In this episode of the Unnecessary Harm Podcast, Dr Kevin Sabet exposes how the cannabis industry uses the same playbook as Big Alcohol to normalise marijuana whilst undermining prevention efforts. As co-founder and president of Smart Approaches to Marijuana, Sabet has advised three US presidents on drug policy. He discusses his recently released book, One Nation Under the Influence: America’s Deadly Drug Habit and How We Can Overcome It—what colleagues call his “magnum opus”.

Sabet’s journey began at 16 when California’s 1996 medical marijuana ballot initiative radicalised him. He researched who funded the campaign and discovered not cancer doctors or genuine patients, but big money billionaires whose goal was cannabis legalisation disguised as compassion. They exploited vulnerable people and their families for profit. That deceit drove him into four decades of drug policy work spanning the White House, Oxford University, and global advocacy.

The book examines successful prevention models from Iceland, sets the record straight on Portugal’s misrepresented drug policies, explores evidence-based treatment approaches including contingency management, and exposes how harm reduction has been weaponised by legalisation advocates. Sabet argues we know what works in prevention and recovery—we simply need the political will to implement it.

From Student Activist to Presidential Advisor

Sabet grew up in Southern California in a family that fled Iran’s 1979 revolution. His parents came to America for economic and religious liberty. They never drank alcohol. Sabet never used drugs. This outsider perspective proved critical.

As an eighth-grader, Sabet was selected for a peer counselling programme where students could confide in fellow students about problems. The common denominator? Marijuana. When the school board threatened to cut the programme, Sabet advocated to save it. He won. He realised how vital drug and alcohol programmes were.

California’s Medical Marijuana Deception

At 16, California’s Proposition 215 appeared on the ballot. Marketed as “medical marijuana,” the initiative allowed cannabis for any illness for which someone thought it provided relief. No prescription. No doctor oversight. De facto legalisation disguised as medicine.

“I saw who was behind it,” Sabet recalls. “Big money billionaires whose goal was to legalise marijuana, but they were going to put the word medical before the word marijuana so they could make it more palatable. Their deceit radicalised me.”

The initiative passed 56-44%. Sabet’s predictions about consequences proved accurate.

Three White House Calls

At University of California Berkeley, “like starting the coalition for a wine-free France,” Sabet founded an anti-drug group. During the MDMA epidemic, he and friends stood outside San Francisco clubs passing out postcards showing brain scans of “your brain on ecstasy.” The White House noticed. They invited the 20-year-old to work as a paid researcher at the Office of National Drug Control Policy.

“I still didn’t think this could be a profession,” Sabet admits. “I wanted to become a judge. This felt like random events happening one after another.”

The White House called again whilst Sabet studied at Oxford. Return as a speechwriter. After 9/11, whilst friends went to war, Sabet saw drug policy work as serving his country differently. He completed his PhD in social policy at Oxford, still uncertain about career direction. Then came a third White House invitation at the beginning of the Obama administration.

“Third time I was asked, I realised this was really a sign,” Sabet explains. “I needed to stick with it.”

After two and a half years, Sabet left to start Smart Approaches to Marijuana. He craved independence. He wrote Reefer Sanity. The rest is history.

The Kennedy Partnership That Changed Drug Policy

Patrick Kennedy remains extremely involved in Smart Approaches to Marijuana. Sabet texts him almost daily. Kennedy is son of the late Ted Kennedy, the “lion of the US Senate” who ran for president. Patrick grew up in privilege and wealth with easy access to drugs and absent parents busy being Kennedys. He hid his addiction whilst serving in the US Congress. A very public car crash in the capital woke him up. He’s been sober approximately 15 years. Completely changed his life. Married with five children.

Kennedy and Sabet met during healthcare expansion discussions. Both worked to ensure expanded coverage included addiction treatment. When Sabet left the White House and marijuana normalisation accelerated, Kennedy called.

