We need a surgeon general cancer warning on pot

The fact that U.S. Surgeon General Vivek Murthy has no legal authority to mandate cancer warnings on alcoholic beverage labels did not prevent him, as Dry January began, to propose just such a caveat. The evidence on the health hazards of alcohol may be mixed — the Harvard School of Public Health says “the evidence is more nuanced than the headlines suggest” — but as a medical advisor to the nation, Murthy is right to use his best judgment and bully pulpit.

But he has been disappointingly silent on a looming public health threat on which a strong statement might make a real difference: the spreading legalization of recreational marijuana and the absence of standardized warnings for a drug whose effects on mental health, particularly, are becoming increasingly clear.

The federal government currently has no regulatory role when it comes to cannabis; that’s up to the states, 24 of which have chosen legalization. But if Murthy chooses to suggest a warning for beer and booze, there’s no reason he shouldn’t do so for pot.

There are, in contrast, a great many reasons he should. Medical research has identified a variety of ill effects, especially from the potent pot edibles. These include Cannabis Hyperemesis Syndrome (persistent and uncontrollable vomiting); marijuana use disorder (aka addiction) and even a link to the onset of schizophrenia in young adults.

As an under-publicized caveat from the Centers for Disease Control puts it: “cannabis use directly affects brain function — specifically the parts of the brain responsible for memory, learning, attention, decision making, coordination, emotions, and reaction time.” It’s the kind of language that might well be on a warning label. It’s no surprise, in other words, that auto accidents caused by those “driving while impaired” have increased in states, including Washington and Oregon, where pot has been legalized longest. 

It’s a situation that cries out for guidance from “the nation’s doctor” — notwithstanding the fact that the surgeon general’s official role is limited by the fact that cannabis is still technically illegal under federal law. States have taken it upon themselves to change that designation — often, as in New York, emphasizing potential tax revenue and new pot farms more than public health.

Across the country, pot warnings that states do require vary dramatically. In New York, that warning is limited to “smoking or vaping is hazardous to health”, and “keep out of reach of children and pets.” California requires a warning akin to what the surgeon general proposes for alcohol: “this product can expose you to marijuana smoke, which is known to cause cancer, birth defects and other reproductive harm”.

The emphasis by state governments has not been on making pot use safe but, at the same time, discouraging it — or even waiting until all the evidence is in and we can follow the science prior to legalizing. Instead, states have rushed toward legalization.

As Jake Nelson, director of traffic safety advocacy at the American Automobile Association has put it, “We’re painting the plane as we fly it when it comes to cannabis legalization, Public health and safety has been more of an afterthought”. One troubling illustration: Gov. Hochul has proposed changing the state’s current pot tax rules to eliminate a higher rate on more potent products. Her “weight-based” substitute could lead to higher sales to the stronger stuff. 

As a doctor, Murthy surely knows that the benefits of so-called “medical marijuana”, have never been certified by the FDA, normally charged with designating drugs as safe and effective. As with alcoholic beverages, Murthy would be speaking truth to power: the emerging “big pot” industry is already valued at $43 billion. But the fact that states continue to consider whether or not to legalize recreational cannabis, as well as the inconsistent warning labels across the country, makes this the right time for federal guidance. 

A strong statement from the surgeon general would be a welcome counterweight to the broad social trend in which government countenances—and even cheerleads—what amounts to unhealthy, indeed libertine behavior — from drug use to sports gambling — in its quest for tax revenue.

A Hochul press release says she “celebrates stronger than ever cannabis industry surpassing $1 billion in retail sales.” Why is this something to celebrate, unless tax revenue is a greater priority than public health? Would she celebrate if New Yorkers smoked more tobacco or drank more whiskey?

As we rush headlong and heedlessly into pot legalization, the surgeon general has added the risks of alcohol to his office’s longstanding warnings about tobacco use. Cannabis should get the same attention. 

Husock is a senior fellow at the American Enterprise Institute.