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In new position paper, ACP calls for decriminalization of possession of small amounts of cannabis and rigorous research into its health effects and potential therapeutic uses

Sept. 13, 2024 (ACP) -- The �ܼ�����ˮ��̳ is urging policymakers to embrace an evidence-based, public health-focused approach as they consider regulations regarding the use of cannabis.

In a new titled “Regulatory Framework for Cannabis: A Position Paper from the �ܼ�����ˮ��̳,” published July 23 in the Annals of Internal Medicine, ACP makes a series of recommendations, calling for possession of small amounts of cannabis to be decriminalized and for rigorous research into the health effects and potential therapeutic uses of cannabis.

“The legal status of cannabis is changing rapidly,” said Dr. Isaac O. Opole, president of ACP. “We need to ensure that regulations are based on a public health approach in jurisdictions where it is legal and that they include a prohibition on use among young people and address unsafe use among adults.”

ACP last addressed the use of cannabis in 2008. Since then, “many people, as well as local and state governments, have become more accepting of cannabis both for medical and recreational uses,” said Dr. David R. Hilden, chair of the ACP Health and Public Policy Committee and a lead author on the policy paper.

At the same time, “the state of the science on cannabis lags behind,” explained Hilden. “For instance, there is not good data to inform decisions on the potential benefits of cannabis use as well as the potential harms. There is little guidance about what regulatory structures need to be in place to help states and people make informed decisions. This ACP paper intends to address those realities so we can make informed decisions as a society.”

In the paper, ACP calls for “rigorous research” into the effects of legalizing cannabis, the prevalence of cannabis use disorder and the impact of cannabis on motor vehicle injuries and impaired driving.

In addition, ACP supports “rigorous scientific evaluation” of the possible therapeutic benefits of cannabis and cannabinoids. “In part, due to the drug's complicated legal status, clinicians have limited evidence about the effects of cannabis use, despite the drug's prevalence,” Opole explained. “We need additional research into the health effects, so we have better evidence about its potential adverse effects and therapeutic uses.”

In regard to legalization, ACP says possession of small amounts of cannabis should be decriminalized. “There is little evidence that criminalization of possession, for personal use, of cannabis has a beneficial effect on individuals or society in general,” Hilden said. “There is compelling evidence that criminalization does, however, impact some communities more than others. People of color, for instance, are more likely to face criminal justice involvement than white people, despite no evidence that people of color use cannabis at higher rates.”

Data cited in the ACP position paper from the Boston University Law Review and American Civil Liberties Union show Black people are 3.64 times more likely to be arrested for cannabis possession than white people.

“Since this ACP paper takes a public health framework into consideration, it is critically important that the structural disparities of this issue are considered and corrected,” Hilden added.

ACP also supports sufficient resources for cannabis-related public health activities, oversight and regulation. “Funding is not consistent for cannabis-related activities,” Hilden said. “Since each state and/or local government is acting independently, the funding for public health measures can vary wildly. But funding is needed for public health education, regulatory mechanisms to ensure product safety, public safety and keeping children and adolescents safe, to name a few.”

ACP also reiterated its strong support for exempting physicians from federal criminal prosecution, civil liability or professional sanctioning if they recommend, prescribe or dispense cannabis in accordance with state laws.

Hilden said the audience for the paper includes physicians, nonphysician practitioners, public health officials, regulators and other officials charged with the public health of their communities. “This paper is not intended to provide individual guidance to people on whether they should or should not use cannabis, however,” he cautioned. “It is intended to guide public health policy through a science-based health equity approach.”

More Information

The position paper, is available on the Annals of Internal Medicine website.

Back to the September 13, 2024 issue of ACP Advocate