Public health and addiction prevention professionals have been closely watching the development of regulations for, and roll-out of, a recreational marijuana industry in Massachusetts. Many concerning policies are being institutionalized with many public health and prevention professionals sounding the alarm regarding the “Social Equity Program” and all associated components included in the Cannabis Control Commission’s regulations, driven by industry representatives, both internal and external to the process. These regulations increase availability and access of marijuana to populations who are already disproportionately affected by youth marijuana use: One quarter (24.5%) of Massachusetts youth (grades 9-12) used marijuana regularly (past 30-day). LGBTQ and Latino youth have higher use rates and students who identify as “multi-racial” are almost twice as likely to use marijuana regularly (45.8% compared to 24.5%) (Monitoring the Future 2015). Although, on the surface the “Social Equity Program” sounds like a good idea, the Cannabis Control Commission’s regulatory language drives market growth, targets communities with high unemployment rates (low income), minorities, veterans, the LGTBQ population, and is counter-productive to the state’s addiction prevention goals.
Much of the regulations center on “social equity” and appear to be based upon a report, written by the former Director of NORML and current Cannabis Policy Director at “HIGH TIMES”, with no disclosure of these associations. Based on the international public health literature, these regulations are likely to increase health inequities and disparities among marginalized populations; low income, minorities, women, veterans, and LGBTQ (marginalized) populations are prioritized in these regulations. Public health professionals are keenly aware that there is a considerable amount of scientific and public health literature based on tobacco and alcohol indicating that low income communities and marginalized populations are often “targeted”, intentionally or unintentionally, by industries selling products with addiction potential.
Given what we know, a “Social Equity Program” with “Priority Justice Applicants” (particularly for a federally illegal substance with addiction potential) is not the best way to help people, their families, and their communities. Meaningful “restitution” and “social justice” would not include subsidized entry into the marijuana industry with all its associated risks. Meaningful and sincere “social justice” and “restitution” would include prioritizing these communities for behavioral health promotion, primary prevention, intervention, and substance use REDUCTION funding and assistance. It would include healthcare and social service measures to reduce health inequities and disparities, not increase them. State and local leaders must support healthy, drug-free norms for family and community; and compassionate enforcement, which support prevention and recovery.
It is important to remember that marijuana/THC does have negative impacts for many users, particularly adolescents and young adults. There is a growing body of scientific literature showing that adolescents and young adults who are regular marijuana users are at increased risk for addiction, mental health disorders (including psychosis, bipolar disorder, and suicide), negative impacts on cognition, and poor academic performance (including decreased student engagement, student success, and increased school failure at the high school and college level).1,2,3,4,5,6,7,8,9 There are indications that the high THC products, more readily available with commercialization, pose increased risk making strict regulatory control for potency limits important. Additionally, CBD may mitigate some of the health risks posed by THC; however, high THC products are driving growth in the legal marijuana market.
The very recent shooting of Sgt. Michael Chesna and Vera Adams by 20 year-old Emanuel Lopes, brings to light many of the concerns shared by public health and prevention professionals. Mr. Lopes posted a picture of himself on social media, prior to the shooting, with marijuana and an envelope of THC concentrate. While it is true that, at this time, it is unclear if THC played a role in the crimes perpetrated by Mr. Lopes, it is also true that the normalization of the sale and use of high THC products (many appealing to youth and young adults) will serve to increase the negative outcomes in our most vulnerable populations and communities. Our communities deserve help in revitalizing and dealing with our state’s drug/addiction crisis. Public health and prevention professionals know that building economic development/empowerment/revitalization off the sale of addictive substances, including THC, will only increase negative health outcomes in the long-term. The robust commercialization of recreational drugs does not bring value to our communities.
Shouldn’t our government be obligated to do the least harm and protect our communities, not create more negative impacts?
We are confident that there are parents and guardians, mothers, fathers, aunts, uncles, grandparents, foster and adoptive parents working hard, scraping by, raising children in these communities, who want fewer drugs with addiction potential and reduced risk of other behavioral health issues in their communities, not more. Local voters seem to intuitively understand what scientific data are revealing, as more and more communities choose to exercise their right to opt out by law. Where there is more marijuana commercialization and availability, more people use the drug, and more youth use the drug.
The “Social Equity Program” was essentially designed by the marijuana industry with no input from public health and prevention professionals; we ask that the Cannabis Control Commission conduct a public health impact assessment, by public health professionals, on the Social Equity Program with all of the associated components. Based on the international public health literature, these regulations are likely to increase public safety risks, health inequities and disparities. We are sure this is not the intention of these regulations; however, given what we know, the risk is high.
Given that high risk, we support communities in taking the time they need to carefully and fully consider, with public health input, the impacts of commercialized marijuana/THC on their local environments.
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1. Murray RM, Quigley H, Quattrone D, Englund A, Di Forti M. 2016 Oct. Traditional marijuana, high- potency cannabis and synthetic cannabinoids: increasing risk for psychosis. 15(3):195-204. World Psychiatry.
2. Marie Stefanie Kejser Starzer, M.D., Merete Nordentoft, Dr.Med.Sc., Carsten Hjorthøj, Ph.D., M.Sc. 2017 Nov. Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis. American Journal of Psychiatry. Epub ahead of print.
3. Broyd, S.J., van Hell H.H., Beale C., Yücel, M., Solowij, N. (2016) Acute and Chronic Effects of Cannabinoids on Human Cognition—A Systematic Review. Biological Psychiatry, 79:557–567.
4. Crean, R. D., Crane, N. A., & Mason, B. J. (2011). An evidence- based review of acute and long-term effects of cannabis use on executive cognitive functions. Journal of Addiction Medicine, 5(1), 1-8.
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(2014). Adverse psychosocial outcomes associated with drug use among US high school seniors: A
comparison of alcohol and marijuana. American Journal of Drug and Alcohol Abuse, 40(6), 438-446.
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predicts lower self-efficacy even after controlling for demographics, personality, and alcohol and
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(2016). The impact of adolescent exposure to medical marijuana laws on high school completion,
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9. Hasin et al. Prevalence of Marijuana Use Disorders in the United States Between 2001–2002 and
2012–2013. 2015 Dec. JAMA Psychiatry. 72(12): 1235–1242.