A recent study in Lancet Psychiatry, which reviewed global data from 2000–2025, found that the commercialization of marijuana in the United States has been associated with increases in marijuana use, cannabis use disorder, and hospital admissions for psychosis.
This has occurred in part because “US states have largely followed a commercial legalised model, with few restrictions on product potency, prices, availability, and marketing.”
Tom Freeman, who is a professor at the University of Bath and was the first author of the study, told The Guardian: “when there’s a for-profit industry, particularly for an addictive product, there’s an incentive to sell cheaper products, and high-potency products, because they know that the more they sell, the more money they’ll make, and that can increase use.”
Pointing to how the alcohol and tobacco industries “have a long history of maximising commercial interests while substantially harming human health,” the study noted that “there are concerns that the cannabis industry will follow a similar path.” In practice, examples of this include the emergence of retail stores, reductions in price, the creation of stronger products, and the “active promotion” of these products.
Moreover, the study noted that the decriminalization of marijuana in parts of Europe, Africa, Oceania, and Asia was not associated with comparable rises in marijuana use, cannabis use disorder, and psychiatric disorders.
Taken together, these global trends suggest that the creation of an underregulated marijuana industry, rather than the removal of criminal penalties for marijuana use, is most responsible for the rise in marijuana-related harms.
Robin Murray, who is a professor at King’s College London and was not involved with the study, told The Guardian: “Is it possible to legalise without commercialising in western capitalist countries? It should be possible, but so far no country has managed this because of the growing power of the multibillion cannabis industry.”