PLEASE NOTE: THIS RESOLUTION WILL BE DEBATED AT THE 2015 COUNCIL MEETING. RESOLUTIONS ARE NOT
OFFICIAL UNTIL ADOPTED BY THE COUNCIL AND THE BOARD OF DIRECTORS (AS APPLICABLE).
RESOLUTION:
16(15)
SUBMITTED BY:
Larry Bedard, MD, FACEP
Jerome Hoffman, MD, FACEP
Dan Morhaim, MD, FACEP
SUBJECT:
Decriminalization and Legalization of Marijuana
PURPOSE: Directs ACEP to support decriminalization for possession of marijuana for recreational use by adults
and to support state and federal governments to legalize, regulate, and tax marijuana for adult use.
FISCAL IMPACT: Budgeted committee and staff resources for developing a policy statement and supporting
legislative and regulatory efforts.
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WHEREAS, The prohibition of marijuana is almost universally accepted as a failed public health and
criminal justice policy; and
WHEREAS, The United States, with 5% of the world’s population, incarcerates 25% of the world’s
criminals, making the U.S. exceptional by having the highest per-capita incarceration rate in the world; and
WHEREAS, More than 600,000 thousand people a year are arrested, prosecuted, and incarcerated for the
possession of a small amount of marijuana for personal use; and
WHEREAS, The single biggest segment of the prison population is incarcerated for the possession and
use of drugs and violation of parole by testing positive for marijuana use; and
WHEREAS, The prohibition of marijuana is an unjust, racist policy because it results in significant racial
disparities as 3-4 times as many Afro-Americans and Latinos as whites are arrested, prosecuted, and incarcerated
for identical infractions; and
WHEREAS, Decriminalization of marijuana use would protect people from the wide-ranging and
debilitating consequences and stigma of a criminal conviction, in areas such as employment, housing, education,
veteran benefits, and parental rights; and
WHEREAS, Emergency Physicians, nurses, and other personnel are forced to participate in this failed,
unjust system by being required to provide medical evaluation of adolescents for incarceration in juvenile
facilities; and
WHEREAS, Decriminalization of marijuana would reduce criminal justice costs and allow law
enforcement resources to be directed to prevent and prosecute serious and violent crimes; and
WHEREAS, The following 16 states have decriminalized possession of small amounts of marijuana:
California, Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Nebraska,
Nevada, New York, North Carolina, Ohio, Rhode Island, and Vermont; and
WHEREAS, Colorado, Washington, Oregon, and Alaska have legalized the possession of marijuana for
adult recreational use without significant adverse effects; and
Resolution 16(15) Decriminalization and Legalization of Marijuana
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WHEREAS, More than 50% of the U.S. population now lives in states that have approved cannabis for
medical use; and
WHEREAS, A recent Gallup poll showed 58% of American support the legalization of marijuana for
recreational use; and
WHEREAS, Economists estimate that the underground marijuana market to be valued at between $70
billion and $120 billion, almost exclusively in cash; and
WHEREAS, Tax revenue from a legalized and regulated marijuana industry would result in billions of
dollars collected, which could be used for education, addiction treatment, and health care access; and
WHEREAS, There is no record in history of any person ever dying from a marijuana overdose, though
hundreds of thousands have died from the legal drugs alcohol and tobacco; and
WHEREAS, The AMA’s Code of Ethics states: “In general if a physician believes a law is unjust they
should work to change it”; therefore be it
RESOLVED, That ACEP believes that the federal and state governments should decriminalize the
possession of small amounts of marijuana for personal use for people aged 21 and older; and be it further
RESOLVED, That ACEP believes that state and the federal government should legalize, regulate, and tax
marijuana for adult use.
Background
This resolution calls for ACEP to support decriminalization for possession of small amounts of marijuana for
personal use for people aged 21 and older and support legalization, regulation, and taxation of marijuana for adult
use. This resolution is similar to previously submitted resolutions (see prior Council action). Two of the states that
have legalized marijuana, CO and WA, now have at least a year of post implementation experience.
Colorado
The state has collected more than $76 million in taxes and allocated more than $8 million in retail tax revenue for
youth substance abuse prevention and education, mental health, and community-based developmental programs.
In addition to the $2.5 million allocated to fund health workers in Colorado schools, $2 million of marijuana tax
revenue has been allocated to help fund community-based youth services programs that offer mentoring and focus
on drug prevention and school retention, and more than $4.3 million will fund school-based outreach programs
for students using marijuana. In addition, arrests for marijuana possession are down 84%.
Washington State
Washington has seen $83 million in tax revenue from sales and has used some of these funds for substance abuse
programs, community health services, prevention and treatment, and research on marijuana. Arrests for
possession are down 98%, violent crime has decreased slightly in the state, and there has been no increase in
traffic fatalities.
Oregon and Alaska are in earlier stages of implementation.
While total decriminalization for recreational use by adults has not been embraced widely by the states, clearly
opinions are changing across the country with regard to medical use of marijuana. Most of the states that have
passed new laws allowing medical marijuana use have done so in very limited ways. Interestingly, many of the
new laws are named for individuals suffering from various medical conditions that sought pain or symptom relief
Resolution 16(15) Decriminalization and Legalization of Marijuana
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through use of some form of cannabis and appealed to their legislators. Since the 2014 Council resolution, a few
more states have passed laws approving the use of medical marijuana, although most of these are strictly limited.
