Attorney General Jeff Sessions will soon receive a report he has been waiting for. The document, from the President’s Task Force on Crime Reduction and Public Safety, is expected to clarify the federal government’s position on marijuana — and the conflicts that exist between state and federal laws. It clear what Sessions wants to do: Over the past month, he has asked Congress for permission to prosecute medical cannabis suppliers who are acting in accordance with their state’s laws, reauthorized civil asset forfeiture (a highly controversial practice used in drug cases), and announced his desire to start a new “war on drugs.”
On at least one front, however, Sessions’s new war on drugs is likely to fail. In taking on cannabis — particularly the medical uses of cannabis — he is staking out a position that is at odds with powerful interests and an overwhelming majority of Americans from nearly all walks of life. This tide is too strong to swim against.
The first obstacle is that the medical community has largely resolved the question of whether cannabis is clinically useful. In January, the National Academies of Sciences, Engineering and Medicine (NAS) reported that there is “conclusive evidence” that cannabis (both whole plant and extracts) is clinically effective at treating some diseases, including chronic pain. Cannabis may prove to be a pain management strategy that could substitute for opioids for many desperate patients, and the National Institute on Drug Abuse (NIDA) acknowledges that cannabis may be an effective tool to combat the opioid crisis. Researchers studying the relationship between medical cannabis laws and opioid use have found that states with such laws have nearly a 25 percent reduction in opioid-related deaths. The contrast between opioids — which killed more than 33,000 Americans in 2015 — and cannabis could not be more striking. As NIDA states on its DrugFacts — Marijuana Web page: “There are no reports of teens or adults fatally overdosing (dying) on marijuana alone.”
Further, medical cannabis may also save lives in unexpected ways. Data published in the American Journal of Public Health in February suggests that laws allowing it were associated with fewer traffic fatalities. While we always have to be careful about making claims that a policy caused an outcome, evidence from multiple studies, with careful statistical analyses, is building a case that medical cannabis has real, beneficial, spillover effects.
State governments are a second major hurdle for Sessions. States are sharply opposed to his moves to crack down on their cannabis policies. Eight states (with nearly one-fifth of the U.S. population) have legalized recreational cannabis use by adults. Even more striking, 29 states and the District of Columbia have approved the medical use of botanical cannabis, with 17 more having cannabis extract laws in place. This doesn’t just save lives; it also saves money.
In two studies, we find substantial reductions in a broad array of prescription spending for both Medicare and Medicaid in states that have medical cannabis laws in effect. Medicare and Medicaid don’t cover cannabis, but it nevertheless appears to substitute for many prescription drugs that the programs do cover. Nationally, the savings could be in the billions of dollars across the two programs if all states would adopt medical cannabis laws.
States benefit directly. Our work on Medicaid spending shows that they saved money — as much as $98 million in the case of California in 2014 — when they implemented medical cannabis laws in an environment in which the federal government took a hands-off attitude. . . .
