Earmarking state taxes on recreational sales of marijuana is an underused strategy for financing mobile psychiatric crisis units, the National Suicide Prevention Lifeline, and more, new research shows.

When buying alcohol, tobacco, or gasoline, US consumers pay excise taxes, or levies on specific products above and beyond a sales tax. Governments sometimes put these taxes in place to offset the societal problems caused by consuming the goods—for instance, by earmarking alcohol and tobacco taxes to pay for substance use prevention and treatment.

Now, new excise taxes are being added to the sale of recreational marijuana as it is legalized in a growing number of states—and they generated more than $3 billion in revenue in 2021 alone.

Public health advocates have argued that decriminalization can help foster equitable communities by eliminating racial and ethnic disparities in drug arrests. But with marijuana still illegal at the federal level, which has blocked most scholars from studying it, research on the drug’s health effects—including potential benefits—is still in its nascency. Even so, a growing body of evidence points to a link between frequent marijuana use and an increased risk for certain mental health issues, particularly psychosis.

Could earmarking recreational marijuana taxes for investments in mental health offset the potential health consequences of marijuana legalization, while retaining its benefits to communities?

“If more and more states are passing recreational marijuana laws and adding excise taxes, then it would make sense that at least some of this is earmarked for mental health,” says Jonathan Purtle, an associate professor of public health policy and management at New York University and the author of a new JAMA Health Forum paper arguing that the earmarked taxes have the potential to help millions.

Here, Purtle details a vision for how this new revenue stream could bolster mental health services that have long been underfunded: