Cannabis Commercialization as a Modifiable Public Health Exposure.

Gilman J.; Foo C.; Hyatt A.; Evins A. · JAMA psychiatry · 2026

**Background & Methods** This is a policy-focused viewpoint article that examines cannabis commercialization practices as a modifiable public health exposure rather than a traditional clinical intervention study. The authors conducted a narrative review of evidence linking commercialization policies to psychiatric outcomes and mental health risk factors in the population. **Key Findings** - Cannabis commercialization features—including product potency increases, marketing strategies, retail accessibility, and pricing structures—constitute controllable policy exposures that may significantly influence psychiatric risk at the population level, particularly among vulnerable groups such as adolescents and individuals with genetic predisposition to psychotic disorders. - Specific commercialization practices associated with elevated psychiatric risk include high-potency THC products, delivery app accessibility, social media marketing, and competitive pricing that reduces barriers to use, with evidence suggesting dose-response relationships between product potency and psychotic symptoms. - Recommended mitigation strategies include regulatory caps on THC potency, restrictions on marketing and product placement, licensing requirements limiting retail density, taxation structures discouraging high-potency products, and public health messaging about psychiatric risks, particularly regarding use in adolescence and among at-risk populations. **Dosage & Administration** Not reported. **Safety & Adverse Effects** The viewpoint emphasizes psychiatric adverse effects as the primary safety concern, particularly psychotic symptoms, psychosis risk, and psychiatric hospitalization, with stronger associations noted for high-potency THC products and regular adolescent use. Commercialization practices that increase accessibility, potency, and normalization are identified as factors amplifying these psychiatric risks. **Evidence Quality** This is a narrative policy review rather than a primary research study, representing lower levels of evidence (Level 5). Limitations include reliance on observational epidemiologic studies and policy analyses rather than randomized controlled trials. Strengths include synthesis of multiple evidence streams linking commercialization to psychiatric outcomes and provision of evidence-based policy recommendations. The viewpoint addresses an important gap in cannabis policy literature by framing commercialization itself as an intervention point for public health, though causality cannot be definitively established from existing literature. Generalizability may vary across jurisdictions with different regulatory frameworks.

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