Published January 4, 2023
Innovation of state laws concerning cannabis, a plant that has for centuries been used as a medicine in many cultures, dates back nearly 50 years.
Variation in policy surrounding cannabis is diverse across the states. Now after years of decriminalization and legalization, the evidence shows that the complex plant itself has changed because of the policy environment that has emerged in the United States.
Rosalie Pacula, the Elizabeth Garrett Chair in Health Policy, Economics and Law at the University of Southern California Sol Price School of Public Policy and senior fellow at the Leonard D. Schaeffer Center for Health Policy and Economics, is an economist whose research examines policies that influence a range of public health issues. Pacula recently delivered the 34th annual J. Warren Perry Lecture, “The Impact of Policy on Public Health: Evidence from Cannabis Legalization Experiments in the U.S. and Canada.”
Pacula’s topics of interest include the regulation of cannabis, opioids and other addictive substances, along with their treatment. She studies how policy variation over the past 25 years—particularly decriminalization, medicalization and adult recreational use of cannabis—has influenced a range of public health and social impacts on society. Among the positive outcomes are reduction in criminal justice costs and arrests associated with marijuana and the creation of nearly a half a million new jobs. The transition of these markets from illicit to legal has, in 2021, generated sales of $27 billion and $4 billion in state tax revenue.
However, the market demands of consumers seeking intoxicating effects has resulted in higher levels of THC in the plants used to make cannabis products.
“This is a substantially different plant than that used in the early 1990s,” Pacula said. “It has been bred to have more expression of the THC, less expression of CBD, and the impacts of that on the body is what we're trying to understand.”
With the growth of the recreational market, psychosis, acute poisonings for both adults and children and disruption of the digestive and cardiovascular systems have also been on the rise. These impacts are correlated to the higher potencies of these products, greater access to edibles and persistent use.
The goal, Pacula noted, is to create a safe product that people can purchase in a legitimate store where they can learn the benefits and potential risks of cannabis use.
Initiated in 1989, the Perry Award and Lectureship honors J. Warren Perry, PhD, the first dean of the school of health-related professions at the State University of New York at Buffalo. It recognizes people who have provided exemplary leadership in public health, health professions or the health sciences.
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