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Radiation therapy takes advantage of cancer’s poor DNA repair abilities – an oncologist and physicist explain how

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Radiation therapy takes advantage of cancer’s poor DNA repair abilities – an oncologist and physicist explain how

Advances in radiotherapy involve combining new technologies with clinical expertise.
Kateryna Kon/Science Photo Library via Getty Images

Behzad Ebrahimi, University of Chicago and Mark Korpics, University of Chicago

Nearly half of all cancer patients undergo radiation therapy as part of their care. Ionizing radiation, or the emission of high-energy waves or particles, works as a therapy by damaging a cancer cell’s DNA. It’s an effective tool for killing cancer cells because they are generally much less adept at DNA repair compared to healthy cells. Damaging specific parts of DNA prevents cancer cells from reproducing, effectively killing them.

A major limitation of radiation therapy is the damage it may cause as it passes through healthy organs to get to tumors located deep in the body. The need to protect healthy organs limits the dose of radiation that can be delivered to cancerous tissue, thereby reducing the chance of successful treatment.

Overcoming this challenge has long been a mission for medical physicists and radiation oncologists like us. Improvements to radiotherapy will enable clinicians to not only better control tumors overall, but also open the door for more favorable outcomes in patients with cancers that are more resistant to radiation.

Fundamentals of radiation therapy

At the heart of radiation therapy lies the fundamental principle that cancer cells are more susceptible to radiation than healthy cells. However, there are exceptions. Sometimes resistance to radiation in cancer cells may be comparable or even greater than that of their neighboring cells.

When tumors lie close to vital organs that are highly sensitive to radiation, such as the brain or the bowels, it significantly limits the amount of radiation that can be delivered. In cases where tumors are significantly less sensitive to radiation than the organs surrounding it, radiotherapy may not be the best choice.

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Radiation therapy involves directing strong beams of energy to kill cancer cells.

Patient immobilization is another key aspect to reducing toxicity from radiation. Patients need to be completely motionless during treatments to ensure that the beam of radiation mainly targets tumors and not the healthy tissues surrounding them. If a patient moves during treatment, it can mean the radiation beam is partly or even entirely missing the cancer target. This scenario both underdoses the cancer and increases the risk of harming healthy tissue.

There are a few common types of radiotherapy that deliver radiation in different ways:

External beam radiation therapy

External beam radiation involves directing radiation from an outside source to a single part of the body.

Linear accelerators, commonly referred to as LINACs, are currently the most common technology used in radiation treatments. These machines generate beams of high-energy electrons and X-rays that can be aimed at cancer tissue with precision. The high energy of these beams allows in-depth penetration into the body to reach tumors.

Another form of radiotherapy is proton beam therapy, or PBT, which directs protons instead of X-rays at tumors. Currently, PBT is only available at a limited number of locations. It is typically recommended for specific populations such as pediatric patients because, unlike X-rays, it has an adjustable range that minimizes the effects of radiation on organs beyond the target area, potentially reducing toxicity.

Image-guided radiation therapy

In the early 2000s, researchers incorporated CT scanners into LINACs. This enabled real-time imaging of the patient’s anatomy just before or during treatment. By acting as the eyes of the care team, imaging reduced uncertainty about the location of tumors and improved the precision and accuracy of radiation therapy.

Newer linear accelerators are now incorporating MRIs, which significantly improve visualization of patient anatomy and tumors, further advancing treatment precision and accuracy.

Patient laying on stomach in a radiotherapy machine, green lasers crisscrossed over their exposed back
Patients need to stay still during radiotherapy to ensure the beam stays on course.
Mark Kostich/iStock via Getty Images Plus

Researchers are also adding positron emission tomography, or PET, scanners that provide information about the metabolic function of tumors. This advance makes it possible to increase the radiation dose specifically at the most active areas of tumors.

Adaptive therapy

An emerging approach to radiation therapy called adaptive therapy uses imaging to dynamically adjust treatment as the tumor or its positioning changes each day.

