Until November 2012, no modern jurisdiction had removed the prohibition on the commercial production, distribution, and sale of marijuana for nonmedical purposes—not even the Netherlands. Government agencies in Colorado and Washington are now charged with granting production and processing licenses and developing regulations for legal marijuana, and other states and countries may follow. Our goal is not to address whether marijuana legalization is a good or bad idea but, rather, to help policymakers understand the decisions they face and some lessons learned from research on public health approaches to regulating alcohol and tobacco over the past century. Marijuana legalization is no longer an abstract notion. In November 2012, voters in Colorado and Washington passed initiatives that not only made it legal to possess up to an ounce of marijuana for nonmedical purposes but also allow for-profit firms to supply the market. Colorado’s initiative additionally allows home production. Although marijuana remains illegal under federal law, policymakers in these states are now developing regulatory regimes that will allow licensees to produce and sell marijuana and other cannabis products, including infused candies and other edibles, to anyone who is aged 21 years or older. (“Marijuana” is an American term, customarily applied to the dried leaves and flowers of the cannabis plant. There are other cannabis plant products, including resin, which is referred to in the United States as “hashish.” The majority of cannabis consumed in the United States is in the form of marijuana, which is probably why initial state legalization statutes that have passed are specifically about “marijuana” although even these laws do not mean to be restrictive in their terms. For example, Washington speaks of “marijuana-infused” drinks and edibles, and Colorado’s Amendment 64 defines “marijuana” to be all possible products of the plant except industrial hemp.) Bills to legalize marijuana are being introduced in other states, and we will likely see more ballot initiatives in future elections. Although many jurisdictions have experimented with alternatives to strict marijuana prohibition, including decriminalization, medical marijuana, and the Dutch “coffee shops,” no industrialized nation has legalized the cultivation, processing, distribution, and supply of marijuana for recreational purposes in the modern era—not even the Netherlands. In the Netherlands, de facto legalization extends only to retail sales of up to 5 grams; wholesale distribution of marijuana to coffee shops remains illegal and is actively enforced. That is not to say that it has never been legal; in fact, marijuana was a legal commodity in the United States until the early 1900s. But regulatory policy on the cultivation, processing, distribution, and sale of marijuana and its derivative products is unprecedented in the modern era. Because there are no modern examples of marijuana regulation, policymakers are confronting many new questions about how to manage a marijuana market. Should the number of licensees be restricted, and, if so, how should those scarce licenses be allocated? Should vertical integration be allowed, or should there be separate licenses for growing, processing, and selling marijuana? What product safety requirements should be considered (in terms of specific ingredients allowed or disallowed), and who will be responsible for testing the product? How restrictive should licenses be in terms of permitted quantity and potency? Should taxes be assessed per unit weight, as a percentage of value (ad valorem), or on some other basis, such as Δ-9-tetrahydrocannabinol (THC) content? Should marijuana be sold in conventional stores alongside other products or only in specialized venues? What about within-state Internet sales? Although the questions are new for marijuana, policymakers have grappled with similar questions pertaining to alcohol and tobacco, raising the question of what lessons can be learned from these 2 substances and applied to marijuana policy. We have summarized insights and ideas that grew out of a meeting of alcohol, tobacco, and illicit drug policy experts hosted by the RAND Drug Policy Research Center on February 11, 2013, to foster discussions about how one might regulate marijuana to promote public health objectives assuming a decision to legalize has already been made. The arguments here do not necessarily reflect the opinions of every coauthor but, instead, reflect a general consensus of ideas that grew out of those discussions. The conference was filmed by C-SPAN. 1.
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