Minn. docs: Limit harm from legal pot

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With the DFL holding a majority in the House and Senate, and the governor's office, it appears legalizing recreational cannabis is likely this session. One of the authors of proposed legislation made it very clear: "2023 will be the year we legalize adult-use cannabis."

On behalf of the Minnesota Medical Association (MMA), the state's oldest and largest professional association of physicians and physicians-in-training, I urge policymakers and the public to recognize that legalizing adult use of cannabis will impact the health of Minnesotans. It is also true that the current legal approach to cannabis use in Minnesota and much of the country comes with its own set of negative health and socioeconomic impacts, particularly among historically marginalized populations.

As physicians, we urge policymakers to be mindful of the harmful and difficult lessons learned with respect to alcohol and tobacco regulation. These lessons, combined with the best available, albeit insufficient, evidence on the health effects of cannabis must inform any future Minnesota policy.

To best protect the health of Minnesotans, the MMA urges legislators to consider the following:

1. Research has consistently shown that human brain development and maturation is not complete until the age of 25. Therefore, individuals under age 25 should be prohibited from purchasing, possessing, or using cannabis or cannabis-infused products.

2. Cannabis use may increase the risk of developing psychiatric disorders, including psychosis (schizophrenia), depression and anxiety, particularly among individuals with a pre-existing genetic or other vulnerability. Public awareness of these risks is not well understood.

3. During pregnancy, cannabis use may increase the risk of low birth weight. In addition, prenatal cannabis exposure before or after maternal knowledge of pregnancy may increase the risk for psychopathology during middle childhood. Again, public awareness of these risks is limited.

4. Current addiction treatment capacity and resources are insufficient. Cannabis use may increase the risk of developing substance use disorders and further strain addiction treatment availability.

5. Children and adolescents, in particular, face risks from various cannabis inhalation delivery systems, ingestion of edibles and exposure to secondhand smoke or vapor.

6. Tobacco and alcohol experiences have demonstrated the importance of strict product packaging, marketing, sales and advertising regulations to prevent use by children, adolescents and other at-risk individuals.

7. Ongoing monitoring of health impacts, through data collection and analysis, is essential.

As with many issues, I appreciate that this is not a simple decision. There are pros and cons of the status quo, and there are pros and cons of change. It will be up to policymakers to make the final calculation. As physicians, we will continue to urge policymakers to learn from the past and lead with health.

William Nicholson, of White Bear Lake, is a physician and president of the Minnesota Medical Association.