Getting it Right from the Start

Cannabis equity programs were created for an important reason: Black and Latino communities suffered disproportionately from decades of ma*****na criminalization and the War on Drugs.

Legalization should create meaningful opportunities for those communities to participate in and benefit from the legal market.
But a powerful New York Times investigation shows how that promise can be undermined.

New York prioritized licenses for people harmed by ma*****na enforcement. Yet in Hudson, wealthy investors have used their access to capital and “justice-involved” partners to gain control of businesses intended to advance equity.

In one striking case, a formerly incarcerated Black entrepreneur received just a 1% stake in a venture that relied on his participation to obtain an equity license. He later said he had been “exploited as merely a proxy justice-involved individual.”

Equity licensing remains an important tool for addressing the harms of the War on Drugs. But licenses alone cannot deliver equity if those with wealth and power can capture opportunities intended for the communities most harmed by prohibition.

Read The New York Times: https://bit.ly/4yk42qS

Kratom and increasingly potent 7-OH products remain widely available in California smoke shops.

Lynn Silver, MD, MPH, director of Getting it Right from the Start at the Public Health Institute, spoke with Redwood News about what consumers should know—and what our new statewide field research found.

Our researchers visited 86 retailers in 23 California communities and found kratom or 7-OH products in nearly half, despite growing concern about addiction, overdose and other health risks.

And the reporter did more than interview us: Redwood News visited local smoke shops and found the products for sale firsthand.

Watch/read the Redwood News coverage:

Public Health Institute Officials Warn Public of Kratom Products in California A substance known as kratom is becoming increasingly common in smoke shops and convenience stores across California, prompting concern from some public health advocates about newer, more concentrated products derived

NEW STUDY: Are we measuring the right thing when it comes to teen cannabis use?

National surveys showing relatively flat rates of adolescent cannabis use are often cited as evidence that legalization hasn't affected young people. But a new study of 637,000 Northern California adolescents found a different pattern when researchers looked at diagnosed cannabis use disorder:

- Before California legalized recreational cannabis, new CUD diagnoses were falling about 6% per year.
- After legalization passed, they rose about 8% per year, reversing the previous decline.

The findings suggest that measuring whether teens use cannabis—and how often—may not tell us enough about how many are experiencing serious problems from that use.

“Most surveys of adolescent cannabis use tell us how many teens have tried cannabis, but don’t tell us how many are developing a disorder that brings them into clinical care,” said lead author Alisa Padon, PhD, research director at Getting it Right from the Start.

The takeaway: To understand the public health effects of cannabis legalization, we need to measure harm—not just use.

Read the new study by Public Health Institute's Getting it Right from the Start and Kaiser Permanente Northern California Research Division and findings in News Medical: https://bit.ly/4gVoAQs

NEW: What’s being sold in California smoke shops?

A new field survey from Public Health Institute’s Getting it Right from the Start and the San Fernando Valley Partnership visited 86 retailers in 23 California communities—and found psychoactive products widely available.

Among smoke shops surveyed:
• 49% sold kratom or 7-OH products
• 24% sold nitrous oxide
• 19% sold psychoactive mushroom products
• 37% were within four blocks of a school or college

“Having a to***co license is not a license to sell drugs to kids,” said Lynn Silver, MD, MPH, senior advisor at the Public Health Institute and director of Getting it Right from the Start. “California has shown with intoxicating h**p that strong public health rules and enforcement can make a real difference. We need to sustain that urgency nationally for intoxicating h**p and extend it to the other addictive and potentially dangerous products now appearing on smoke-shop shelves.”

The findings point to important gaps in regulation and enforcement—and the need for stronger protections, particularly for young people.

Read the new policy brief, “Searchlight on Smokeshops”: https://bit.ly/46bZfLS
Media release: https://bit.ly/4qWGpBP

California just took an important step to better protect children from cannabis products designed and marketed in ways that can appeal to them.

