With New Jersey’s recent passage of the Marijuana Legalization Amendment, safety must be prioritized for the legalization process to succeed, said Diane Calello, executive medical director of the New Jersey Poison Control Center at Rutgers New Jersey Medical School, according to a press release.
“We can certainly legalize (marijuana) safely, but it's our responsibility to do so if we're (going to) have legal cannabis,” she said. “Otherwise, there are consequences that we could predictably avoid that we should be working to minimize as we roll out (cannabis) commerce.”
One positive effect of marijuana legalization is that legally sold products will be safer than current products due to required testing for contamination, quantity of tetrahydrocannabinol (THC) and other marijuana compounds, Calello said.
Based on other states’ experiences, some unintended consequences may include an increase in poison exposure for adults and young children, traffic accidents and negative psychiatric effects of cannabis use, she said.
Calello said health experts should take part in decision making for issues that impact public health so they can provide advice and counteract other influences, such as the desire for cannabis trade to be successful.
The only way to know the impact on public health is to track it, which provides information for implementing prevention strategies, she said. It is for this reason that surveillance should be included in the marijuana legislation.
“(Measures similar to those from the) National Highway Traffic Safety (Board) ... should be written into the bill to say as a state, 'We're (going to) undertake the following data gathering and monitoring operations so that we can keep our eyes on actually how it's going, and not just flip the switch to turn it on and then let it go,'” she said.
She said she believes the existing legislation has given some consideration to surveillance, such as the most recent version’s call for child-resistant packaging and packaging that displays the Poison Control Center phone number. There has also been increased discussion of surveillance, which Calello said she hopes will lead to more detailed legislation in the future.
“(The legalization of marijuana) is a big change and there’s a lot of ramifications that have to be taken step-by-step,” she said. “Really anticipating consequences and laying out how we're (going to) do it, and then how are we gonna surveil it and keep an eye on how it's going and whatever is really essential, otherwise we won't know what we're doing.”
Calello said New Jersey also has to answer questions like whether to allow cannabis edibles to look like candy, which could potentially increase the likelihood of children eating them or how much THC should be in one dose and how many doses should be in one package.
Another consideration is how to define cannabis-impaired driving, Calello said. New Jersey and other states do not have a well-developed system for determining marijuana influence as it does with alcohol, where drunk driving is determined by visible signs of intoxication and breathalyzer testing.
“I definitely think we will (develop the system soon), I just think it's a matter of taking a step-by-step approach and making sure that the focus is largely on safety,” Calello said. “So then we're not saying we wish we'd done this or we wish we'd done that. If we do it right the first time, we’ll all be much happier.”
Editor's Note: A previous version of this article did not include a reference to the National Traffic Safety Board.