“Kevin, as you know, I’m in recovery and this is going to threaten people in recovery,” Kennedy said. “This is awful for us. What can we do?”

They launched Smart Approaches to Marijuana together. Kennedy remains extremely passionate about the work.

SAM operates globally. The organisation provides evidence-based resources to policymakers, communities, and advocates worldwide. For prevention professionals and recovery communities, Smart Approaches to Marijuana offers invaluable support against the cannabis industry’s propaganda machine.

Seven Years Fighting Synthetic Marijuana

On 11th November 2025, prominent pro-legalisation publication Marijuana Moment posted a headline dripping with spin: “Senate rejects attempt to save hemp industry from THC ban in key spending bill.” They claimed the bill “overrides the regulatory framework of several states, cancels the collective decision of hemp consumers, and destroys the livelihoods of hemp farmers.”

This represents a huge win for public health, society, communities, and families across the United States. Smart Approaches to Marijuana was a key actor in securing this victory after seven years of advocacy.

The Hemp Loophole That Flooded America

The 2018 agricultural bill included a hemp provision allowing farmers to compete in the hemp industry. Hemp is a small niche industry. Canada and China produce it far more cheaply. The US always imported hemp legally but couldn’t grow it domestically. Farmers argued they should be allowed to grow it. Legislators agreed to try.

A loophole emerged. Rogue chemists and lab operators manipulated hemp to extract intoxicating substances. Synthetic marijuana made in labs from chemical structures flooded convenience stores and petrol stations. Twelve-year-olds accessed these products easily.

The industry grew rapidly. They convinced conservative Republicans including Texas’s governor that hemp deserved protection. Smart Approaches to Marijuana worked tirelessly lobbying the Senate to repeal the loophole.

“We got it into a bill that had to pass when the government came back into session,” Sabet explains. “Now they have a one-year waiting period, but these products will be completely illegal in a year.”

The industry works overtime to reverse the decision. SAM has them in a strong position after seven years of trying to correct this dangerous policy gap.

The pro-legalisation lobby, including NORML and other major pushers, saw synthetic marijuana as another opportunity to addict the public. The addiction-for-profit sector loves addiction-for-profit products. They guarantee a customer base for life, or as short as that may be.

The Rescheduling Threat Undermining Public Health

President Trump recently signed an executive order declaring fentanyl a weapon of mass destruction. When a substance kills more people than several wars combined, the logic makes sense. Trump asked: “Name one bomb that’s killed 80,000 people.”

But underneath this radar sits a sneaky threat undermining drug policy achievements: pending marijuana rescheduling from Schedule 1 to Schedule 3.

Research over the last 20 years hasn’t proven cannabis to be beneficial. It’s proven the opposite. Cannabis is a highly toxic psychotropic substance that inflicts untold harm on multiple levels: short-term, long-term, and intergenerational.

Trump will issue an executive order saying marijuana should be rescheduled. He cannot simply decree rescheduling. It must go through a process. But it sends a very strong signal to the attorney general to get this done.

What Rescheduling Would Accomplish

What would rescheduling accomplish?

First, it would provide tax breaks to the marijuana industry. “We don’t want to make them more profitable than they already are,” Sabet emphasises. “That’s terrible.”

Second, it signals marijuana is less harmful than previously thought, even though it’s more harmful than previously thought. The headline becomes: “Marijuana rescheduled to less dangerous substance.” This is the complete opposite of where science points.

“What we don’t know is what it really means for policy,” Sabet admits. “Schedule 3 drugs in the United States are things like Tylenol with codeine. Tylenol with codeine cannot make claims about cancer. It cannot make any claims not approved by the FDA. It cannot be infused in candies or vapes.”

The situation remains uncertain regarding actual policy implications. But the signal it sends and the tax breaks it allows are reason enough for Smart Approaches to Marijuana to oppose rescheduling.

The Research Justification Doesn’t Hold Up

One presumed justification is research. But nearly five billion US dollars has been spent researching marijuana in the last 30 years. Rescheduling isn’t about research.

