why marijuanas should be legal essay conclusion

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The Evidence—and Lack Thereof—About Cannabis

Research is still needed on cannabis’s risks and benefits. 

Lindsay Smith Rogers

Although the use and possession of cannabis is illegal under federal law, medicinal and recreational cannabis use has become increasingly widespread.

Thirty-eight states and Washington, D.C., have legalized medical cannabis, while 23 states and D.C. have legalized recreational use. Cannabis legalization has benefits, such as removing the product from the illegal market so it can be taxed and regulated, but science is still trying to catch up as social norms evolve and different products become available. 

In this Q&A, adapted from the August 25 episode of Public Health On Call , Lindsay Smith Rogers talks with Johannes Thrul, PhD, MS , associate professor of Mental Health , about cannabis as medicine, potential risks involved with its use, and what research is showing about its safety and efficacy. 

Do you think medicinal cannabis paved the way for legalization of recreational use?

The momentum has been clear for a few years now. California was the first to legalize it for medical reasons [in 1996]. Washington and Colorado were the first states to legalize recreational use back in 2012. You see one state after another changing their laws, and over time, you see a change in social norms. It's clear from the national surveys that people are becoming more and more in favor of cannabis legalization. That started with medical use, and has now continued into recreational use.

But there is a murky differentiation between medical and recreational cannabis. I think a lot of people are using cannabis to self-medicate. It's not like a medication you get prescribed for a very narrow symptom or a specific disease. Anyone with a medical cannabis prescription, or who meets the age limit for recreational cannabis, can purchase it. Then what they use it for is really all over the place—maybe because it makes them feel good, or because it helps them deal with certain symptoms, diseases, and disorders.

Does cannabis have viable medicinal uses?

The evidence is mixed at this point. There hasn’t been a lot of funding going into testing cannabis in a rigorous way. There is more evidence for certain indications than for others, like CBD for seizures—one of the first indications that cannabis was approved for. And THC has been used effectively for things like nausea and appetite for people with cancer.

There are other indications where the evidence is a lot more mixed. For example, pain—one of the main reasons that people report for using cannabis. When we talk to patients, they say cannabis improved their quality of life. In the big studies that have been done so far, there are some indications from animal models that cannabis might help [with pain]. When we look at human studies, it's very much a mixed bag. 

And, when we say cannabis, in a way it's a misnomer because cannabis is so many things. We have different cannabinoids and different concentrations of different cannabinoids. The main cannabinoids that are being studied are THC and CBD, but there are dozens of other minor cannabinoids and terpenes in cannabis products, all of varying concentrations. And then you also have a lot of different routes of administration available. You can smoke, vape, take edibles, use tinctures and topicals. When you think about the explosion of all of the different combinations of different products and different routes of administration, it tells you how complicated it gets to study this in a rigorous way. You almost need a randomized trial for every single one of those and then for every single indication.

What do we know about the risks of marijuana use?  

Cannabis use disorder is a legitimate disorder in the DSM. There are, unfortunately, a lot of people who develop a problematic use of cannabis. We know there are risks for mental health consequences. The evidence is probably the strongest that if you have a family history of psychosis or schizophrenia, using cannabis early in adolescence is not the best idea. We know cannabis can trigger psychotic symptoms and potentially longer lasting problems with psychosis and schizophrenia. 

It is hard to study, because you also don't know if people are medicating early negative symptoms of schizophrenia. They wouldn't necessarily have a diagnosis yet, but maybe cannabis helps them to deal with negative symptoms, and then they develop psychosis. There is also some evidence that there could be something going on with the impact of cannabis on the developing brain that could prime you to be at greater risk of using other substances later down the road, or finding the use of other substances more reinforcing. 

What benefits do you see to legalization?

When we look at the public health landscape and the effect of legislation, in this case legalization, one of the big benefits is taking cannabis out of the underground illegal market. Taking cannabis out of that particular space is a great idea. You're taking it out of the illegal market and giving it to legitimate businesses where there is going to be oversight and testing of products, so you know what you're getting. And these products undergo quality control and are labeled. Those labels so far are a bit variable, but at least we're getting there. If you're picking up cannabis at the street corner, you have no idea what's in it. 

And we know that drug laws in general have been used to criminalize communities of color and minorities. Legalizing cannabis [can help] reduce the overpolicing of these populations.

What big questions about cannabis would you most like to see answered?

We know there are certain, most-often-mentioned conditions that people are already using medical cannabis for: pain, insomnia, anxiety, and PTSD. We really need to improve the evidence base for those. I think clinical trials for different cannabis products for those conditions are warranted.

Another question is, now that the states are getting more tax revenue from cannabis sales, what are they doing with that money? If you look at tobacco legislation, for example, certain states have required that those funds get used for research on those particular issues. To me, that would be a very good use of the tax revenue that is now coming in. We know, for example, that there’s a lot more tax revenue now that Maryland has legalized recreational use. Maryland could really step up here and help provide some of that evidence.

Are there studies looking into the risks you mentioned?

Large national studies are done every year or every other year to collect data, so we already have a pretty good sense of the prevalence of cannabis use disorder. Obviously, we'll keep tracking that to see if those numbers increase, for example, in states that are legalizing. But, you wouldn't necessarily expect to see an uptick in cannabis use disorder a month after legalization. The evidence from states that have legalized it has not demonstrated that we might all of a sudden see an increase in psychosis or in cannabis use disorder. This happens slowly over time with a change in social norms and availability, and potentially also with a change in marketing. And, with increasing use of an addictive substance, you will see over time a potential increase in problematic use and then also an increase in use disorder.

If you're interested in seeing if cannabis is right for you, is this something you can talk to your doctor about?

I think your mileage may vary there with how much your doctor is comfortable and knows about it. It's still relatively fringe. That will very much depend on who you talk to. But I think as providers and professionals, everybody needs to learn more about this, because patients are going to ask no matter what.

Lindsay Smith Rogers, MA, is the producer of the Public Health On Call podcast , an editor for Expert Insights , and the director of content strategy for the Johns Hopkins Bloomberg School of Public Health.

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Essays on Cannabis Legalization

Thomas, Danna Kang

Though the drug remains illegal at the federal level, in recent years states and localities have increasingly liberalized their marijuana laws in order to generate tax revenue and save resources on marijuana law enforcement. Many states have adopted some form of medical marijuana and/or marijuana decriminalization laws, and as of 2017, Washington, Colorado, Maine, California, Oregon, Massachusetts, Nevada, Alaska, and the District of Columbia have all legalized marijuana for recreational use. In 2016 recreational marijuana generated over $1.8 billion in sales. Hence, studying marijuana reforms and the policies and outcomes of early recreational marijuana adopters is an important area of research. However, perhaps due to the fact that legalized recreational cannabis is a recent phenomenon, a scarcity of research exists on the impacts of recreational cannabis legalization and the efficacy and efficiency of cannabis regulation. This dissertation aims to fill this gap, using the Washington recreational marijuana market as the primary setting to study cannabis legalization in the United States. Of first order importance in the regulation of sin goods such as cannabis is quantifying the value of the marginal damages of negative externalities. Hence, Chapter 1 (co-authored with Lin Tian) explores the impact of marijuana dispensary location on neighborhood property values, exploiting plausibly exogenous variation in marijuana retailer location. Policymakers and advocates have long expressed concerns that the positive effects of the legalization--e.g., increases in tax revenue--are well spread spatially, but the negative effects are highly localized through channels such as crime. Hence, we use changes in property values to measure individuals' willingness to pay to avoid localized externalities caused by the arrival of marijuana dispensaries. Our key identification strategy is to compare changes in housing sales around winners and losers in a lottery for recreational marijuana retail licenses. (Due to location restrictions, license applicants were required to provide an address of where they would like to locate.) Hence, we have the locations of both actual entrants and potential entrants, which provides a natural difference-in-differences set-up. Using data from King County, Washington, we find an almost 2.4% decrease in the value of properties within a 0.5 mile radius of an entrant, a $9,400 decline in median property values. The aforementioned retail license lottery was used to distribute licenses due to a license quota. Retail license quotas are often used by states to regulate entry into sin goods markets as quotas can restrict consumption by decreasing access and by reducing competition (and, therefore, increasing markups). However, license quotas also create allocative inefficiency. For example, license quotas are often based on the population of a city or county. Hence, licenses are not necessarily allocated to the areas where they offer the highest marginal benefit. Moreover, as seen in the case of the Washington recreational marijuana market, licenses are often distributed via lottery, meaning that in the absence of an efficiency secondary market for licenses, the license recipients are not necessarily the most efficient potential entrants. This allocative inefficiency is generated by heterogeneity in firms and consumers. Therefore, in Chapter 2, I develop a model of demand and firm pricing in order to investigate firm-level heterogeneity and inefficiency. Demand is differentiated by geography and incorporates consumer demographics. I estimate this demand model using data on firm sales from Washington. Utilizing the estimates and firm pricing model, I back out a non-parametric distribution of firm variable costs. These variable costs differ by product and firm and provide a measure of firm inefficiency. I find that variable costs have lower inventory turnover; hence, randomly choosing entrants in a lottery could be a large contributor to allocative inefficiency. Chapter 3 explores the sources of allocative inefficiency in license distribution in the Washington recreational marijuana market. A difficulty in studying the welfare effects of license quotas is finding credible counterfactuals of unrestricted entry. Therefore, I take a structural approach: I first develop a three stage model that endogenizes firm entry and incorporates the spatial demand and pricing model discussed in Chapter 2. Using the estimates of the demand and pricing model, I estimate firms' fixed costs and use data on locations of those potential entrants that did not win Washington's retail license lottery to simulate counterfactual entry patterns. I find that allowing firms to enter freely at Washington's current marijuana tax rate increases total surplus by 21.5% relative to a baseline simulation of Washington's license quota regime. Geographic misallocation and random allocation of licenses account for 6.6\% and 65.9\% of this difference, respectively. Moreover, as the primary objective of these quotas is to mitigate the negative externalities of marijuana consumption, I study alternative state tax policies that directly control for the marginal damages of marijuana consumption. Free entry with tax rates that keep the quantity of marijuana or THC consumed equal to baseline consumption increases welfare by 6.9% and 11.7%, respectively. I also explore the possibility of heterogeneous marginal damages of consumption across geography, backing out the non-uniform sales tax across geography that is consistent with Washington's license quota policy. Free entry with a non-uniform sales tax increases efficiency by over 7% relative to the baseline simulation of license quotas due to improvements in license allocation.

