Cannabis in the United States

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Marihuana Tax Act of 1937 $1 marijuana revenue stamp, 1937 issue
US cannabis arrests by year[1][2][3][4]

The use, sale, and possession of

recreational use.[8][9]

Cannabis for industrial uses (hemp) was made illegal to grow without a permit under the CSA because of its relation to cannabis as a drug, and any imported products must adhere to a

2018 Farm Bill.[13]

As a

U.S. Supreme Court has ruled in United States v. Oakland Cannabis Buyers' Cooperative (2001) and Gonzales v. Raich (2005) that the federal government has a right to regulate and criminalize cannabis, whether medical or recreational. As a result, cannabis dispensaries are licensed by each state;[16] these businesses sell cannabis products that have not been approved by the U.S. Food and Drug Administration,[17] nor are they legally registered with the federal government to sell controlled substances.[18] Although cannabis has not been approved, the FDA recognizes the potential benefits and has approved two drugs that contain components of marijuana.[19]

The ability of states to implement cannabis legalization policies was weakened after U.S. Attorney General

U.S. attorneys to enforce federal law related to marijuana.[20] The Cole memo, issued by former Deputy Attorney General James Cole in 2013, urged federal prosecutors to refrain from targeting state-legal marijuana operations.[21] Regarding the medical use of cannabis, the Rohrabacher–Farr amendment still remains in effect to protect state-legal medical cannabis activities from enforcement of federal law.[22][23] On May 1, 2024, the Associated Press reported on federal plans to change marijuana to a Schedule III drug.[24]

Historic overview

The Marihuana Tax Act of 1937 was one of the first measures to tax cannabis nationwide.[25] This act was overturned in 1969 in Leary v. United States, and was repealed and replaced with the Controlled Substances Act (CSA) by Congress the next year.[26] Under the CSA cannabis was assigned a Schedule I classification, deemed to have a high potential for abuse and no accepted medical use – thereby prohibiting even medical use of the drug. The classification has remained since the CSA was first signed into law, despite multiple efforts to reschedule.[27][28] In direct response, the U.S. Libertarian Party was one of the first major parties to endorse cannabis legalization in their first platform in 1972 which stated, "We favor the repeal of all laws creating "crimes without victims" now incorporated in Federal, state and local laws—such as laws on voluntary sexual relations, drug use, gambling, and attempted suicide."[29] As cannabis prohibition continued into the 21st Century, the U.S. Marijuana Party was formed in 2002 as a single-issue party to end the war on drugs and to legalize cannabis.[30] States have also begun to engage in the process of nullification to override federal laws pertaining to cannabis. California started the trend by legalizing medicinal cannabis in 1996.[31] Now, cannabis has been fully legalized for recreational use in 24 states, three U.S. territories and Washington D.C., with most states having some sort of state nullification of federal cannabis laws.[32] In 1969, Gallup conducted a poll asking Americans whether "the use of marijuana should be legal" with only 12% at the time saying yes.[33] In 1977, it rose to 28% and experienced a period of gradual increase thereafter. According to the latest poll, two-thirds of Americans think marijuana use should be legal.[34] In addition, a report by Business Insider indicates that in 2022 alone, Americans spent an estimated $30 billion on legal marijuana products. The report further predicts that legal pot sales could surpass $33 billion in the current year, surpassing combined sales of chocolate and craft beer.[35]

Usage

A large cannabis flower bud, Alaska

Roger Roffman, a professor of social work at the University of Washington, asserted in July 2013 that "approximately 3.6 million Americans are daily or near daily users."[36] Peter Reuter, a professor at the School of Public Policy and the Department of Criminology at the University of Maryland, College Park, said that "experimenting with marijuana has long been a normal part of growing up in the U.S.; about half of the population born since 1960 has tried the drug by age 21."[36] A World Health Organization survey found that the U.S. is the world's leading per capita marijuana consumer.[37] The 2007 National Survey on Drug Use & Health prepared by the U.S. Department of Health and Human Services indicated that 14.4 million U.S. citizens over the age of 12 had used marijuana within a month.[38] The 2008 survey found that 35 million Americans[39] were willing to tell government representatives[40] that they had used marijuana in the past year.[39]

