Legalizing Cannabis Could Benefit Public Health, According to Research

New research suggests that legalizing cannabis at the federal level could help mitigate sales of high-potency cannabis products, which can be harmful to overall health.Federal decriminalization would mean states could set their own cannabis laws, but some states may not set a limit on the amount of THC that can be included in products.According to experts, a universal THC limit on products in all states could be an effective solution.

According to the researchers, federal legalization of cannabis would provide an opportunity to establish regulations that better protect public health.

In a white paper published July 18, researchers at the University of Southern California’s Leonard D. Schaeffer Center for Health Economics and Policy outlined several potential policies the federal government could enact if it decriminalizes cannabis.

This includes putting limits on the amount of tetrahydrocannabinol (THC), the main psychoactive compound in cannabis, that can be included in products and restricting how much people can buy at one time based on the amount of THC in the product.

Other policies include taxing cannabis products based on potency instead of weight or retail price, and tracking all cannabis or hemp from cultivation to sale as a product.

A July 2022 study published in The Lancet Psychiatry suggests that people who use higher potency cannabis have a higher risk of developing a cannabis use disorder. They are also more likely to suffer from a psychotic disorder, such as schizophrenia.

According to the USC white paper, other research has shown that state-level cannabis legalization is linked to an increase in cannabis-related emergency room visits by children and adolescents, and an increase in driving cannabis-related impairment.

“A public health approach to cannabis regulation is to incentivize users in a way that maximizes benefits and minimizes harms.” Rosalie Liccardo PaculaPhD, a senior fellow at the USC Schaeffer Center and the Elizabeth Garrett Chair in Health Policy, Economics and Law at the USC School of Public Policy, Price told Healthline.

Pacula added that a public health approach to how cannabis products are sold and developed is “aware that higher levels of THC induce more impairment and more health risks.”

In the United States, cannabis is illegal at the federal level, although many states have passed laws allowing it medical and/or recreational use of cannabis.

A bill presented to the US Senate on July 21 would decriminalize cannabis at the federal level and allow states to set their own cannabis laws. Other bills in the House and Senate are pending.

While this may seem like a positive development for cannabis enthusiasts, Pacula expressed concern. “If the federal government legalizes cannabis without putting a [THC] none, we’ll never have one,” he said. “The only states that have established potency limits have been the states that did it when they first legalized cannabis.”

Current state cannabis laws vary in terms of purchase quantity limits and potency limits. For example, Vermont i Connecticut are the only states that have established THC potency limits for both cannabis flower and concentrates, according to USC researchers.

Pacula said the limits set by those two states are “probably reasonable for the US market, although they may still be too high.” But I’m fine with letting it be, rather than not setting any boundaries at all.”

Additionally, she and her colleagues point out that most states that limit cannabis sales do so based on the weight and type of product rather than the amount of THC the product contains. This allows people to buy a large amount of higher potency cannabis products at once.

The policies the USC researchers outline in the white paper would discourage excessive use of cannabis, particularly the use of higher THC products such as cannabis edibles and concentrates.

“Right Now [cannabis] flower is the main product that is sold, but we are seeing a big shift to vape oil concentrates, while edibles have stabilized in the market,” Pacula said.

Although the policies outlined in the white paper focused on the THC content of cannabis products, Liz Roganfounder of The Cannabis Business Council of Santa Barbara County, said this misses the role that different components of cannabis may play in the intoxicating or other effects of these products.

Pacula stressed, however, that the standards should be adjusted as additional scientific data becomes available about the risks associated with different doses of THC. These policy updates could also take into account new science about the effects of other components of cannabis.

“It took us decades to understand alcohol and what a standardized drink was,” Pacula said. “So we should set these limits and wait at least 5 years before adjusting them because it will take time for the science to come out.”

R. Lorraine Collins, PhD, professor and associate dean for research at the University at Buffalo’s School of Public Health and Health Professions, supports the policies proposed in the white paper. He said setting THC limits for cannabis products and taxing products based on THC content would be easy to implement, calling those strategies an “excellent start.”

For a THC limit to work to be effective, Collins said laws would have to limit the potency of all cannabis products, including those that come directly from the cannabis plant and those derived from hemp or cannabis.

“The cannabis industry is very smart,” he said. “One of the things they do is if you say you’re going to limit the potency of cannabis flower, they’re going to increase the potency of other cannabis products. So the key is to limit THC in ‘all cannabis products.’

He also said the laws should be broad enough to cover cannabis products developed in the future.

As for individual limits on cannabis purchases, Collins expressed some reservations about the policy, as the US does not have similar limits for other adult-use products such as alcohol and tobacco.

Rogan agreed: “This is an adult we’re talking about. This is someone who should be able to make their own decisions,” he said. “It really comes down to personal choice – you have it [the] freedom to do what you want; we expect you to be responsible.”

Also, Collins said, individual purchase limits may not be very effective. “What prevents a person from switching from a retail outlet?” she said “You could accumulate a lot of cannabis that way, even if there’s a limit to how much you can buy at one time.”

Rogan is also concerned about the impact a cap on THC limits and purchase limits may have on people who use cannabis to treat medical conditions.

“When you’re treating cancer or chronic pain, you often need high doses of THC,” he said. “So it is only fair that this person should go to the [cannabis] dispensary every day and buy more often because they can’t buy the products in concentrated form?

While states like Connecticut and Vermont have stricter limits on THC content, the USC researchers argue that federal regulation would ensure that public health is protected equally across the country.

“You don’t encourage good cannabis industry standards by letting states vary these limits,” Pacula said. “It will be much easier to do it at the federal level.” A federal limit, he added, would only set the maximum potency for cannabis products. States could have more restrictive laws.

Additionally, there is now precedent for the federal government to regulate the maximum THC content of cannabis products.

“The FDA, which finally got the go-ahead to regulate nicotine products, is able to do things like set a limit on the amount of nicotine in cigarettes or remove certain types of tobacco flavors,” Collins said.

Collins noted that having different cannabis laws in each state, particularly THC limits, could lead people in places with more restrictive laws to buy cannabis in neighboring states with more lenient regulations. Something similar happened before all states set age 21 as a minimum age to consume alcoholshe said

Still, Collins said many people will be drawn to the legal cannabis market for what it offers: being able to buy products that are safe and contain exactly what they’re supposed to.

“You don’t have to worry about whether your weed is cut with fentanyl or some other drug that can hurt you,” he said. “You also don’t have to worry about bad cultivation leading to mold that could hurt you when you smoke cannabis.”

New research makes a compelling case for regulating cannabis at the federal level. Decriminalizing cannabis could help limit the sales and use of high-potency cannabis products, which studies have shown pose dangers to human health.

However, even with federal legalization, experts like Collins and Rogan say that setting limits on THC could still push consumers to buy higher-potency products on the illicit cannabis market.

“If people are concerned about young people, especially men 26 and under, using THC-rich products, the legal system will be better off,” Rogan said. “Because at least they know what they’re getting there versus if they’re getting a product on some street corner.”

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