This week Eating in America has ventured out the kitchen door to the living room to explore something that might be on the coffee table of 44 million Americans in the last month. That is to say, cannabis.
Cannabis has become widely legal but also highly potent, and regulations are loose and vary by jurisdiction. Enforcement is sometimes loose. There is increasingly good evidence about the risks of cannabis use while at the same time it has become highly accepted as a mostly safe part of our recreational landscape, joining alcohol in that regard. It is also felt by millions of Americans to provide medical benefit that is mostly not available to them from the traditional medical system.
What should be medical cannabis look like going forward when each state that has medicalized it has a different system? How big is the money around cannabis today, and how is that influencing policy and public perceptions? And what are some policy changes that would help address safety and public health issues while aligning cannabis use and regulation with both science and public attitudes?
And what role does the continuing black market play as regulations are created and refined?
POTENCY
Higher levels of potency are linked to higher rates of cannabis use disorder, where an individual’s control over use begins to slip while some facet of life – health, relationships, work - is being negatively affected.
Growing technique boosted black market cannabis strength from 2% THC content, THC being the high-producing chemical in cannabis, in the 1960s to 17% by 2017. But it was the legalization of recreational cannabis in 24 states and Washington D.C. that spurred the creation of ultraprocessed cannabis now available in legal dispensaries and on the gray market. Extracted cannabis products in dispensaries are on offer at THC levels above 90%.
With legality has come not only potency but big money, with an estimated market of $47 billion in sales in 2026. Has the big money in cannabis found Big Tobacco’s playbook? Have they studied the page about encouraging the addictive effects of their products yet not acknowledging them? The gray market producers of high-level THC products made from low-THC hemp, a $24 billion industry, have taken advantage of the lack of age restrictions for hemp products and are blatantly marketing to minors, packaging THC-infused candy and treats in child-friendly packages. Getting them while young was an important chapter in the Big Tobacco playbook.
In the 1980s Big Tobacco acquired the ultraprocessed food companies General Mills, Kraft, and Nabisco and brought their playbook with them. The main premise of ultraprocessed food is hyperpalatability, the sense that a food is so good it is hard to stop eating. Addictive qualities and the targeting of children have been key to making ultraprocessed food a $2 trillion dollar industry.
The federal government joined with the states in the public health effort to control tobacco and together they have had great success reducing smoking rates. There remains much more to be done, and we can’t tolerate any more U.S. Surgeon General nominees like Casey Means, who owned stock in Big Tobacco.
But a framework in which ultraprocessed food could be limited has begun to be constructed, although controlling a $2 trillion dollar industry will demand a prioritization of public health that administrations so far have not been able to make.
The federal government’s position with Big Cannabis is actually better than it was with tobacco or ultraprocessed food. Cannabis is still illegal at the federal level. Loosening the cannabis law to a level of tight regulation will be easier than creating restrictions on largely unregulated markets, as was the case with tobacco and will hopefully be the case with ultraprocessed food.
Here are seven recommendations for federal cannabis policy.
Acknowledging that recreational cannabis use can be safe and is widely popular and that medical cannabis is regarded as uniquely beneficial by patients who use it, a public health first approach would call for, minimally:
1. Copious support for research into all aspects of cannabis use, including medical use for physical and mental health conditions.
2. Legalization and full regulation at the federal level, including strict product testing for contaminants and chemical components and full labeling of those components. Regulation would cover both recreational and medical products.
3. A minimum federal age requirement and safety labeling that would align with the development of scientific evidence about brain development concerns as it becomes available.
4. Federal marketing regulation that would require front of package safety labeling, forbid packaging that targets youth, and forbid health claims that are not fully supported by scientific evidence.
5. Creation of a window for transition of medical cannabis from state licensed dispensaries to pharmacies, with federal approval of the efficacy of a product allowing insurance coverage and lowered prices for patients.
6. Adherence to the November 2026 federal deadline to ban manufacturing and sale of hemp-based products with more than a non-intoxicating level of THC.
