Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
Department of Psychiatry and Behavioral Sciences, Veterans Affairs Health Care System and Stanford University, Palo Alto, CA, USA.
Am J Drug Alcohol Abuse. 2019;45(6):698-706. doi: 10.1080/00952990.2019.1569669. Epub 2019 Mar 14.
Cannabis (marijuana) has been legalized for recreational and/or medicinal use in many US states, despite remaining a Schedule-I drug at the federal level. As legalization regimes are established in multiple countries, public health professionals should leverage decades of knowledge from other policy areas (e.g., alcohol and tobacco regulation) to inform cannabis policy. Identify policy lessons from other more established policy areas that can inform cannabis policy in the United States, Canada, and any other nations that legalize recreational cannabis. Narrative review of policy and public health literature. We identified six key lessons to guide cannabis policy. To avoid the harms of "a medical system only in name," medical cannabis programs should either be regulated like medicine or combined with the recreational market. Capping potency of cannabis products can reduce the harms of the drug, including addiction. Pricing policies that promote public health may include minimum unit pricing or taxation by weight. Protecting science and public health from corporate interest can prevent the scenarios we have seen with soda and tobacco lobbies funding studies to report favorable results about their products. Legalizing states can go beyond reducing possession arrests (which can be accomplished without legalization) by expunging prior criminal records of cannabis-related convictions. Finally, facilitating rigorous research can differentiate truth from positive and negative hype about cannabis' effects. Scientists and policymakers can learn from the successes and failures of alcohol and tobacco policy to regulate cannabis products, thereby mitigating old harms of cannabis prohibition while reducing new harms from legalization.
尽管大麻(大麻)在联邦一级仍被归类为附表 I 药物,但在美国许多州已将其合法化用于娱乐和/或药用。随着多个国家建立合法化制度,公共卫生专业人员应该利用其他政策领域(例如,酒精和烟草监管)数十年的知识为大麻政策提供信息。从其他更成熟的政策领域中汲取经验教训,为美国、加拿大和任何其他合法化娱乐性大麻的国家的大麻政策提供信息。对政策和公共卫生文献的叙述性回顾。我们确定了六个关键的经验教训来指导大麻政策。为了避免“徒有其名的医疗体系”造成的危害,医用大麻计划要么像药品一样受到监管,要么与娱乐市场相结合。限制大麻产品的效力可以减少药物的危害,包括成瘾。促进公共健康的定价政策可能包括最低单位定价或按重量征税。保护科学和公共卫生免受企业利益的影响,可以防止我们在苏打水和烟草游说团体资助研究以报告其产品有利结果方面看到的情况。合法州可以通过清除与大麻相关的定罪的先前犯罪记录,超越减少持有逮捕(可以在不合法的情况下完成)。最后,促进严格的研究可以区分大麻效应的真相与积极和消极的炒作。科学家和政策制定者可以从酒精和烟草政策的成功和失败中吸取教训,规范大麻产品,从而减轻大麻禁令的旧有危害,同时减少合法化带来的新危害。