According to the 2001 National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services, 41.9% (more than 2 in 5) of all Americans 12 or older have used cannabis at some point in their lives, while 11.5% (about 1 in 9) reported using it "this year."[41] According to a 2022 Gallup survey, 16% of Americans reported being marijuana smokers (up from 7% in 2013) and 48% reported trying marijuana at some point in their lifetimes (up from 4% in 1969).[42]

Medical use is a common reason people buy cannabis online. According to the National Institute on Drug Abuse, "Medical marijuana refers to using the whole unprocessed marijuana plant or its basic extracts to treat a disease or symptom." While some report symptom relief from buy cannabis online, scientific evidence on its effectiveness remains inconsistent. More research is needed to confirm its benefits and evaluate potential risks. However, the U.S. Food and Drug Administration (FDA) has not officially approved

marijuana as a medicine.[43]

Cannabis has been used for its therapeutic effects since it was first documented in China in 2800 Bc. In the 19th century scientist believed that using drugs like cannabis can prevent and cure diseases due to the plants therapeutic properties.[44]

Health effects

Main article: Effects of cannabis

Approximately 18 million adults, nearly a third of users aged 18 and older, have reported symptoms of cannabis use disorder, according to a data analysis by a Columbia University epidemiologist for The New York Times. This reflects ongoing use despite significant negative impacts, with around three million individuals classified as addicted. These estimates are based on the 2022 U.S. national drug use survey, which focused on individuals who reported cannabis consumption in the past year. Among those aged 18 to 25, over 4.5 million reported using cannabis daily or nearly every day, and 81 percent of these users met the criteria for cannabis use disorder. Wilson Compton, deputy director of the National Institute on Drug Abuse, noted that this suggests that almost all daily users report problems related to their use, and that it is "a very clear warning sign." In 2023, the federal government's National Survey on Drug Use and Health reported a cannabis use disorder rate of 16.6 percent among individuals aged 18 to 25, which was comparable to the rate of alcohol use disorder at 15.1 percent.[45]

Cannabinoid hyperemesis syndrome, resulting from heavy cannabis use, is characterized by nausea, vomiting, and abdominal pain. It can lead to severe dehydration, seizures, kidney failure, and cardiac arrest, with at least eight reported deaths in the United States. Since its documentation in 2004, there has been a significant rise in reported cases. Accurate tracking of the condition is difficult due to inconsistent recording in medical records. Researchers estimate that up to one-third of near-daily cannabis users in the U.S. may experience symptoms, ranging from mild to severe, affecting approximately six million people. The rise of the syndrome in the past two decades coincides with the expansion of marijuana legalization in the United States. According to data from the nonprofit Health Care Cost Institute, cannabis-related diagnoses among individuals under 65 with employer-paid insurance increased by over 50 percent nationwide between 2016 and 2022, rising from approximately 341,000 to 522,000. The organization stated that these figures "almost certainly" represent an undercount.[45]

In 2017, the National Academies of Sciences, Engineering, and Medicine released a review of research on the health effects of cannabis, highlighting that the absence of evidence-based information represents a public health risk.[45]

Legality

Main articles: Legality of cannabis by U.S. jurisdiction and Legal history of cannabis in the United States
See also: Medical cannabis in the United States and Legalization of non-medical cannabis in the United States
Gallup polls in US on legalizing marijuana. See data table below.[46]
Gallup polls. Do you think the use of marijuana should be legal, or not?[46]
Date % Yes, legal
10/2/2023 70
10/3/2022 68
10/1/2021 68
10/1/2020 68
10/1/2019 66
5/15/2019 64
10/1/2018 66
10/5/2017 64
10/5/2016 60
10/7/2015 58
10/12/2014 51
10/3/2013 58
11/26/2012 48
10/6/2011 50
10/7/2010 46
10/1/2009 44
10/13/2005 36
11/10/2003 34
8/3/2001 34
8/29/2000 31
8/28/1995 25
5/17/1985 23
6/27/1980 25
5/18/1979 25
4/1/1977 28
1/26/1973 16
5/3/1972 15
10/2/1969 12

Federal

Since the

U.S. Constitution, federal law preempts conflicting state and local laws. In most cases, the absence of a state law does not present a preemption conflict with a federal law.[23]

The federal government criminalized marijuana under the

U.S. Supreme Court in Gonzales v. Raich
, 545 U.S. 1, in 2005.

