An ad hoc committee of the National Academies of Sciences, Engineering, and Medicine will review the public health impacts of cannabis and cannabinoid use, both medical and non-medical, among adults in the states and localities where it is legal. Specifically, the committee will:
• Describe the status of cannabis availability and use, including various product types (e.g., concentrates, edibles, dabs, vaping cartridges) and component cannabinoids (e.g., cannabidiol) in the US. Assess how different regulatory models have influenced the make-up of the cannabis industry, as well as product safety, composition and potency, dosage/serving size, availability, quality control, and labeling and marketing.
o Discuss the implications for public health of the various regulatory models. Where relevant, describe how lessons from other countries and from tobacco, alcohol, and other regulated products or industries can inform US regulations, and whether they have or have not been applied.
• Assess these regulatory frameworks through a social and equity lens, exploring outcomes such as employment, tax revenues, and other economic indicators; environmental impact of the cannabis and hemp agriculture; encounters with the justice system; impact on the unregulated market; and availability of community prevention and treatment resources for cannabis use disorder. Include, as appropriate social and equity impact of decriminalization and incarceration for cannabis possession.
• Describe strengths and weaknesses of existing state or national surveillance and pharmacovigilance systems for recreational and medicinal use and other data sources and identify key public health outcomes that could serve as sentinels for adverse exposure and health consequences. Such outcomes might include, but are not limited to, harmful exposures, adverse cancer outcomes and interactions with cancer treatments, low-birth weight, motor vehicle accidents, worker impairment and injury, poisonings in children, hospitalizations for acute mental health problems or for cardiovascular disease, indoor air quality, and use/co-use of other substances including alcohol and tobacco. Review what is known about whether these outcomes have changed in states and localities that have changed their regulatory approach to cannabis and cannabinoids. Data sources may include information on the medical conditions for which cannabis is prescribed by physicians or recommended by dispensaries, self-reported reasons for cannabis use, and beneficial health outcomes.
• Make comparisons throughout, as appropriate, to the illicit unregulated market.
• Provide recommendations for strengthening a harm reduction approach, which would minimize harms, of various regulatory models, including but not limited to social, employment, education, and health impacts.
• Make recommendations for policy research for the next 5 years.