5 things to know from this week’s big cannabis story

More than half of U.S. states have legalized cannabis, whether for medical purposes, recreational use, or both. Cannabis dispensary shelves offer an ever-widening range of candies, drinks and joints.

Meanwhile, the federal government still considers most types of cannabis illegal.

A new report of the National Academies of Sciences, Engineering and Medicine, released this week, finds that this disconnect between states and the federal government leads to fragmented policies and risks to the public.

As states built new commercial markets for cannabis, they initially focused on regulating sales and revenue. “The consequence of this is that public health aspects have often taken a back seat and we are now playing catch-up,” says Dr Steven Teutschchair of the National Academies committee that wrote the report on the impact of cannabis on public health.

The report calls for federal leadership and national standards on cannabis quality and potency to protect public health.

Here are five takeaways:

1. Cannabis is consumed more often than alcohol

It’s true, people use cannabis more regularly than alcohol in the United States.

In 2022, more U.S. adults reported using cannabis rather than alcohol on a near-daily basis, according to the National Survey on Drug Use and Health. This was the first time that regular marijuana use exceeded regular alcohol use.

Regular cannabis use has skyrocketed over the past 30 years, from less than a million people reporting near-daily use in 1992 to more than 17 million in 2022.

Weed has become more accessible as it has gained legal status in many states: About two-thirds of people ages 12 and older consider it “somewhat easy” or “very easy” to obtain. And its price has also fallen, in terms of the price per unit of delta-9-tetrahydrocannabinol, or THC – the main compound responsible for its psychoactive effects.

2. Weed and Vapes Can Be Super Potent

And it’s not always disclosed.

The concentration of THC in cannabis flower has increased over time. “I think most people are aware of the phenomenon that ‘this is not your grandfather’s weed’…I hear that all the time,” Staci Gruber of McLean Affiliated Hospital at Harvard, told NPR in 2019.

And while most people still consume weed by smoking dried cannabis flowers, there has been an increase in cannabis edibles, vape oils and other products, according to Dr Yasmin Hurddirector of the Mount Sinai Institute of Addiction and vice chair of the NASEM committee.

“There are now concentrates such as dabs, waxes and shatters that contain very high concentrations of THC, even in the range of 60 to 90 percent,” she says. Hurd spoke at a news conference Thursday announcing the release of the report.

Higher concentrations of THC cause people to consume more than intended, which has contributed to more traffic accidents and hospital visits related to cannabis use, Hurd says.

While many states where cannabis use is legalized have set limits on the amount of THC in gummies and other edibles, these rules often do not apply to other cannabis products, according to the report.

3. Psychoactive hemp products are widely available

Even in states where cannabis is illegal.

Cannabis is classified in Annex I substance by the United States Drug Enforcement Administration, meaning the federal government considers it a drug with a high potential for abuse and no accepted medical use.

Thanks to the 2018 Farm Bill — which defined a subset of cannabis as hemp and excluded it from the Controlled Substances Act — there has been a boom in products containing hemp-derived chemicals. These include CBD and delta-8 THCa psychoactive compound extracted and synthesized from CBD, and they can be sold in states that have not legalized cannabis.

These have escaped regulation, even though some of these chemicals have been processed to increase their psychoactive properties. American health authorities from the CDC And The FDA warned on health and safety risks.

The report recommends that Congress close this gap, clarifying that all intoxicating forms of cannabis – including those derived from hemp – are subject to regulation.

4. Cannabis research is stifled

Scientific research into the health effects of cannabis has made little progress in recent years because there are enormous obstacles to studying the drug.

Since cannabis is classified as a Schedule I substance, researchers often cannot obtain it for their studies. Even if they can, they face all kinds of strict regulations.

The White House Office of National Drug Policy is not authorized to study the impacts of cannabis legalization, even though it has already happened in many states.

Earlier this year, the DEA cannabis reclassification proposal as a Schedule III drug, like ketamine – a drug with recognized medical uses, low to moderate abuse potential, and fewer restrictions.

The report also recommends that Congress remove restrictions on research for the Office of National Drug Policy.

5. Cannabis can be dangerous

But people hear more about its benefits than its risks.

People tend to think that cannabis is less dangerous once legalized, Hurd says.

But many people are not fully informed of the potential dangers. “The risks associated with THC use – psychosis, suicidal ideation, cannabis use disorder – increase as the dose increases,” says Hurd.

More and more children and young adults are now see pro-cannabis messages through advertising, and the cannabis industry lobby is increasingly influential – successfully defeating efforts to limit the concentration of THC in Washington, for example, or to limit the use of pesticides in cannabis farms in Colorado, according to the report.

“We really need to approach cannabis within a public health framework,” Dr. Pamela Ling, director of the UCSF Center for Tobacco Control Research and Education, wrote in an email after reviewing the report at NPR’s request.

“The good news is that we don’t have to start from scratch. We have best practice models in tobacco and alcohol control that can be applied to cannabis, including marketing restrictions, age restrictions, retail environment, taxation and ways to reduce access for young people,” she says.

The report also recommends public health campaigns describing the risks, particularly for children and young adults, pregnant women and the elderly. And cannabis retailer staff must be trained to speak knowledgeably about the risks and benefits to customers.

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