In conventional radiation therapy, patients receive the same treatment plan across multiple treatment sessions. However, adaptive therapy may apply several adjustments or lead to a completely new treatment plan in order to address changes to the tumor’s condition over the course of treatment.

Historically, the concept of adaptive therapy was more theoretical than practical. It faced many challenges, including a lack of suitable imaging technologies. Additionally, creating a treatment plan involves heavy computational work and collaboration among various specialties within a care team. The fact that the process needs to be repeated multiple times renders adaptive therapy particularly resource-intensive and time-consuming. However, researchers are looking into ways to use artificial intelligence to automate some of these steps to make this approach more practical.

Brachytherapy

Brachytherapy – stemming from the Greek word “brachys,” meaning “short” – is another widely used method in radiation therapy. It involves placing a radioactive source called a seed near or directly inside a tumor or affected area, reducing the distance from the radiation source to its target.

In contrast to external beam radiation therapy, where radiation often must pass through healthy tissue to reach cancer cells, brachytherapy applies radiation directly to the tumor. This technique is particularly advantageous for certain cancer types that are accessible through noninvasive or minimally invasive procedures, such as skin cancers, gynecological tumors and genitourinary tumors.

Diagram showing the insertion of high-dose radioactive wires to treat prostate cancer
By placing the radioactive source inside the body, brachytherapy can target tumors more directly than external beam radiotherapy.
Cancer Research UK/Wikimedia Commons, CC BY-SA

The conventional approach to brachytherapy involved using needles to place or inject radioactive seeds inside or adjacent to the cancerous tissue. These seeds would remain in the body either temporarily or permanently, with the goal of irradiating the area at a low dose over a long period of time.

An increasingly popular form of brachytherapy called high-dose rate brachytherapy involves using a tube to guide a more highly radioactive seed directly to the affected tissue before removing it after a few minutes. The seed emits a high dose of radiation in a short period of time, which enables clinicians to treat patients quickly in an outpatient setting.

Future of radiation therapy

Radiation therapy is continually evolving to more effectively and precisely treat cancer.

For example, a technique that delivers radiation at an ultra-high rate called FLASH-RT has shown promise in its ability to increase dosages without excessive toxicity. Researchers are also exploring treatments using ions heavier than protons to more effectively damage DNA in cancer cells and enhance the efficacy of radiation therapy.

Advances in the field hint at a future of more personalized radiation therapy, highlighting the fusion of technology and medical expertise in the fight against cancer.The Conversation

Behzad Ebrahimi, Assistant Professor of Radiation and Cellular Oncology, University of Chicago and Mark Korpics, Assistant Professor of Radiation and Cellular Oncology, University of Chicago

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Francis − a pope who has cared deeply for the poor and opened up the Catholic Church

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theconversation.com – Mathew Schmalz, Professor of Religious Studies, College of the Holy Cross – 2025-02-24 15:05:00

Francis − a pope who has cared deeply for the poor and opened up the Catholic Church

Pope Francis during the Palm Sunday Mass at St. Peter’s Square on April 2, 2023, in Vatican City.
Antonio Masiello/Getty Images

Mathew Schmalz, College of the Holy Cross

Pope Francis, who remains in critical condition and hospitalized as he battles pneumonia in both lungs, was elected pope on March 13, 2013, after the surprise resignation of Benedict XVI.

Prior to becoming pope, he was Jorge Mario Bergoglio, archbishop of Buenos Aires, and was the first person from the Americas to be elected to the papacy. He was also the first pope to choose Francis as his name, thus honoring St. Francis of Assisi, a 13th-century mystic whose love for nature and the poor have inspired Catholics and non-Catholics alike.

Pope Francis chose not to wear the elaborate clothing, like red shoes or silk vestments, associated with other popes. As a scholar of global Catholicism, however, I would argue that the changes Francis brought to the papacy were more than skin deep. He opened the church to the outside world in ways none of his predecessors had done before.