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• Marijuana industry
• Drug legalization
• Drugs--Economic aspects

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Five Reasons Why We Should Legalize Cannabis

Cannabis use in the United States has had a long and complicated history. For decades, people who used cannabis were subject to social ostracization and criminal prosecution. However, attitudes toward cannabis have been evolving in recent years. An increasing number of states have started to legalize cannabis for medical or recreational use. This shift in policy has been driven by a variety of factors including changing public attitudes and the potential economic benefits of legalization. In this article, we will explore the potential benefits of legalizing cannabis in our country.

1. Legalization for the Environment

Legalizing cannabis can have significant benefits for the environment. When cannabis is grown illegally, it is often done in environmentally damaging ways, such as using chemical pesticides or clearing primary forests to make room for crops. Legalization could allow customers to support more environmental growers. This will incentivize more responsible growing practices, such as the use of organic farming methods or the use of renewable energy sources to power indoor grow operations. In addition, the culture of growing cannabis can help to discover and preserve precious marijuana seeds , increasing biodiversity and facilitating a deeper understanding of cannabis plants and their cultivation.

2. Legalization for Justice

Where cannabis is illegal, people are being arrested and charged for possession or sale, which leads to costly court cases and a burden on the criminal justice system. Legalization would free up law enforcement resources to focus on more serious crimes and simultaneously reduce the number of people incarcerated for non-violent drug offenses. This could help to reduce the overall prison population and save taxpayers money.

In addition, legalization can have significant benefits for justice and equity, particularly for marginalized communities that have been disproportionately affected by the criminalization of cannabis. Communities of color have been particularly affected by the war on drugs, with Black Americans being nearly four times more likely to be arrested for cannabis possession than white Americans, despite similar rates of use.

By regulating cannabis cultivation and sales, legalization can help to eliminate the black market and reduce the involvement of criminal organizations in the cannabis industry. This can lead to safer communities and reduced drug-related violence in communities that have been most affected by the criminalization of cannabis.

3. Legalization for Public Health

Cannabis has been shown to have many beneficial and therapeutic effects on both physical and mental health. However, people may be hesitant to seek medical marijuana treatment due to fear of legal repercussions if cannabis is illegal. Legalization can allow more people to enjoy better health outcomes. It can also promote the safer use of cannabis by educating the public on appropriate cannabis use and providing quality control measures for cannabis products. Legalization can also lead to increased research into potential medical applications of cannabis and could lead to the development of innovative treatments.

Another potential perk of cannabis legalization is that it could reduce the use of more harmful drugs. In the absence of cannabis, people may turn to more dangerous drugs like heroin or fentanyl to manage chronic pain or other conditions. By legalizing cannabis, we can provide a safer alternative for these individuals and could reduce the overall demand for these more dangerous drugs. States that have legalized cannabis found a decrease in opioid overdose deaths and hospitalizations, suggesting that cannabis are an effective alternative to prescription painkillers.

4. Legalization for the Economy

The legalization of cannabis can generate significant tax revenue for governments and create new economic opportunities. When cannabis is illegal, it is sold on the black market, and no taxes are collected on these sales. However, when it is legal, sales can be regulated, and taxes can be imposed on those sales. In states that have legalized cannabis, tax revenue from cannabis sales has been in the millions of dollars , with California registering a whopping $1.2 billion in cannabis tax revenue in 2021. This impressive income can be used to reduce budget deficits, fund various public services such as education and healthcare, and create new opportunities for investment in projects that revitalize the economy.

Aside from tax revenue, legalizing cannabis can create new jobs. The cannabis industry is a rapidly growing industry, and legalization could lead to the creation of new jobs in areas such as cultivation, processing, and retail sales. This can help to reduce unemployment and create new gainful opportunities for people who may have struggled to find employment in other industries. Legalization can also lead to increased investment in related industries, such as the development of new products or technologies to improve cannabis cultivation or the creation of new retail businesses. There are now several venture capital funds and investment groups that focus solely on cannabis-related enterprises.

5. Legalization for Acceptance

Finally, legalization could help reduce the stigma surrounding cannabis use. Before cannabis legalization, people who use the plant were often viewed as criminals or deviants. Legalization can help change this perception and lead to more open and honest conversations about cannabis use. Ultimately, legalization could lead to a more accepting and inclusive society where individuals are not judged or discriminated against for their personal and healthcare choices. By legalizing cannabis, we can harness the power of a therapeutic plant. Legalization can heal not just physical and mental ailments of individuals but also the social wounds that have resulted from its criminalization.

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Americans overwhelmingly say marijuana should be legal for medical or recreational use

With a growing number of states authorizing the use of marijuana, the public continues to broadly favor legalization of the drug for medical and recreational purposes. 

An overwhelming share of U.S. adults (88%) say either that marijuana should be legal for medical and recreational use by adults (59%) or that it should be legal for medical use only (30%). Just one-in-ten (10%) say marijuana use should not be legal, according to a Pew Research Center survey conducted Oct. 10-16, 2022. These views are virtually unchanged since April 2021.

The new survey follows President Joe Biden’s decision to pardon people convicted of marijuana possession at the federal level and direct his administration to review how marijuana is classified under federal law. It was fielded before the Nov. 8 midterm elections, when two states legalized the use of marijuana for recreational purposes – joining 19 states and the District of Columbia , which had already done so.

Pew Research Center asked this question to track public views about the legal status of marijuana. For this analysis, we surveyed 5,098 adults from Oct. 10-16, 2022. Everyone who took part in this survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used for this report, along with responses, and its methodology .

Over the long term, there has been a steep rise in public support for marijuana legalization, as measured by a separate Gallup survey question that asks whether the use of marijuana should be made legal – without specifying whether it would be legalized for recreational or medical use. This year, 68% of adults say marijuana should be legal , matching the record-high support for legalization Gallup found in 2021.

There continue to be sizable age and partisan differences in Americans’ views about marijuana. While very small shares of adults of any age are completely opposed to the legalization of the drug, older adults are far less likely than younger ones to favor legalizing it for recreational purposes.

This is particularly the case among those ages 75 and older, just three-in-ten of whom say marijuana should be legal for both medical and recreational use. Larger shares in every other age group – including 53% of those ages 65 to 74 – say the drug should be legal for both medical and recreational use.

Republicans are more wary than Democrats about legalizing marijuana for recreational use: 45% of Republicans and Republican-leaning independents favor legalizing marijuana for both medical and recreational use, while an additional 39% say it should only be legal for medical use. By comparison, 73% of Democrats and Democratic leaners say marijuana should be legal for both medical and recreational use; an additional 21% say it should be legal for medical use only.

Ideological differences are evident within each party. About four-in-ten conservative Republicans (37%) say marijuana should be legal for medical and recreational use, compared with a 60% majority of moderate and liberal Republicans.

Nearly two-thirds of conservative and moderate Democrats (63%) say marijuana should be legal for medical and recreational use. An overwhelming majority of liberal Democrats (84%) say the same.

There also are racial and ethnic differences in views of legalizing marijuana. Roughly two-thirds of Black adults (68%) and six-in-ten White adults say marijuana should be legal for medical and recreational use, compared with smaller shares of Hispanic (49%) and Asian adults (48%).

Related: Clear majorities of Black Americans favor marijuana legalization, easing of criminal penalties

In both parties, views of marijuana legalization vary by age

While Republicans and Democrats differ greatly on whether marijuana should be legal for medial and recreational use, there are also age divides within each party.

A 62% majority of Republicans ages 18 to 29 favor making marijuana legal for medical and recreational use, compared with 52% of those ages 30 to 49. Roughly four-in-ten Republicans ages 50 to 64 (41%) and 65 to 74 (38%) say marijuana should be legal for both purposes, as do 18% of those 75 and older.

Still, wide majorities of Republicans in all age groups favor legalizing marijuana for medical use. Even among Republicans 65 and older, just 17% say marijuana use should not be legal even for medical purposes.

While majorities of Democrats across all age groups support legalizing marijuana for medical and recreational use, older Democrats are less likely to say this. About half of Democrats ages 75 and older (51%) say marijuana should be legal for medical or recreational purposes; larger shares of younger Democrats say the same. Still, only 8% of Democrats 75 and older think marijuana should not be legalized even for medical use – similar to the share of all other Democrats who say this.

Note: Here are the questions used for this report, along with responses, and its methodology .

