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Dr. R. Lorraine Collins Discusses Cannabis Use and Policies

The Schroeder Center for Health Policy welcomed Dr. R. Lorraine Collins on Tuesday, October 26, as the third speaker in its "State Policy on Mental Health and Substance Abuse" speaker series. Dr. Collins, the Associate Dean for Research and Professor of Community Health and Health Behavior at the University at Buffalo’s School of Public Health and Health Professions, spoke to the question, "Does Research on the Health Effects of Cannabis Influence Policy?" Dr. Collins received her B.A. from McGill University and her M.S. and Ph.D. in psychology from Rutgers University. She conducts research on addictive behaviors, specifically focusing on alcohol and cannabis use. Her most recent research involved an innovative study in testing a smartphone app as part of a technological initiative to help young adults reduce their cannabis use.

Cannabis research and policy implementation are taking on increasing importance. In her talk, Dr. Collins mentioned that although not as prevalent as alcohol use, cannabis is currently the most used illicit substance in the U.S., with over 48 million people – about 18% of Americans -- using it at least once in 2019. Cannabis contains two key chemical components known as Δ-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). Because THC is psychoactive, cannabis is illegal under Federal law and is regulated by the U.S. Food and Drug Administration (FDA). In addition to noting Federal law, Dr. Collins also discussed the patchwork of state-regulated cannabis programs around the country. Currently, medical cannabis is legal in most states and D.C., but laws vary as to which components of cannabis are legal and which illnesses and symptoms can be addressed (e.g., pain, nausea, etc.).

Dr. Collins then examined the policy of legalizing adult-use cannabis and its potential impacts. Currently, recreational use rates surpass medicinal use rates, but there is some overlap. Other impacts, reviewed by Dr. Collins, include increases in consumption among heavy, frequent users and diversification of consumption methods (smoking, vaping, edibles, oral capsules, oils/sprays, etc.) by users who prefer certain methods to others. Dr. Collins reported that, at this point, the research is unclear on how legalized cannabis use among adults impacts traffic fatalities. The findings about impact on rates of youth cannabis use are mixed and have not increased to the levels that were predicted. 

Dr. Collins touched briefly on the cannabis programs in both New York and Virginia. As of July 1, 2021, according to Virginia’s cannabis website, Virginia “ended the prohibition of simple possession of marijuana for adults 21 years and older”, and adults are permitted to grow up to four marijuana plants per household. However, it is still not legal in Virginia to sell marijuana until January 1, 2024. The Cannabis Control Authority (CCA) is authorized to regulate Virginia’s marijuana industry and implement both “equity and safety initiatives”. 

Dr. Collins noted that regulations are needed for medicinal and recreational cannabis use to manage both access and harm. She described policies to limit cannabis access to the young through age restrictions, marketing, and hours of sale. And she noted that the use of taxes for prevention and interventions may help to mitigate heavy use and cannabis dependence among adults. Dr. Collins supports rigorous research on understanding the health effects of cannabis and using such research to create appropriate public policies. During her talk, she described her work with the National Academies of Sciences, Engineering, and Medicine in its report, "The Health Effects of Cannabis and Cannabinoids: Current State of Evidence and Recommendations for Research". She also discussed lessons learned from the regulation of tobacco. 

In concluding her talk, Dr. Collins mentioned that cannabis use, products, and policies are constantly in flux. She believes that research is at least a decade behind where it needs to be, and that certain Federal cannabis-related policies prevent research needed to build evidence about health effects, prevention, and treatment. She also noted that research is needed to help form the basis for public health messages and policies to promote the responsible use of cannabis.

Please join us on Monday, November 15, from 5-6 pm for the Schroeder Center for Health Policy’s next speakers, Jodi Kwarciany (Senior Manager, Mental Health Policy) and Stephanie Pasternak (Senior Manager, State Affairs, Government Relations, Policy & Advocacy) from the National Alliance on Mental Illness (NAMI).  They will speak about “988: Putting Mental Health Policy to Practice”.  NAMI is “the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.” This is the last talk in the Schroeder Center for Health Policy’s speaker series on “State Policy on Mental Health and Substance Abuse.”  To register and receive the Zoom link, please click here.