Gov. Gavin Newsom has signed AB 2249, authored by Assemblymember Jacqui Irwin, strengthening state rules governing cannabis packaging, labeling, advertising and marketing attractive to children.

The need is clear: since 2016, cannabis-related calls to the California Poison Control System involving children 5 and under have increased 406%. Calls involving cannabis edibles among these young children increased 743% from 2017 to 2024.

Getting it Right from the Start and other public health advocates have pushed for stronger protections for years, including AB 1207 in 2023, which Gov. Newsom vetoed.

AB 2249 doesn't go as far as advocates have sought—it doesn't ban flavored inhaled cannabis products and still allows realistic fruit imagery and adult-oriented celebrity branding. But it makes important progress, establishing clearer standards for packaging, labeling, advertising and marketing that appeal to children, including cartoons, candy and sweets imagery and some stylized fruit imagery.

We thank Assemblymember Irwin for her persistence and leadership. Legal cannabis shouldn't mean cannabis packaged or marketed in ways that put children at risk.

ABC 10 covers story: https://bit.ly/4qRyNRe

Laughing gas belongs in the dentist's office—not the smoke shop.

California lawmakers have unanimously passed SB 936, legislation restricting the sale of large, flavored and direct-inhalation nitrous oxide products while preserving legitimate medical, dental and culinary uses.

Nitrous oxide has legitimate purposes. But products designed and marketed for recreational inhalation are increasingly raising public health concerns, including serious neurological injury and deaths.
The Legislature acted with overwhelming bipartisan support. Now it's Governor Newsom's turn.

Governor Newsom: Sign SB 936!

The public health case for this legislation has brought together a broad coalition, including the California Medical Association, American Academy of Pediatrics–California, and California's local health officers, along with local governments and public safety organizations across the state.

With strong support from California's physicians, pediatricians and public health leaders—and unanimous approval by the Legislature—it's time to protect young people and put public health first - not smokeshop profits.

Learn more from Sen. Blakespear: https://bit.ly/4xxqP2g

Catherine Blakespear California Medical Association American Academy of Pediatrics

Two major new reports underscore a growing public health problem: cannabis use disorder is rising as today's cannabis products have become dramatically more potent.

A new national study led by researchers at the National Institute on Drug Abuse found cannabis use disorder (CUD) increased among both men and women from 2021–2024, including increases in moderate-to-severe CUD.

Perhaps most striking: among adults who reported using cannabis in 2024, about 30% showed symptoms consistent with cannabis use disorder. Among people who drank alcohol, fewer than 20% showed symptoms consistent with alcohol use disorder.

“The notion that cannabis is not addictive may basically be incorrect,” NIDA Director Dr. Nora Volkow told The New York Times. She pointed directly to today's much stronger products: “The higher the content of the drug, the higher the risk for addiction.”

And those products are dramatically different from cannabis of previous generations. Writing in The New York Times this week, child and adolescent addiction psychiatrist Dr. Sivabalaji Kaliamurthy notes that cannabis contained roughly 2–5% THC a few decades ago. Today's cannabis flower often contains around 20%, while cartridges and concentrates can exceed 70% THC.

His prescription: regulate cannabis based on risk—including THC potency caps, standardized labeling and dosing, stronger health warnings, research, and better public education.

That's an important distinction. The question isn't whether we return to cannabis prohibition. It's whether legalization means allowing an increasingly commercialized industry to sell ever-more-potent products with inadequate public health safeguards.

As alcohol use declines, replacing one preventable public health problem with another isn't progress. Cannabis policy needs to catch up with the products being sold today.

New York Times investigative piece by Rony Robin: https://www.nytimes.com/2026/08/19/well/cannabis-use-disorder-alcohol.html

NY Times opinion piece by Dr. Nora Volkow: https://lnkd.in/gKS5Y4CC

As More Americans Turn to Cannabis, Problem Use Is Increasing A growing number of Americans report they are unable to quit or cut down.

Nine intoxicating h**p brands. 837 Instagram posts. Almost no safeguards for young people.

