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Viewpoint
May 16, 2019

The Need for Federal Regulation of Marijuana Marketing

Author Affiliations
  • 1Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla
  • 2Division of Health Policy, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla
JAMA. 2019;321(22):2163-2164. doi:10.1001/jama.2019.4432

A national for-profit marijuana industry is expanding substantially in the United States. Thirty-three states have legalized medical marijuana, 10 of which (where 1 in 4 individuals reside) have also legalized recreational marijuana. Sales of marijuana are projected to increase from $8.5 billion to $75 billion by 2030, rivaling current tobacco sales ($125 billion).1 The initial marijuana marketplace was limited to a few states, but emerging brands have developed sophisticated national marketing campaigns that could potentially have an effect across state lines. This marketplace expansion, along with questionable marketing practices, introduces a need for federal action.

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    3 Comments for this article
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    FDA Not Citing Retailers Who Make Health Claims And/Or Sell CBD Dietary Supplements in Violation of the Food, Drug and Cosmetics Act
    Deborah Schlesinger, RN | Consultant
    I have reported violations of the FD&C Act on the FDA's Safety Portal when I see dietary supplements labeled to contain CBD marketed. I also reported those same retailers to the local health departments who are delegated to oversee compliance. I have not seen any action taken against these products to date.
    CONFLICT OF INTEREST: None Reported
    Pesticides: First do no harm
    Vin LoPresti, PhD, Cell Biology | Retired; previously Los Alamos and Sandia National Laboratories
    A local Medical Cannabis activism group has been lobbying the NM Medical Cannabis Advisory Board to recommend legislative policy for an insecticide- & herbicide-free cannabis supply for the medical program, separate from a recreational supply, and is at the point where the state will quite probably move in that direction. Something designated "medicine," whether therapeutic or symptomatically palliative, should pass or surpass the Hippocratic-oath standard.

    Given the 2017 report of the National Academies that the evidence is compelling or conclusive that cannabis is effective for neurogenic chronic pain and the spasticity of MS, we know that
    there are valid reasons for its status as a medication. As a stroke-damaged 20-yr chronic pain patient who manages neurogenic pain and who detoxified from opioids with the help of cannabis, my personal anecdotal experience is also relevant. Therefore, I desire a nontoxic medication.

    Insecticides are illustrative; they are largely neurotoxins binding to proteins in insect brains (e.g., the voltage-gated sodium channel, acetylcholinesterase) that are largely evolutionarily conserved molecular/cellular nano-structures in human brains. This underlies the known insecticide side-effects to human neurology. To expose medical cannabis patients to such compounds or to herbicides like glyphosate is certainly to risk harm. It's unfortunate that this article largely bypassed this aspect of necessary regulation.
    CONFLICT OF INTEREST: None Reported
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    A Timely and Well-Considered Call
    Paul Gronnerud, MA, Clinical Psychology, | Primary clinic-based health care; have worked as clinical and forensic psychologist for many years.
    I have worked on a policy document for the Correctional Service of Canada in light of legalization of recreational cannabis in Canada.

    This Viewpoint makes very astute sociological comments about marketing, and the bizarre claims being made/implied, by companies and promoters. As we worked on our policy document, we were astounded by some of the claims for both harmlessness and medical/psychological efficacy of medical preparations, as well as claims being made for benefits of whole plant usage.

    Personally, I found claims for pain management and a role in opioid replacement of most concern. The absence of mention
    of negative outcomes in advertising and the lack of coherent political oversight has been quite noteworthy as well.

    Our policy document is informed by many of the concerns your article rightly raised. Our working group considered policies and organization practice standards for medicine, psychiatry, nursing, psychology, pharmacy and to a lesser degree, pediatric medicine.

    I'm forwarding this the members of our committee, as I think they will enjoy what they read.
    CONFLICT OF INTEREST: None Reported
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