In January 2009, President

Wo/Men's Alliance for Medical Marijuana (WAMM) provided an example confirming the administration policy as communicated by Attorney General Eric Holder, as WAMM reached an agreement that allowed them to re-open after being shut down by the federal government in 2002.[49][50]

Following the 2012 presidential election, the Office of National Drug Control Policy under the

Federal Reserve regulations.[53]

On August 29, 2013, the Justice Department adopted a new policy (known as the Cole memo) regarding the enforcement of federal law in states that have legalized non-medical cannabis. The policy specified that commercial distribution of cannabis would be generally tolerated, except in certain circumstances, such as if violence or firearms are involved, the proceeds go to gangs and cartels, or if the cannabis is distributed to states where it is illegal.[54]

On December 11, 2014, the Department of Justice told U.S. attorneys to allow Native American tribes on reservations to grow and sell marijuana, even in states where it is illegal. The policy will be implemented on a case-by-case basis and tribes must still follow federal guidelines.[55]

On May 30, 2014, the

U.S. House of Representatives passed the Rohrabacher–Farr amendment, prohibiting the Justice Department from spending funds to interfere with the implementation of state medical marijuana laws. The amendment became law in December 2014, and must be renewed each year in order to remain in effect.[56]

On March 10, 2015, U.S. Senators Rand Paul, Kirsten Gillibrand, and Cory Booker introduced the Compassionate Access, Research Expansion and Respect States Act or CARERS Act. The bipartisan bill would move cannabis from Schedule I to Schedule II of the Controlled Substances Act. This would allow states with medical cannabis laws to legally prescribe it, and allow for much easier research into its medical efficacy. The bill would also allow grow sites besides the University of Mississippi, which has long been the sole supplier of cannabis for academic research, to supply cannabis for study.[57]

The Food and Drug Administration has approved two synthetic cannabis drugs for treating cancer and other medical issues.

U.S. Public Health Service). Many officials point to the difficulty of regulating dosage of cannabis (a problem for treatment as well as research), despite the availability (in Canada and the United Kingdom) of dosage-controlled Sativex. The U.S. has also pressured other governments (especially Canada and Mexico
, with which it shares borders) to retain restrictions on marijuana.

On January 4, 2018, the Cole memo was rescinded by Attorney General Jeff Sessions, restoring the ability of US Attorneys to enforce federal law in states that have legalized non-medical cannabis.[59]

On December 20, 2018, President

delta-8-THC, which is also psychoactive and has since become more popular recreationally across the U.S.[61]

In February 2019, three researchers used MedMen as a case study to illustrate their concerns with marijuana companies' marketing practices.[62] The authors criticized MedMen's use of health claims without health warnings and their appeals to youth. They called for federal regulators to investigate the marketing practices of MedMen and other US-based marijuana companies.

In June 2021, Supreme Court justice Clarence Thomas stated that "A prohibition on interstate use or cultivation of marijuana may no longer be necessary or proper to support the federal government's piecemeal approach," criticizing "[t]he federal government's ... half-in, half-out regime that simultaneously tolerates and forbids local use of marijuana."[63]

In 2022, President Joe Biden released a budget proposal that did not extend protections for states violating federal laws around marijuana. It also did not give the District of Columbia permission to legalize, which drew mild surprise among political observers given the Democratic Party's support of D.C. autonomy.[64]

In July 2022, Cannabis Administration and Opportunity Act "CAOA" (see Text of S.4591)' was introduced by Senators Cory Booker (D-NJ), Chuck Schumer) (D-NY), and Ron Wyden (D-OR) with the aim of decriminalizing cannabis on the federal level and officially acknowledging states' own marijuana laws.[65] Even though the bill includes both Democratic and Republican priorities, it appears unlikely to pass.[66]

President Biden
discusses rescheduling of cannabis.

While marijuana has been decriminalized throughout many states in the US, it remains a Schedule I drug as of October 2024. However, on January 12, 2024, the FDA announced its recommendation that marijuana be moved to a Schedule III drug, which is a much less strictly-regulated category and would acknowledge its potential for medical use.[67] If marijuana is rescheduled according to these recommendations, it would no longer be placed alongside drugs such as heroin and, instead, be placed alongside drugs such as ketamine.

