Getting it Right from the Start

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

04/17/2026

New study in JAMA Network Open, led by Kaiser Permanente and co-authored by our team at Public Health Institute, looks at how adolescent cannabis use has changed over time in California.

Using data from more than 1.3 million teen screenings, the study found:
• Use increased after legalization—even before retail sales began
• Use declined during COVID-19
• By 2024, rates returned to pre-legalization levels

As lead author Dr. Kelly Young-Wolff of Kaiser Permanente noted, the increase following legalization suggests that changes in social norms and perceptions—alongside access—may play an important role in shaping adolescent behavior.

Grateful to Kaiser Permanente for their leadership on this important research.

Study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847868

*****na Kaiser Permanente Public Health Institute

04/14/2026

New op-ed from youth advocate Jim Keddy in Capitol Weekly highlights a growing concern: California is falling short on its promise to protect kids in the era of legalized cannabis.

Keddy makes a clear and compelling case: legalization was never meant to come at the expense of children’s health and safety.

Instead, voters were promised a tightly regulated system — one that would fund youth programs, prevent harm, and hold industry accountable.

But as Keddy outlines, that promise has eroded:
• Funding for youth and prevention programs has been cut, with an estimated $128 million annually diverted away from its intended purpose
• Products and marketing increasingly appeal to children, with packaging resembling candy and a 469% rise in cannabis-related poison control calls among young children
• Potency and risks are rising, with research linking youth cannabis use to serious mental health outcomes

Keddy is clear: this isn’t about undoing legalization — it’s about restoring integrity and accountability to what voters approved.

That’s why legislation like AB 2249 (D- Irwin) is so important. Strengthening safeguards on cannabis marketing and products is a critical step toward aligning policy with public health — and with the original intent of Proposition 64.

At the end of the day, this is about trust.

If we fail to uphold the protections voters were promised, we don’t just put kids at risk — we undermine confidence in the democratic process itself.

Read Editorial: https://capitolweekly.net/california-must-keep-its-promise-to-protect-kids-from-big-cannabis/

04/09/2026

California’s cannabis market is moving faster than its public health safeguards.

AB 2532 (D- Irwin) is a necessary fix.

Right now, cannabis beverages are widely sold with up to 100 mg of THC per container—that’s 10 California “standard” doses! Yet these products are packaged and marketed like single-serving drinks.

That’s not just misleading—it’s dangerous.

At these levels, THC can trigger:
• Severe anxiety, panic, and paranoia
• Loss of consciousness in some users
• Increased risk of accidents and impaired driving
• Serious harm to children if ingested accidentally

We’re already seeing rising cannabis-related ER visits.

AB 2532 sets a simple, common-sense standard:
👉 Limit beverages to 10 mg THC per container (one serving)
👉 Align packaging with how people actually consume these products
👉 Reduce preventable harms to consumers, youth, and families

This approach reflects established public health guidance and expert recommendations.

We don’t allow alcohol products to contain 10 servings disguised as one drink. Cannabis shouldn’t be treated differently.

This is about putting basic guardrails on an out-of-control market—and protecting public health.

*****na

03/30/2026

New peer-reviewed research shows what many of us in public health have been warning:

Cannabis marketing is shaping how young people see risk.

In a new study we co-authored, California youth (ages 16–20) were more likely to see cannabis as fun and less dangerous when ads included flavors, playful imagery, and positive experiences.

That matters—because perception is a key driver of use.

And it’s exactly why stronger safeguards are needed.

California had a chance to act with AB 1207, a landmark bill to limit youth-appealing cannabis marketing. It passed the legislature—but was vetoed.

This new evidence makes the path forward clear:
✔️ Restrict flavors and food-based marketing
✔️ Ban youth-appealing imagery
✔️ Limit “fun” and lifestyle advertising

Because when it comes to cannabis—just like to***co and alcohol— the market will not regulate itself.

Read Study: https://www.tandfonline.com/doi/full/10.1080/10826084.2026.2645776?scroll=top&needAccess=true

03/12/2026

A new study in Sage Journals examining Quebec’s cannabis retail monopoly (SQDC) highlights how cannabis legalization can prioritize public health over profit. Unlike the commercial model used across the United States, Quebec designed its system with a legislated mission:
..to sell cannabis without encouraging consumption.

Researchers identified several safeguards that help prevent commercialization and reduce harm:
• A not-for-profit mandate
• Independent health oversight
• Separation of regulation from revenue agencies
• Profits dedicated to prevention and research

This stands in sharp contrast to U.S. legalization, which has largely prioritized industry growth, product expansion, marketing, and increasing potency.

Public cannabis monopolies — long used for alcohol in many jurisdictions — offer a promising model for balancing legalization with harm reduction. By removing profit incentives and placing public health at the center of policy design, governments can better protect youth and limit the expansion of high-risk products.

As more jurisdictions consider cannabis legalization or reform, policymakers should seriously consider the public monopoly model as a viable alternative to for-profit commercialization.