Care for the marginalized

Pope Francis reached out personally to the poor. For example, he turned a Vatican plaza into a refuge for the homeless, whom he called “nobles of the street.”

A smiling young man, dressed in black, poses for a photo.
The Argentinian Jorge Mario Bergoglio, ordained for the Jesuits in 1969 at the Theological Faculty of San Miguel.
Jesuit General Curia via Getty Images

He washed the feet of migrants and prisoners during the traditional foot-washing ceremony on the Thursday before Easter. In an unprecedented act for a pope, he also washed the feet of non-Christians.

He encouraged a more welcoming attitude toward gay and lesbian Catholics and invited transgender people to meet with him at the Vatican.

On other contentious issues, Francis reaffirmed official Catholic positions. He labeled homosexual behavior a “sin,” although he also stated that it should not be considered a crime. Francis criticized gender theory for “blurring” differences between men and women.

While he maintained the church’s position that all priests should be male, he made far-reaching changes that opened various leadership roles to women. Francis was the first pope to appoint a woman to head an administrative office at the Vatican. Also for the first time, women were included in the 70-member body that selects bishops and the 15-member council that oversees Vatican finances. Shortly before his death, he appointed an Italian nun, Sister Raffaella Petrini, as President of the Vatican City.

Pope Francis holding on to a railing as he greets people.
Pope Francis in St. Peter’s Square on April 18, 2022.
Stefano Spaziani/Mondadori Portfolio via Getty Images

Not shy of controversy

Some of Francis’ positions led to opposition in some Catholic circles.

One such issue was related to Francis’ embrace of religious diversity. Delivering an address at the Seventh Congress of Leaders of World and Traditional Religions in Kazakhstan in 2022, he said that members of the world’s different religions were “children of the same heaven.”

While in Morocco, he spoke out against conversion as a mission, saying to the Catholic community that they should live “in brotherhood with other faiths.” To some of his critics, however, such statements undermined the unique truth of Christianity.

During his tenure, the pope called for “synodality,” a more democratic approach to decision making. For example, synod meetings in November 2023 included laypeople and women as voting members. But the synod was resisted by some bishops who feared it would lessen the importance of priests as teachers and leaders.

In a significant move that will influence the choosing of his successor, Pope Francis appointed more cardinals from the Global South. But not all Catholic leaders in the Global South followed his lead on doctrine. For example, African bishops publicly criticized Pope Francis’ December 2023 ruling that allowed blessings of individuals in same sex couples.

His most controversial move was limiting the celebration of the Mass in the older form that uses Latin. This reversed a decision made by Benedict XVI that allowed the Latin Mass to be more widely practiced.

Traditionalists argued that the Latin Mass was an important – and beautiful – part of the Catholic tradition. But Francis believed that it had divided Catholics into separate groups who worshiped differently.

This concern for Catholic unity also led him to discipline two American critics of his reforms, Bishop Joseph Strickland of Tyler, Texas, and Cardinal Raymond Burke. Most significantly, Carlo Maria Viganò, the former Vatican ambassador, or nuncio, to the United States was excommunicated during Francis’ tenure for promoting “schism.”

Recently, Pope Francis also criticized the Trump administration’s efforts to deport migrants. In a letter to US Bishops, he recalled that Jesus, Mary and Joseph had been emigrants and refugees in Egypt. Pope Francis also argued that migrants who enter a country illegally should not be treated as criminals because they are in need and have dignity as human beings.

Writings on ‘the common good’

In his official papal letters, called encyclicals, Francis echoed his public actions by emphasizing the “common good,” or the rights and responsibilities necessary for human flourishing.

Several people seated in a row watch as the pope washes the feet of one of them.
Pope Francis washes the foot of a man during the foot-washing ritual at a refugee center outside of Rome on March 24, 2016.
L’Osservatore Romano/Pool Photo via AP

His first encyclical in 2013, Lumen Fidei, or “The Light of Faith,” sets out to show how faith can unite people everywhere.

