Marijuana policies: A call to shift from a criminal justice approach to a public health approach

Despite the billions of dollars, marijuana prohibition has cost society; this strategy has failed to protect communities. Instead, it has caused great harm, particularly for marginalized populations. These adverse outcomes are rooted in policies enacted to tackle this public health problem that has little to do with public health.

Marijuana possession continues to be treated as a criminal matter, even though, historically, there are no examples of criminal law solving a public health matter. In effect, this punitive approach has supported mass incarceration for relatively minor offenses, placing an excessive burden on taxpayers, destroying communities, and perpetuating racial biases. 

Ineffective and excessive criminal justice responses 

The decades-long War on Drugs has resulted in harsh sentencing laws and has contributed to one of the highest rates of mass incarceration in the world.

In 2006 alone, there were 829,625 marijuana arrests. During the 1990s through 2005, marijuana arrest rates nearly doubled from 20 percent to 40 percent, but past-month use among high school seniors during this same time increased. Average potency and availability have also increased, despite this sweeping response from the criminal justice system. Criminalization is ineffective.

This overreaction from the criminal justice system is in part due to marijuana currently being classified as a Schedule I drug, the same classification given to heroin. Drugs in this classification are claimed to have the potential for abuse, no currently accepted medical uses, and lack of accepted safety for medical use. Marijuana, however, does not meet these criteria; thus, keeping it as a Schedule I drug unjustifiably maintains its prohibition. 

Racial disparities in enforcement

Non-white individuals are disproportionately targeted by law enforcement, with blacks 3.73 times more likely than Whites to be arrested for marijuana possession nationally, despite similar rates of use.

This disparity is even more extreme in individual states, such as Iowa, where blacks are 8.34 times more likely to be arrested than Whites for marijuana. These figures are consistent with many other sources of evidence that suggest systemic racism drives enforcement patterns. 

Preventing adolescent use

While decriminalization of marijuana is projected to have many economic and social benefits, legislation must balance decriminalization with the need to prevent teenage use. Teenage marijuana use can alter the course of brain development and increase risk for dependence and possibly addiction. Heavy use in adolescence has been associated with several developmental delays. Importantly, when teenagers believe using a drug is not harmful, they are more likely to use it. 

With the loosening of laws surrounding marijuana use, we might anticipate an increasing number of youths more likely to partake. Accordingly, age limits on access to, possession of, and use of marijuana should be concurrently enforced. Also of the utmost importance is for the public to be informed of the hazards of use during adolescence so that appropriate precautions can be taken at the household and community levels.   

Policy recommendations

A substantial body of research justifies reallocating resources from criminal justice to public health policies. A public health approach focuses on the implementation and enforcement of regulations to manage health risks through policy changes, such as taxation, regulation of advertising, and age limits. Several policy recommendations are offered here for consideration:

1. Support a detailed, comprehensive, scientific evaluation of the impacts from current laws surrounding both medical marijuana and adult-use to guide future legislation. 
2. Re-categorize marijuana from Schedule I to Schedule III or IV to be more consistent with its known pharmacological properties and effects. 
3. Update the regulatory structure by applying uniform standards to the types of products that can be sold or marketed to the public. 
4. Invest prevention resources in delaying the age of initiation of marijuana use past the period when the brain is still developing (around age 25) to reduce the impact on neurodevelopment.
5. Support screening, early detection, and intervention. Focus both on at-risk youth who have not yet initiated to avert pathways to use in adolescence and youth who have already begun using marijuana to avoid negative consequences. 

It is time to move away from a criminal approach to marijuana policy and towards a public health approach to more appropriately and effectively allocate precious resources, avoid racial bias, and prevent adolescent misuse.

Elizabeth Long, Ph.D. is a postdoctoral scholar at the Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, and a member of the National Prevention Science Coalition to Improve Lives (NPSC). Diana Fishbein, Ph.D., is a professor and program director at The Pennsylvania State University and co-director of the National Prevention Science Coalition to Improve Lives (NPSC).