The Context: Cannabis Legalization Without Adequate Regulation
New York State legalized recreational cannabis in 2021 and opened its first licensed dispensaries in late 2022. What happened next was predictable to anyone paying attention: the state could not build a licensed retail system fast enough, and unlicensed dispensaries flooded the market.
Overnight, New York City went from having a small number of medical marijuana dispensaries to having hundreds of cannabis retailers -- most of them operating without a license. At the peak, unlicensed shops outnumbered licensed ones by a factor of roughly 40 to 1. As of our study, there were approximately 19 licensed cannabis retailers in the entire city, compared to over 800 outlets selling cannabis products.
This created an obvious public health question: if most cannabis products are being sold by unlicensed retailers who are not subject to state regulations, what are consumers actually getting?
Our team at Columbia set out to answer that question. The labeling study, published in the American Journal of Preventive Medicine (AJPM), was the second phase of our broader Cannabis Access and Safety in New York (CASNY) project. Phase one had already shown that unlicensed retailers rarely verify age, making it easy for young people to purchase cannabis. Phase two focused on what is on the label -- or, more often, what is not.
How We Did the Study
We sent our research team to visit a random selection of cannabis retailers across the five boroughs of New York City. Using Google Maps, we had created a comprehensive directory of 840 cannabis outlets, including licensed medical dispensaries, licensed recreational dispensaries, unlicensed dispensaries, and smoke shops.
Our 22-year-old research assistant, posing as a consumer, visited 37 stores from this directory: 5 licensed medical dispensaries, 7 licensed recreational dispensaries, 10 unlicensed dispensaries, and 15 smoke shops (4 of which denied selling cannabis and were removed). At each location, the research assistant purchased cannabis products and systematically collected them for analysis.
We then examined 88 cannabis products across all retailer types, evaluating them on a standardized set of labeling criteria:
- Was the product identified as a cannabis product?
- Was THC potency listed?
- Was a standard dose indicated?
- Was there an expiration date?
- Were safety warnings present (e.g., "Keep Away from Children," poison control information)?
- Was a certificate of analysis displayed or referenced?
- Were there child-oriented elements (cartoons, bright colors, candy-like packaging)?
What We Found
The results were concerning, though not surprising given the regulatory vacuum.
Labeling Compliance by Retailer Type
| Labeling Element | Licensed Dispensaries | Unlicensed Dispensaries |
| Product identified as cannabis | High compliance | Variable -- some products not clearly identified |
| THC potency listed | Consistently present | Frequently absent |
| Standard dose indicated | Present on most products | Rarely present |
| Expiration date | Usually present | Rarely present |
| "Keep Away from Children" warning | Present on most products | Frequently absent |
| Poison control information | Sometimes present | Rarely present |
| Certificate of analysis displayed | Present at all licensed recreational dispensaries | Rarely displayed |
| Child-oriented elements | Rare | Common (cartoons, candy-like packaging) |
The Child Safety Problem
The finding that concerned us most was the prevalence of child-oriented packaging among unlicensed retailers. We found products with cartoon characters, bright candy-like packaging, and designs that were virtually indistinguishable from legitimate snack products. These products were being sold in shops that also carried energy drinks, soda, and candy -- and that rarely verified customer age.
This is not a theoretical risk. Pediatric cannabis exposure has increased significantly since legalization, with poison control centers reporting sharp rises in calls related to children accidentally ingesting cannabis edibles. When a THC gummy looks identical to a regular gummy bear and is sold alongside actual candy, accidental exposure is predictable.
The THC Potency Problem
Beyond labeling, our broader CASNY project -- including chemical analysis conducted in collaboration with Colin Nuckolls' lab at Columbia -- has revealed significant discrepancies between labeled and actual THC potency. Previous small studies and our own preliminary testing have found grossly inaccurate THC potency labeling, with some products containing substantially more or less THC than advertised.
This matters for several reasons:
- Overconsumption: If a product contains more THC than labeled, a consumer following the "standard dose" is unknowingly consuming more than intended
- Underconsumption: If a medical cannabis patient receives a product with less THC than labeled, they may not achieve their therapeutic target
- Cannabis use disorder risk: Inaccurate potency labeling makes it difficult for consumers to track and moderate their THC intake
- Psychosis risk: High-potency THC exposure, especially in young people, is associated with increased psychosis risk. Mislabeling that leads to unexpected high-dose exposure is particularly dangerous
Contaminants
Our chemical analysis has also identified concerning contaminants in cannabis products from NYC retailers. We found pesticides exceeding legal limits, high levels of fatty acids that may present neurotoxic risks, and compounds generated during production processes that are not routinely tested for and have unknown biological effects.