In his next encyclical, Laudato Si’, or “Praise Be to You,” Francis addressed the environmental crisis, including pollution and climate change. He also called attention to unequal distribution of wealth and called for an “integral ecology” that respects both human beings and the environment.

His third encyclical in 2020, Fratelli Tutti, or “Brothers All,” criticized a “throwaway culture” that discards human beings, especially the poor, the unborn and the elderly. In a significant act for the head of the Catholic Church, Francis concluded by speaking of non-Catholics who have inspired him: Martin Luther King Jr., Desmond Tutu and Mahatma Gandhi.

In his last encyclical, Dilexit Nos, or “He Loved Us,” he reflected on God’s Love through meditating on the symbol of the Sacred Heart that depicts flames of love coming from Jesus’ wounded heart that was pierced during the crucifixion.

Francis also proclaimed a special “year of mercy” in 2015-16. The pope consistently argued for a culture of mercy that reflects the love of Jesus Christ, calling him “the face of God’s mercy.”

A historic papacy

Francis’ papacy has been historic. He embraced the marginalized in ways that no pope had done before. He not only deepened the Catholic Church’s commitment to the poor in its religious life but also expanded who is included in its decision making.

The pope did have his critics who thought he went too far, too fast. And whether his reforms take root depends on his successor. Among many things, Francis will be remembered for how his pontificate represented a shift in power in the Catholic Church away from Western Europe to the Global South, where the majority of Catholics now live.The Conversation

Mathew Schmalz, Professor of Religious Studies, College of the Holy Cross

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The murder rate in Venezuela has fallen − but both Trump and Maduro are wrong about why

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theconversation.com – Rebecca Hanson, Assistant Professor of Latin American Studies, Sociology and Criminology, University of Florida – 2025-02-24 07:41:00

The murder rate in Venezuela has fallen − but both Trump and Maduro are wrong about why

Members of government-backed militias take part in a march in Caracas, Venezuela, on Jan. 7, 2025.
AP Photo/Matias Delacroix

Rebecca Hanson, University of Florida

The body of former Venezuelan army officer Ronald Ojeda was found on Feb. 19, 2024, in a suitcase buried under 5 feet of concrete. Ojeda, accused by Venezuela of plotting against the government, had gone missing nine days earlier, when men dressed as police broke into his apartment in the Chilean capital of Santiago and dragged him away.

Following a yearlong investigation, authorities in Chile have now pointed the finger at the Venezuelan gang Tren de Aragua, claiming members carried out the assassination at the behest of that country’s president, Nicolás Maduro.

It comes as the relationship between Maduro’s government and criminal gangs is under increased scrutiny, both among regional governments in Latin America and in the United States.

Conservative media outlets in the U.S. and right-leaning groups such as the Heritage Foundation have accused Maduro of sending gang members into the U.S. to destabilize the country.

President Donald Trump has even suggested that Maduro successfully reduced crime by exporting gang members to the U.S. “Crime is down in Venezuela by 67% because they’re taking their gangs and their criminals and depositing them very nicely into the United States,” he told supporters in April 2024.

According to data from the Venezuelan Ministry of Health, shared with me by scholar of Venezuelan politics Dorothy Kronick, homicide rates have indeed come down in recent years. And this trend is confirmed by the Venezuelan Observatory of Violence.

The fall in homicide rates has coincided with Maduro successfully consolidating his authoritarian rule in Venezuela. And explanations of the drop in crime tend to imply that it is the result of the government co-opting and controlling gangs. Some observers have even referred to Venezuela as a “narcostate,” suggesting that drug trafficking in the country is an organized venture between top officials and criminal groups.