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Ted Van Green is a research analyst focusing on U.S. politics and policy at Pew Research Center .

9 facts about Americans and marijuana

Most americans favor legalizing marijuana for medical, recreational use, most americans now live in a legal marijuana state – and most have at least one dispensary in their county, clear majorities of black americans favor marijuana legalization, easing of criminal penalties, concern about drug addiction has declined in u.s., even in areas where fatal overdoses have risen the most, most popular.

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The Reasons Why Marijuana Should be Made Legal Research Paper

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Introduction

Arguments against marijuana, arguments for marijuana, works cited.

Drugs that cause addiction and have negative effects health has been illegalized in most constitutions. These drugs are seen to have minimal benefits and enormous side effects. Among drugs that have been illegalized include: heroin, cocaine and marijuana among others. On the other hand those that are legalized include tobacco and alcohol. This research paper main interest is in the legalization of marijuana.

Marijuana has been illegalized because it is considered to be risk factors in people’s health and is believed to temper with the brain. It is also associated with criminal acts such as gang behavior and is discouraged. The purpose of this research paper is to address the reasons why marijuana should be made legal.

Among the reasons that support the legalization of marijuana include: the medical basis that marijuana has some benefits and that the state could gain revenue from the trade of marijuana as opposed to the costs incurred in the implementation of the laws against use the controlled drug. Furthermore, the legalization would enable the state to monitor and introduce legal outlets that would enforce the correct use of the drug (Barnes: 11).

Medical reasons against use of marijuana as medically unfit to use

In the argument against marijuana to be made illegal, Barnes (9) ascertains that marijuana should not be made legal in the medical field. There are certain cases that marijuana has negatively affected the immune system of the person taking the drug. In other cases, side effects like the damage of the brain and poisonous forms have occurred.

Testing must be done

Before marijuana is fully accepted as a medication, extensive testing of the drug must be done to establish the adverse effects as well as the benefits. This is because the state has the responsibility of ensuring that the drug is harmless before legalizing it. The state can consider thorough investigations before it is legalized. They may also consider what other institutions have assessed and made conclusions about the use of the drug (Barnes 11).

Measurements of elements contained in marijuana

Another reason against the use of marijuana in the medical field is the inability to have power over the purity of the drug. Marijuana is not a synthetic drug and hence it may be difficult to establish control over the natural growing marijuana. It may also develop other challenges concerned with the way productions and distribution of the drug.

However, this argument is challenged with the tobacco industry where it has been established and seems to be doing well. This is because the manufacturers of tobacco have been able to follow directives as by the government and controlled it. So, if the same measures are employed with marijuana the control may be successful.

Marijuana should not be prescribed

In his argument against marijuana to be prescribed in medical institutions Barnes (12) disputes that the state will be able to uphold its uprightness in the testing of the drug. This is because it may not be able to follow keenly the patients under testing of marijuana for medical purposes and therefore may fail to accurately get the right assessment. This is because monitoring the marijuana consumers may be difficult, thus paralyzing the testing of the drug.

Marijuana is replaceable

Barnes (11) states that the medical field does consider the use of marijuana as unnecessary as there are other drugs that could replace it and have fewer side effects. Therefore, marijuana can be avoided and the alternative drugs be used in its place. Despite some medical practitioners ignoring the use of marijuana for cancer cases like vomiting, patients have proffered marijuana to the synthetic drugs. In other cases marijuana has been argued to be of benefit to cancer patients as well as other diseases (Cervantes: 6).

Marijuana may be misinterpreted to be safe on human health

Barnes (15) mentions that if marijuana is legalized for medical reasons it may be misinterpreted by the public. This is because they may consider use of marijuana safe for their health following the states approval for medical use. As a result, marijuana would be used for leisure hence create more health problem among the public especially if excessively smoked.

Illegal businesses will be encouraged

If legalized, businesses will be set up to sell marijuana. The traders will sell it assuming that it helps cancer patients whereas just a few may benefit. This is because the people selling may be unauthorized to sell. This implies that those taking the drug may lack monitoring from a professional in the medical field hence the treatment may be inadequate or in excess or even wrong. Consequently, the state may welcome more harm instead of good.

Marijuana is different from alcohol

Smith (8) argues against marijuana saying that marijuana is harmful to health just like cigarettes. When smoked after a long time the person may develop lung problems. For expecting mothers smoking may lead to death of the fetus or cause births with deformities.

Marijuana be used only when necessary

Despite the fact that legalized marijuana may bring more evil than good, the state can consider the use of marijuana for medical situations that require the specific intervention of the drug. The use of the drug will purely be made possible by a qualified professional who by careful consideration of all options recommends the use of marijuana. Therefore, the government should not abolish the use marijuana even for medical reasons.

Marijuana does not cause health problems

Marijuana rarely causes biological problem. The persons using marijuana cannot be affected in the mind destroy the immune system or transfer effects to through inheritance. However, persistence use of marijuana can make one suffer from bronchitis if they smoke it.

This is a preventable cause because marijuana can be consumed in food for instance baked products. Additional marijuana is not known to cause serious illnesses like those caused by other drugs like cocaine. Marijuana cannot cause death if simply taken in large quantities (Legalization of marijuana.com Para 8).

On the contrary Stimson says that “the scientific knowledge is clear that marijuana is addictive and that its use significantly impairs bodily and mental functions. Marijuana use is associated with memory loss, cancer, immune system deficiencies, heart disease and birth defects, among other conditions. Even where decriminalized, marijuana trafficking remain a source of violence, crime and social integration” (p. 1)

Marijuana is a source of revenue

Another reason why marijuana should be legalized is that it is a source of revenue for the government and a source of income for the individual. Those trading marijuana gain profits that can support the family besides paying all the taxes. When the breadwinner is arrested for being in possession of the illegal drug, the family suffers. Children are transferred to children’s home separating them from their parent (Legalization of marijuana.com Para 5).

The other concern that is raised as a source of income is the spread of drug network in the name of legalized trade. Stimson (2) notes that legalization of marijuana may lead to expansion of the drug associations that sell drugs under ground. This may be an opportunity for them to sell other drugs that have much worse adverse effect. In addition, the groups selling drugs may end up selling it to underage children who should be protected from taking the drug.

Marijuana has medical benefits

As Barnes (8) point out, marijuana can be used for medical treatment of some illnesses and therefore should be legalized. Marijuana may have fewer side effects when compared to other drugs in the medical field when used to treat a certain illness. As a matter of fact, marijuana as a medical drug would work effectively and be the best drug for particular patients. For instance, marijuana is very effective in managing nausea in patients and the side effects can be tolerated to treat this symptom.

Marijuana get equal treatment as alcohol and tobacco

Gieringe (2) supports the legalization marijuana just like other drugs that have been legalized like the prominent tobacco and the consumption of alcohol. Like other drugs it has benefits and short comings which in most cases may be equal to those of the legalized drugs.

Furthermore, the use of marijuana hardly encourages the use of much superior drugs and therefore should be considered safe for the users. Another consideration is that the consumers of marijuana are not involved in unlawful behaviors and thus it is unfair to consider those consuming it to be criminals.

Stimson (3) argues against the treatment of marijuana as being similar to alcohol. In his article, he makes it clear that although both marijuana and alcohol have similar side effects, alcohol have adverse effects that are less acute as those of marijuana. On further considerations, alcohol is more widely accepted in many cultures of the world and accepted by many. Legalizing the drug would therefore go against many cultures and societies.

Report findings from the COMPAS (2) reveal that most people believe that crime will increase if marijuana is legalized. Others strongly believe that it will increase consumption behavior and some people will develop dependency. The results of being dependent will be an increase in people with deteriorating health.

Crime is believed to increase because the people who have developed dependency must keep taking the drug. Since the drug is costly, they look for more money after they have used whatever they had. Consequently, the persons may neglect their obligations perhaps in the family or at work to acquire the drug. This is undesired in the society because it affects the economy of an individual negatively.

Retractions lead to increased consumption

The individuals who are use marijuana controllably remain capable of driving as well as remain not addicted. Driver’s judgment on the road is not affected and therefore those under the influence of the drug can drive safely. For this reason, Gieringe (2) argues that restricting the marijuana will lead to increased consumption. This is because it is impossible to eradicate societal vices as they tend to increase when prohibited. Therefore, it is appropriate to legalize marijuana.

Illegal measures have failed

Punishments given for being in possession or using marijuana are futile. Regardless of whatever measures the state puts to control the use of prohibited drugs like marijuana, the public continues the consumption. Gieringe (4) indicates that strict punitive measures do not deter the users from using it.

In most cases they have secretive ways of producing and selling the same as well as consume it without being noticed. It is necessary to consider that consumption of the drug is an individual choice hence limiting or availing the drug may not be the factors to consider but rather it is an individual choice.

An example of the case of California

According to Gieringe (5) the law against the use of marijuana turned to be ineffective. The law was introduced with an aim to stop the broadening of the consumption as was introduced by a group of people. Following prohibition, the drug gained prominence as many learned to use. Apart from the consequences illegal marijuana on the people, the government used a lot of funds to curb the problem of illegal drugs.

When the public is introduced to prominent drug use Stimson (6) insists that a majority become addicted. Accordingly, the brain is affected making them unable to perform like other members of society, who do not use the drug. As a result, the affected at times have little ability to learn as before and so students who take drugs discontinue education for failure or inability to concentrate. The people who work and have jobs most often fail to perform well and are relieved from work.

