Dr. Rosado tells Parliament regulation is the safer path for Cannabis in St. Maarten

GREAT BAY--Dr. Joseph Rosado, a Florida physician active in medical cannabis policy and practice, made a strong case in Parliament on Thursday for St. Maarten to move toward cannabis regulation, arguing that a properly controlled legal framework would better protect public health, support vulnerable individuals, strengthen mental health services and replace the current unregulated market with one built on oversight, standards and accountability. He is also the author of 𝘏𝘰𝘱𝘦 𝘢𝘯𝘥 𝘏𝘦𝘢𝘭𝘪𝘯𝘨: 𝘛𝘩𝘦 𝘊𝘢𝘴𝘦 𝘧𝘰𝘳 𝘊𝘢𝘯𝘯𝘢𝘣𝘪𝘴.

His was a sustained public health case for cannabis regulation, arguing that the real danger to St. Maarten lies not in a controlled legal framework but in the continued existence of an unregulated market with no standards, no clinical safeguards and no dedicated funding stream for mental health and substance abuse services. His presentation formed one of the most detailed medical contributions of the meeting and placed questions of psychosis, schizophrenia, treatment access and health system preparedness at the center of the national cannabis debate.

Appearing as a medical specialist supporting the Native Nations presentation, Dr. Rosado told Members of Parliament that any serious cannabis framework must explicitly address support for institutions such as Turning Point, the Mental Health Foundation and related services. He said those services should not be treated as optional side issues, but as part of the structure of the legislation itself.

Regulation would allow a defined portion of cannabis-related revenue to be directed by law toward mental health and substance abuse support, rather than leaving such institutions without any direct benefit from an industry that already exists in the shadows. Revenue allocation under the proposed model would support mental health services and substance abuse programs.

A major portion of Dr. Rosado’s remarks dealt with one of the most sensitive concerns raised by MPs, namely the relationship between cannabis, psychosis and schizophrenia. He sought to draw a distinction between risk and causation, telling Parliament that the presence of mental health risk should not be denied or minimized, but must also not be overstated beyond what available evidence supports. In his remarks, he argued that the often-cited 3 percent figure refers to the general prevalence of psychotic disorders in the wider population, not a rate caused by cannabis use itself. He maintained that there is no established primary causal relationship between cannabis use and the onset of psychosis in the general population, and said the real risk is concentrated among individuals with an underlying genetic vulnerability.

Dr. Rosado’s message to MPs was that these vulnerable individuals already exist in St. Maarten today, under prohibition, and are already exposed to cannabis products with no oversight. He emphasized that this problem is not theoretical. In his framing, the issue before Parliament is not whether vulnerable people may encounter risk, but whether the country will continue allowing them to encounter that risk in an unregulated environment where potency is unknown, product history cannot be traced, and no public health interventions are built into the system.

He also responded directly to concern that cannabis potency, rather than simple frequency of use, may play a decisive role in triggering psychiatric episodes among persons already predisposed to such outcomes. On that point, Dr. Rosado told MPs that psychosis is not about the number of joints used, but about concentration and individual neurobiological sensitivity. He argued that a single high-potency product may trigger a psychotic episode in a genetically vulnerable person in ways that lower-potency exposure may not. In making that argument, he sought to support the case for regulation by suggesting that potency control, labeling and dose transparency are among the tools that only a legal and supervised market can provide.

His wider point was that the science, as he presented it, does not support the claim that cannabis causes schizophrenia in otherwise healthy individuals, even though the association between cannabis and psychosis is real and well documented. He told Parliament that in genetically vulnerable individuals, cannabis may accelerate the onset of a condition that was already developing, but that this should not be confused with proof that cannabis is the primary cause of schizophrenia. He further argued that if cannabis use itself were a major standalone cause of schizophrenia at the population level, one would expect schizophrenia rates to have risen alongside the long-term increase in cannabis use and potency across Western countries. According to Dr. Rosado, that pattern has not materialized, and schizophrenia rates have remained relatively flat over time.

That argument formed the basis of his central conclusion: regulation is not a dismissal of risk, but a mechanism for managing it. In that regard, his remarks were closely aligned with the accompanying Native Nations media brief, which states that mental health risks do exist but are better managed under a regulated system, and that regulation reduces risk compared with the illegal market by introducing testing, labeling and public health safeguards.

Dr. Rosado also pushed back against the assumption that legalization would automatically increase demand for drug treatment related to cannabis. In his presentation, he said the data does not show a consistent increase in cannabis-related treatment demand after regulation in multiple jurisdictions. In some places, he argued, there is evidence of a substitution effect, where the use of higher-risk substances declines. His broader position was that a regulated framework provides better opportunities for education, earlier intervention, structured prevention and more targeted health responses than prohibition has been able to deliver.

Beyond the psychiatric discussion, Dr. Rosado sought to present cannabis regulation as part of a larger public health reform effort. He argued that a legal framework would allow Government to mandate potency labeling, THC concentration guidelines, age restrictions, clinical screening protocols and stronger consumer education. He also said it would improve the ability of authorities and health providers to identify at-risk persons earlier and support them more effectively. In the Native Nations media brief, this same approach is described as a framework intended to work alongside public health organizations, strengthening prevention, treatment and education.

One of the more human elements of Dr. Rosado’s contribution came when he moved away from policy talk and described the experience of a patient from his own medical practice. He told MPs about a woman who presented with multiple conditions, including seizures, post-traumatic stress disorder, generalized anxiety disorder with panic attacks, recurrent major depressive disorder, attention deficit disorder, fibromyalgia, thyroid dysfunction, swelling of the lower legs, hot flashes and weight-related issues. According to his account, that patient had once been taking between 42 and 58 pills per day, with her life revolving around medication alarms on her phone. He said that after entering a regulated medical cannabis system and obtaining lawful access to tested products through the official process, she was able to function more normally, work, volunteer at church and pick up her children from school without being heavily sedated by other medications.

He presented that case as a public health illustration. His point to Parliament was that the existing pharmaceutical burden on some patients can itself create serious health and quality-of-life concerns, and that regulated medical cannabis may, in some cases, offer a safer and more manageable alternative than leaving people dependent on large numbers of stronger medications. In doing so, he tried to shift the discussion from a narrow question of whether cannabis carries risks, to a broader question of how St. Maarten evaluates comparative risk across its health system.

Dr. Rosado returned repeatedly to one underlying principle: the illegal market offers no standards. He argued that an unregulated environment does not test products, does not label potency, does not restrict contaminants, does not screen for vulnerable consumers and does not create any protected revenue stream for public health institutions. By contrast, the framework presented to Parliament, according to both his remarks and the media brief, is intended to introduce oversight, accountability, education and structured safeguards into a space that already exists but currently operates outside government control.

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