Barrister Dave Evans, who litigates against the cannabis industry for harms done to communities, made a fascinating observation during a previous podcast. The only new medicine brought to market was Epidiolex by GW Pharmaceuticals, now Jazz Pharmaceuticals. They spent 1.3 billion dollars over 11 years developing this non-THC-based epilepsy medicine. It’s a fourth-line treatment with 25% efficacy. All that research, hundreds of thousands of studies, five billion dollars spent, produced one new medicine. This happened whilst cannabis remained Schedule 1. Rescheduling isn’t necessary for drug policy reform that advances medical development.

Rescheduling is about public perception. Bad actors leverage mechanisms like rescheduling to claim cannabis isn’t as harmful as prevention advocates declare. This sends clear signals particularly to the wilfully ignorant who want to continue propagating false narratives. Tax breaks feed the addiction-for-profit sector with greater capacity to generate wealth and invest back into addiction-for-profit enterprises.

Smart Approaches to Marijuana Pushes Back

This is bad public health practice. Smart Approaches to Marijuana, Drug Free America Foundation, and other groups push back hard against this policy failure.

Everything happening in the United States has a trickle effect. Bad actors in other countries say: “See what America’s done. See what President Trump has done.”

The concern is whether the fentanyl weapon-of-mass-destruction executive order, which deserves support, might bury the rescheduling issue underneath massive news coverage. Boats being sunk in the Caribbean dominate newsfeeds globally. This could be a multi-layered strategy where one major announcement obscures another problematic policy shift.

This is the game. It’s insidious, malicious, and predictable. If you don’t see it coming, you get done by it like the Greeks with the Trojans.

One Nation Under the Influence: Hope Over Hopelessness

Two decades ago, Jay Vinson Peterson released a shocking exposé: A Nation Under the Influence: America’s Addiction to Alcohol. The book argued the United States is deeply and systematically shaped by alcohol, treating it as socially acceptable but highly destructive. It frames the US as a culture under the influence where alcohol use is normalised despite extensive evidence of harm and addiction patterns.

Peterson’s book critiqued US alcohol policy as fragmented and heavily influenced by industry. It called for a shift from individual blame to population-level prevention and regulation, emphasising education, early intervention, community-based prevention, and evidence-informed treatment services.

Big Cannabis uses the same playbook. Sabet calls it Big Alcohol 2.0.

We Know What Works

One Nation Under the Influence argues we know what works in drug policy reform. It’s about implementation and political will. Some people think the problem is so severe that nothing works. They advocate legalising drugs or accepting drug use or “managing” it.

“First of all, there’s no such thing as safe drug use or managing it at all,” Sabet insists.

The book discusses how original harm reduction addressed AIDS when it was a death sentence. Now AIDS is more or less eradicated in most of the world. Harm reduction served a purpose then. But people with other intents, legalisation advocates, have usurped genuine harm reduction.

Solutions From Iceland to Contingency Management

The book explores solutions. It examines Iceland’s prevention programmes. It sets the record straight on Portugal, which did not legalise drugs and presents a very mixed, nuanced picture. It discusses programmes that motivate people to seek help.

“Addiction, if you’re going to call it a disease, is the only disease where you can essentially bribe somebody to get better,” Sabet notes, referring to contingency management.

You cannot tell someone with Alzheimer’s you’ll give them one hundred dollars if they remember your name tomorrow. You cannot tell someone with multiple sclerosis not to have spasms and receive payment. That doesn’t work. With addiction, it does work because it’s a bio-behavioural disorder with biological elements but critically important behavioural components.

The book talks about real solutions and why we shouldn’t get hopeless. When we do get hopeless, we latch onto things like injection sites or prescribing opioids to heroin and fentanyl addicts. That makes the problem worse. Sabet discusses Vancouver, where such approaches have made the crisis horrible.

