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OK, marijuana is now legal. So where’s the public health approach?

Strictly speaking, marijuana use isn’t fully legal across the U.S. yet. But when Montana and Missouri have legalized recreational use and the Senate is debating legal banking for cannabis companies, you know it’s all over but the shouting.

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For years health experts have argued that criminalizing marijuana use was a mistake, and that rather than handling the drug as a law enforcement problem, with cops, lawyers, and jails, we should manage it as a public health problem, with prevention, treatment, and harm reduction. I have served as health commissioner for both New York City and Philadelphia, and at one time I had hopes of moving to a public health approach to illegal drugs. But instead, to my horror, the legalization freight train rolling across the nation is replacing law enforcement with corporate marketing reminiscent of the tactics of Big Tobacco in the 20th century. It’s time for us to respond to marijuana now as we belatedly responded to tobacco.

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