Getting it Right from the Start

Getting it Right from the Start Research & advocacy to protect public health, youth & equity in cannabis. Handle: Please contact us for more information.

As a project of the Public Health Institute, we collaboratively develop and test models of optimal cannabis policy (retail practices, marketing & taxation) with the goal of reducing harms, youth use & problem use. These models are based on the best scientific evidence and guided by the principles of public health, social justice, and equity. We also provide technical assistance to jurisdictions co

nsidering legalizing cannabis. Our work includes:
Developing model local ordinances for licensing cannabis retailers, marketing, and general and special taxes on cannabis, all based on decades of accumulated experience from tobacco and alcohol control. Carrying out research with multiple national stakeholders and experts to identify best practices. Developing legal analyses of relevant issues for local licensing, constraints on marketing, and local taxation. Developing a Listserv, webinars and other technical assistance tools to support communities and exchange experiences and questions. Providing public health oriented input to regulatory processes. Getting it Right From the Start is funded by the Conrad N. Hilton Foundation, without whose generous support our work would not be possible. Our research is generously funded by the following (but does not necessarily represent the official views of any organization other than Getting it Right From the Start):

Tobacco-Related Disease Research Program
National Institutes of Drug Abuse

Another major international review validates what public health experts have been warning for years. A new review publis...
06/23/2026

Another major international review validates what public health experts have been warning for years. A new review published in Psychiatry and highlighted this week by the Guardian found a consistent pattern across cannabis policy changes around the world:
• Commercial cannabis markets were associated with increases in cannabis use, higher-potency products, and more cannabis-related psychosis and other psychiatric harms.
• Decriminalization alone did not show the same increases.
• Countries using strictly regulated public models, such as Uruguay, likewise did not experience the same public health trends seen in highly commercialized markets.

These findings go directly to the heart of the debate. The greatest public health risks come not simply from legalization, but from building a for-profit cannabis industry whose financial success depends on increasing consumption. Like the to***co and alcohol industries before it, commercial markets create powerful incentives to:
• Increase product potency
• Expand marketing and promotion
• Normalize frequent use
• Develop products that appeal to new consumers
• Oppose stronger public health safeguards

One promising example is Quebec's public monopoly model, where cannabis sales occur through a government-operated retailer rather than private companies competing to maximize sales. A public monopoly can prioritize health objectives over shareholder returns, helping limit commercialization while reducing criminal penalties.

As more jurisdictions reconsider cannabis policy, the evidence continues to point in the same direction: The choice isn't simply legalization vs prohibition. It's commercialization vs public health.

Read: https://bit.ly/3SIvvmd

The Guardian

The Washington Post latest review of cannabis research reinforces what public health experts have been warning for years...
06/18/2026

The Washington Post latest review of cannabis research reinforces what public health experts have been warning for years: context matters. As cannabis products become more potent and daily use becomes more common, researchers are reaching growing agreement on several key findings:

• Higher-potency products pose greater risks, particularly for frequent users and young people.
• Adolescent brains are the most vulnerable, with research linking youth cannabis use to increased risks of psychosis, bipolar disorder, and other mental health problems.
• Frequency matters. Heavy, long-term use is associated with measurable effects on working memory and brain function, while occasional adult use appears to have fewer detectable impacts.
• Many claimed mental health benefits remain unsupported. Recent systematic reviews conclude there is little high-quality evidence supporting cannabis for most psychiatric conditions, while documenting important risks.

The article also highlights an encouraging finding: some cognitive effects may improve after reducing or stopping cannabis use, underscoring the value of prevention, education, and informed decision-making.

As cannabis policy continues to evolve, public health must be guided by evidence—not marketing. That means honest education about potency, youth vulnerability, and the importance of reducing risk.

Read article here: https://bit.ly/3Q9ZHWH

ig Cannabis just took a major step toward Wall Street.Following the federal government's decision to move medical cannab...
06/12/2026

ig Cannabis just took a major step toward Wall Street.

Following the federal government's decision to move medical cannabis to Schedule III—a decision currently being challenged in court—Trulieve has become the first U.S. cannabis company to trade on the New York Stock Exchange.

According to reporting in the Washington Post Health Brief, Trulieve generated $1.2 billion in revenue last year, operates more than 230 dispensaries, and has over 4 million square feet of cultivation and processing capacity.

Supporters argue rescheduling will expand research opportunities. More research is important and long overdue.

But many products sold in state "medical cannabis" programs have never undergone the rigorous FDA approval process required of prescription drugs. Products can vary dramatically in potency, formulation, and intended use, even as they are marketed within systems built around claims of medical benefit.

The ability to create publicly traded cannabis companies marks another step in the emergence of a powerful "Big Cannabis" industry. Greater access to investment capital may fuel industry expansion and increase political influence even as many cannabis products continue to bypass the rigorous scientific review required of approved medicines.