How Harm Reduction Gets Hijacked

Australia exported bad harm reduction practices globally. Harm reduction has a place, helping those caught in addiction’s tyranny stay alive whilst they exit drug use. That’s the key defining caveat.

Pro-drug activists get underneath harm reduction. They pretend to find compassion and care whilst actually equipping and enabling ongoing drug use. They find a mother who lost her daughter and tell her: “If only we had pill testing, your daughter would be alive.” They use tragedy as a manipulative tool to justify mechanisms that enable ongoing drug use rather than facilitate exit.

Genuine harm reductionists care about drug users. They desperately want family and community members off drugs. They want people alive until they exit drug use. Those are compassionate, wonderful goals.

Bad actors hijack these mechanisms for drug policy that serves corporate profit, not public health.

The Fence or the Ambulance

The podcast asks Sabet: should prevention and treatment receive equal priority, or should one receive more emphasis?

“I think you have to have both,” Sabet responds. “There’s always going to be somebody that climbs that fence or doesn’t make it up there. Both are equally important.”

Problems arise when policies prioritise one over the other. Some harm reduction policies are good policies fitting within the continuum of care. But when investment goes to only one thing, if you’re not investing in prevention, treatment, recovery, everything throughout that continuum, you never solve these problems.

“I’m a prevention person,” Sabet admits. “I truly believe if you invest more on the front end, you don’t have to spend all that down there. If we’re going to invest resources unevenly, we should favour prevention and really double down there, because then you don’t have to spend money on Band-Aids and everything else.”

Building Fences at the Top of the Cliff

Communities remain far from that balance. Many people need triage. They must be kept through the continuum of care. The current imbalance leaves prevention under siege whilst resources flood toward crisis management.

Sabet adds a third element: the classroom.

“Education and knowledge and realising our worth as individuals and our soul, that is going to be the shortest route out of this issue.”

Resilience-building is part of protective factors at the top of the cliff. Build strong, wonderful, protective fences. The more fences you have at the top, the fewer ambulances you need at the bottom.

The Path Forward With Smart Approaches to Marijuana

Despite decades of legalisation momentum, awareness is raising. High-potency cannabis products have wreaked havoc on communities affecting public health and public safety. Parents have lost children to psychotic breaks. Parents have lost children to marijuana-impaired drivers. People commit violent crimes whilst high on marijuana.

“For every three steps we take in a positive direction, we get punched back a few steps,” Sabet acknowledges. “I feel like that’s how it’s been for the last 20 years.”

Reversing Bad Policy

But momentum exists to overturn bad policies, pass new laws, and educate policymakers. Smart Approaches to Marijuana works to reverse legalisation in several states including Massachusetts.

Then comes something like the potential executive order to reschedule marijuana, threatening to undermine progress.

Sabet’s message to policymakers and communities remains clear: prevention works when properly funded and implemented. Real change requires legislative action, community mobilisation, and unwavering commitment to stopping drug initiation before it starts.

Get Resources, Take Action

A 16-year-old boy in California stepped in and made significant difference in drug policy. We must encourage our communities to do the same. Get resources. Get research. It’s available in spades through Smart Approaches to Marijuana at https://learnaboutsam.org/, Drug Free America Foundation, the Delgano Institute, and other groups.

We have evidence in spades on what constitutes poor practice and what constitutes good and best practice. We know how to move forward as communities.

The continuum of care process is key. Communities want people not to enter drug use. If they do enter, communities want them to exit as quickly as possible. That distance between those two ends needs to shrink. This requires recognising that flawed drug policy serves corporate interests, not public health.

As Sabet powerfully concludes: the shortest route out of the addiction crisis runs through the classroom, building resilience and protective factors that prevent substance use before it starts.

Listen to the full episode “One Nation Under the Influence: America’s Drug Crisis and the Fight Against Big Cannabis – A Conversation with Dr Kevin Sabet” on the Unnecessary Harm Podcast.