While legalising recreational cannabis looks set to fail, doctors say the debate on decriminalisation should continue, while balancing associated health issues.
Voters opposed a proposed cannabis legalisation bill by 53 per cent to 46 per cent, with the preliminary results announced yesterday.
The Royal College of General Practitioners took a neutral stance on the referendum, but president Dr Samantha Murton said there were conversations that still needed to happen following the result.
She said decriminalisation could balance health issues with the need to stop people being unfairly punished in the courts.
"The reason that this was put up was that there are issues with how cannabis is dealt with currently," she said. "Because there are issues, then we need to deal with them, but then also the other side of that coin is there's some significant health issues, and so we need to be able to deal with it in a balanced way."
Murton also said the publicity about cannabis legalisation made people more comfortable about talking to their GP about drug use.
While Manukau councillor Efeso Collins opposed legalisation of cannabis, he said he would support decriminalisation to stop young people being imprisoned.
However, he said the referendum gave a clear signal that a large number of people wanted change - and that the government should have made its own decision on legalisation, rather than putting it to the people.
"I think it's a clear mandate for decriminalisation, that's where we should have been in the first place," he said. "What we've seen from central government is a lack of courage on their part to actually make a decision."
The government has also been urged to use the results from the referendum to make changes to truly improve outcomes for Māori.
Ahead of the referendum, the prime minister's chief science advisor Juliet Gerrard released a report that suggested legalising cannabis would significantly improve police bias against Māori.
It said Māori were three times more likely to be arrested and convicted of a cannabis-related crime than non-Māori. Māori were almost twice as likely as non-Māori to go to court over a first offence and nearly seven times more likely to be charged.
It was estimated that legalising cannabis would reduce Māori cannabis convictions by almost 1300 a year, put Māori on a more equal footing with other people and would mean they could expect better outcomes for education, travel, and employment.
Dr Hirini Kaa, an Anglican Minister and historian who lectures at Auckland University, said Labour could now consider the issues more carefully and with more consultation.
He said the focus should be on systemic justice and health problems - and that addressing the underlying racism was more important than addressing cannabis itself.
"Those two systems are failing us so spectacularly," He said. "If they do manage to make major changes in those areas, then cannabis won't be such a problem."