There are many perspectives to consider when weighing the legalization of recreational marijuana.

Public opinion certainly is an element, and it appears that the politics associated with public opinion, along with promised revenue, are driving the initiative toward approval.

There is measurable public support for marijuana. Roughly 60 percent of New Yorkers favor it by one recent measure. However, lawmakers would be wise to consider what voters have consistently indicated as far more important to them — their health. In the most recent election, in New York and nationally, poll after poll found that voters by far were most concerned about their health. It was the leading voter issue in the 2018 cycle.

As public health officials, NYSACHO members are focused on the concrete, local level considerations associated with legalizing marijuana. The experience of other states, where traffic deaths and emergency room visits have increased significantly, shows that legalizing recreational marijuana could likely adversely impact the health of a great many New Yorkers. Therefore, a great many questions must be answered before proceeding.

Among them:

• How will we protect motorists from drivers under the influence of marijuana? What will be the impairment standard, and how will it be enforced?

• THC remains in the breast milk of mothers for up to six days after marijuana use3. How will we protect infants and children from unintentional exposure to the drug?

• New York has proven itself as one of the most aggressive anti-smoking states in the nation, establishing the Clean Indoor Air Act and spending tens of millions of dollars in tobacco settlement revenue to curtail smoking. How is legalizing the smoking of marijuana (the most widely used means of ingestion) consistent with both the spirit and technical implementation that act?

• Brightly colored edibles shaped and/or packaged like candy have strong appeal to children. How will we keep these forms of the drug out of the hands of children?

• Marijuana potency is widely and wildly variable. Many varieties induce a debilitative loss of mental and physical capability. How will potency be measured, tested and enforced?

• Research has substantiated that marijuana use significantly increases the likelihood of addiction to other drugs. What resources will be made available to address the care needs of a new class of persons living with drug addiction?

• What resources will be made available to support public information campaigns that better ensure New Yorkers fully understand these and other potential health impacts?

County health officials serve as the first line of defense in our communities, and they have seen up close the devastation associated with the abuse of legalized prescription opioid medications. While the addictive risk of opioids is different than marijuana, we are very concerned that the legalization of marijuana will similarly result in unintended, harmful consequences for countless New Yorkers.

As a representative of the state’s local public health stewards, those sworn to protect their communities from preventable illness and harm, NYSCAHO remains opposed to the legalization of recreational marijuana, and we implore lawmakers to proceed thoughtfully to address the concerns we and others have expressed.

Proceeding swiftly, without building in essential protections and providing resources necessary to mitigate the impact of legal marijuana, could come back to haunt lawmakers with the onset of another preventable public health crisis caused by the use of a legal drug.

Sarah Ravenhall is the executive director of the New York State Association of County Health Officials. NYSACHO supports, advocates for, and empowers local health departments in their work to promote health and wellness and prevent disease, disability and injury throughout New York State. Visit us at: www.nysacho.org