Legalizing marijuana would contradict the law. Most governments have prohibited the production, distribution and consumption of illegal drugs. A law that would legalize one of the controlled drugs would send a message that with time even other drugs can be made legal. The argument is that the law would contradict itself since some of the other illegal drugs posses same adverse effects as those of marijuana (Stimson: 8). Instead the law should remain constant so that such laws do not fail as Rosenthal & Kubby (174) notes.

The budget after legalization of marijuana

Legalizing marijuana not only has advantages in the decrease in unlawful activities but also bring economic benefits in the budget of the state. Miron (2) indicates that the budget drastically incur large expenditure in the implementation of laws against marijuana.

This is opposed to the fact that, if legalized, marijuana such costs would not be realized and the state would therefore gain revenue for transactions involved in marijuana. Caputo and Brian (480) also point out that the sales made in the illegal sale of marijuana are not taxed. If the government would implement taxation, then the state would have increased revenue.

Some of the costs are as follows: The police are funded by the state budget to conduct arrests of those found with marijuana. Other cost is spent in the justice system. After the sent the criminal to prison another cost is incurred. This cost can be scraped off and the government would gain instead (Miron: 2).

Control Measures by the state

Upon legalization there should be restrictions that the state can enforce to monitor the production distribution and consumption of marijuana. First, it can consider making the any individuals who is concerned with marijuana trade to obtain a license given the state. Additionally, the concerned people must surrender the marijuana before selling for inspection of its contents and grading.

This will make it possible for the state to standardize the product assess whether there are harmful contents and allow only the safe product to be sold. Upon the assessment for the elements, the trader will then be taxed. Selling will also be done by authorized persons through specific channels. As with the use of other tobacco, it can be sold to adults in specific areas at a particular time.

Obtaining of a licenses should not be made difficult by the state or remain within the reach of a few. Those who wish for a medium scale business can be allowed to have such licenses. It may also be relevant to consider allowing individuals to plant some marijuana for own consumption although in small quantities as allowed by the state. This is similar to the home made wine made for own use and is also in line with individual liberties.

The challenged face with implementing the home grown marijuana is the control of the plant in terms of production. Another challenge is to be able to discourage children from accessing and using the drug before they are of the legal age Stimson (2). Punitive measures can also be made similar to those of the tobacco trade where the trader forfeits the license and risks being fined if they fail to adhere to rules.

Benefits of legalizing marijuana

The state will have reduced expenditure concerned with the unlawful trade of marijuana. This implies that, there will be fewer criminals the laws against will have been withdrawn. Therefore, the responsibility of taking the drug will be left upon individual judgment and for medical interventions.

More individuals will conform to the regulations about the consumption and encourage legal trade as opposed to illegal trade. The monitored distributers will make it impossible for people bellow the recommended age to obtain the drug. In addition, the quality and elements in the plant will be assessed and thus individuals will obtain safe marijuana. Lastly, the distributors will pay levy just like other businesses (Gieringer: 10).

Gieringe (7) notes that marijuana can be made legal and most problems associated with the consumption would be eliminated. If licensed individuals would be allowed to produce the crop and sell it through controlled channels of adults then the problems of misuse would decline.

There would be revenue generated and some individuals would support their families without fear of separation due to arrests. The drug can be categorized in the same group as alcohol and tobacco and receive equal treatment. With time, the sale will decline and be similar to that of tobacco. The production will also decline with the increase in production and lowering of prices. Consequently, the government will gain taxes from the sale as it loses in the illegal trade of marijuana.

The use of marijuana has adverse effects that are undesirable. The negative effects they have on human health when used for a long time are to be avoided by moderate use of the substance. Criminals are known to be drug users of among others marijuana hence it bring social evils. Since it damages the brain, students suffer and drop from school while those working fail to keep up to the task.

Although, those who are associated with marijuana are thought to be criminals the society can view them differently and legalize the use of the drug while monitoring its use. Marijuana has medical benefits and should be considered. The state also benefit from the taxes collected from the legal sale of marijuana.

Barnes, Eric. Reefer madness: Legal and moral issues surrounding the medical Prescription of marijuana , 2000. Web.

Caputo, Michael and Brian, Ostrom. “Potential Tax Revenue from a Regulated Marijuana Market: A Meaningful Revenue Source.” American Journal of Economics and Sociology , 1994, 53, 475-490.

Cervantes, Jorge. Marijuana horticulture: the Indoor/Outdoor Medical grower’s bible. North America: Van Patten Publishing, 2006.

COMPAS. Legalization of marijuana: A Compass Report for the National Post, 2004. Web.

Gieringer, Dale. Testimony of the legalization of Marijuana , 2009. Web.

Legalization of marijuana.com. Legalizing marijuana , 2010. Web.

Miron, Jeffrey. The budgetary implications of marijuana legalization in Massachusetts, 2003. Web.

Rosenthal, Ed & Kubby, Steve. Why marijuana should be legal. New York: Thunder Mouth press, 2003.

Smith, Sandra . Lee Marijuana . New York: The rasen publishing group, 1995. Web.

Stimson, Charles. Legalizing marijuana: why citizens should just say no , 2010. Web.

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Home — Essay Samples — Law, Crime & Punishment — Marijuana Legalization — Unpacking the Debate: The Pros and Cons of Legalizing Marijuana

Unpacking The Debate: The Pros and Cons of Legalizing Marijuana

• Categories: Cannabis Marijuana Marijuana Legalization

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Words: 1686 |

Published: Mar 18, 2021

Words: 1686 | Pages: 4 | 9 min read

Bibliography

• https://www.canabomedicalclinic.com/10-common-conditions-medical-cannabis-prescribed-for/
• http://edition.cnn.com/2014/07/30/opinion/gitlow-marijuana-use/index.html
• https://www.marijuanabreak.com/marijuana-related-deaths
• https://www.iflscience.com/health-and-medicine/new-study-suggests-risks-marijuana-use-have-been-overestimated/
• https://www.theperspective.com/debates/living/should-we-legalize-marijuana/
• http://www.dailyhelmsman.com/online_features/opinion-should-marijuana-be-legal/article_c0c79d52-2e6e-11e9-8df2-6f1cc833c9f9.html
• https://www.debatingeurope.eu/focus/arguments-legalising-cannabis/#.XOhhMYhKjIU
• https://thesleepdoctor.com/2018/11/27/thinking-about-using-cannabis-for-sleep-here-are-some-things-to-know/?cn-reloaded=1
• https://www.huffpost.com/entry/marijuana-legalization_n_4151423?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAFWwBQJd8aZZvM2CkRM4j_ahPD0AgNS8dV0urMpRILLvpG3DtwUdUX6cFlPsFejjN4K6JIKNo6J_ijqP3j5CMkPUlE2q1oonqdYNjrk_vXj-xaZF0pLDUbrURy4C6HBmAF4bhAkQk4FK_vkK2XPv2F6B18f5d8iRzp2wlhcgs-fv
• https://www.medicalnewstoday.com/articles/320984.php
• https://www.webmd.com/mental-health/addiction/recreational-marijuana-faq
• https://www.drugabuse.gov/publications/research-reports/marijuana/what-marijuana
• https://elpais.com/elpais/2018/10/18/inenglish/1539863917_686561.html
• https://www.scmp.com/week-asia/society/article/2172531/green-gold-rush-thailand-malaysia-race-legalise-medical-marijuana
• https://www.bbc.com/news/world-46374191 (globally diverse source/for)
• http://www.businessworld.in/article/Why-Cannabis-Should-Be-Legalised-In-India/13-01-2019-166025/

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The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017)

Chapter: summary.

Over the past 20 years there have been substantial changes to the cannabis policy landscape. To date, 28 states and the District of Columbia have legalized cannabis for the treatment of medical conditions ( NCSL, 2016 ). Eight of these states and the District of Columbia have also legalized cannabis for recreational use. These landmark changes in policy have markedly changed cannabis use patterns and perceived levels of risk. Based on a recent nationwide survey, 22.2 million Americans (12 years of age and older) reported using cannabis in the past 30 days, and between 2002 and 2015 the percentage of past month cannabis users in this age range has steadily increased ( CBHSQ, 2016 ).

Despite the extensive changes in policy at the state level and the rapid rise in the use of cannabis both for medical purposes and for recreational use, conclusive evidence regarding the short- and long-term health effects (harms and benefits) of cannabis use remains elusive. A lack of scientific research has resulted in a lack of information on the health implications of cannabis use, which is a significant public health concern for vulnerable populations such as pregnant women and adolescents. Unlike other substances whose use may confer risk, such as alcohol or tobacco, no accepted standards exist to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively.

Within this context, in March 2016, the Health and Medicine Division

(formerly the Institute of Medicine [IOM] 1 ) of the National Academies of Sciences, Engineering, and Medicine (the National Academies) was asked to convene a committee of experts to conduct a comprehensive review of the literature regarding the health effects of using cannabis and/or its constituents that had appeared since the publication of the 1999 IOM report

__________________

1 As of March 2016, the Health and Medicine Division continues the consensus studies and convening activities previously carried out by the Institute of Medicine (IOM).