Read article: https://bit.ly/43zkgPj

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How much more evidence do we need on high-potency cannabis?A new Stateline investigation highlights growing concern amon...
06/09/2026

How much more evidence do we need on high-potency cannabis?

A new Stateline investigation highlights growing concern among researchers, physicians, and policymakers about the connection between high-potency cannabis products and increased risks of addiction, psychosis, and other mental health harms—particularly among adolescents and young adults.

The concerns raised in the article mirror findings from two major recent California efforts that Getting it Right from the Start helped advance:

✅ A recent JAMA Health Forum study of more than 460,000 Northern California adolescents found significantly increased risks of psychotic and bipolar disorders, depression, and anxiety among youth who used cannabis. The study was covered by more than 100 media outlets nationwide and was cited in this Stateline report.
✅ The California High Potency Cannabis Think Tank report, co-authored by GIRFTS Executive Director Dr. Lynn Silver, concluded that high-potency products present unique public health risks and recommended a range of evidence-based safeguards to better protect youth and vulnerable populations.

Yet despite the growing body of evidence, California has failed to implement the recommendations of the California Department of Public Health's High Potency Cannabis Scientific Advisory Committee.

Meanwhile, today's cannabis market bears little resemblance to the products of previous generations. As Stateline notes, many cannabis concentrates now exceed 80% THC, while flower commonly reaches 15-20% THC or more.
Public health policy should follow the evidence. The evidence is becoming increasingly difficult to ignore.

Stateline Article: bit.ly/4aDNX5v
High Potency Report: bit.ly/4fBzMBy

For years, public health advocates have raised concerns that cannabis policy decisions are often shaped as much by econo...
06/02/2026

For years, public health advocates have raised concerns that cannabis policy decisions are often shaped as much by economic and market considerations as by health outcomes.

Now, new peer-reviewed research authored by our Getting it Right from the Start team, provides some of the first empirical evidence that economic considerations often compete with—and sometimes outweigh—public health priorities in cannabis policymaking.

Published in BMC Public Health, the study surveyed California local elected officials responsible for decisions about cannabis licensing and regulation. The findings reveal a significant tension between economic priorities and public health considerations.

Among the study's findings:
- Tax revenue (41%) and economic development (41%) were among the top priorities identified by elected officials.
- Youth cannabis use (38%) was also a major concern, yet fewer than 4% of California jurisdictions that allow cannabis retail have adopted restrictions on youth-attractive packaging—even though 84% of surveyed officials supported such protections.

Researchers found that cannabis policy decisions are often influenced by economic, ideological, or cultural narratives rather than public health evidence.

The findings highlight an important challenge facing policymakers: ensuring that cannabis regulations are guided first and foremost by public health goals, particularly when it comes to protecting youth.

At Getting it Right from the Start, we've long argued that legalization and commercialization are not the same thing. The success of cannabis policy should not be measured solely by sales, tax revenue, or market growth, but also by whether it protects health, advances equity, and prevents avoidable harms.

This study adds important new evidence to that conversation and identifies opportunities for stronger evidence-based policymaking and bipartisan youth protections.

Read the study: https://bit.ly/3QdFpeK

Public Health Institute

As more countries and jurisdictions consider expanding access to cannabis, an important question is emerging: What happe...
05/26/2026

As more countries and jurisdictions consider expanding access to cannabis, an important question is emerging: What happens when a medicinal product becomes a commercial industry?

In a recent hashtag feature examining medicinal cannabis prescribing in the Channel Islands of and , Getting it Right from the Start's Dr. Lynn Silver shared lessons from the United States that policymakers around the world should not ignore.

Dr. Silver warned of the "insane promotion" of ma*****na use for a wide array of clinical conditions for which it is not effective—and may even be harmful. She also cautioned policymakers to be very careful when crafting cannabis laws and strongly discouraged allowing the emergence of a for-profit cannabis industry.

These concerns are not unique to the U.S.. At Getting it Right from the Start, we have long argued that legalization and public health protections are not competing goals. In fact, they should go hand in hand.

The experiences emerging from the United States—and increasingly being examined by policymakers abroad—underscore a simple but important reality: Legalization alone shouldn’t be the goal. The goal should be getting legalization (if that’s what they do) right from the start.

Read: https://bit.ly/4nTTeeO

*****na ITV News Public Health Institute

Virginia Governor Spanberger deserves credit for putting public health and safety first! Although she has expressed supp...
05/21/2026

Virginia Governor Spanberger deserves credit for putting public health and safety first! Although she has expressed support for hashtag legalization, she vetoed Virginia's retail cannabis bill, arguing that legalization must be implemented with strong protections, effective oversight, and adequate enforcement from day one.

Her reasoning reflects a growing recognition across the country: how cannabis is regulated matters. And just because its legal, doesn’t mean its harmless. In her veto statement, Gov. Spanberger emphasized that Virginians deserve a system that prioritizes children's health and safety, public safety, product integrity, and accountability—not simply the replacement of the illicit market.