7. Critically, the setting of maximum strength levels across all types of cannabis products. These potency caps would need to be set at a conservative level until research could prove equivalent safety in higher dose products – or at least provide reliable estimates of increased risk with increased doses upon which to decide ultimate cap levels.
On this last point, researchers have proposed the need for potency caps, and others, including recently the New York Times Editorial Board, have proposed cannabis taxation based on product strength. In the same way as whiskey is taxed more than beer, products with higher concentrations of THC would be taxed more than lower THC products.
Tiered taxation might be warranted but only if done in combination with caps. It would be irresponsible to allow continued sales of THC concentrations that exceed amounts required for enjoyment by most people. Putting a government stamp of approval on high-doses is not in the public interest. Just as alcohol consumers can drink themselves into inebriation, so can cannabis users continue to consume cannabis until reaching a state of mind (or lack of it) equal to that reached more quickly with high-potency cannabis. They would still have the freedom to take that risk.
The result of implementing these measures would be a cannabis landscape somewhat similar to that for alcohol sales. Standards would be set at the federal level and licensing and most enforcement would remain at the local level. Taxation would occur at both the federal and state level, as with alcohol.
THE BLACK MARKET
The continued activity everywhere of the black or illicit market for cannabis is an important consideration in setting regulatory standards in a legalized environment.
Canada had good success in reducing illegal sales, which by 2023 had dropped from 88% to 24% of total sales in the five years following recreational legalization in 2018. (It’s noteworthy that along with recreational legalization, medical sales in Canada decreased from 12% to 4% of total sales.)
In 2014 Uruguay became the first country to legalize cannabis, taking an approach that allowed cannabis clubs that could grow their own, home growing, and pharmacy sales of state-controlled and -priced product.
Initially the illicit, organized crime-controlled market in Uruguay remained dominant because of overly strict regulations for legal cannabis that included limiting THC levels to just 3%. To increase uptake of the government produced cannabis sold in pharmacies, maximum allowed THC levels were increased to 9%, then 15%, and currently 20%. The organized crime-controlled market is now only 7% of the total, although a gray market of distribution from home growers is estimated at 30% of the market.
Uruguay seems to demonstrate a model where potency caps can be put in place while keeping the least safe black market purchases, those from criminal enterprises, small in volume.
In the U.S., the volume of black market sales in legalized states varies, influenced by state taxes and regulations and local conditions. California is repeatedly mentioned as a state with significant black market and unlicensed retailer sales.
THE CREATION OF BIG CANNABIS
The political and countercultural revolution of the 1960s was the turning point for wide acceptance of cannabis in America. The advocacy group NORML was formed in 1970, and the call for legalization began and continued unabated with the work of activists and the funding of various pro-cannabis organizations and efforts by benevolent donors.
With the beginning of recreational legalization in 2012, corporate money took over the funding of activists and has also paid for political lobbyists. Large donations to legislators began to correspond closely to “yes” votes for legalization. Congressional efforts to legalize cannabis in 2021 attracted $4 million in lobbying by the cannabis industry and large expenditures by Big Tobacco and beer manufacturers.
The cannabis industry might exceed hundreds of billions of dollars in sales in the next decade. Just as with the explosion of ultraprocessed food beginning in the 1970s, the prospect of large cannabis profits has unleashed intense lobbying, in the case of cannabis for legalization and relaxed regulation.
The regulatory position of the cannabis industry is strengthened by the happiness of recreational use states which are enjoying the large cannabis tax revenues they are collecting: $4.4 billion in 2024, for example. In 2021, in 11 states with legal cannabis sales, cannabis taxes brought in more revenue than alcohol taxes by 20%.
As legalization pushes forward and the need for greatly increased regulation becomes more apparent, the flow of billions of dollars in sales and tax revenues will tend to make further increasing revenue a priority for states and a continued number one priority for the cannabis industry. Public health concerns will need active voices and strong defending.
That’s the conclusion of our series “Ultraprocessed Cannabis: Potency, Policy, and Public Health in America.” You can find the first three articles in the series at EatingInAmerica.co.
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