Marijuana and Medicine . The resulting Committee on the Health Effects of Marijuana consisted of 16 experts in the areas of marijuana, addiction, oncology, cardiology, neurodevelopment, respiratory disease, pediatric and adolescent health, immunology, toxicology, preclinical research, epidemiology, systematic review, and public health. The sponsors of this report include federal, state, philanthropic, and nongovernmental organizations, including the Alaska Mental Health Trust Authority; Arizona Department of Health Services; California Department of Public Health; CDC Foundation; Centers for Disease Control and Prevention (CDC); The Colorado Health Foundation; Mat-Su Health Foundation; National Highway Traffic Safety Administration; National Institutes of Health/National Cancer Institute; National Institutes of Health/National Institute on Drug Abuse; Oregon Health Authority; the Robert W. Woodruff Foundation; Truth Initiative; U.S. Food and Drug Administration; and Washington State Department of Health.

In its statement of task, the committee was asked to make recommendations for a research agenda that will identify the most critical research questions regarding the association of cannabis use with health outcomes (both harms and benefits) that can be answered in the short term (i.e., within a 3-year time frame), as well as steps that should be taken in the short term to ensure that sufficient data are being gathered to answer long-term questions. Of note, throughout the report the committee has attempted to highlight research conclusions that affect certain populations (e.g., pregnant women, adolescents) that may be more vulnerable to potential harmful effects of cannabis use. The committee’s full statement of task is presented in Box S-1 .

STUDY CONTEXT AND APPROACH

Over the past 20 years the IOM published several consensus reports that focused on the health effects of marijuana or addressed marijuana within the context of other drug or substance abuse topics. 2 The two IOM reports that most prominently informed the committee’s work were Marijuana and Health , published in 1982, and the 1999 report Marijuana and Medicine: Assessing the Science Base. Although these reports differed in scope, they were useful in providing a comprehensive body of evidence upon which the current committee could build.

The scientific literature on cannabis use has grown substantially since the 1999 publication of Marijuana and Medicine. The committee conducted an extensive search of relevant databases, including Medline, Embase,

2 See https://www.nap.edu/search/?year=1995&rpp=20&ft=1&term=marijuana (accessed January 5, 2017).

the Cochrane Database of Systematic Reviews, and PsycINFO, and they initially retrieved more than 24,000 abstracts that could have potentially been relevant to this study. These abstracts were reduced by limiting articles to those published in English and removing case reports, editorials, studies by “anonymous” authors, conference abstracts, and commentaries. In the end, the committee considered more than 10,700 abstracts for their relevance to this report.

Given the large scientific literature on cannabis, the breadth of the statement of task, and the time constraints of the study, the committee developed an approach that resulted in giving primacy to recently published systematic reviews (since 2011) and high-quality primary research for 11 groups of health endpoints (see Box S-2 ). For each health endpoint,

systematic reviews were identified and assessed for quality using published criteria; only fair- and good-quality reviews were considered by the committee. The committee’s conclusions are based on the findings from the most recently published systematic review and all relevant fair- and good-quality primary research published after the systematic review. Where no systematic review existed, the committee reviewed all relevant primary research published between January 1, 1999, and August 1, 2016. Primary research was assessed using standard approaches (e.g., Cochrane Quality Assessment, Newcastle–Ontario scale) as a guide.

The search strategies and processes described above were developed and adopted by the committee in order to adequately address a broad statement of task in a limited time frame while adhering to the National

Academies’ high standards for the quality and rigor of committee reports. Readers of this report should recognize two important points. First, the committee was not tasked to conduct multiple systematic reviews, which would have required a lengthy and robust series of processes. The committee did, however, adopt key features of that process: a comprehensive literature search; assessments by more than one person of the quality (risk of bias) of key literature and the conclusions; prespecification of the questions of interest before conclusions were formulated; standard language to allow comparisons between conclusions; and declarations of conflict of interest via the National Academies conflict-of-interest policies. Second, there is a possibility that some literature was missed because of the practical steps taken to narrow a very large literature to one that was manageable within the time frame available to the committee. Furthermore, very good research may not be reflected in this report because it did not directly address the health endpoint research questions that were prioritized by the committee.

This report is organized into four parts and 16 chapters. Part I: Introduction and Background , Part II: Therapeutic Effects (Therapeutic Effects of Cannabis and Cannabinoids), Part III: Other Health Effects , and Part IV: Research Barriers and Recommendations . In Part II , most of the evidence reviewed in Chapter 4 derives from clinical and basic science research conducted for the specific purpose of answering an a priori question of whether cannabis and/or cannabinoids are an effective treatment for a specific disease or health condition. The evidence reviewed in Part III derives from epidemiological research that primarily reviews the effects of smoked cannabis. It is of note that several of the prioritized health endpoints discussed in Part III are also reviewed in Part II , albeit from the perspective of effects associated with using cannabis for primarily recreational, as opposed to therapeutic, purposes.

Several health endpoints are discussed in multiple chapters of the report (e.g., cancer, schizophrenia); however, it is important to note that the research conclusions regarding potential harms and benefits discussed in these chapters may differ. This is, in part, due to differences in the study design of the reviewed evidence, differences in characteristics of cannabis or cannabinoid exposure (e.g., form, dose, frequency of use), and the populations studied. As such, it is important that the reader is aware that this report was not designed to reconcile the proposed harms and benefits of cannabis or cannabinoid use across the report’s chapters. In drafting the report’s conclusions, the committee made an effort to be as specific as possible about the type and/or duration of cannabis or cannabinoid exposure and, where relevant, cross-referenced findings from other report chapters.

REPORT CONCLUSIONS ON THE ASSOCIATION BETWEEN CANNABIS USE AND HEALTH

From their review, the committee arrived at nearly 100 different research conclusions related to cannabis or cannabinoid use and health. Informed by the reports of previous IOM committees, 3 the committee developed standard language to categorize the weight of evidence regarding whether cannabis or cannabinoid use (for therapeutic purposes) is an effective or ineffective treatment for the prioritized health endpoints of interest, or whether cannabis or cannabinoid use (primarily for recreational purposes) is statistically associated with the prioritized health

3 Adverse Effects of Vaccines: Evidence and Causality ( IOM, 2012 ); Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence ( IOM, 2008 ); Veterans and Agent Orange: Update 2014 ( NASEM, 2016 ).

endpoints of interest. Box S-3 describes these categories and the general parameters for the types of evidence supporting each category. For a full listing of the committee’s conclusions, please see this chapter’s annex .

REPORT RECOMMENDATIONS

This is a pivotal time in the world of cannabis policy and research. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives. The committee has put forth a substantial number of research conclusions on the health effects of cannabis and cannabinoids. Based on their research conclusions, the committee members formulated four recommendations to address research gaps, improve research quality, improve surveillance capacity, and address research barriers. The report’s full recommendations are described below.

Address Research Gaps

Recommendation 1 : To develop a comprehensive evidence base on the short- and long-term health effects of cannabis use (both beneficial and harmful effects), public agencies, 4 philanthropic and professional organizations, private companies, and clinical and public health research groups should provide funding and support for a national cannabis research agenda that addresses key gaps in the evidence base. Prioritized research streams and objectives should include, but need not be limited to:

Clinical and Observational Research

• Examine the health effects of cannabis use in at-risk or under-researched populations, such as children and youth (often described as less than 18 years of age) and older populations (generally over 50 years of age), pregnant and breastfeeding women, and heavy cannabis users.
• Investigate the pharmacokinetic and pharmacodynamic properties of cannabis, modes of delivery, different concentrations, in various populations, including the dose–response relationships of cannabis and THC or other cannabinoids.
• Determine the harms and benefits associated with understudied cannabis products, such as edibles, concentrates, and topicals.
• Conduct well-controlled trials on the potential beneficial and harmful health effects of using different forms of cannabis, such

4 Agencies may include the CDC, relevant agencies of the National Institutes of Health (NIH), and the U.S. Food and Drug Administration (FDA).

• as inhaled (smoked or vaporized) whole cannabis plant and oral cannabis.
• Characterize the health effects of cannabis on unstudied and understudied health endpoints, such as epilepsy in pediatric populations; symptoms of posttraumatic stress disorder; childhood and adult cancers; cannabis-related overdoses and poisonings; and other high-priority health endpoints.

Health Policy and Health Economics Research

• Identify models, including existing state cannabis policy models, for sustainable funding of national, state, and local public health surveillance systems.
• Investigate the economic impact of recreational and medical cannabis use on national and state public health and health care systems, health insurance providers, and patients.

Public Health and Public Safety Research

• Identify gaps in the cannabis-related knowledge and skills of health care and public health professionals, and assess the need for, and performance of, continuing education programs that address these gaps.
• Characterize public safety concerns related to recreational cannabis use and evaluate existing quality assurance, safety, and packaging standards for recreational cannabis products.

Improve Research Quality

Recommendation 2 : To promote the development of conclusive evidence on the short- and long-term health effects of cannabis use (both beneficial and harmful effects), agencies of the U.S. Department of Health and Human Services, including the National Institutes of Health and the Centers for Disease Control and Prevention, should jointly fund a workshop to develop a set of research standards and benchmarks to guide and ensure the production of high-quality cannabis research. Workshop objectives should include, but need not be limited to:

• The development of a minimum dataset for observational and clinical studies, standards for research methods and design, and guidelines for data collection methods.
• Adaptation of existing research-reporting standards to the needs of cannabis research.
• The development of uniform terminology for clinical and epidemiological cannabis research.
• The development of standardized and evidence-based question banks for clinical research and public health surveillance tools.