She also stressed the importance of learning from the experiences of other states and ensuring regulators have the authority, staffing, testing capacity, inspection resources, and enforcement tools necessary to protect the public.

Perhaps most notably, she concluded by saying Virginia must "get this right." That framing resonates strongly with us.

For years, public health advocates have warned that legalization without adequate safeguards can lead to unintended consequences—including increased youth exposure to cannabis marketing, normalization of use, proliferation of high-potency products, misleading health claims, and inadequate protections for consumers.

The conversation is evolving. More policymakers, researchers, parents, educators, and public health leaders are asking important questions about what responsible cannabis regulation should look like in practice.

Supporting legalization and demanding strong public health protections are not contradictory positions. In fact, they should go hand in hand. Gov. Spanberger's veto sends an important message: the goal should not simply be legalization—it should be getting legalization right from the start.

Read the Virginia Mercury: https://virginiamercury.com/2026/05/19/spanberger-vetoes-cannabis-bill-stalling-legal-sales-again/

New California research reinforces what Getting it Right from the Start’s prior prevention research has repeatedly found...
05/14/2026

New California research reinforces what Getting it Right from the Start’s prior prevention research has repeatedly found: adolescents increasingly perceive cannabis as less harmful than other substances — even as higher-risk cannabis use patterns have grown in the post-legalization era.

A new UC San Diego study of more than 175,000 California students found teens consistently viewed cannabis as the least harmful commonly used substance.

This is concerning because prior California youth research has also shown:
- increasing normalization of cannabis
- youth exposure to cannabis marketing
- rising use of high-potency products
- increased va**ng and concentrate use
- growing risks associated with today’s far stronger commercial cannabis products

Today’s cannabis market is fundamentally different from past generations, with THC concentrations often dramatically higher and product formats designed for greater potency and efficiency.

Public health solutions include:
- stronger warning labels
- THC potency transparency
- limits on youth-appealing advertising
- restrictions near schools, parks, and libraries
- prevention-centered public education

Legalization without strong prevention safeguards risks widening the gap between perceived safety and actual adolescent health risks.

hashtag Study: https://today.ucsd.edu/story/teens-view-cannabis-as-less-harmful-than-alcohol-vapes-and-cigarettes

Major legal accountability may finally be coming for Big Ma*****na — and it could mark a major public health turning poi...
05/05/2026

Major legal accountability may finally be coming for Big Ma*****na — and it could mark a major public health turning point.

As reported by Chicago Tribune journalist Robert McCoppin, sweeping new lawsuits target some of the nation’s largest cannabis corporations over allegations of false medical claims, deceptive marketing, and downplaying serious health risks.

For years, Getting it Right from the Start has warned that parts of the cannabis industry are increasingly borrowing from Big Tobacco’s deadly playbook: misleading health claims, aggressive commercialization, and minimization of real harms.

These lawsuits are significant because they target major industry players — not small operators — and could help expose harmful practices much like to***co litigation once did.

Public health demands:
• Honest, evidence-based marketing
• Stronger consumer protections
• Accountability for deceptive industry practices
• Prevention of another corporate-driven public health crisis

The cannabis industry must not be allowed to repeat Big Tobacco’s deadly playbook.

Read the Chicago Tribune’s important reporting by Robert McCoppin: https://www.chicagotribune.com/2026/05/05/lawsuit-cannabis-companies-false-claims/

*****na

Important new reporting on youth cannabis use—and why it mattersKudos to Paul Sisson at the San Diego Union-Tribune for ...
04/22/2026

Important new reporting on youth cannabis use—and why it matters

Kudos to Paul Sisson at the San Diego Union-Tribune for a thoughtful and much-needed piece on emerging research around cannabis and adolescent brain development.

His article highlights a major new UC San Diego–led study of 11,000 youth nationwide, finding that adolescents who used cannabis showed slower gains in memory, focus, and thinking speed compared to those who did not.

This builds on a growing body of evidence—including research we’ve helped lead—showing that cannabis use during adolescence is associated with meaningful risks to mental health and cognitive development.

A few key takeaways:
• Even as all youth develop over time, cognitive progress was slower among those using cannabis
• The study used toxicological testing, strengthening accuracy beyond self-reporting
• Researchers controlled for key factors—and still found a clear relationship between cannabis use and developmental outcomes

Why this matters for policy
At Getting it Right from the Start, we’ve consistently emphasized a simple point: Legalization does not mean harmless. And commercialization without guardrails comes with real risks—especially for youth.

From rising potency…to products designed and marketed in ways that appeal to young people…to declining public perception of harm…We are seeing the consequences of a system that has drifted from its original public health intent.

A legal cannabis market can exist—but it must be grounded in evidence, accountability, and strong protections for youth.
More of this, please! Read here: https://www.sandiegouniontribune.com/2026/04/20/ucsd-ma*****na-study-affirms-drugs-negative-effect-on-youth/

*****na

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