Because when it comes to potentially harmful products, the goal should not be maximizing sales — it should be minimizing harm.

Study: https://journals.sagepub.com/doi/full/10.1177/00914509261416113

*****na

03/02/2026

We are at an inflection point in how the United States talks about cannabis and youth mental health.

Our new research - led by Kaiser Permanente - in JAMA Health Forum followed nearly 500,000 adolescents over eight years. The strongest associations were with psychotic and bipolar disorders — where risk was about doubled. Importantly, cannabis use was reported one to two years before diagnosis.

At the same time, clinicians are describing dramatic shifts in what they are seeing on the ground. As pediatrician Dr. Natalie Laub shared this week with KCBS, prior to 2020 her hospital saw a few dozen adolescent cannabis-related cases per year. In 2025, that number approached 600.

Today’s cannabis products are more potent than in previous generations. Youth from lower-income communities are disproportionately affected. Commercialization has moved quickly. Public health protections have not kept pace.

To be clear: this research does not argue for restarting the drug war or criminalizing possession. It does underscore the need for guardrails:
• Meaningful age restrictions
• Potency limits
• Restrictions on youth-targeted marketing
• Clear warning labels
• Science-based parent and community education

Legalization and public health are not opposites. We can oppose incarceration and still prevent hospitalization.

The growing national coverage and clinical conversations reflect something important: the narrative is shifting. Evidence-based, prevention-focused approaches are gaining traction.

Watch key recent interviews with Kelly Young-Wolffe as well as our own Dr. Lynn Silver:

Contemporary Pediatrics: https://bit.ly/4cCr0Sn
Redwood TV: https://bit.ly/4r7BJYp
KCBS: https://bit.ly/4cRKphW

*****na Kaiser Permanente Public Health Institute

A new study published in the Journal of the American Medical Association associates adolescent cannabis use with increased risk for serious mental health conditions.

02/23/2026

Major national coverage for Kaiser Permanente's (that we co-authored with researchers from USC and UCSF) new JAMA Health Forum study. NPR’s Rhitu Chatterjee featured our research on Weekend Edition Saturday, highlighting findings from one of the largest longitudinal studies to date examining adolescent cannabis use and mental health outcomes.

Researchers followed 460,000 adolescents in the Kaiser Permanente system through age 25. After excluding teens with prior psychiatric symptoms, the study found:
• More than double the risk of psychotic disorders
• Roughly double the risk of bipolar disorder
• A one-third increase in depression
• A one-quarter increase in anxiety

As Dr. Lynn Silver explained to NPR, the adolescent brain is still developing — and regular cannabis use may disrupt healthy neural development in ways that increase vulnerability to serious psychiatric disorders. She also underscored that legalization has contributed to a widespread perception of cannabis as a harmless, natural stress remedy — a perception not supported by emerging evidence.

Grateful to NPR for thoughtful, careful coverage of this research.

See article: https://www.npr.org/2026/02/21/nx-s1-5719338/cannabis-ma*****na-weed-teens-psychosis-jama

*****na Public Health Institute NPR

Researchers followed more than 400,000 teens until they were adults. It found that those who used ma*****na were more likely to develop serious mental illness, as well as depression and anxiety.

02/20/2026

A major new study published today in JAMA Health Forum followed nearly 463,000 adolescents and found that past-year cannabis use during adolescence was associated with a significantly increased risk of developing psychotic, bipolar, depressive, and anxiety disorders by young adulthood. The risk of psychotic and bipolar disorders — among the most serious mental health conditions — approximately doubled.

Cannabis use preceded psychiatric diagnoses by an average of 1.7 to 2.3 years, strengthening evidence that adolescent exposure may contribute to the development of mental illness rather than simply reflect underlying symptoms.

The research was conducted by scientists at Kaiser Permanente Division of Research (lead authors), the Public Health Institute’s Getting it Right from the Start, UCSF, and USC, and funded by the National Institute on Drug Abuse.

As lead author, Kelly Young-Wolff, Kaiser Permanente, noted: “Even after accounting for prior mental health conditions and other substance use, adolescents who reported cannabis use had a substantially higher risk of developing psychiatric disorders — particularly psychotic and bipolar disorders. This study adds to the growing body of evidence that cannabis use during adolescence could have potentially detrimental, long-term health effects. It’s imperative that parents and their children have accurate, trusted, and evidence-based information about the risks of adolescent cannabis use.”

Dr. Lynn Silver, program director of Getting it Right from the Start and study co-author continued: “As cannabis becomes more potent and aggressively marketed, this study indicates that adolescent cannabis use is associated with double the risk of incident psychotic and bipolar disorders…The evidence increasingly underscores the importance of a strong public health response.”

Cannabis is the most commonly used illicit drug among U.S. adolescents. At the same time, THC potency in legal markets has risen dramatically compared to prior decades. As legalization expands, this study adds to a growing body of evidence that youth exposure is not benign — and that prevention, accurate risk communication, and thoughtful policy guardrails matter.

Study link in comments.

