over 16 years of study in Europe.
What should Minnesota do? Minnesota should rely on established science to guide policy. The 2017 report from the National Academies of Sciences, Engineering, and Medicine found evidence supporting treatment of cancer patients for nausea, for example. But little evidence to support the use of CBD except for seizures (Epidiolex is the first FDA-approved cannabis-derived drug in the US).
9. Implement an equity permit program to minimize barriers to licensing for residents who are victims of the war on drugs.
Los Angeles has implemented a cannabis social equity program, which is described as “equitable ownership and employment opportunities in the cannabis industry in order to decrease disparities in life outcomes for marginalized communities and to address the disproportionate impacts of the war on drugs in those communities.”
What should Minnesota do? Minnesota should provide local control after legalization. In California, the law permits dual control where local municipalities can decide whether or not to issue a retail license.
10. Reserve the right to revisit this playbook for marijuana legalization as more evidence is available.
It is possible to move toward a correction of criminal injustices for communities that were harmed by marijuana laws, but we are charged with completing that task with eyes wide open to the known and unknown risks of marijuana use. If Minnesota legalizes marijuana then policymakers should adopt smart and strong public policy that protects the population while allowing consumption by adults.
Raymond Boyle, Ph.D., is a public health scientist living in Berkeley. Before California, Boyle was the director of research for ClearWay Minnesota, a tobacco control organization. He has spent most of his career conducting tobacco control research in Minnesota and has published more than 100 peer-reviewed scientific papers.
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#3 speaks volumes.
The idea of a 20% tax 10% of the state 10% to the town is absurd that’s not going to get rid of the black market that’s going to maintain it. This is a medical plant people can help themselves and you want to turn it into something where people are forced to be outside the law. Limiting potency limits the ability of the medicinal properties as well.the evidence may be anecdotal but those of us who have seen it in person know if this is a medicinal plant.what the legislature here in Minnesota has done in creating the single worst medical marijuana program in the entire country is harm its citizenry. People cannot afford their medicine now you’re proposing to make that even bad from a recreational standpoint. The strongest cannabis in the world is still thousands of times safer than aspirin millions of times safer than alcohol. Should people drive while high no at least you’re not going to overdose on this treating it as if it’s somehow worse than alcohol isn’t a service to the community and the citizenry of Minnesota the legislature treating it as if it’s somehow controversial is a disservice to the citizens of Minnesota. we do not need corporate marijuana in Minnesota we need to be able to grow plants are self none of this b******* like Colorado are California you shouldn’t have to feel like you’re doing something wrong when you go to buy cannabis. We certainly don’t want to go get a six pack from the local liquor store.the fact that police make money of cannabis being illegal is a reason why they’re so afraid of it being legal not the so-called effects. And frankly that is pathetic.
Same old baloney. “THC content should be limited to reduce harm” etc. I was in California in January for the first time in 30 years. The people behind me in the grocery store reeked of skunk. I guess they forgot to roll down the windows. One of my assigned partners at the local links pulled out a pipe at the turn and asked if I minded if he smoked. I was interested in what he was smoking, but not in joining him. Hybrid apparently. I stayed a couple of weeks, the culture was very outdoor oriented, all kinds of people biking, scooters were big, people were friendly and the apocalypse apparently had not snuck in behind their pot policy. Ironically many of the same people preaching caution now are the same people who have prevented any research being conducted over the last five decades. It’s a mystery.
The last bit is exactly right – the people preaching caution now are the ones who blocked even looking at marijuana in the past. Reefer madness.
While legalization makes sense, I hope people are aware that the illegal sale of marijuana is a source of money for a lot of low-income people. Everything they’re earning now will be taken from them and given to the pharmaceutical companies producing “legal” marijuana, further impoverishing disadvantage communities and profiting the already-wealthy. Additionally, there are a LOT of people in prison now for marijuana-related crimes – these people should be pardoned and their weed-related convictions expunged.
Yeah . . . I’m ok with big pharma taking over from street dealers. Some people will lose their income, but its not really a good career choice.
There are collateral effects from keeping marijuana sales illegal. Those engaged in the business will resort to illegal, usually violent, means to resolve disputes. I would much rather see a suit under the Clayton Act than a drive-by shooting.
Interestingly, the same economic argument was made when New York established a state lottery. The lottery put numbers runners, who were accepted in the community as businesspeople providing a service, out of business in favor of a state-controlled monopoly.
The regulation of tobacco, alcohol and marijuana should be very similar. Legal age of 21, heavily taxed, limited outlets and hard enforcement of black market and under age sales. All products should have warning labels on the package and in paid advertising. Similar restrictions should be considered for legalized gambling.
If current economic policy is any indication, current leadership cannot be trusted, as they will let legal cannnabis turn into a monopoly and look to criminalize anyone who challenges that monopoly.
You say the tobacco companies cannot be trusted; but this citizen cannot grow tobacco for personal use, thus you support monopoly and all the pathological power therein.
You might instead trust the people, rather than treating them like silly children who will lose their way if they are given too much freedom. Maybe trusting us more will make us feel more dignified, and thus treat these substances with a greater respect?
I am curious as to how the law will treat cultivation by individuals for personal use. I hope regulation follows the beer and wine model rather than that of distilled spirits. Or maybe treat it like tobacco. As far as I know one can legally grow tobacco in the back yard for personal use without restriction.
I don’t know that there are any restrictions on growing tobacco for any purpose. There are restrictions on selling it at retail, but if the climate will bear it, anyone is free to grow it.
Moonshining is still illegal.
I didn’t have room to add the garden cultivation section. But in California legalization permits someone to grow 6 plants that are “out of sight”. So, in the backyard is fine.
Very nice photo Raymond thanks for your advice. We are considering starting use for an alternative to taking anti inflammatory drugs that are very hard on the liver also to maybe get off a cpac device that I can’t stand. Wish us well. I am a 63 yr old mail I have not been a Mari Jane user. I do know People that are doing very good as an alternative to mainstream drugs. The list is growing for approved conditions for. THC / CBD treatment. This is great news insurance companies right. Or maybe you won’t want to be involved. Or maybe thy shouldn’t be allowed to be involved. Thanks again MINNPOST