Background

Cannabis Legalization is Happening

States are rapidly legalizing cannabis for adults. Since 2012, more than ten states, representing 25% of the U.S. population, have legalized the possession of cannabis by adults, with nearly all also regulating production, distribution, and sales. Uruguay legalized cannabis in 2013 and Canada in 2018. The top courts in Argentina, South Africa, and Mexico have ruled that cannabis prohibition is unconstitutional. Polls show that a substantial majority Americans–both Democrats and Republicans–now support full legalization and over 35 states have legalized medical cannabis. In fact, this is one of the few current political issues that enjoys support from both sides of the political aisle. U.S. and Canadian companies have invested billions of dollars in the cannabis industry and cannabis-derived tax revenues are benefitting government budgets. The U.S. federal is now discussing the legalization of cannabis for adults, and several other countries will likely follow in the near future.

What Cannabis Regulation Must Do

Cannabis regulation must optimize public health and promote social justice, with two key priorities:

• reduce the harmful consequences associated with cannabis misuse
• reduce the illegal cannabis market with minimal reliance upon the criminal justice system, which has contributed to social injustice and individual harms

These two priorities lie in tension. Eliminating the illegal cannabis market is straightforward. Removing all penalties and restrictions regarding the production, distribution, and possession of cannabis would eliminate the illicit market because, by definition, all such activity would be legal. However, that approach does not address the harms associated with cannabis misuse. Conversely, a prohibitive or highly restrictive regulatory environment may slightly reduce problematic use, but it increases the viability and profitability of the illegal market. So, the optimal approach to cannabis regulation is a moderate one, balancing the needs of social justice and public health.

Some pressing issues for cannabis regulations

The specific regulations needed to meet many of these goals are complex and may vary between different states and regions. An optimal system will enable changes and improvements as we gain more experience with cannabis regulation.

Cannabis regulation must address several key questions:

• How can we best prevent cannabis misuse in vulnerable populations?
• How can we best reduce illicit cultivation, sale, and possession?
• What is the best process for expungement of past cannabis convictions?
• How can we reduce the incidence of impaired driving related to cannabis and other drugs?
• How should cannabis-derived revenues support the prevention of cannabis misuse?
• How can we regulate the instruction and care of patients obtaining cannabis from dispensaries?

What DFCR is doing to ensure effective regulation

In 2015, fifty prominent US physicians came together to find a middle ground between the failed policy of prohibition and unfettered legalization of cannabis. We formed Doctors for Cannabis Regulation (DFCR), the first national physicians’ association dedicated to the legalization and effective regulation of cannabis in the US and around the world. DFCR launched in 2016 with its Declaration of Principles, and soon after we published a Platform of Regulations. Thanks to the active participation and support of its worldwide membership, DFCR has chosen a multifaceted approach to the realization of our Mission:

• Writing. Our members publish op-eds, letters to the editor, and open letters in both medical and lay publications. Through our articles, we make the well-reasoned case for regulation as an alternative to prohibition and its little sibling — decriminalization.
• Speaking. Vetted DFCR spokespeople appear in a variety of public settings, including town halls, places of worship, and conferences. We are available for media interviews and frequently appear in online, broadcast and print media.
• Teaching. DFCR believes that evidence-based education is the best way to dismantle the failed prohibition of cannabis. Through the written and spoken word, DFCR educators share the science of the endocannabinoid system with physicians, trainees, and other healthcare professionals. We also teach lay audiences, from teens to adults, about the evidence-based health effects of cannabis use.
• Advocating. DFCR experts have testified before the U.S. Congress and many state legislatures around the country. And through special projects, such as DFCR’s NFL campaign, we’re working to end the stigmatization of cannabis users.