This process is very lengthy, and first required a two month period for public comment, from May 21 to July 22.[68] There were nearly 43,000 comments in total, about 69% of whom stated the government should instead decriminalize marijuana entirely, with 23% supporting the move and 8% wanting marijuana to remain a schedule I drug.[69] Since then, a public hearing has been scheduled for December 2, and reclassification will not occur until after then.[70]

Marijuana's status and classification under federal law hinders oversight and scientific research. States have implemented inconsistent standards and regulations, with only two states capping THC levels in most recreational marijuana products and just ten requiring warnings about the potential for habit formation. Even fewer states mandate warnings regarding cannabinoid hyperemesis syndrome or psychosis, and none are equipped to monitor or assess the full range of health outcomes related to cannabis use.[45] A 2024 report from the National Academies of Sciences highlights the inconsistent legal framework surrounding cannabis legalization, which prioritizes sales revenue and taxes over public health.[71] The report calls for a more unified approach to cannabis regulation, including a federal campaign to educate the public about the risks of increasingly potent cannabis products.[72] It also advocates for lifting restrictions on cannabis research to better understand its health impacts. The CDC is urged to take a more active role in shaping cannabis policy, but additional funding would be required to implement these recommendations.[73]

State

See also: Legalization of non-medical cannabis in the United States and Medical cannabis in the United States
Retail store, Homer, Alaska

In 1973 Oregon became the first state to decriminalize cannabis, and in 2012 Colorado and Washington became the first states to legalize recreational use.[74] As of November 2023, twenty-four states (Alaska, Arizona, California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont, Virginia, and Washington), Guam, the Northern Mariana Islands, the U.S. Virgin Islands, and the District of Columbia have legalized recreational use of cannabis, with all but Virginia and D.C. having legalized its commercial sale.[75] Another 7 states are considered to have decriminalization policies in effect.[75]

In 1996, California became the first state to legalize the medical use of cannabis when voters approved

Proposition 215.[74] As of March 2023, thirty-eight states, four out of five permanently inhabited U.S. territories, and the District of Columbia have legalized medical cannabis.[9] Ten other states have more restrictive laws limiting THC content, for the purpose of allowing access to products that are rich in cannabidiol (CBD), a non-psychoactive component of cannabis.[9] In 2024 thirty-seven states including District of Columbia have legalized the use of medical marijuana and CBD including recreational use as well.[76]

It was reported that in 2023 the states with marijuana legalized for personal consumption purposes generated around 4.2 billion in annual tax revenue. However this income does not include city takings or the proceeds that are taken to be distributed to smaller administrative divisions. This means that the number 4.2 billion was actually quite higher to begin with.[77]

State and territory laws

Main article: Legality of cannabis by U.S. jurisdiction
2018 Farm Bill.


Research

Prior to 2021, the National Center for Natural Products Research in Oxford, Mississippi was the only facility in the U.S. that was federally licensed by the Drug Enforcement Administration to cultivate cannabis for scientific research. The facility is part of the School of Pharmacy at the University of Mississippi, and cultivates cannabis through a contract with the National Institute on Drug Abuse, to which it provides the cannabis.

Cannabis research has been hindered by the monopoly held by the National Institute on Drug Abuse that existed prior to 2021.[78] The cannabis supplied by NIDA has been criticized by researchers for a variety of reasons, including high amounts of stems and seeds,[79] high mold and yeast levels,[80] low THC content,[27] and low diversity of strains available.[79] NIDA has also been criticized for the length of time in which it responds to proposals, and for favoring research on the harms caused by cannabis over research on the health benefits of cannabis.[81] In August 2016 the DEA announced intention to issue additional cultivation licenses, however,[82] and in 2021 the first licenses were granted.[83][84]

Research conducted on cannabis also requires licensing from the DEA (specific to Schedule I drugs),

U.S. Public Health Service, but this requirement was eliminated to make it less difficult for cannabis research to be approved.[86] Numerous medical organizations in the U.S. have called for restrictions on cannabis research to be further eased, including the American Academy of Family Physicians,[87] American Psychological Association,[88] American Cancer Society,[89] American Academy of Pediatrics,[90] and the American Nurses Association.[91]