Improve Surveillance Capacity

Recommendation 3 : To ensure that sufficient data are available to inform research on the short- and long-term health effects of cannabis use (both beneficial and harmful effects), the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Association of State and Territorial Health Officials, National Association of County and City Health Officials, the Association of Public Health Laboratories, and state and local public health departments should fund and support improvements to federal public health surveillance systems and state-based public health surveillance efforts. Potential efforts should include, but need not be limited to:

• The development of question banks on the beneficial and harmful health effects of therapeutic and recreational cannabis use and their incorporation into major public health surveys, including the National Health and Nutrition Examination Survey, National Health Interview Survey, Behavioral Risk Factor Surveillance System, National Survey on Drug Use and Health, Youth Risk Behavior Surveillance System, National Vital Statistics System, Medical Expenditure Panel Survey, and the National Survey of Family Growth.
• Determining the capacity to collect and reliably interpret data from diagnostic classification codes in administrative data (e.g., International Classification of Diseases-10 ).
• The establishment and utilization of state-based testing facilities to analyze the chemical composition of cannabis and products containing cannabis, cannabinoids, or THC.
• The development of novel diagnostic technologies that allow for rapid, accurate, and noninvasive assessment of cannabis exposure and impairment.
• Strategies for surveillance of harmful effects of cannabis for therapeutic use.

Address Research Barriers

Recommendation 4 : The Centers for Disease Control and Prevention, National Institutes of Health, U.S. Food and Drug Administration, industry groups, and nongovernmental organizations should fund the convening of a committee of experts tasked to produce an objective and evidence-based report that fully characterizes the impacts of regulatory barriers to cannabis research and that proposes strategies for supporting development of the resources and infrastructure necessary to conduct a comprehensive cannabis research agenda. Committee objectives should include, but need not be limited to:

• Proposing strategies for expanding access to research-grade marijuana, through the creation and approval of new facilities for growing and storing cannabis.
• Identifying nontraditional funding sources and mechanisms to support a comprehensive national cannabis research agenda.
• Investigating strategies for improving the quality, diversity, and external validity of research-grade cannabis products.

CBHSQ (Center for Behavioral Health Statistics and Quality). 2016. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf (accessed December 5, 2016).

IOM (Institute of Medicine). 2008. Treatment of postraumatic stress disorder: An assessment of the evidence . Washington, DC: The National Academies Press.

IOM. 2012. Adverse effects of vaccines: Evidence and causality . Washington, DC: The National Academies Press.

NASEM (National Academies of Sciences, Engineering, and Medicine). 2016. Veterans and agent orange: Update 2014 . Washington, DC: The National Academies Press.

NCSL (National Conference of State Legislatures). 2016. State medical marijuana laws. November 9. http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx (accessed November 21, 2016).

Report Conclusions 5

Chapter 4 conclusions—therapeutic effects of cannabis and cannabinoids.

There is conclusive or substantial evidence that cannabis or cannabinoids are effective:

• For the treatment of chronic pain in adults (cannabis) (4-1)
• As antiemetics in the treatment of chemotherapy-induced nausea and vomiting (oral cannabinoids) (4-3)
• For improving patient-reported multiple sclerosis spasticity symptoms (oral cannabinoids) (4-7a)

There is moderate evidence that cannabis or cannabinoids are effective for:

• Improving short-term sleep outcomes in individuals with sleep disturbance associated with obstructive sleep apnea syndrome, fibromyalgia, chronic pain, and multiple sclerosis (cannabinoids, primarily nabiximols) (4-19)

There is limited evidence that cannabis or cannabinoids are effective for:

• Increasing appetite and decreasing weight loss associated with HIV/AIDS (cannabis and oral cannabinoids) (4-4a)
• Improving clinician-measured multiple sclerosis spasticity symptoms (oral cannabinoids) (4-7a)
• Improving symptoms of Tourette syndrome (THC capsules) (4-8)
• Improving anxiety symptoms, as assessed by a public speaking test, in individuals with social anxiety disorders (cannabidiol) (4-17)
• Improving symptoms of posttraumatic stress disorder (nabilone; a single, small fair-quality trial) (4-20)

___________________

5 Numbers in parentheses correspond to chapter conclusion numbers.

There is limited evidence of a statistical association between cannabinoids and:

• Better outcomes (i.e., mortality, disability) after a traumatic brain injury or intracranial hemorrhage (4-15)

There is limited evidence that cannabis or cannabinoids are ineffective for:

• Improving symptoms associated with dementia (cannabinoids) (4-13)
• Improving intraocular pressure associated with glaucoma (cannabinoids) (4-14)
• Reducing depressive symptoms in individuals with chronic pain or multiple sclerosis (nabiximols, dronabinol, and nabilone) (4-18)

There is no or insufficient evidence to support or refute the conclusion that cannabis or cannabinoids are an effective treatment for:

• Cancers, including glioma (cannabinoids) (4-2)
• Cancer-associated anorexia cachexia syndrome and anorexia nervosa (cannabinoids) (4-4b)
• Symptoms of irritable bowel syndrome (dronabinol) (4-5)
• Epilepsy (cannabinoids) (4-6)
• Spasticity in patients with paralysis due to spinal cord injury (cannabinoids) (4-7b)
• Symptoms associated with amyotrophic lateral sclerosis (cannabinoids) (4-9)
• Chorea and certain neuropsychiatric symptoms associated with Huntington’s disease (oral cannabinoids) (4-10)
• Motor system symptoms associated with Parkinson’s disease or the levodopa-induced dyskinesia (cannabinoids) (4-11)
• Dystonia (nabilone and dronabinol) (4-12)
• Achieving abstinence in the use of addictive substances (cannabinoids) (4-16)
• Mental health outcomes in individuals with schizophrenia or schizophreniform psychosis (cannabidiol) (4-21)

Chapter 5 Conclusions—Cancer

There is moderate evidence of no statistical association between cannabis use and:

• Incidence of lung cancer (cannabis smoking) (5-1)
• Incidence of head and neck cancers (5-2)

There is limited evidence of a statistical association between cannabis smoking and:

• Non-seminoma-type testicular germ cell tumors (current, frequent, or chronic cannabis smoking) (5-3)

There is no or insufficient evidence to support or refute a statistical association between cannabis use and:

• Incidence of esophageal cancer (cannabis smoking) (5-4)
• Incidence of prostate cancer, cervical cancer, malignant gliomas, non-Hodgkin lymphoma, penile cancer, anal cancer, Kaposi’s sarcoma, or bladder cancer (5-5)
• Subsequent risk of developing acute myeloid leukemia/ acute non-lymphoblastic leukemia, acute lymphoblastic leukemia, rhabdomyosarcoma, astrocytoma, or neuroblastoma in offspring (parental cannabis use) (5-6)

Chapter 6 Conclusions—Cardiometabolic Risk

There is limited evidence of a statistical association between cannabis use and:

• The triggering of acute myocardial infarction (cannabis smoking) (6-1a)
• Ischemic stroke or subarachnoid hemorrhage (6-2)
• Decreased risk of metabolic syndrome and diabetes (6-3a)
• Increased risk of prediabetes (6-3b)

There is no evidence to support or refute a statistical association

between chronic effects of cannabis use and:

• The increased risk of acute myocardial infarction (6-1b)

Chapter 7 Conclusions—Respiratory Disease

There is substantial evidence of a statistical association between cannabis smoking and:

• Worse respiratory symptoms and more frequent chronic bronchitis episodes (long-term cannabis smoking) (7-3a)

There is moderate evidence of a statistical association between cannabis smoking and:

• Improved airway dynamics with acute use, but not with chronic use (7-1a)
• Higher forced vital capacity (FVC) (7-1b)

There is moderate evidence of a statistical association between the cessation of cannabis smoking and:

• Improvements in respiratory symptoms (7-3b)
• An increased risk of developing chronic obstructive pulmonary disease (COPD) when controlled for tobacco use (occasional cannabis smoking) (7-2a)

There is no or insufficient evidence to support or refute a statistical association between cannabis smoking and:

• Hospital admissions for COPD (7-2b)
• Asthma development or asthma exacerbation (7-4)

Chapter 8 Conclusions—Immunity

• A decrease in the production of several inflammatory cytokines in healthy individuals (8-1a)

There is limited evidence of no statistical association between cannabis use and:

• The progression of liver fibrosis or hepatic disease in individuals with viral hepatitis C (HCV) (daily cannabis use) (8-3)
• Other adverse immune cell responses in healthy individuals (cannabis smoking) (8-1b)
• Adverse effects on immune status in individuals with HIV (cannabis or dronabinol use) (8-2)
• Increased incidence of oral human papilloma virus (HPV) (regular cannabis use) (8-4)

Chapter 9 Conclusions—Injury and Death

There is substantial evidence of a statistical association between cannabis use and:

• Increased risk of motor vehicle crashes (9-3)

There is moderate evidence of a statistical association between cannabis use and:

• Increased risk of overdose injuries, including respiratory distress, among pediatric populations in U.S. states where cannabis is legal (9-4b)
• All-cause mortality (self-reported cannabis use) (9-1)
• Occupational accidents or injuries (general, nonmedical cannabis use) (9-2)
• Death due to cannabis overdose (9-4a)

Chapter 10 Conclusions—Prenatal, Perinatal, and Neonatal Exposure

There is substantial evidence of a statistical association between maternal cannabis smoking and:

• Lower birth weight of the offspring (10-2)

There is limited evidence of a statistical association between maternal cannabis smoking and:

• Pregnancy complications for the mother (10-1)
• Admission of the infant to the neonatal intensive care unit (NICU) (10-3)