Licensed products were not immune to these issues, but unlicensed products -- which are not subject to any mandatory testing -- presented a higher risk profile. The consumer buying from an unlicensed dispensary has essentially no way to know what is in the product they are purchasing.
Why This Matters for Public Health
The labeling findings from our AJPM study point to a fundamental problem with how cannabis legalization has been implemented -- not just in New York, but in many states. The core issue is this: legalization has dramatically increased the availability of cannabis products, but regulation has not kept pace.
In a regulated market, product labeling serves critical functions:
- It informs consumers about what they are purchasing
- It enables dosing decisions based on accurate potency information
- It communicates safety information -- warnings, contraindications, child safety precautions
- It provides traceability if a product is found to be contaminated
When the majority of the market operates outside the regulatory system, none of these functions are served. Consumers are purchasing products of unknown composition, unknown potency, and unknown safety profile. They are, in a very real sense, conducting uncontrolled experiments on themselves.
Policy Implications
Our findings point to several policy priorities that I believe are urgent:
1. Enforcement Against Unlicensed Retailers
New York City has begun cracking down on unlicensed cannabis shops, but the effort has been slow relative to the scale of the problem. The data from our study make the case that this is not just a regulatory compliance issue -- it is a public health issue. Unlicensed retailers sell products with inadequate labeling, do not verify age, and use marketing practices that appeal to young people.
2. Standardized Labeling Requirements
Even among licensed products, labeling practices vary. There should be clear, enforceable standards for what information must appear on every cannabis product -- potency, dosing, ingredients, allergens, warnings, and child-proofing requirements. These standards should be at least as rigorous as those for alcohol and tobacco.
3. Mandatory Testing
All cannabis products sold in the state should be subject to mandatory testing for potency, pesticides, heavy metals, microbes, and other contaminants. The current system, in which only licensed products are tested, leaves the majority of the market unscrutinized.
4. Child-Resistant Packaging
Cannabis edibles must be sold in child-resistant packaging, and products that resemble candy, snacks, or other items appealing to children should be prohibited. This is not a new concept -- we have similar requirements for medications and household chemicals. Cannabis should be no different.
Our Research Team
This study was a collaborative effort led out of the Mental Health Informatics Lab at Columbia. Co-authors included Timothy D. Becker, Peter Menzi, Mark Olfson, Frances Levin, Deborah Hasin, and Collin Nuckolls. The project reflects the interdisciplinary nature of cannabis safety research -- combining expertise in psychiatry, epidemiology, chemistry, and public health policy.
The labeling study is part of our broader CASNY (Cannabis Access and Safety in New York) project, which has also examined youth access to cannabis, the chemical composition of commercial products, and the effects of cannabis on adolescent mental health. Together, these studies provide a comprehensive picture of how legalization is affecting consumer safety on the ground in New York City.
What Consumers Should Know
If you are purchasing cannabis in New York City -- or anywhere with a mixed regulated/unregulated market -- here is my practical advice:
- Buy from licensed dispensaries. Licensed retailers are required to verify age, display certificates of analysis, and sell products that have been tested for potency and contaminants.
- Check the label. Look for THC potency, standard dosing information, expiration dates, and safety warnings. If these are absent, you do not know what you are getting.
- Start low. If you do not know the true potency of a product, err on the side of taking less. This is especially important for edibles, which take longer to take effect and are easier to overconsume.
- Keep products away from children. Store cannabis products in locked containers, out of reach. Edibles that look like candy are a particular risk.
- Be skeptical of health claims. Cannabis products marketed with health claims (stress relief, pain management, sleep aid) are generally not backed by rigorous evidence. Treat these claims with the same skepticism you would apply to any unregulated supplement.
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Concerned About Cannabis Use? Dr. Ryan Sultan provides expert evaluation and treatment for cannabis-related concerns, including cannabis use disorder, cannabis-induced psychiatric symptoms, and guidance for parents. Board-certified in adult and child psychiatry at Columbia University. |
Further Reading
- Cannabis Safety and Mental Health Hub
- THC Potency: What You Need to Know
- THC Potency and Health Risks
- Cannabis and Teen Mental Health Study
- Schedule a Consultation