More commercialized models of cannabis regulation in the United States are providing valuable insights. However, thinking about cannabis policy should not be limited to US experiences given the range of less commercialized policy options that are possible, and being explored elsewhere.
Cannabis legalization is arguably the most significant and rapidly evolving issue in drug policy today but, despite the increased attention devoted to the topic, legalization is still often treated as if it were a policy end-point, rather than the mere process that it is (namely, of making something il- legal, legal). Caulkins & Kilmer [1] remind us that what comes after legalization is the critical issue; all legal prod- ucts are subject to at least some degree of regulation, and the details of how that regulation is designed is key to whether legalization produces better outcomes than con- tinued prohibition.
Prices are of particular concern in a newly legal canna- bis market. Legalization is likely to lead to a dramatic re- duction in production costs which, in the absence of state interventions in the market, will translate into retail prices far lower than current illicit-market levels. This, in turn, is likely to trigger an increase in consumption, even if the ex- tent of such an increase remains largely speculative [2]. Even if regulated products are safer, this could still mean an increase in health harms. Policymakers seeking to legal- ize prudently must therefore use some mechanism to raise prices artificially and prevent levels of use from rising too high.
As Caulkins & Kilmer note, the cannabis tax regimes administered in US legalization states currently fall well short of making up this price gap. Although they may face political obstacles in the United States—where in many places there is deep-seated hostility to state intervention —there are other measures that can be effective in this re- gard, and merit consideration both in the United States and other jurisdictions exploring cannabis regulation.
Minimum unit pricing (MUP) is one option. Economet- ric modelling of the impact of MUP for alcohol suggests that it would reduce alcohol consumption and related harms, with heavier drinkers most affected [3]. MUP for alcohol has been approved in Scotland, although has not yet been implemented due to a legal challenge from the drinks in- dustry [4].
Direct price-fixing is another obvious way of mitigating against a fall in cannabis prices and subsequent increase in use. Having designed its nascent legal cannabis market along similar lines to Borland’s [5] ‘regulated market model’ for tobacco, the Uruguayan government will have a monopoly on the trade [6], enabling it to directly set can- nabis prices at, or marginally under, prices found on the country’s existing illicit market [7]. This is a cautious mea- sure, designed to provide at least some financial incentive for legal purchases (and thereby deprive the illicit market of trade), while at the same time moderate any price-re- lated impacts on levels of use.
Looking at other aspects of a legal cannabis market, Caulkins & Kilmer highlight that Uruguay’s ban on all can- nabis advertising and promotion is unlikely to be feasible in the United States because of laws guaranteeing so-called ‘commercial free speech’ [8]. However, it is important to recognize that many other countries will be far more ame- nable to restrictive controls of the kind Uruguay has im- posed. Hence, the same logic that has informed moves to legalize cannabis in the United States is likely to result in markedly different cannabis regulation models when ap- plied in Europe or Latin America, for example. The cul- tural, legal and political environment in which legal cannabis markets are developed is key.
However, that is not to say there is no scope to halt the march of commercialization—and the public health costs that tend to come with it—in the United States. Caulkins & Kilmer mention the possibility that states could place cannabis production and supply under the control of non-commercial entities such as ‘for-benefit’ corporations; and if the conflict between federal law and state law on cannabis can be negotiated, then a state monopoly may also be viable in the longer term.
It is therefore important not to allow thinking about regulatory designs for future legal cannabis markets be dominated by those that have already been established in the United States. More cautious alternatives exist, are feasible, and should be considered. Unlike with alco- hol and tobacco, with regard to cannabis regulation we have, for now, what is effectively a clean slate: we do not have to retrofit well-established commercial markets with tighter controls, in the face of industry resistance. It is up to policymakers to take advantage of this situation.
Declaration of interests
Both authors are employed by Transform Drug Policy Foundation—a UK-registered charity with a campaigning remit focusing on drug policy and law reform, specifically including establishing a just and effective system of regula- tion for currently illegal or unregulated drugs. No financial or other conflicts of interest declared.
2 Commentary
Keywords Cannabis, commercialization, drug policy, legalisation, markets, regulation.
STEVE ROLLES & GEORGE MURKIN
Transform Drug Policy Foundation, Bristol, UK E-mail: steve@tdpf.org.uk
Transform Drug Policy Foundation, Bristol, UK E-mail: steve@tdpf.org.uk
References
STEVE ROLLES & GEORGE MURKIN
Transform Drug Policy Foundation, Bristol, UK E-mail: steve@tdpf.org.uk
Transform Drug Policy Foundation, Bristol, UK E-mail: steve@tdpf.org.uk
- Caulkins J. P., Kilmer B. Considering marijuana legalization carefully: insights for other jurisdictions from analysis for Ver- mont. Addiction 2016; DOI: 10.1111/add.13289.
- Kilmer B., Caulkins J. P., Pacula R. L., MacCoun R., Reuter P. Assessing how marijuana legalization in California could influ- ence marijuana consumption and public budgets. Santa Monica, CA: RAND Corporation; 2010. Available at: www. rand.org/pubs/occasional_papers/OP315.html (accessed 1 March 2016).
- Holmes J., Meng Y., Meier P. S., Brennan A., Angus C., Camp- bell-Burton A. et al. Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: a modelling study. Lancet 2014; 383: 1655–64. Available at: http://www.thelancet.com/journals/lancet/article/PIIS0140- 6736(13)62417-4/fulltext (accessed 1 March 2016).
4. The Scottish Government. Minimum pricing; 2015 [online]. Available at: http://www.gov.scot/Topics/Health/Services/Al- cohol/minimum-pricing (accessed 4 March 2015).
5. BorlandR.Astrategyforcontrollingthemarketingoftobacco products: a regulated market model. Tob Control 2003; 12: 374–82. Available at: http://tobaccocontrol.bmj.com/con- tent/12/4/374.fulltext (accessed 1 March 2016).
6. PardoB.CannabispolicyreformsintheAmericas:acompara- tive analysis of Colorado, Washington, and Uruguay. Int J Drug Policy 2014; 25: 727–35. Available at: http://www. sciencedirect.com/science/article/pii/S095539591400139X (accessed 1 March 2016).
7. Castaldi M. Three types of marijuana to hit Uruguayan pharmacies in 2015 [online]. Reuters, 05.12.15. Available at: http://www.reuters.com/article/us-uruguay-marijuana- idUSKBN0TO0R620151205 (accessed 1 March 2016).
8. Gostin L. O. Corporate speech and the constitution: the deregu- lation of tobacco advertising. Am J Public Health 2002; 92: 352–55.
© 2016 Society for the Study of Addiction
