By Lindsey Greto and Meghan King, Public Health marijuana program

It’s been six years since Washington State legalized retail cannabis and since then, several other states and Canada have also legalized retail cannabis. This dramatic shift in public policy has raised some complex issues and public health challenges. To help focus their work, Public Health – Seattle and King County (Public Health) and the King County Department of Community and Human Services (DCHS) drafted a paper called Health and Human Services priorities regarding marijuana legalization – the “priority statement” for short. This handy guide summarizes six key priority areas to watch as we monitor the evolving cannabis industry and culture in our state.

What are the priorities?

Leaders across Public Health and DCHS identified the six main health and human services-related cannabis issues in King County: 1) limited research and evidence, 2) youth use, 3) use during pregnancy or breastfeeding, 4) injury, poisoning, and death, 5) environmental health, and 6) equity.

Here are more details on each of these priority areas:  

priority_1_graphic[1]1. Broaden the evidence base

Currently, Public Health and DCHS utilize and take direction from the Centers for Disease Control and Prevention (CDC) as our credible source on cannabis. There isn’t a huge amount of research on cannabis, however, and what is available typically involves small samples or includes confounding criteria. Furthermore, studies are frequently based on less potent cannabis than many of the retail products currently available. Expanding what is known about cannabis, its uses and effects are very important, especially since that knowledge is key to informing all of the other priority areas.

priority_2_graphic[1]2. Prevent youth use and ensure access to treatment

Purchasing, possessing, and using cannabis is only legal in Washington for adults ages 21 and older. When young people use cannabis, they can experience negative effects on their developing brains, as well as legal and academic consequences. Plus, they are put at greater risk of addiction; while 1 in 10 adult cannabis users can become addicted, that number rises to 1 in 6 for people under 18. Addiction means kids may make unsuccessful efforts to quit using cannabis or may choose to use marijuana over engaging in important activities with friends or family.

priority_3_graphic[1]3. Inform pregnant and breastfeeding women about potential risks

Research shows that using cannabis during pregnancy may cause low birth weight and developmental problems in newborns. Using while breastfeeding may also have negative effects on infants—but research is still catching up on the exact, long-term consequences. Bottom line: any cannabis use (including medical) should be avoided during pregnancy or breastfeeding.


priority_4_graphic[1]4. Protect people from injury, poisoning, and death

It’s important to keep cannabis products away from kids, pets, or other people who might accidentally ingest and be poisoned by them. Poisoning can also happen from using highly concentrated cannabis products. For any poisoning concerns, call the Washington Poison Center at (800) 222-1222, available 24/7/365. People who use cannabis should not drive while they are high, since being high can affect the ability to drive safely—putting people at greater risk of crashes, injury, and death.

priority_5_graphic[1]5. Ensure environmental health and safety

When cannabis is grown, workers and surrounding communities can be put at risk of safety issues like mold, mildew, and pesticide or herbicide runoff. Plus, products can be contaminated with chemicals (like pesticides and herbicides).

Air quality is important as well. Breathing in secondhand marijuana smoke may be harmful to the health of nonsmokers.

priority_6_graphic[1]6. Promote racial equity and healthy communities

People of color are far more likely to experience disproportionate enforcement of marijuana law violations than white people. Additionally, youth of color are more likely to be burdened with life-long consequences of underage use, such as school suspension or interaction with the criminal justice system. Addressing and minimizing these disproportionate consequences in criminal justice, schools, clinics, and communities is essential to building and maintaining healthy communities.

Stay tuned for our next blog posts, which will tell you all about each priority and give examples of current work being done in King County. First up: we’ll share our interview on cannabis research with Dr. Beatriz Carlini, a research scientist at the University of Washington’s Alcohol and Drug Abuse Institute.

Originally published on Dec. 3, 2018.


  1. #6 Racial Equity and Healthy Communities . What are restrictions re number of businesses selling marijuana permitted per geographical area? It appears there are many in close proximity to each other in the Rainier and South King County areas where income is proportionally lower and ethnicity/race diversity is great.

    1. Paula, I’m answering as a resident of one of the communities in the unincorporated county impacted by a large number of retail cannabis stores. To recap after nearly five years of state marijuana licensing, there are currently 13 retail cannabis stores open in the unincorporated county, population approximately 250,000. Distribution of these stores is now limited to west side unincorporated communities with six in White Center/Top Hat, five in Skyway (with a sixth proposed that the county endorsed), and two on Vashon. These communities represent a population of less than 40,000 and 13 stores represents the largest aggregation in any municipality save Seattle. In contrast, the cities of Bellevue and Renton combined (> 245,000 population) have chosen to limit themselves to no more than 11 cannabis stores.

      Perhaps unsurprisingly, the council representatives of over 80% of the county’s unincorporated population have been highly resistant to any stores at all, and in fact no stores have been sited in their districts. Beyond that, current county land use regulations specify a maximum of only two retail stores per council district if and when the county finally expands the commercial zones where these stores would be allowed to match such similar businesses as convenience stores (cigarettes, beer and wine), pharmacies, and liquor stores are already permitted.

      My take is that this de facto redlining of retail stores out of the east side population centers of the unincorporated county, combined with the absence of initial restrictions on clustering or limits on the numbers of stores in the smaller west side communities of the county, can’t have resulted in anything else but the retail cannabis landscape we see in the unincorporated county today.

      Fairness really dictates that these land use rules must be altered to treat each community in the unincorporated county far more equally than the current rules do now.

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