Q&A: ACP calls for a public health approach to evidence-based cannabis policy
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Key takeaways:
- The ACP recommends that cannabis policy be based on strong scientific evidence.
- More research into the drug’s potential therapeutic and adverse effects is needed.
The ACP recently recommended an evidence-based, public health-focused approach to addressing cannabis use.
The organization made several recommendations in a position paper published in the Annals of Internal Medicine. The authors wrote that, despite the rapidly changing public policy on cannabis in the United States, the drug’s federal legal status has limited research into its potential adverse or therapeutic health effects. A recent Healio special report that summarizes the current scientific research and incorporates expert opinion is available here.
Healio spoke with Isaac O. Opole, MBChB, PhD, MACP, president of the ACP, to learn about the recommendations, what primary care providers need to know about cannabis use and more.
Healio: Why did the ACP release this position paper?
Opole: More and more states have legalized or are moving toward legalizing “medicinal” and recreational use of cannabis, also known as marijuana, without much attention to scientifically proven therapeutic uses or potential negative health effects. The ACP feels that adopting a public health approach can help prevent and control adverse cannabis-related health outcomes and promote research into potential therapeutic benefits of cannabis and cannabinoids. The ACP also recognizes and hopes to mitigate injustices resulting from drug control policies that have disproportionately affected marginalized sectors of our population. This paper details the rationale for the ACP’s policy position.
Healio: What should PCPs specifically know about the complicated relationship between cannabis and health care?
Opole: PCPs should know that the ACP encourages education and research into the health effects of cannabis and cannabinoids. Many physicians, even those who prescribe “medical cannabis,” have little or no training on its health effects, partly because there is sparse research or information available. The ACP encourages medical schools to develop curricula to train physicians in the health effects — positive and negative — of cannabinoids and for continuing medical education providers to develop up-to-date content that PCPs can use to educate themselves on cannabis use.
Healio: One of the recommendations noted the ACP “supports an evidence-based public health approach to addressing cannabis and hemp-derived products,” focusing on preventing unsafe use among adults and prohibiting access to children and adolescents. What might this approach look like?
Opole: Cannabis has a negative effect on the developing brain, so we need to prevent cannabis use among young people. We can start by building upon strategies from tobacco and alcohol regulation and applying them to cannabis — restricting sales to people aged younger than 21 years, banning packaging that attracts kids, requiring childproof packaging and other interventions. We also need to adopt population health strategies to prevent cannabis use among pregnant people and intoxicated driving. To help address the disproportionate harm that the nation’s drug control policies have had on systemically marginalized communities, we recommend policymakers decriminalize the possession of small amounts of cannabis to encourage treatment rather than incarceration of persons with cannabis use disorder.
Healio: What role would PCPs play in this approach?
Opole: PCPs are the front line of patient care, but are also the vanguard of clinical research — evaluating patients on clinical drug trials, vaccines, etc. They can play a pivotal role in any cannabis use research program through their expertise and access to a wide patient population.
Healio: What is the take-home message for PCPs here?
Opole: Legal cannabis is here. We need to be aware that our patients are or will be consumers of cannabis. We need to participate in research and policy around cannabis for the benefit of and to avoid harm to our patients.
Healio: Is there anything else you would like to add?
Opole: The changes in the legal status of cannabis have outpaced the evidence base. The ACP believes that legalization and other policies around cannabis should be based on strong scientific evidence. Most people live in a state where cannabis can be obtained legally for medical or recreational purposes. We need to establish a robust public health strategy to prevent use among the most vulnerable. The ACP also believes in decriminalization and removal of discriminatory practices and social stigma around cannabis.