The United States is in the process of a major reckoning regarding cannabis—at least at the state level. The vast majority of states have legalized some form of cannabis for medical use, and just under half have also enacted measures to allow nonmedical (recreational) adult use.

This sea change in attitudes toward cannabis nationwide is welcome news to people with disabilities, many of whom have long relied on cannabis as a medical treatment for things such as chronic pain and other symptoms. But cannabis is still criminalized for all uses under federal law—a stance that not only is out of step with national attitudes, but also disproportionately harms people with disabilities, negatively impacting both their health and economic wellbeing. Ending the federal criminalization of cannabis would not only improve the lives of people with disabilities, but would be politically popular as well.

The Feds Are Behind the Curve

According to the Pew Research Center, in 2022, over 88 percent of Americans favor the legalization of cannabis for either medical or recreational purposes, with 73 percent of Democrats in favor. More recently, in 2023, Gallup reported that Democrats were 87 percent in favor of legal use and Republicans were 55 percent in favor, making it an issue with broad and growing agreement across the political spectrum.

Despite cannabis’s popularity, however, it remains illegal under federal law. The federal prohibition against cannabis goes back to the regulatory system of the Drug Enforcement Agency (DEA) as created in 1971 by President Richard Nixon, as a part of his war on drugs. The DEA still classifies cannabis as a Schedule I substance, which means it is defined as having no federally accepted medical use, is said to have a high probability of abuse, and faces significant barriers to medical research.

Yet, even as cannabis’s inclusion in the war on drugs continues at the federal level, thirty-eight states, three territories, and the District of Columbia have legalized cannabis for medical use, with an additional nine states legalizing cannabis derivatives for medical use, while twenty-four states have also legalized nonmedical (recreational) adult use. That means only three states—Idaho, Kansas, and Nebraska—do not allow access to some form of cannabis as a medical treatment.

Only three states—Idaho, Kansas, and Nebraska—do not allow access to some form of cannabis as a medical treatment.

California, Washington State, Oregon, and Maine were four of the first states to legalize cannabis medically, as early as 1996, paving the way for residents of those states to receive an alternative, potentially more accessible and appropriate form of care than federally approved treatment options (some of which, comparatively, may do more harm than good, from everyday prescriptions such as antidepressants to opioids and chemotherapy). Much of this state-level progress is due to the tireless advocacy by people who had few other medical options to turn to—people with life-threatening diseases, such as cancer; people with chronic illnesses; and people with disabilities.

However, cannabis legalization advocates have achieved some movement at the federal level in recent years. The Marijuana Opportunity, Reinvestment, and Expungement (MORE) Act has passed in the House of Representatives twice since it was introduced. The bill would eliminate cannabis from the controlled substance list, effectively decriminalizing the drug. Additionally, the MORE Act would begin to repair some of the damage caused by the war on drugs by establishing a trust fund for those communities most impacted by criminalization and prosecution and creating a process for expungement and review of those with cannabis convictions. In 2022, the Cannabis Administration and Opportunity Act (CAOA) was introduced and expanded on the criminal justice and community reinvestment provisions of the MORE Act along with a more robust federal regulatory structure.

Cannabis and Disability Economic Justice

As one in four Americans have a disability, the positive impact of cannabis decriminalization at the federal level would be revolutionary. Disabled people still face disproportionate barriers to health, economic security, opportunity, and inclusion thirty-three years after the signing of the Americans with Disabilities Act (ADA).

Disabled people are disproportionately incarcerated as well—according to the Prison Policy Initiative, 40 percent of people in state prisons and 29 percent of people in federal prisons have a disability. No states allow incarcerated people to have access to medical cannabis and many states restrict individuals on supervised release from accessing medical cannabis programs or, for people found to possess cannabis during release, remove the supports that supervised release programs provide to ensure safe re-entry. People returning to society from incarceration already face significant obstacles to employment and these challenges are made even greater for people for whom cannabis works best as a medical treatment.

The continuing criminalization of cannabis at the federal level only compounds the barriers that people with disabilities face. To address the disparities and harms faced by people with disabilities, federal officials should take into account the following five key factors toward accepting cannabis decriminalization as a disability economic justice issue:

1. Many people with disabilities and chronic illnesses use cannabis as a remedy for chronic pain, as well as other symptoms, because it is more accessible than other forms of treatment.

According to the Center for Disease Control and Prevention’s National Health Interview Survey, in 2021, nearly 21 percent of Americans experienced chronic pain. But due to geographic, financial, societal, and socioeconomic barriers, disabled and chronically ill people—especially those who are multiply marginalized—often don’t have access to a lot of options for medications and services for treatment. They may encounter barriers to entering the health care system for a diagnosis, they may not be given a concrete diagnosis, or there may be no cure for their diagnosis. Many people who live with chronic pain, for example, choose cannabis as a form of health care because it’s a homeopathic, home-grown avenue of treatment without the need for endless doctor appointments, enabling them to remain in control of their care.

2. Cannabis offers a low-cost treatment option that is more affordable for many people with disabilities, as they are more likely to have limited financial resources.