Legal Medical Marijuana States
Alaska
Arizona
California
Colorado
Connecticut
Delaware
Georgia
Hawaii
Illinois
Maine
Maryland
Massachusetts
Michigan
Minnesota
1998
2010
1996
2000
2012
2011
2015
2000
2013
1999
2014
2012
2008
2014
Montana
Nevada
New Hampshire
New Jersey
New Mexico
New York
Oklahoma
Oregon
Rhode Island
Texas
Vermont
Virginia
Washington
Washington, DC
2004
2000
2013
2010
2007
2014
2015
1998
2006
2015
2004
2015
2008
2010
It is not clear if a national consensus has been reached on research reflecting potential benefits of medical
marijuana, but, in addition to the table above, several other states have approved tightly controlled use of medical
marijuana for specific conditions (primarily epilepsy and MS): AL, FL, IA, KY, MS, NC, SC, TN, UT, and WI.
In 2014 or 2015, legislation to permit medical marijuana in ID was vetoed by the governor, and legislation failed
to pass in KS.
The level of legislative activity on the part of over half the states calls into question the justification of the Drug
Enforcement Agency’s (DEA) continuing position “that marijuana has no known medical benefits.” While the
DEA refers to smoked cannabis specifically, the Schedule I categorization has continued to baffle clinicians and
researchers alike. This categorization also stands in stark relief to lesser classification of opioids – drugs that have
caused a national crisis of overdose deaths.
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A 2015 study published by the National Bureau of Economic Research, (a non-partisan think-tank), "States
permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and
opioid overdose deaths compared to states that do not."
In 2014, the Journal of the American Medical Association (JAMA) Internal Medicine also reported that the
enactment of statewide medicinal marijuana laws is associated with significantly lower state-level opioid
overdose mortality rates. "States with medical cannabis laws had a 24.8 percent lower mean annual opioid
overdose mortality rate compared with states without medical cannabis laws," researchers concluded.
Specifically, they determined that overdose deaths from opioids decreased by an average of 20 percent one
year after the law's implementation, 25 percent by two years, and up to 33 percent by years five and six.
Since 2008, the American College of Physicians has publically supported research into the therapeutic role
of marijuana.
Changes in state law do not change the fact that using marijuana continues to be an offense under the Federal
Controlled Substances Act and that federal law can pre-empt state law on this issue.
In 2011, the DEA denied a petition to reschedule marijuana, and in 2013 a three-judge panel of the US Court
of Appeals for DC argued that judicial review of federal status (i.e., Schedule I) was not warranted.
In the states that allow the use of medical marijuana, physicians are generally not allowed to “prescribe” it;
they may only “recommend” its use or “advise consideration” of such therapy.
A 2015 Pew Research Center opinion poll found that the proportion of adults supporting legalization – at
least for medical use, is now over 50 percent, compared to 16 percent in 1990.
In spite of the seeming success of legalization in CO, some sheriffs from the State, as well as from NE and
KS have filed lawsuits claiming that the CO law is unconstitutional and imposes a burden on law
enforcement.
Resolution 16(15) Decriminalization and Legalization of Marijuana
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ACEP Strategic Plan Reference
Promote quality and patient safety, including development and validation of quality measures.
Fiscal Impact
Budgeted committee and staff resources for developing a policy statement and supporting legislative and
regulatory efforts.
Prior Council Action
Resolution 27(14) National Decriminalization of Possession of Marijuana for Personal and Medical Use not
adopted.
Amended Resolution 19 (14) Cannabis Recommendations by Emergency Physicians not adopted. The original
resolution called for ACEP to support emergency physician rights to recommend medical marijuana where it is
legal; object to any punishment or denial of rights and privileges at the state or federal level for emergency
physicians who recommend medical marijuana; and support research for medical uses, risks and benefits of
marijuana. The amended resolution directed ACEP to support research into the medical uses, risks, and benefits of
marijuana.
Resolution 23 (13) Legalization and Taxation of Marijuana for both Adult and Medicinal Use not adopted. This
resolution requested ACEP to support, endorse, and advocate for the legalization and taxation of marijuana.
Resolution 25 (11) Regulate Marijuana Like Tobacco not adopted. This resolution would have revised ACEP
policy on tobacco products to apply to marijuana or cannabis.
Resolution 20(10) Legalization and Taxation of Marijuana not adopted. This resolution requested ACEP to
support, endorse, and advocate for the legalization and taxation of marijuana.
Resolution 16 (10) Classification Schedule of Marijuana as a Controlled Substance not adopted. The resolution
requested ACEP to convene a Marijuana Technical Advisory Committee to advocate for change in the
classification status of marijuana from a DEA Schedule I to a Schedule II drug.
Resolution 16(09) Legalization and Taxation of Marijuana not adopted. This resolution requested ACEP to
support, endorse, and advocate for the legalization and taxation of marijuana and for a trust fund to be established
using tax revenue from marijuana sales that would fund research and treatment of drugs and alcohol dependence.
Prior Board Action
None
Background Information Prepared by: Barbara Tomar
Federal Affairs Director
Reviewed By: Kevin Klauer, DO, EJD, FACEP, Speaker
James Cusick, MD, FACEP, Vice Speaker
Dean Wilkerson, JD, MBA, CAE, Council Secretary and Executive Director