I have studied crime, violence and policing in Venezuela since 2011 and know that this narrative is at best oversimplistic, at worst outright mistruth. As I explore in my new book, “Policing the Revolution: The Transformation of Coercive Power and Venezuela’s Security Landscape During Chavismo,” the case of Venezuela is not one of government control over criminal groups. Rather, it is characterized by an unstable and volatile relationship between the government and multiple competing armed actors, including gangs and the police.

Violent, but becoming less so

Falling homicide rates should not mask the fact that Venezuela is still plagued by violence. Since the mid-2000s it has been ranked as one of the most violent countries in the world.

Former President Hugo Chávez was never able to get a handle on crime, particularly violent crime, which increased exponentially under his government. The trend continued during Maduro’s first years in office after Chávez’s death in 2013.

However, all available evidence suggests that Venezuela’s homicide rate has declined since reaching a peak in 2016 – by around 42%.

But there’s no evidence this is because the government is “offshoring” criminals.

Maduro’s own explanation for this decline portrays the government as handily controlling criminals by means of incredibly lethal police raids carried out between 2015 and 2019. In short, Maduro claims that the police have effectively “wiped out” criminal groups.

Competing police forces …

But rather than “wiping out” criminal organizations, the Maduro government has instead maintained volatile relationships with many armed groups, including gangs, nonstate paramilitary groups and even the country’s own police forces.

These relationships have produced significant conflict and dysfunction within state institutions. This is clear when looking at institutions presumed to be synonymous with state control, such as the police.

Chávez’s and Maduro’s governments put more police and soldiers in the streets. They created security institutions, such as the Policía Nacional Bolivariana, or Bolivarian National Police.

However, rapid growth of the security apparatus, amid competing approaches, has generated more conflict than coordination.

Police officers and police reformers I interviewed referred to state security policies and the changes they produced as akin to Frankenstein’s monster – an aberration rapidly outpacing the creator’s ability to control it.

What they mean is the government had created new security institutions so quickly that it is unable to supervise and control them. As one former police officer and Chavista politician told me: “Our challenge now is how to manage the monster we created.”

People in army fatigues and holding guns stand in front of a building.
Members of the National Guard take part in an anti-gang security operation in Caracas on July 13, 2015.
Federico Parra/AFP via Getty Images

State policies have also generated significant distrust between the police and the government, and among different police forces.

This distrust has even resulted in police forces coming to blows with each other in the streets on multiple occasions. On Feb. 19, 2020, a section of the Prados del Este highway in Caracas was shut down as officers from Venezuela’s National Police and the country’s investigative police brandished weapons, shoving, punching and wrestling each other to the ground.

… cooperating gangs

It is, as such, highly unlikely that falling homicide rates are the result of policing. Indeed, I interviewed over 200 police officers while conducting research for my book, and most believed that the government’s policing initiatives contributed to crime and violence rather than reducing it.

A more plausible explanation for falling homicide figures is that Maduro’s policies have resulted in more consolidated relationships between criminal groups themselves.

Maduro’s government has built relationships with gangs, but this doesn’t necessarily imply control over them. Since 2013 the government has negotiated pacts with some of the country’s largest gangs, including a gang confederation led by the infamous El Koki in Caracas and the Belén gang in the state of Miranda.

The government agreed to tolerate illicit activities within certain areas and prohibit police from entering gang territory. In exchange, gangs agreed to reduce killings and other highly visible crimes such as kidnapping. As my book and previous research with Verónica Zubillaga, Francisco Sánchez and Leonard Gómez shows, these pacts allowed gangs to consolidate control over territory and illicit markets.

Gangs also negotiated agreements among themselves in case the government pacts fell through. For example, they agreed to divide territory and markets to avoid future conflict and share resources such as weapons and ammunition. This produced less conflict between gangs and less disruption in illicit markets, resulting in fewer homicides.

When pacts have ruptured in the past, the spectacularly violent confrontations that ensued between gangs and the police have shown gangs’ capacity to resist government intervention. Still, the overall effect of pacts and gang consolidation has been a reduction in homicides.

