Cannabis is
controlled as strictly as heroin, which means the federal government can't research and regulate it for safer use.
Oct. 12, 2019, By Vin
Gupta, assistant professor of pulmonary and critical care medicine at the
University of Washington
That
marijuana remains illegal at the federal level is arguably the biggest blind
spot today in American public health policy. This is wrong, ill-informed and
part of the reason why people are dying today from formulations of vaped cannabinoids. Where the
federal government turns a blind eye, chaos reigns. This recent crisis was
avoidable.
A
substance that has been shown to be safer than alcohol or tobacco and with
greater medicinal value than either should not be as strictly controlled as
heroin.
A
substance that has been shown to be safer
than alcohol or tobacco and with greater medicinal value than
either should not be as strictly controlled as heroin. Most of America agrees. In response, the
federal government should do with marijuana what it has already done quite
effectively with alcohol and tobacco: fund increased research on its health
effects, stipulate regulations on safety, institute age restrictions on
purchase and ensure mechanisms are in place to hold vendors accountable to a
standardized set of rules across state lines.
As it
currently stands, despite its legalization in 11 states and
Washington, D.C., marijuana’s Schedule 1 classification means that the Food and
Drug Administration (FDA) has no oversight authority on its use. It cannot
evaluate something our government considers illegal, even if a growing number
of states disagree and come up with their own set of nonstandardized
regulations. Legalization would make us safer, as the FDA would be freed to do
the job it should have been allowed to do all along: evaluate marijuana and
vaping products for health and safety impacts. Former FDA commissioner Dr.
Scott Gottlieb has repeatedly said as much since
stepping down earlier this year.
Half
measures like decriminalization miss the
point entirely, conceiving of marijuana primarily as a criminal justice issue
when it is foremost a public health and safety one. With decriminalization,
individual users aren’t charged with a crime for possession, but distribution
can still be punished. In the 38 states where it remains illegal to sell it,
criminal black markets continue to thrive. Only through legalization do you
significantly lessen the financial incentive for a black market and, crucially,
allow for safety regulations to be put in place regarding quality and health
impacts.
For
those who think legalization is a pathway to more traffic accidents and
increased teen usage rates, early findings from first adopters of legalization
(Colorado and Washington state) argue otherwise, making clear the health
benefits from legalization outweigh the downsides. The impact of federal
inaction, meanwhile, has had discouraging effects, given how market forces are
shaping the future of marijuana use.
The
lack of regulatory oversight has been a key ingredient in creating a thriving
black market of cannabis products, many of which are sold as vaping cartridges.
Consider that vaping marijuana now accounts for nearly 30 percent of all legal sales of cannabis,
up from just 10 percent in 2014. Within this context, it is especially alarming
that the FDA has been on the sidelines, as up to now it has not evaluated any of
the vaping devices (cannabis or otherwise) on the market for safety impacts.
Why have an FDA at all if it is sidelined on issues so directly related to the
public’s safety?
Other
federal agencies, like the Alcohol and Tobacco Tax and Trade Bureau (TTB), exist
to ensure compliance with a host of laws regulating advertising, product safety
and voluntary recall of alcohol and tobacco products. Placing marijuana under
their jurisdiction would establish further safeguards on how these potentially
damaging substances can be used (for example, among states that have legalized
cannabis, it is harder for teens to obtain marijuana as
drug dealers are replaced by stores that require proof of age).
Separately,
the Center for Tobacco Products at the FDA serves
an indispensable role funding research into existing and novel forms of tobacco
that then informs regulatory policies. There is no reason why a similar
watchdog infrastructure cannot be established for marijuana or incorporated
into the one already overseeing alcohol and tobacco.
The
agencies also collect taxes on these substances, which theoretically could be
used to fund substance abuse programs and promote harm reduction, similar to the approach some states have utilized when
allocating revenue from state taxes on these products. Some estimates calculate
that federal taxes on sales nationwide could approach nearly $130 billion over the next decade
and create 1 million jobs if marijuana were legalized nationally. For
comparison purposes, the government yearly nets about $20 billion from tobacco taxes and
about $10 billion from alcohol levies.
This system of taxation functions well because the Bureau
of Alcohol, Tobacco, Firearms and Explosives, in part, oversees tax
evasion regarding the sale of alcohol or tobacco.
None of
the above matters, though, if we don’t have an activist FDA that is freed to do
the job it was founded to do — provide leadership in
protecting the public’s interest. Marijuana legalization would allow the FDA to
fulfill its responsibilities on oversight while also bringing necessary
scrutiny to existing vaping technology already in use. It is well past time to
legalize marijuana nationally, not just decriminalize it.
Vin Gupta,
MD, is a health policy researcher and assistant professor of global health
and pulmonary/critical care medicine at the University of Washington School of
Medicine. He tweets @VinGuptaMD.
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