In a new study out today in Addiction (journal of the Society for the Study of Addiction): Alisa Padon, a researcher with the Public Health Institute’s Getting it Right from the Start program, teamed up with researchers at Rutgers University and others to analyze those posts. Here’s what they found:

- 49.6% used youth-oriented content: memes, cartoons, pop culture references
- 52% promoted relaxation and happiness, showing products in everyday social settings
- Beverages were marketed most aggressively: 84.3% used recreational themes, 56.9% youth-oriented themes
- Just 2.5% carried any health or age warning

This is the familiar tension between economic interests and public health: allow marketing tactics that drive sales at the expense of people’s health or protect the health of Americans.

Public Law 119-37 — which takes effect November 12 and prohibits these products by narrowing the federal definition of h**p and capping THC per package — is now being challenged. Maintaining that federal prohibition will be important to protect our youth.

Read more about the study: https://www.phi.org/press/youth-oriented-marketing-intoxicating-h**p-products/

Study: Nearly Half of Intoxicating H**p Posts on Instagram Use Youth-Oriented Marketing; Just 2.5% Carry Warnings Brands selling intoxicating h**p products are rarely warning about health risks or age limits, according to a new study.

A powerful Sacramento Bee opinion from Tom Philp raises urgent questions about California’s cannabis regulations—particularly access for young people ages 18–20.

Philp examines the tragic case of Carlos Reales Dominguez, who obtained a medical cannabis authorization online at age 19, later developed schizophrenia, and in 2023 killed two people and seriously wounded another during a stabbing spree in Davis.

We cannot know whether cannabis caused Dominguez’s schizophrenia or what role it may have played in this tragedy. But his case highlights a broader problem: California allows 18–20-year-olds—whose developing brains are particularly vulnerable to cannabis-related harms—to gain legal access to the full range of dispensary products through medical recommendations.

Research we conducted with Kaiser Permanente Northern California (lead author) underscores the concern: adolescents who reported cannabis use were more than twice as likely to later be diagnosed with a psychotic disorder or bipolar disorder, with increased risks of depression and anxiety as well.

The circumstances surrounding Dominguez’s authorization are also troubling. According to Philp, an online physician cited diabetes as a justification even though Dominguez’s application did not indicate he had diabetes. Online medical-card businesses can make cannabis remarkably easy to access, raising serious questions about whether California’s standards for medical recommendations are being adequately followed and enforced.

We know substantially more about cannabis, the developing brain, addiction, and mental health risks today than we did when California legalized adult-use cannabis in 2016. Our policies should reflect that evidence. As Philp concludes: “Sacramento needs to wake up.”

Read the Sacramento Bee opinion: https://bit.ly/4gizz5Z

California should rethink teen access to cannabis after Davis stabbings | Opinion Carlos Dominguez started legally using cannabis at age 19. Four years later and with schizophrenia, he went on a stabbing spree in Davis.

For years, Getting it Right from the Start has warned that a loophole in the 2018 Farm Bill allowed intoxicating h**p products—including gummies, beverages, and vapes—to be sold with far too few public health safeguards.

Last year, Congress voted to close that loophole by changing the federal definition of h**p and establishing new limits that would effectively remove most intoxicating h**p products from the market. Now, according to Forbes, Senate leaders have proposed delaying implementation of those restrictions until December while industry groups lobby for a different legislative approach.

This is an important moment for public health advocates. After years of work to strengthen protections against intoxicating h**p products, we encourage policymakers to preserve the progress already made and keep the focus where it belongs: protecting young people, consumers, and public health—not reopening the loophole that allowed this largely unregulated market to flourish.

Read more in Forbes: https://www.forbes.com/sites/maryroeloffs/2026/08/03/senate-seeks-delay-on-crackdown-of-h**p-thc-products/

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H**p Industry Scores Major Win To Keep Intoxicating THC Products Legal Congress is trying to delay a law that would effectively kill the $28 billion intoxicating h**p industry.