As one neighbor living in gang territory put it: “Before, gangs confronted each other; they killed each other. Now they don’t. Now they are growing.”

‘Mother of all infuriations’

Relationships between the government and various nonstate armed groups, including gangs, have generated enormous discontent within police forces.

As one police officer explained in an interview, these pacts represented the “mother of all infuriations.” For many officers, the goverment’s pacts with other armed groups is tantamount to its sponsorship of criminal activities.

And this discontent has produced sporadic violent confrontations. Even when government-gang pacts are in place, the government has been unable to keep police forces from entering gang territory and engaging in deadly shootouts.

Certainly from the outside, it may look like Maduro’s government has co-opted gangs for political purposes. And with the U.S. government adding Tren de Aragua to its list of global terrorist groups, that could put Venezuela in danger of being labeled a “state sponsor of terrorism.”

However, the Ojeda case in Chile should not be taken as evidence that stable and strong ties exist between Maduro’s government and criminal groups – at least not yet.

Instead, authoritarian survival in Venezuela for now seems to depend on volatile relationships between multiple and competing armed groups that collaborate temporarily with the government when their diverse interests overlap.The Conversation

Rebecca Hanson, Assistant Professor of Latin American Studies, Sociology and Criminology, University of Florida

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As Pennsylvania inches toward legalizing recreational cannabis, lawmakers propose selling it in state-owned dispensaries similar to state liquor stores

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theconversation.com – Daniel J. Mallinson, Associate Professor of Public Policy and Administration, Penn State – 2025-02-24 07:37:00

As Pennsylvania inches toward legalizing recreational cannabis, lawmakers propose selling it in state-owned dispensaries similar to state liquor stores

Advocates believe Pennsylvania and Hawaii may be the next fronts in recreational cannabis legalization.
Spencer Platt/Getty Images

Daniel J. Mallinson, Penn State

After a long, largely successful march over 25 years to liberalize cannabis laws in the United States, the movement had a tough election in 2024.

Legalization ballot measures failed in Florida, North Dakota and South Dakota. In Arkansas, votes on legalization were not even counted due to litigation over the measure. The only successful measures were passed in Nebraska. While they are being implemented, litigation on the programs is pending.

Federally, many of President Donald Trump’s nominees in key posts at the Department of Health and Human Services, Department of Justice and Drug Enforcement Administration have made strong anti-cannabis statements. This may not bode well for the effort started by President Joe Biden to reschedule marijuana as a less dangerous drug.

So, what is the future of cannabis legalization in the United States?

As political scientist Lee Hannah and I argued in our 2024 book “Green Rush,” the states are central to the story of cannabis legalization in the United States.

In fact, advocates are looking to places such as Pennsylvania and Hawaii in 2025 as the next fronts in recreational legalization.

Let’s zoom in on Pennsylvania.

Pennsylvania is a middling adopter

Pennsylvania is following about the same trajectory with adult-use recreational legalization as it did with medical marijuana. It is not an innovator but also not a laggard.

When Pennsylvania adopted medical marijuana in 2016, 23 states had already done so.

The political environment is very different in 2025 than 2016, however, which raises the difficulty of passing a bill that makes recreational marijuana use legal, even in a state where legalization is popular.

In 2016, Pennsylvania’s General Assembly was controlled completely by Republicans, and the governor was a Democrat. Now, the Democrats hold a single-seat majority in the House that erodes every time there is a vacancy. Republicans still control the Senate, and Democrat Josh Shapiro is the governor.

A major key to medical cannabis legalization passing in 2016 was Republican state Sen. Mike Folmer’s advocacy within his caucus. Without a Republican champion, it may not have passed.

For legalization of recreational cannabis, state Sen. Dan Laughlin has been the clear Republican champion. He has been working with Democratic state Sen. Sharif Street of Philadelphia to build support and find a policy design that works for Republicans and Democrats.

