Cannabis Lobbying Reshaped US Drug Policy. At What Cost?

On 18 December 2025, Kim Rivers sat alone in a Washington D.C. hotel room staring at a thick marker pen. Hours earlier, President Donald Trump had signed an executive order directing his Attorney General to reschedule marijuana from Schedule I to Schedule III — the most significant shift in American federal drug law in nearly sixty years. Trump had given Rivers the pen as a souvenir. She kept it. Back home in Tallahassee, it now sits under a plastic case on a filing cabinet next to her desk, beside a red MAGA hat Trump signed with the words: “Kim, Great Job.”

Rivers, the 48-year-old CEO of Florida-based cannabis giant Trulieve, had pulled off something remarkable. She had become, as Forbes described her, “the cannabis industry’s Trump whisperer” — the executive who bent the ear of a president who has never smoked or had a drink, and helped move the policy needle on cannabis for the entire United States. It is, on its surface, an impressive story about access, persistence, and influence.

From a public health and prevention perspective, it raises a different set of questions entirely.

What Cannabis Lobbying Actually Bought

Rivers did not achieve this outcome through persuasion alone. Cannabis lobbying at this scale is an expensive operation. Federal Election Commission records show Trulieve donated $750,000 to Trump’s inaugural committee and a further $250,000 to his MAGA Inc. super PAC. Rivers attended a $1 million-per-plate fundraiser at Trump’s Bedminster golf club. The company spent over $400,000 on federal lobbying in 2024 and the first half of 2025, retaining firms with direct links to the Trump White House — including Ballard Partners, the same firm previously employed by Trump’s chief of staff Susie Wiles.

Ten days before the executive order was signed, Rivers was seated at the Resolute Desk in the Oval Office, flanked by the Secretary of Health and Human Services, the administrator of the Centres for Medicare and Medicaid Services, the CEO of Scotts Miracle-Gro, and a Boston financier. Together, they were explaining to the President of the United States that marijuana was in the wrong drug category.

The Deals Behind the Deal

A leaked document photographed on the laptop of former Representative Matt Gaetz — Trump’s initial attorney general nominee — appeared to show a draft contract in which Gaetz would provide “administration-related guidance” in lobbying efforts for a firm affiliated with Trulieve, with $250,000 payable on resolution of an unnamed “matter” and a reported additional “Super Success Fee” of potentially $2 million for “exclusive policy remedies.” Neither party confirmed the arrangement. The document, however, was widely reported.

Trulieve also paid a conservative social media influencer over $160,000 for two tweets supporting a Florida cannabis ballot initiative, with reporting suggesting a wider network of influencers promoted rescheduling in ways not always transparently disclosed to their audiences.

This is not the first time questions about Trulieve’s relationship with political power have surfaced. Rivers’ former husband John Burnette was convicted in 2021 of extortion, bribery, and other charges. During the trial it emerged that he had bragged to an undercover FBI agent about working with a state legislator to insert language into Florida cannabis legislation that would block Trulieve’s competitors from the market. Burnette later walked back the statement in court. Neither Rivers, Trulieve, nor the legislator were implicated. Trulieve voiced its continued support for Rivers throughout. The episode is not a finding against Rivers — but it does form part of the broader picture of how cannabis lobbying and political access have shaped Trulieve’s rise.

The Financial Motive

The financial stakes for Trulieve could not have been higher. Cannabis companies currently operate under tax code 280E, designed for drug traffickers, which can impose an effective tax rate of 60 per cent or more on gross revenue. Trulieve reported $1.2 billion in revenue last year and still posted a net loss of $122 million. Rivers has said that rescheduling to Schedule III would represent an “overnight flip” to profitability. The company has already received $114 million in IRS refund cheques based on its own legal theory that 280E does not apply to its business — while simultaneously acknowledging a potential $670 million tax liability if the IRS disagrees. Rescheduling resolves that liability entirely.

What the Oval Office meeting was not, is a public health decision. Addiction medicine specialists were not in that room. Adolescent mental health researchers were not at the Resolute Desk. Prevention advocates did not attend the Bedminster fundraiser. The question of who shapes drug policy — and who cannot afford to — is one Australia must take seriously before the same pattern arrives here.

The Starbucks of Weed

Rivers is candid about her commercial vision. She has modelled Trulieve on Starbucks — constant innovation, a consistent product, and a loyalty programme designed to create what she calls “a raving fan” and drive “return visitors on a regular basis.” She speaks openly about the importance of the customer knowing the brand knows them: “Hi Kim, can I get you your usual?”

These are standard retail strategies. The question worth asking from a public health standpoint is straightforward: when you apply “raving fan” loyalty programme thinking to a psychoactive substance with established dependence potential, who carries the risk? The answer is not the shareholders.

Cannabis use disorder is a recognised clinical condition. It is the most prevalent drug use disorder globally. There are no approved pharmacological treatments for it. A 2025 meta-analysis found the odds of depression were 51 per cent higher in young cannabis users. In Canada, cannabis-attributable hospitalisations increased 120 per cent between 2007 and 2020, driven substantially by neuropsychiatric conditions in children and young people. These findings did not feature in the Oval Office discussions that shaped the rescheduling decision.

Nancy’s Water

While Rivers was navigating Washington, something else was happening in Jefferson County, Florida — the rural community of 15,000 people where Trulieve operates its flagship 80-acre cultivation facility, a site the company calls its “crown jewel.”

Nancy Gebhart lives directly across the street from the plant. She told local television that beyond any questions about water quality, the smell was the hardest part. Other residents described water runoff flowing onto neighbouring properties and a persistent “skunk odour” they believed came from the facility. State Representatives Allison Tant and Jason Shoaf began fielding calls from constituents worried about water quality and possible runoff, prompting Tant to contact the governor’s office, the Department of Health, the Department of Environmental Protection, and the Suwannee Valley Water Management District.

The Suwannee River Water Management District issued a notice of non-compliance in April after inspections found the facility had violated conditions of its Environmental Resource Permit, with inspectors reporting unpermitted impervious surfaces, standing water in a stormwater pond, erosion linked to prolonged water discharge, and tests indicating excessive pollutants leaving the property.

The Florida Department of Environmental Protection separately put Trulieve on notice, with fines of up to $15,000 per day applicable until violations are resolved. The Florida Department of Health established a water testing distribution site for local residents — limited to the first 75 applicants.

When residents packed the county courthouse annex for a special meeting in late April, one resident spoke plainly: “You’re telling me we’re to live with that and y’all come in here with a good speech, good spiel… and what do we get… we got nothing.”

Trulieve maintains it is in compliance and has agreed to return to the next commission meeting with a more detailed plan. That is appropriate. But it is also worth noting that a company which spent over $197 million on Florida cannabis ballot initiatives, and hundreds of thousands more on cannabis lobbying in Washington, has faced years of documented community complaints in the county where it operates its most celebrated facility — complaints that remain unresolved.

What Prevention Asks

The evidence-based prevention community does not suggest that drug policy should never change. What it does insist is that change should happen on the basis of evidence, not economics — and that the communities most likely to bear the costs of commercial cannabis expansion deserve to be heard as loudly as the investors who stand to gain from it.

Kim Rivers is a capable and driven executive. The story of how she secured that pen is genuinely impressive as a piece of corporate strategy. The question prevention advocates must keep asking — in America and in Australia — is what policy looks like when the people who profit from drug use are the loudest voices shaping the rules around it.

Nancy Gebhart and her neighbours in Jefferson County know something about that gap. So do the families navigating cannabis use disorder without an approved treatment pathway. Their voices belong in this conversation as much as anyone seated at the Resolute Desk.

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