According to research conducted by The Century Foundation’s Disability Economic Justice team, disabled people in the United States face poverty rates twice as high as nondisabled people. Meanwhile, members of the American disability community are nearly three times as likely to struggle to put food on the table as people without disabilities, and four in ten disabled people in the United States are struggling to afford their rent, compared with a national average of 25 percent. And workers with disabilities face a stark earnings gap: disabled workers were paid 74 cents on the dollar, on average, compared with nondisabled workers in 2020. Opportunities for savings and wealth creation are extremely limited as well, especially since saving is prohibited by asset limits in disability programs such as Social Security Disability Insurance (SSDI). Furthermore, many of the support programs that disabled people turn to in order to afford food and housing and to receive home- and community-based services are significantly underfunded. Because people with disabilities do not always have traditional means available to them for earning or saving, many must seek the lowest cost health care options, which for some may include cannabis.

3. The criminalization of cannabis further compounds the disproportionate criminalization of disability in the United States.

Many people with disabilities are institutionalized in the nation’s prisons and jails. People in U.S. prisons are nearly three times as likely, and those in U.S. jails four times as likely to have a disability, as the nonincarcerated population. More specifically, four in ten people in state prisons, and three in ten people in federal prisons are people with disabilities; and nearly 50 percent of women in prisons identified as having a disability. Because cannabis is still illegal at the federal level, many states add prison time and charges for offenses when the presence of cannabis is discovered, either on the person or in their bloodstream, thus pushing people who use this substance as health care out of their homes and into the system at a higher rate and for longer periods of time than non-users. Once they leave the prison system, they re-enter their communities with a longer record and a potentially damaged psyche, rendering it more difficult to find employment and make their re-entry. If they are out on supervised release and, due to challenges to both finding employment and the lack of health insurance coverage, resort to medical cannabis—thus potentially disqualifying them from employment and violating their parole—they can be reincarcerated, further compounding the cyclical disability-based discrimination many disabled people already face. Federally decriminalizing cannabis would represent a significant step forward in breaking this cycle and decriminalizing disability.

4. People with disabilities already face numerous discrimination barriers when it comes to employment, which federal cannabis criminalization only adds to.

Nine in ten employers (not to mention four in five landlords and three in five colleges and universities) use criminal background checks when reviewing applications—and jobseekers with a record are less than half as likely to receive a callback as those without. And to be clear, it is increasingly only the criminal record that employers react to, not cannabis use itself: while not all employers take this approach, many have stopped drug testing for THC because it was eliminating otherwise qualified job candidates, especially those of a racial or ethnic minority. Furthermore, the National Institute of Justice has concluded that THC tests were not a reliable meter for intoxication and impairment levels.

A cannabis-related conviction can mean the difference between employment and poverty, and such barriers have an even greater impact for disabled people of color. Due to the compounding effects of structural as well as cultural ableism and racism, one in four disabled Black adults in the United States lived in poverty in 2020, compared with just over one in seven of their white counterparts. Furthermore, the disability wage gap is wider for Black workers with disabilities, who are paid only 68 cents for every dollar paid to white workers without a disability. Removing the unnecessary barriers that cannabis convictions or use adds to employment would expand the opportunities for people with disabilities to have meaningful, sustained employment.

5. Bringing a disability justice lens to cannabis decriminalization could open pathways to good jobs for disabled workers and undo past harms.

The cannabis market holds numerous job opportunities that could fill gaps in the workforce for people with disabilities, offering the culture, flexibility, and opportunity many need to thrive. First, it’s a potential route toward self-employment. Furthermore, workers in the cannabis industry are not required to hold degrees to be considered qualified, nor do they have to take cannabis drug tests.

The average yearly salary for a person working in the field of cannabis cultivation, processing, and sales is around $58,500, an 11 percent increase over the national median income overall, as reported by Finance Online’s Cannabis Industry Statistics. The field created some 300,000 jobs in the United States by 2019, and is still growing, according to Forbes. This means more accessible, equitable, well-paying jobs that lend themselves well to employees with disabilities—so long as cannabis can become decriminalized, allowing the Occupational Safety and Health Administration (OSHA) to establish permissible exposure levels and other cannabis-industry safety-specific precautions. Fortune Business Insights values the 2023 cannabis industry at over $57 billion, and projects it to grow to over $444 billion by 2030, with a compound annual growth rate (CAGR) of over 34 percent.

While there continues to be a blanket federal ban on cannabis, there are limited opportunities to legally increase that economic growth, as well as to tax that growth. Increased economic activity means an opportunity for a federal excise tax through cannabis legalization; such a tax base could be used to repair the damage wrought by the decades-long war on drugs, invest in the communities most impacted, and fund critical services to support individuals and families in rebuilding their lives, many of whom are members of the disability community.

Looking Ahead

Core to the values embedded within the American dream is having a system of government that is by the people, for the people, and that works for the people. Like all people living in the United States, people with disabilities want to be able to live healthy and productive lives without facing discrimination. Unfortunately, the criminalization of cannabis disproportionately harms the health and economic opportunities of those living with disabilities, and these harms fall more heavily on those with disabilities who are multiply marginalized, as well as those returning from incarceration. Decriminalizing cannabis would be a significant measure toward allowing those living with disabilities to be able to live in wellness and prosperity. The wishes of the American people are clear: it is incumbent on our policymakers to update our laws to more accurately reflect the people’s understanding of justice. Given that ending cannabis criminalization enjoys significant bipartisan support, the federal government should take leadership on this issue.