But Republican Senate leadership has remained cool to the idea. Senate President Pro Tempore Kim Ward is not a supporter and has been pushing the governor to get more involved.

“If (Shapiro) wants something done, he needs to lead on it,” Ward said. “He can’t throw an idea out there, which he did last year, and say, ‘Let the legislature figure it out, I’ll sign it.’”

Expected revenues likely to fall short

For his part, Shapiro has included projected revenues from legalization in his budget proposals since assuming office in 2023.

This year, he projected an even greater first-year haul – US$536 million – if recreational cannabis is legalized. This estimate includes revenue from initial licensing fees.

The assumptions going into these projections aren’t clear. And while cannabis legalization has been lucrative for state revenues in other places, revenues often fall short of what was projected during legalization debates.

Importantly, Pennsylvania is now nearly surrounded by states with legal recreational cannabis. That includes New York, New Jersey, Delaware, Maryland and Ohio, but not West Virginia.

It is no secret that, in the words of Shapiro, “Pennsylvanians who want to buy cannabis are just driving across the border to one of our neighbors.”

Research on how ideas and policies spread makes clear the intense pressure that comes as a state’s neighbors adopt a policy, especially one with major economic ramifications.

But pressure does not determine the result. The internal politics of a state can still block a policy from being adopted.

State-owned cannabis stores

The biggest challenge for legalization in Pennsylvania will be navigating those internal political dynamics – especially finding a compromise that can be supported by both Democrats and Republicans.

Public safety is often raised as a concern during legalization debates. To counter this point, Democrats in the state House have proposed selling legal cannabis in state-owned stores, just like how liquor and some wine is sold in Pennsylvania now.

Man and woman crossing street in front of a store with sign that reads: Fine Wine & Good Spirits
The Pennsylvania Liquor Control Board operates nearly 600 Fine Wine & Good Spirits stores across the state.
Paul Weaver/SOPA Images/LightRocket via Getty Images

No other states do this, and it puts the state on potentially very slippery ground with the federal government, which still considers cannabis to be completely prohibited. State-run stores mean that states are providing a banned substance directly to citizens. That is a significant step further than creating an infrastructure to regulate private entities that are breaking federal law.

Moreover, there has been a decades-long effort in Pennsylvania by conservatives to privatize the state liquor stores. It seems odd that Republicans would support using that model to create a recreational cannabis market.

If privately owned but government-regulated dispensaries are used, there is significant debate among cannabis policy experts as to whether it is wise to give existing medical dispensaries first dibs on recreational licenses. Doing so allows states to open their recreational programs very quickly.

The drawback, however, is that large, multistate operators such as Trulieve, which runs dispensaries in several states, are positioned to gain a significant share of the market. This is why the industry supports the approach to initial licensing. Legalization advocates such as Shaleen Title, however, are very concerned about the development of a “Big Cannabis” that resembles Big Tobacco, with oligopoly control by a few large companies.

Social equity is another challenge facing recreational legalization that was not a major factor in medical. In short, social equity is about ensuring members of marginalized communities that were previously targets of the War on Drugs somehow benefit from the cannabis industry now that it is legal. While the issue was central to recreational legalization debates in neighboring New York and New Jersey, there’s been little public discussion of this particular facet of Pennsylvania’s proposed legalization plans.

While a middling adopter of medical cannabis, Pennsylvania’s program also had important innovations in research and social equity that influenced legislators in other states. Whatever happens in the commonwealth around recreational cannabis may well do so again, especially as fewer states have the option of adopting recreational cannabis via the ballot.

Finding a legislative solution to these thorny issues in a divided government could thus push legalization forward. Or the recent winds against legalization could stall the effort in Pennsylvania, at least for now.

Read more of our stories about Philadelphia and Pennsylvania.The Conversation

Daniel J. Mallinson, Associate Professor of Public Policy and Administration, Penn State

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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