In a Health Affairs Forefront article, three researchers outline some of the harms created by marijuana commercialization and call for increased regulation and enforcement.

The main point: The authors argue that the problem is not legalization itself, but the default to commercialization, which treats drugs like any other consumer product and revolves around profit.

• From a public health standpoint, legalization means using licensing, taxation, product standards, marketing restrictions, public education, and enforcement to make substances less harmful, not more profitable. It means ending incarceration for drug use while making harmful substances harder to access, less potent, and less appealing, especially to young people.
• The bottom line: Measured against that standard, state marijuana markets are failing.

The details:

• Companies compete to sell stronger products more cheaply, in more appealing forms, while enforcement of even the modest rules on the books (e.g., warning labels, advertising restrictions, sales limits) is often weak or nonexistent.
• Commercialization has normalized heavy use, expanded access, and created powerful commercial interests whose obligation is to shareholder value, not public health.

Recommendations:

• States should adopt a regulatory model that includes strictly limited licenses and sales outlets, restrictions on potency, taxes that raise prices without fueling an illicit market, bans on advertising and promotion, prominent health warnings, and enforcement.
• Amid federal rescheduling, the Food and Drug Administration (FDA) and Federal Trade Commission (FTC) should treat unsubstantiated therapeutic claims by marijuana retailers the way they treat unlawful health claims for any other consumer product.