There is insufficient evidence to support or refute a statistical association between maternal cannabis smoking and:

• Later outcomes in the offspring (e.g., sudden infant death syndrome, cognition/academic achievement, and later substance use) (10-4)

Chapter 11 Conclusions—Psychosocial

• The impairment in the cognitive domains of learning, memory, and attention (acute cannabis use) (11-1a)
• Impaired academic achievement and education outcomes (11-2)
• Increased rates of unemployment and/or low income (11-3)
• Impaired social functioning or engagement in developmentally appropriate social roles (11-4)

There is limited evidence of a statistical association between sustained abstinence from cannabis use and:

• Impairments in the cognitive domains of learning, memory, and attention (11-1b)

Chapter 12 Conclusions—Mental Health

• The development of schizophrenia or other psychoses, with the highest risk among the most frequent users (12-1)
• Better cognitive performance among individuals with psychotic disorders and a history of cannabis use (12-2a)
• Increased symptoms of mania and hypomania in individuals diagnosed with bipolar disorders (regular cannabis use) (12-4)
• A small increased risk for the development of depressive disorders (12-5)
• Increased incidence of suicidal ideation and suicide attempts with a higher incidence among heavier users (12-7a)
• Increased incidence of suicide completion (12-7b)
• Increased incidence of social anxiety disorder (regular cannabis use) (12-8b)
• Worsening of negative symptoms of schizophrenia (e.g., blunted affect) among individuals with psychotic disorders (12-2c)
• An increase in positive symptoms of schizophrenia (e.g., hallucinations) among individuals with psychotic disorders (12-2b)
• The likelihood of developing bipolar disorder, particularly among regular or daily users (12-3)
• The development of any type of anxiety disorder, except social anxiety disorder (12-8a)
• Increased symptoms of anxiety (near daily cannabis use) (12-9)
• Increased severity of posttraumatic stress disorder symptoms among individuals with posttraumatic stress disorder (12-11)

There is no evidence to support or refute a statistical association between cannabis use and:

• Changes in the course or symptoms of depressive disorders (12-6)
• The development of posttraumatic stress disorder (12-10)

Chapter 13 Conclusions—Problem Cannabis Use

There is substantial evidence that:

• Stimulant treatment of attention deficit hyperactivity disorder (ADHD) during adolescence is not a risk factor for the development of problem cannabis use (13-2e)
• Being male and smoking cigarettes are risk factors for the progression of cannabis use to problem cannabis use (13-2i)
• Initiating cannabis use at an earlier age is a risk factor for the development of problem cannabis use (13-2j)

There is substantial evidence of a statistical association between:

• Increases in cannabis use frequency and the progression to developing problem cannabis use (13-1)
• Being male and the severity of problem cannabis use, but the recurrence of problem cannabis use does not differ between males and females (13-3b)

There is moderate evidence that:

• Anxiety, personality disorders, and bipolar disorders are not risk factors for the development of problem cannabis use (13-2b)
• Major depressive disorder is a risk factor for the development of problem cannabis use (13-2c)
• Adolescent ADHD is not a risk factor for the development of problem cannabis use (13-2d)
• Being male is a risk factor for the development of problem cannabis use (13-2f)
• Exposure to the combined use of abused drugs is a risk factor for the development of problem cannabis use (13-2g)
• Neither alcohol nor nicotine dependence alone are risk factors for the progression from cannabis use to problem cannabis use (13-2h)
• During adolescence the frequency of cannabis use, oppositional behaviors, a younger age of first alcohol use, nicotine use, parental substance use, poor school performance, antisocial behaviors, and childhood sexual abuse are risk factors for the development of problem cannabis use (13-2k)

There is moderate evidence of a statistical association between:

• A persistence of problem cannabis use and a history of psychiatric treatment (13-3a)
• Problem cannabis use and increased severity of posttraumatic stress disorder symptoms (13-3c)

There is limited evidence that:

• Childhood anxiety and childhood depression are risk factors for the development of problem cannabis use (13-2a)

Chapter 14 Conclusions—Cannaabis Use and the Abuse of Other Substances

• The development of substance dependence and/or a substance abuse disorder for substances, including alcohol, tobacco, and other illicit drugs (14-3)
• The initiation of tobacco use (14-1)
• Changes in the rates and use patterns of other licit and illicit substances (14-2)

Chapter 15 Conclusions—Challenges and Barriers in Conducting Cannabis Research

There are several challenges and barriers in conducting cannabis and cannabinoid research, including

• There are specific regulatory barriers, including the classification of cannabis as a Schedule I substance, that impede the advancement of cannabis and cannabinoid research (15-1)
• It is often difficult for researchers to gain access to the quantity, quality, and type of cannabis product necessary to address specific research questions on the health effects of cannabis use (15-2)
• A diverse network of funders is needed to support cannabis and cannabinoid research that explores the beneficial and harmful health effects of cannabis use (15-3)
• To develop conclusive evidence for the effects of cannabis use on short- and long-term health outcomes, improvements and standardization in research methodology (including those used in controlled trials and observational studies) are needed (15-4)

Part I Introduction and Background

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Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk.

However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively.

Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agenda—outlining gaps in current knowledge and opportunities for providing additional insight into these issues—that summarizes and prioritizes pressing research needs.

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Pros and Cons of Legalizing Marijuana

The pros of legalizing marijuana, the cons of legalizing marijuana.

• Scientific Evidence

The pros and cons of legalizing marijuana are still being debated. Today, 37 U.S. states allow for the medical use of marijuana. A growing number allow recreational use.

However, as a Schedule I controlled substance, marijuana is illegal under federal law. This Drug Enforcement Administration designation means that marijuana is considered to have "no currently accepted medical use and a high potential for abuse." It also limits medical studies into the potential benefits of cannabis .

This article explains the pros and cons of legalizing marijuana, as some have argued them.

Americans overwhelmingly support the legalization of marijuana. In fact, according to the Pew Research Center, 88% of Americans support legalizing marijuana. Of those, 59% say it should be legal for medical and recreational use and 30% say it should be legal for medical reasons only.

Several possible health benefits of medical marijuana have been proposed:

• Nausea : Marijuana is effective in relieving nausea and vomiting. Studies have shown that cannabis can decrease nausea caused by chemotherapy and almost eliminate vomiting.
• Spasticity : Marijuana can relieve pain and spasticity associated with multiple sclerosis.
• Appetite : Marijuana can help treat appetite loss associated with conditions like  HIV/AIDS and certain types of cancers.
• Chronic pain : Marijuana can relieve certain types of chronic pain, including neuropathic pain, which is caused by nerve damage.

And arguments in favor of using medical marijuana include:

• It's safer : Marijuana is safer than some other medications prescribed to treat pain. For example, some people may use it instead of opioids for pain management. Opioids are highly addictive and are typically not recommended for long-term use in treating chronic pain.
• You can use it in many ways : You do not need to smoke cannabis for its benefits. Products such as cannabidiol oil (CBD), topical pain relief treatments, edibles, and other non-smoking applications are now available.
• You don't need to get high : As studies continue, researchers are finding benefits in the individual compounds in cannabis. When these chemicals are isolated—such as CBD has been—they can offer treatment options without the "high" produced by the compound commonly known as THC.
• It's natural : People have used marijuana for centuries as a natural medicinal agent with good results.

Recreational Marijuana

Marijuana is legal for recreational use in 20 states and the District of Columbia. In 20 other states, marijuana has been decriminalized. This means there are no criminal penalties in these states for minor marijuana-related offenses like possession of small amounts or cultivation for personal use.

Those who oppose the legalization of marijuana point to the health risks of the drug, including:

• Memory issues : Frequent marijuana use may seriously affect your short-term memory.
• Cognition problems : Frequent use can impair your cognitive (thinking) abilities.
• Lung damage : Smoking anything, whether it's tobacco or marijuana, can damage your lung tissue. In addition, smoking marijuana could increase the risk of lung cancer .
• Abuse : Marijuana carries a risk of abuse and addiction.
• Accidents : Marijuana use impairs driving skills and increases the risk for car collisions.

The fact that the federal government groups it in the same category as drugs like heroin, LSD, and ecstasy is reason enough to keep it illegal, some say. As Schedule I drugs are defined by having no accepted value, legalization could give users the wrong impression about where research on the drug stands.

Scientific Evidence Remains Limited

In the past, clinical trials to to determine if marijuana is effective in treating certain conditions have been restrictive and limited. However, as medical marijuana becomes more common throughout the world, researchers are doing more studies.

Expert reviews of current research continue to say more studies are needed. In addition, many hurdles involve controlling the quality and dosing of cannabis with what is legally available to researchers.

One review of research noted that the long-term effects of cannabis are still unknown. Without more research into dosage and adverse effects, scientific evidence of risks and therapeutic effects remains soft.

Researchers need to evaluate marijuana using the same standards as other medications to understand whether it is valuable for managing any conditions.

Until the federal government downgrades marijuana from a Schedule I drug, widespread clinical trials are unlikely to happen in the United States.

Medical marijuana is increasingly available in the U.S. It is often used to treat chronic pain, muscle spasms, and nausea and vomiting, and to increase appetite. However, it can affect thinking and memory, increase the risk of accidents, and smoking it may harm the lungs and lead to cancer.

More studies are needed to understand the benefits of medical marijuana. However, unless the federal government removes it as a Schedule I controlled substance, research, access, and legality will remain complicated.

