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When we founded Americans for Safe Access more than two decades ago, the “safe” in safe access primarily meant protecting medical cannabis stakeholders from arrest, raids, and prosecution. 

With the long-term goal of integrating cannabis into our healthcare system, much of our early work focused on ending the criminalization of patients and building legal medical cannabis access programs at the state level. Our campaigns helped create the legal frameworks that allowed patients to possess cannabis, doctors to recommend it, caregivers to assist patients, and regulated systems to provide patients with legal access to their medicine.

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

Patient advocacy is rarely understood, but that is especially true for medical cannabis patient advocates because of the assumption 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.

Access starts with legal reform, but we have learned that even laws authorizing medical cannabis can still leave patients vulnerable. A state can technically have a medical cannabis program while patients struggle to find participating healthcare professionals or safe products, travel hours to reach a dispensary, encounter products they cannot afford, or lack protections in employment, housing, hospitals, schools, and other institutions. Legal access is an essential foundation, but the protections surrounding that access ultimately determine whether patients are truly safer.

Safe access also means ensuring protections are implemented, outdated policies are updated, and patients understand their rights and responsibilities. The recent changes in federal cannabis policy will require the same diligence. Government agencies, states, healthcare institutions, employers, businesses, and other institutions will need to update their policies and practices to reflect changes in federal law before patients fully experience the benefits of those reforms. At the same time, broader cannabis safety concerns can create backlash that threatens continued progress if those concerns are ignored or poorly addressed.

As cannabis has moved beyond medical programs and into adult use and hemp markets, demands and expectations surrounding cannabis safety have expanded beyond patients to include families, workers, drivers, consumers, and communities. 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 evidence-based, 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. Unaddressed safety concerns are increasingly being cited by opponents of cannabis reform as reasons to slow, restrict, or reverse progress, making it even more important that advocates engage these issues directly and credibly.

During September, we are looking at what that evolving expectation of safety 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.

Achieving medical cannabis access also creates a responsibility for advocates, regulators, healthcare professionals, businesses, and policymakers to keep asking what cannabis safety requires, identify where our systems fall short, and 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.