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When we founded Americans for Safe Access more than two decades ago, safety in the world of medical cannabis primarily meant protecting patients from arrest, prosecution, raids, loss of custody, and punishment simply for using a medicine that worked for them. Much of our early work focused on ending the criminalization of patients and building legal medical cannabis programs. We fought for patients to possess cannabis, for doctors to recommend it, for caregivers to assist patients, and eventually for regulated systems where patients could legally obtain their medicine.

Those changes have been enormous, and millions of patients are safer because of them. But “safer” for some Americans was never our goal. As our advocacy changed the world for patients, our demands and expectations for safety had to change too.

The work of patient advocates is not always well understood. For medical cannabis patient advocates, that challenge is compounded by the fact that many people think primarily about the legal struggles patients have faced and see legalization itself as the finish line. They assume that once patients can legally obtain cannabis, the need for advocacy is over. In reality, legal access creates the opportunity to build safer systems, but those systems still have to be built, evaluated, and improved. That also means being willing to address legitimate safety concerns while preventing those concerns from being distorted into arguments for returning patients to prohibition.

Safe access starts with legal reform. But even laws that authorize medical cannabis can still leave patients vulnerable. A state can technically have a medical cannabis program while patients struggle to find participating healthcare professionals, travel hours to reach a dispensary, encounter products they cannot afford, or lack protections in employment, housing, hospitals, schools, and other institutions. A law intended to protect public health can unintentionally push patients toward products outside the regulated system. Legal does not automatically mean accessible, and accessible does not automatically mean safe.

The changing federal landscape makes this even more important. As federal cannabis policy changes, government agencies, states, healthcare institutions, employers, businesses, and others must determine how those changes affect their existing policies. Patients should not be expected to navigate those changes alone. Safe access means making sure laws are understandable, protections are implemented, institutions update outdated policies, and patients know their rights and responsibilities.

Today, adult use and hemp markets have expanded cannabis safety concerns far beyond the traditional relationship among patients, caregivers, and healthcare professionals. As cannabis has moved beyond medical programs and into adult use and hemp markets, our demands and expectations for safety have had to expand beyond patients as well. What “safe” requires now includes responsibilities to families, workers, drivers, consumers, and communities.

When those broader safety concerns are not addressed responsibly, they can also affect the progress and stability of medical cannabis programs. Are parents receiving credible information about youth and cannabis? Can we accurately distinguish impairment from the simple presence of cannabis in a person’s body? Are public health policies based on evidence, or are old assumptions about cannabis simply being carried into new laws and regulations? These are not questions patient advocates can afford to ignore simply because they extend beyond the traditional boundaries of medical cannabis policy.

This is why we created Cannabis Safety Month. We wanted to make space for conversations that cannabis advocacy has sometimes been reluctant to have and that opponents of cannabis reform have too often distorted. We should be able to acknowledge legitimate safety concerns without allowing those concerns to become an excuse to punish patients or return to prohibition. We should also be able to defend medical cannabis without pretending that every product, every pattern of use, every regulation, or every policy is equally safe.

During the remaining weeks of Cannabis Safety Month, we are looking at what that evolving definition of safe requires today. Product safety means knowing what is in your cannabis and having standards capable of identifying problems when they occur. Health safety means giving patients honest information about benefits, risks, drug interactions, adverse events, and the limits of what research currently tells us. Youth safety means preventing accidental and unauthorized access while recognizing that some children and adolescents are themselves medical cannabis patients. Public health safety means addressing issues such as impaired driving, workplaces, emergency events, and environmental impacts with accurate data, not fear or assumptions.

For me, the word “safe” in Americans for Safe Access has always meant more than avoiding harm. It means creating the conditions that allow patients to make informed decisions, obtain reliable products, receive competent medical care, understand the laws that affect them, and participate fully in society without being treated as criminals or second-class citizens because of their medicine.

The work of safe access therefore changes as laws, science, products, and society change. Our responsibility is to keep asking what safety requires now, identify where our systems are falling short, and be willing to improve them as we learn more.

That is the conversation I hope Cannabis Safety Month can help us have.

As federal cannabis policy continues to change, these conversations are also helping shape what comes next. ASA is bringing what we have learned from patients, state medical cannabis programs, product safety, healthcare, and public health into our work on the Medical Cannabis and Cannabinoid Act (MCCA), our proposed framework for a national medical cannabis program that would establish more consistent federal standards and patient protections. Thank you to the Cannabis Safety Month partners and sponsors whose support has made these conversations possible and helped us bring patients, healthcare professionals, researchers, advocates, regulators, and other stakeholders together to strengthen cannabis safety and safe access for everyone.