Since 1978, 33 states have approved the use of cannabis in some form, putting them in direct conflict with federal law: 10 have legalized and regulated marijuana for recreational use; another eleven have decriminalized marijuana, defining low-level possession as a civil rather than criminal offense; 33 allow doctors to prescribe marijuana to patients for certain conditions.

Taxation and Regulation: refers to the terms and conditions of state legalization for recreational use. In 2012, voters in Colorado and Washington endorsed the legalization of marijuana and the development of regulated Voters in Oregon and Alaska took similar action in the 2014 mid-term election, as did California. Maine, Massachusetts, and Nevada followed suit in November 2017.

The regulation of marijuana establishes standards for production, manufacturing, and distribution. It protects consumers from tainted supplies and gives them important information about potency and dosage. Regulation can also establish protective ecological measures for cannabis production, mitigating the adverse environmental impacts of illegal marijuana growth operations.

Taxation and regulation brings the marijuana industry into the legal economy, creating formal jobs and economic growth. In 2016, Colorado received $200 million in tax revenue from over $1 billion in sales, far exceeding the amounts received from taxes on alcohol.

In January, 2018, Vermont became the first state to legalize marijuana for personal use through legislative action rather than ballot initiative. Michigan took this step in September, 2018.  New Jersey, Connecticut, Rhode Island and Illinois, among other states, are also pursuing legalization via legislation.

Decriminalization: refers to enforcement that regards the possession of marijuana as a civil, but not a criminal offense, much like a minor traffic violation. Individuals found in possession of small amounts are not arrested but instead issued a fine, a citation, or simply released. The sale or trafficking of drugs remains a crime.

In 1973, Oregon became the first state to decriminalize. (It has since moved to “tax and regulate.”) Missouri, Delaware, Illinois, and New Hampshire are the most recent states to take this step. Many feared that decriminalization would lead to increased use. This has not proven to be the case.

Under decriminalization the illicit market continues to dominate. Revenue that would otherwise be available for public purposes such as law enforcement, drug treatment, and education flows to drug traffickers. It is also not possible to regulate quality and to inform consumers what they are buying. Purchasers must often turn to sellers seeking to promote the use of far more dangerous drugs.

Medical Marijuana: refers to the legal use of marijuana as medicine under state law. In 1996, California became the first state to approve medical marijuana, followed by Washington, Oregon, Alaska, and Nevada in 1998. 33 states have now taken this step, 14 by ballot initiative and 15 by legislative action. Oklahoma, Missouri, and Utah are the most recent states to grant approval.

AIDS, hepatitis C, cancer, Crohn’s disease, multiple sclerosis, glaucoma, epilepsy, and chronic pain are among those conditions most frequently covered under state medical marijuana laws. Regulatory requirements for doctors and patients, and methods of distribution of cannabis differ greatly between states.

The American Academy of Family Physicians, American Nurses Association, American Public Health Association, American Academy of HIV Medicine, and Epilepsy Foundation are among the many professional organizations supporting some form of physician-supervised access to medical marijuana. Recent studies have found that marijuana can be useful in helping victims of opioid abuse to address their addiction.

At the federal level, cannabis continues to be classified under Schedule 1, the most restrictive category, deemed of “high potential for abuse and with no medical value.” The federal scheduling system considers marijuana to be as dangerous as heroin and more dangerous than cocaine and methamphetamines. Many challenges have been mounted against this classification which, among other things, drastically impedes research on medical uses. The Marijuana Justice Act, filed in the US. House last fall, and the Senate in January, 2018, would effectively legalize marijuana at the federal level.

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