Crime

United States Bureau of Justice Statistics[92]

The great majority of cannabis arrests are for possession.[93] However, in 1997, the vast majority of inmates in state prisons for marijuana-related convictions were convicted of offenses other than simple possession.[94]

According to the Federal Bureau of Investigation's annual Uniform Crime Report, there have been over twelve million cannabis arrests in the U.S. since 1996, including 749,825 persons for marijuana violations in 2012. Of those charged with marijuana violations in 2012, 658,231 (88%) were charged with possession only. The remaining 91,593 individuals were charged with "sale/manufacture", a category that does not differentiate for cultivation offenses, even those where the marijuana was being grown for personal or medical use. Marijuana arrests comprise almost one-half (48.3%) of all drug arrests reported in the U.S.[95] According to the American Civil Liberties Union, there were 8.2 million marijuana arrests from 2001 to 2010, and 88% of those arrests were just for having marijuana with them.[96]

Racial disparity in marijuana arrests

In a study done by the American Civil Liberties Union, from 2001 to 2010 Black and white people use marijuana at about the same rate.[97] Nationwide, Black people are 3.6 times more likely than white people to be arrested for marijuana, despite similar usage rates.[98] Racial disparities vary in severity among states. For example, Colorado has the lowest disparity with Black people being 1.5 more likely than whites to be arrested for marijuana. On the other hand, in Montana, Kentucky, Illinois, West Virginia and Iowa, Black people are more than seven times more likely to be arrested for marijuana than white people.[98] Nonetheless, in all states whether marijuana is legalized, decriminalized or illegal, Black people still are more likely of going to prison on marijuana charges,[98] proving that legalizing or decriminalizing marijuana alone will not change the disparity.

Racial profiling among law enforcement is to blame for these disparities. Law enforcement often targets people on their actual and perceived race instead of having reasonable suspicion for a crime.[98] Minor offense like possession of marijuana are strictly enforced in racial communities, while the same offenses are often ignored in white affluent communities.[98] This racial profiling results in the mass incarceration of Black, Hispanic and Latino individuals.

Political support

Main article: Cannabis political parties of the United States

The

Libertarian Party and the Green Party are known for advocating for the legalization of marijuana.[99] There are also active cannabis political parties in at least five states. These include the Grassroots–Legalize Cannabis Party, the Legal Marijuana Now Party, the Legalize Marijuana Party, and the U.S. Marijuana Party
.

History of cannabis political parties in the U.S.

In July 2016, delegates at the

party platform calling for cannabis to be removed from the list of Schedule I substances, as well as calling for a "reasoned pathway for future legalization".[110]

Polling

Gallup began polling the public as to the issue of legalizing cannabis in 1969; in that year 12% were in favor.[111] The 2017 Gallup poll showed a record high of 64% in favor of legalizing cannabis, including a majority of Republicans for the first time.[112] In 2018, the same poll increased to an all-new high of 68%, showing that the great majority of Americans favored legalizing recreational marijuana.[113]

According to a 2013 survey by Pew Research Center, a majority of Americans favored complete or partial legalization of cannabis.[114] The survey showed 52% of respondents support cannabis legalization and 45% do not. College graduates' support increased from 39% to 52% in just three years, the support of self-identified conservative Republicans (a group not traditionally supportive of cannabis legalization) had increased to nearly 30%, and bipartisan support had increased across the board. The 2018 version of the poll showed public support had increased to 61%.[115]

Attitudes regarding marijuana regulation changed as some states (Colorado, Washington, Oregon, Maine, and Alaska) passed their own laws legalizing marijuana for recreational use. According to a Gallup Poll published in December 2012, 64% of Americans believe the federal government should not intervene in these states.[116]

A 2018 study in Social Science Research found that the main determinants of these changes in attitudes toward marijuana regulation since the 1990s were a decline in perception of the riskiness of marijuana, changes in media framing of marijuana, a decline in overall punitiveness, and a decrease in religious affiliation.[117]

Marijuana legalization polled as very popular in 2019 according to three major national polls.[118]

See also

Advocacy

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Further reading

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