Over the past several decades, more than half of all U.S. states have legalized cannabis for adult and/or medical use, but it remains illegal at the federal level. The public health consequences of cannabis policy changes have not been comprehensively evaluated.

Therefore, the Centers for Disease Control and Prevention and the National Institutes of Health tasked the National Academies with reviewing cannabis and cannabinoid availability in the U.S., assessing regulatory frameworks for the industry with an emphasis on equity, and describing strengths and weaknesses of surveillance systems for cannabis.

The resulting report finds that there has been limited federal guidance to states regarding protecting public health, which has led to inconsistent protection across the states. The report recommends a strategy to minimize public health harms through stronger federal leadership, a robust research agenda, and more.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON THE PUBLIC HEALTH CONSEQUENCES OF CHANGES IN THE CANNABIS POLICY LANDSCAPE
• Reviewers
• Acknowledgments
• Preface
• Acronyms and Abbreviations
• Key Terms
• Summary
  • STUDY CONTEXT
  • STUDY CHARGE AND APPROACH
  • RECOMMENDATIONS
  • PUBLIC HEALTH IMPACTS OF CANNABIS POLICY
  • CONCLUSION
• 1. Introduction
  • CANNABIS USE AND HEALTH
  • CHANGES IN CANNABIS PRODUCTS AND USE
  • PHARMACOKINETICS AND METHOD OF ADMINISTRATION
  • FEDERAL ROLE IN CANNABIS POLICY
  • STUDY CHARGE AND APPROACH
  • ORGANIZATION OF THE REPORT
  • HISTORY OF CANNABIS POLICY IN THE UNITED STATES
  • REFERENCES
• 2. Overview of Cannabis Policy
  • CANNABIS REGULATORY REGIMES ACROSS THE WORLD
  • CANNABIS REGULATION IN THE UNITED STATES
  • CANNABIS LEGALIZATION IN CANADA AND URUGUAY
  • CONCLUSIONS AND RECOMMENDATIONS
  • REFERENCES
• 3. Cannabis Consumption and Markets in the United States
  • TRENDS IN PERCEIVED AVAILABILITY OF CANNABIS AND CANNABIS USE PATTERNS
  • TRENDS IN CANNABIS CONCENTRATION AND PRICES
  • WHAT IS HAPPENING WITH THE ILLEGAL CANNABIS MARKET?
  • CONCLUSIONS
  • REFERENCES
• 4. Applying the Core Public Health Functions to Cannabis Policy
  • ASSESSMENT
  • POLICY DEVELOPMENT
  • ASSURANCE
  • CONCLUSIONS AND RECOMMENDATIONS
  • REFERENCES
• 5. How Cannabis Policy Influences Social and Health Equity
  • IMPACTS ON HEALTH EQUITY RELATED TO CRIMINAL JUSTICE
  • CONCLUSIONS AND RECOMMENDATIONS
  • REFERENCES
• 6. Available and Needed Research on Cannabis Policy
  • HEALTH EFFECTS OF CANNABIS: RESEARCH NEEDS
  • LITERATURE REVIEW ON PUBLIC HEALTH IMPACTS OF CANNABIS POLICY
  • CONCLUSIONS AND RECOMMENDATION
  • CONCLUSION
  • REFERENCES
• Appendix A. Committee Member and Staff Biosketches
• Appendix B. Public Meeting Agendas
• Appendix C. Data Sources Available for Cannabis Surveillance
• Appendix D. Evidence Review: Methods and Approach

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2024. Cannabis policy impacts public health and health equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/27766.

Digital Object Identifier: https://doi.org/10.17226/27766

Library of Congress Control Number: 2024949046

This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Printed in the United States of America.