Marijuana continues to be a hot topic in drug policy. Nearly three fourths of drug policy legislation introduced at the state level tracked by S.O.S. is marijuana-related. Over time we have witnessed trends moving away from efforts to decriminalize personal possession amounts of marijuana to legislation that creates a commercialized pot industry by legalizing the possession, cultivation, distribution and retail sale of marijuana.

Marijuana as Medicine

Marijuana remains a Schedule I drug because it has no accepted medical value and has a high potential for addiction. There is no scientifically documented benefit for the use of crude marijuana for any medical purpose. In fact, crude smoked marijuana has been rejected by major reputable national medical associations in the country including the American Medical Association, the National Multiple Sclerosis Society, and the American Cancer Society.

The Food and Drug Administration (FDA) does not approve of the use of smoked marijuana medical purposes and its use is, therefore, unregulated. This has significant implications for patient care since there are too many health risks associated with such use. Past evaluations by several Department of Health and Human Services (HHS) agencies, including the FDA, Substance Abuse and Mental Health Services Administration (SAMHSA) and National Institute for Drug Abuse (NIDA), found no sound scientific studies supported medical use of marijuana for treatment in the United States and no animal or human data supported the safety or efficacy of marijuana for general medical use.

Similar to the poppy plant, there are components of the marijuana plant that have medical potential. In fact there are cannabis-based medications already approved by the FDA and currently prescribed for use under doctor supervision. Several other products are in different stages of the approval process. These products are developed from extracts of specific components of marijuana similar to how opioids are extracts from opium. Marijuana should not be exempt from the FDA approval process. Consumers rely on the rigorous process for efficacy and protection.


“Recreational” use of marijuana is now legal in four states (Alaska, Colorado, Oregon and Washington) and the District of Columbia. When voted on, many were led to believe the movement was about alleviating an overcrowded prison system by not arresting those in passion of minor amounts of marijuana. In reality, less than 1% of inmates in federal prison are there for simple marijuana possession and what legalization was really about was the creation of a commercial marijuana industry. Far more liberal that what is allowed in the Netherlands, these states have legalized the cultivation, distribution, possession and retail sale of marijuana.

The consequences have been disastrous and have resulted in an increase in youth and adult use, increased traffic fatalities caused by drivers high on marijuana, increased ER visits and calls to poison control and a decrease in perception of harm associated with marijuana use.

Legalization didn’t eliminate the black market; it continues to exist and heavily targets our youth (whom legalization laws don’t apply) and adults looking to avoid paying the higher prices levied to create a regulatory system.

Civil Citations

Many states, approximately 1/3, have shifted the way they deal with marijuana offenses by decriminalizing marijuana possession intended for personal use. Decriminalization is typically means amending state law to keep certain marijuana possession acts criminal, but no longer subject to prosecution. This means individuals caught with specifically defined amounts of marijuana for personal use won’t receive a criminal record or a jail sentence. Each state law differs, but in many states minor possession by an adult is treated similar to a minor traffic infraction.

Rather than decriminalizing adult marijuana possession, states should consider a similar program based on the model used in Florida for juvenile civil citations. Using Florida as an example again, Leon County implemented a pilot adult civil citation program for first-time offenses including possession of less than 20 grams of marijuana and alcohol-related offenders. The program uses a full needs assessment to determine individual needs that could include drug screening, community service, targeted behavior change interventions and other sanctions to address behavioral change. The program uses both in-person and online systems that allow law enforcement and service providing agencies to manage each participant. The intervention plan includes the following:

    • Community service – 25 hours (case manager may increase)
    • Online educational interventions (eLearning resources
    • Drug screening, AA or NA meetings
    • Program fees (flexible payment system)

Counseling sessions: Cognitive behavioral therapy and motivational interviewing (two at minimum but could be more as determined by assessment)


Civil Citation programs for first time youth and adult simple marijuana possession offenders coupled with an assessment, services and sanctions allow for the opportunity at behavior change without jail time and criminal adjudication. The programs outlined above have high completion rates and low recidivism rates. These programs are examples of action items that were identified in the President’s Task Force on 21st Century Policing where it was recommended that law enforcement agencies “should consider adopting preferences for seeking least harm; resolutions, such as diversion programs or warning and citations in lieu of arrest for minor infraction.” Civil Citation programs that include services and sanctions have the potential to quickly address the behavioral needs of first time offenders at first point of contact with the justice system.


2018 State Ballot Measures
Who is Really Using November 2017 version
Legalization of Marijuana in Colorado The Impacts Vol. 4
Civil Citation Programs A Promising Prevention Tool to Effect Behavioral Changes with Substance Abusers