States could substantially reduce marijuana’s price and increase heavy use and marijuana-related problems such as dependence and substance misuse among those who already use the drug. In the longer term, legalization may also increase the number of new users (Hall & Lynskey, 2016). To provide background to the issue of legalization of marijuana, the following is a brief outline of the history: ● 1850 : In the United States, marijuana was sold over the counter and was commonly used as treatment for such diseases as cholera, alcoholism, opiate addiction, and convulsive disorders. ● 1906 : Congress passed the Pure Food and Drug Act, a piece of legislation designed to restrain abuses in the patent- medicine industry. It was also the first piece of legislation in the United States to mention marijuana. Until this time, there was no concerted effort on the part of the government to regulate psychoactive substances. Cocaine was still in Coca- Cola; heroin kits were available for sale in the Sears, Roebuck catalog. No drug was illegal. ● 1930 : The Federal Bureau of Narcotics (FBN) was established. ● 1936 : Every state then in the union passed a law restricting possession of marijuana and eliminating its availability as an over-the-counter drug. ● 1937 : Although opposed by the American Medical Association, the Marihuana Tax Act of 1937 was passed to prohibit all nonmedical use of marijuana in the United States. However, the law also limited medical use with fees and regulatory restrictions that imposed a significant burden on physicians prescribing marijuana. ● 1970 : On October 27, 1970, the Comprehensive Drug Abuse Prevention and Control Act was enacted. Title II of the Act – The Controlled Substances Act – established categories varying from Schedule I (the strictest classification) to Schedule V (the least strict). Marijuana was placed in the Schedule I category, thereby prohibiting its use for any purpose. ● 1996 : California voters approved Proposition 215 to legalize medical marijuana. However, the Clinton Administration opposed the proposition and threatened to revoke the prescription-writing privileges of doctors who prescribed the drug. Since the passage of Proposition 215, marijuana use among youth in California has declined significantly. (Lee, 2012) Although the federal government of the United States currently prohibits the sale and use of marijuana, as of June 14, 2022, 18 U.S. states, Guam, and the nation’s capital have passed legislation making recreational marijuana legal for all adults (Mayorquin, 2022), and most states allow for some use of medicinal marijuana (only 11 states prohibit the drug completely). The Marijuana Policy Project (n.d.) and the National Conference of State Legislatures (2019) provide Web-based resources that detail each state’s legalization status for medicinal marijuana. Contained within the federal budget are provisions to protect a state’s right to responsibly regulate medical marijuana programs. Since December 2014, the Rohrabacher- Farr amendment (now technically known as the Rohrabacher- Blumenauer amendment ; Higdon, 2017) has prohibited the Community considerations and concerns No single constituent determines the risks to public health from illicit marijuana use or misuse of medicinal marijuana. Apples, after all, are not removed from the market or banned from farms because the seeds contain cyanide. The risk is weighed against the benefit, which is often a matter of degree. The people and their state legislatures seem to be weighing risks against benefits as, one by one, states are voting to legalize marijuana in varying degrees after decades of prohibition. This section focuses on community health and education considerations and concerns related to the growth of the marijuana industry in American communities. When weighing the benefits and risks
Justice Department from spending funds to interfere with the implementation of state medical marijuana laws. This amendment must be renewed each fiscal year to remain in effect. Despite concerns that legalization of marijuana could increase crime risk, several studies have shown that laws allowing for medicinal marijuana and dispensaries are not associated with increased crime. In 2012, a study published in the Journal of Studies on Alcohol and Drugs found that the density of medicinal marijuana dispensaries was not associated with violent or property crime rates (Kepple & Freisthler, 2012). In 1914, the Harrison Narcotics Tax Act placed narcotics under the regulatory control of the federal government, restricting access to nonmedical consumers. The Harrison Narcotics Tax Act made the first legal distinction between recreational and medicinal use of drugs. That year, undercover sting operations led to the arrest of 25,000 physicians on narcotics charges. Three thousand were given prison sentences and “thousands had their licenses revoked for giving out opiates” (Lee, 2012, p. 41). The pharmaceutical industry’s lobby did, however, keep marijuana from being covered by the Harrison Narcotics Tax Act. Few people were smoking marijuana at the time, although some were still eating hashish. Prohibition of marijuana began in California, where it was outlawed in 1915. The political rationale was control of Mexicans in the labor force. “Arrests and convictions of ‘Mexican’ workers for marijuana possession were most concentrated during the years of, and in the areas with, the highest levels of labor organization and action” (Lee, 2012, p. 42). During most of the Prohibition era, marijuana was exempt from national crime legislation; however, in 1929 Congress passed the Narcotic Farms Act (later repealed in 1944), which misclassified Indian hemp as a habit-forming narcotic (Lee, 2012) and authorized construction of two hospitals in the prison system for treating drug addicts, including non-medicinal marijuana users deemed addicts (Lee, 2012). As a social upside, marijuana was at the center of the jazz culture that brought together Black and White Americans interested in the emerging music genre. By 1930, when the Federal Bureau of Narcotics was established, many states had banned marijuana. Marijuana is listed as a Schedule I substance under the Controlled Substances Act of 1970, the highest classification under the legislation, and remains illegal at the federal level. The Controlled Substances Act regulates the manufacture, importation, possession, use, and distribution of substances such as marijuana. A Schedule I drug, as defined by the U.S. Drug Enforcement Administration (DEA), is a substance that has a high potential of being abused by its users and has no acceptable medical use (DEA, n.d.). Recently, however, legislation has been rapidly changing at the state level. Health professionals, along with the public and legislators, are reviewing the evidence resulting from the changing marijuana laws. Some evidence suggests that recent more permissive medical marijuana laws have contributed to increased prevalence of illicit marijuana use and marijuana use disorders (Hasin et al., 2017). States recognize and make the policy for medicinal use, limited medicinal use, no access, or some recreational use. of using marijuana, some basic questions arise that are relevant to healthcare professionals as represented in professional white papers, position statements, and scientific discussions and publications: ● What do people who use marijuana in their self-care practices need in order to do so safely? ● What is the new role of government in protecting the public if it abandons marijuana prohibition? ● What are the roles and responsibilities of healthcare professionals related to marijuana use?
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