*****na

02/10/2026

A long-overdue shift in the cannabis conversation. This week, the Editorial Board of the The New York Times published an important editorial acknowledging what public-health researchers and community advocates have been warning for years: legalization without strong regulation has real and growing costs.

The piece documents dramatic increases in frequent use, addiction, ER visits, psychosis, and impaired driving—alongside the clear failure of many states to adequately regulate potency, marketing, and industry behavior after legalization.

While the editorial isn’t perfect—it understates today’s rates of dependency and repeats outdated comparisons to alcohol—it marks a meaningful break from the long-standing assumption that cannabis legalization would bring few downsides.

Notably, it calls for:
• Limits on THC potency
• Taxation based on THC content
• A shift away from treating cannabis as an economic growth strategy
• Regulation grounded in public health, not industry profits

The editorial lifts up the concept of “grudging toleration,” advanced by late drug-policy scholar Mark Kleiman—keeping cannabis legal while actively working to curb excessive use, addiction, and harm. That approach stands in sharp contrast to the high-potency, profit-driven markets many states have allowed to flourish.

Big questions remain—especially around federal action, industry influence, and how to set a true regulatory floor without repeating the mistakes of commercialization. But acknowledging reality is a necessary first step.

This is where local policy matters. Our cannabis scorecards show, jurisdiction by jurisdiction, where states and local governments have failed to regulate—and where stronger, evidence-based protections are possible right now.

Alarm bells are finally ringing where they matter. The next step is using evidence to guide smarter policy.

Our Scorecards (special thanks to The Center at Sierra Health Foundation for their support): https://bit.ly/3MfmYV8
Editorial: https://bit.ly/4chAWQK

*****na The Center at Sierra Health Foundation

Given the growing harms from ma*****na use, American lawmakers should do more to regulate it.

02/06/2026

Another strong example of how our California Cannabis Policy Scorecards are meant to function — and why independent journalism plays such a critical role in advancing public health.

In a deeply reported column for the Orange County Register, Teri Sforza examines how multiple Orange County cities stack up on protecting youth and communities as legal cannabis continues to expand. The piece does exactly what the scorecards are designed to enable: it names scores city by city, explains what each locality has done, and just as importantly, what it has not — making local policy choices visible and comparable.

Just as importantly, the article situates those scores within the broader public-health context driving this work. It walks readers through the growing body of evidence around today’s hyper-commercialized cannabis market — including rising potency, youth-appealing flavors and packaging, declining risk perception among adolescents, increased emergency-room visits, mental-health harms, and the particular risks to youth and young adults. The message is clear: legalization has moved faster than the guardrails needed to protect public health.

Against that backdrop, the reporting highlights why local policy matters so much. The article explains why Pomona leads the state (60 points), and then details how Orange County cities such as Santa Ana (40), Laguna Woods (25), Costa Mesa (21), La Habra (21), and Stanton (18) earned their scores — connecting specific policies (or gaps) around retailer limits, buffers from schools, health warnings, delivery rules, event bans, marketing, and use of cannabis tax revenue to real health implications.

That transparency is the point. The scorecards are not just a grading exercise. They are a tool to show that state law is a floor, not a ceiling — and that as cannabis becomes more potent, more aggressively marketed, and more widely available, local governments have both the authority and responsibility to do more.

Read the full article here: https://www.ocregister.com/2026/02/06/cannabis-report-card-do-o-c-cities-make-the-grade/

Public Health Institute *****na Prevention Institute

Columnist Teri Sforza writes: In the few O.C. cities that allow cannabis businesses, the industry generates tax revenue — up to $10 million for youth and safety programs. But public health ty…

02/05/2026

We’re incredibly grateful for the in-depth, public-service reporting by Michele Chandler and the Redding Record Searchlight (USA Today Network) on our newly released 2025 California Cannabis Policy Scorecards.

This story takes a close look at how Redding, Anderson, and Shasta Lake are doing when it comes to protecting youth and public health as legal cannabis expands — and, importantly, why those local policy choices matter. It doesn’t just report the scores; it explains where communities are making progress and where key protections are still missing.

That’s exactly how we hope these scorecards will function.

They are meant to do two things at once:

- Recognize leadership, by highlighting communities that go beyond state minimums to protect health and advance equity.
-Create accountability, by clearly showing where local governments are leaving proven public-health protections on the table.

As the article underscores, simply following state law isn’t enough. Local governments have real authority to shape safer cannabis markets — and the scorecards provide both transparency and a roadmap for how to do better.

We’re especially thankful for the care and depth of this reporting, and for the opportunity to contribute data and analysis that can help inform local conversations and drive smarter, science-based policy.

Read the full story here: https://www.redding.com/story/news/2026/02/05/california-cities-cannabis-policies-fail-to-protect-youth/88476560007/?gnt-cfr=1&gca-cat=p&gca-uir=true&gca-epti=z11xx81p002750c002750v11xx81d--66--b--66--&gca-ft=140&gca-ds=sophi

*****na

Current California rules on legal cannabis aren't tough enough, according to an Oakland-based research group.