Cannabis legalization is a serious topic of discussion in the Western Hemisphere. Since 2012, voters in eight U.S. states have passed laws to legalize large-scale cannabis production and allow profit-maximizing companies to grow and sell it for nonmedical purposes. Voters in Washington DC also approved legalization, but supply is limited to home production and gifting—retail sales are not allowed. In 2013, Uruguay’s President José Mujica ratified a legalization bill that is noteworthy for at least three reasons. Most importantly, it made Uruguay the first country in the world to remove the prohibition on cannabis supply for nonmedical purposes. Second, Uruguay’s middle-ground approach to cannabis supply falls in between the two options commonly discussed in the United States: prohibition versus the standard commercial model. Third, the law was approved by politicians, not the voters.

Jurisdictions considering alternatives to prohibiting supply have a number of options to consider (See Fig. 1; Caulkins et al., 2015); Uruguay chose three middle-ground options. Uruguayan citizens who are 18 years and older and want legal cannabis can either (1) grow cannabis at home (similar to Washington DC); (2) join a cannabis social club (CSC; similar to some European countries); or (3) purchase cannabis from a pharmacy (not yet operational). Adults are only allowed to choose one supply mechanism and there are limits to the amount grown (six plants) or purchased (no more than 40 g per month, 10 g per week).1 The government will tightly control the cannabis produced for the pharmacies and advertising is prohibited.

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