A Word From Verywell

There are both benefits and risks to medical marijuana. If you're considering using marijuana medicinally, don't be afraid to talk to your doctor about it. They can help you determine whether marijuana may be the proper treatment for you.

Medical marijuana remains controversial, but it is gaining traction as a legitimate recommendation for various symptoms. Even though many states have legalized cannabis for medicinal purposes and recreational use, more research is needed.

National Conference of State Legislatures. State medical marijuana laws .

United States Drug Enforcement Administration. Drug scheduling .

Pew Research Center. Americans overwhelmingly say marijuana should be legal for recreational or medical use .

Badowski ME. A review of oral cannabinoids and medical marijuana for the treatment of chemotherapy-induced nausea and vomiting: a focus on pharmacokinetic variability and pharmacodynamics . Cancer Chemother Pharmacol. 2017;80(3):441-449. doi:10.1007/s00280-017-3387-5

Corey-Bloom J, Wolfson T, Gamst A, et al. Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial .  CMAJ . 2012;184(10):1143-1150. doi:10.1503/cmaj.110837

American Cancer Society. Marijuana and Cancer .

Hill KP. Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: A clinical review . JAMA. 2015;313(24):2474-83. doi:10.1001/jama.2015.6199

Choo EK, Feldstein Ewing SW, Lovejoy TI. Opioids out, cannabis in: Negotiating the unknowns in patient care for chronic pain . JAMA . 2016;316(17):1763-1764. doi:10.1001/jama.2016.13677

Corroon J, Sexton M, Bradley R. Indications and administration practices amongst medical cannabis healthcare providers: a cross-sectional survey . BMC Fam Pract. 2019;20(1):174. doi:10.1186/s12875-019-1059-8

Morales P, Reggio PH, Jagerovic N. An overview on medicinal chemistry of synthetic and natural derivatives of cannabidiol . Front Pharmacol . 2017;8:422. doi:10.3389/fphar.2017.00422

The Council of State Governments. State approaches to marijuana policy .

Harvard Health Publishing, Harvard Medical School. The Effects of Marijuana on your Memory .

Ghasemiesfe M, Barrow B, Leonard S, Keyhani S, Korenstein D. Association between marijuana use and risk of cancer: a systematic review and meta-analysis . JAMA Netw Open. 2019;2(11):e1916318. doi:10.1001/jamanetworkopen.2019.16318

Preuss U, Huestis M, Schneider M et al. Cannabis use and car crashes: A review . Front Psychiatry . 2021;12. doi:10.3389/fpsyt.2021.643315

Deshpande A, Mailis-Gagnon A, Zoheiry N, Lakha SF. Efficacy and adverse effects of medical marijuana for chronic noncancer pain: Systematic review of randomized controlled trials . Can Fam Physician. 2015;61(8):e372-81.

Hill KP, Palastro MD, Johnson B, Ditre JW. Cannabis and pain: a clinical review .  Cannabis Cannabinoid Res . 2017;2(1):96-104. doi:10.1089/can.2017.0017

Maida V, Daeninck PJ. A user's guide to cannabinoid therapies in oncology . Curr Oncol. 2016;23(6):398-406. doi:10.3747/co.23.3487

Meier MH, Caspi A, Cerdá M, et al. Associations between cannabis use and physical health problems in early midlife: A longitudinal comparison of persistent cannabis vs tobacco users. JAMA Psychiatry. 2016;73(7):731-40. doi:10.1001/jamapsychiatry.2016.0637

By Angela Morrow, RN Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.

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How marijuana’s reclassification could change U.S. drug policy

Amna Nawaz Amna Nawaz

Azhar Merchant Azhar Merchant

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• Copy URL https://www.pbs.org/newshour/show/how-marijuanas-reclassification-could-change-u-s-drug-policy

This month, President Biden announced the Justice Department is planning a shift in the federal approach to marijuana, reclassifying it from a Schedule I drug to Schedule III. This would put it in the same category as Tylenol and ketamine. It would classify it as a drug that has the potential for abuse but has medicinal benefits. Amna Nawaz discussed more with Natalie Fertig of Politico.

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Notice: Transcripts are machine and human generated and lightly edited for accuracy. They may contain errors.

Amna Nawaz:

This month, President Biden announced the Department of Justice is planning a historic shift in the federal approach to marijuana, reclassifying it from what's known as a Schedule I drug to Schedule III.

This would make federal treatment of marijuana far less restrictive and consider it less dangerous, putting it in the same category as Tylenol with codeine and ketamine. It would classify it as a drug that has potential for abuse, while still being acknowledged for its medicinal benefits.

The president talked about the decision in a video posted on X.

Joe Biden, President of the United States: Far too many lives have been upended because of failed approach to marijuana. And I'm committed to righting those wrongs. You have my word on it.

Joining us now is Natalie Fertig. She's federal cannabis policy reporter for Politico.

Natalie, thanks for being here.

Natalie Fertig, Federal Cannabis Policy Reporter, Politico:

Thanks for having me.

So this is the next step in a reclassification process that the president began back in 2022, right? So walk us through the timeline here. Where in that process are we now?

Natalie Fertig:

So, we just began a 60-day comment period, where the DOJ said, we have now made our formal decision. We have issued a draft rule that we're going to reschedule cannabis.

So the 60 days started last week, and now this could end five months from now or this could end six or seven years from now, depending on if there's legal challenges in that process.

OK, so still a lot we don't yet know, right?

We should note, we have seen a real sea change when it comes to cannabis legalization in America over the past decade or plus.

If you take a look at the map, some 24 states have legalized marijuana possession for adults. Some 38 states have established medical marijuana programs. So more than half of all Americans now live in states where marijuana is recreational, legal at the state level.

So what does this classification or what would this classification change in a practical way?

There's a lot of things that it would not change, actually. But the main difference that it would have is on the cannabis industry itself in the states where it is legal.

It would change the amount of taxes that they have to pay, meaning there might be more money in the cannabis industry's pocket, which means they could expand in legal states.

And what does that mean? There's some, what, 15,000 cannabis dispensaries in the country right now.

So, potential tax changes? Does it change how they interact with banks or anything else?

It's not clear exactly how the big banks will approach the change in schedule. That's one of those remain to be seen once this — all the dust settles.

But what — it would have an impact on the amount of taxes that they pay.

It's also been reported that dispensaries would have to register with the DEA, like other pharmacies would. Is that true? And how would that change the industry?

So, under Schedule III or under Schedule I, where they currently are, they need to register with the DEA. They do not currently. And so one of the other questions of rescheduling is, will the DEA start to enforce some of the rules that the cannabis industry is currently already breaking, like getting registered with the DEA?

So this is something President Biden mentioned in that video he released too, was the impact on the criminal justice system, in particular, people who have already been convicted of marijuana-related crimes.

What would this change mean for them, either retroactively or people who are currently incarcerated?

One of the biggest criticisms of Biden's rescheduling movement is that it doesn't have a big impact on people who have criminal records, especially at the state level.

The majority of people who have criminal records for cannabis are in the state criminal justice system, not in the federal criminal justice system. Biden did issue some pardons for people with low-level nonviolent marijuana offenses, but that's just a couple thousand people.

We do know the proposal needs to move through the DEA. How are they likely to look at this? Do we know if that proposal is going to move through, and when would we see that kind of approval?

Yes, so what we just saw recently was the DEA and the DOJ coming out and saying we have looked at the review that was sent to us by HHS, and we are recommending a reschedule.

People get to comment on that. There might be some legal challenges to that. And so, when the dust settles, there would need to be some big changes or big challenges for the DEA to change its mind on that. It's likely to be a reschedule. But then that reschedule is also likely to get challenged in the courts, which means in the end this might be up to the court system.

It's so fascinating too when you take a look back and you see the America in which this is all unfolding.

We can now say — there was a study published in the journal "Addiction" last month that showed marijuana use now surpasses daily alcohol consumption in the U.S. for the first time in history. And Americans have very different views when it comes to pot right now.

You look at the latest Gallup numbers from a poll last year, found some 70 percent of adults now support legalization. That is the highest number ever reported in that survey. What does your reporting tell you about the why behind all of this, why President Biden is pushing for these changes now?

Well, a big part of that sea change has come from the youngest generation. Gen Z and millennials, my generation, are much more likely to be consuming cannabis than generations before them.

And they're also much more likely to poll in favor of cannabis. And Biden is heading into a really important election right now. He's not necessarily doing as well among those voters, the younger voters, as he would like to. So there's some hope that, potentially, amongst Democrats, something like this with marijuana could push some of those voters that are skeptical or annoyed or frustrated with the president to turn out to vote in November.

We will see if it does, in fact.

Natalie Fertig, federal cannabis policy reporter for Politico, great to have you here. Thanks so much.

Thanks. Thanks for having me.

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Argumentative Essay On Marijuana Legalization

Published by gudwriter on May 27, 2018 May 27, 2018

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Why Marijuana Should be Legalized Argumentative Essay Outline

Introduction.

Thesis: Marijuana should be legalized as it is more beneficial that it may be detrimental to society.

Paragraph 1:

Marijuana has not caused turmoil in some of the countries where it has been legalized.

• Marijuana does not increase violent, and property crimes as many suggest.
• Studies reveal that in Colorado, violent crimes have declined following the legalization of marijuana.

Paragraph 2:

Prohibiting use of marijuana does not limit its consumption.

• In spite of the many laws prohibiting the use of marijuana, it is one of the most highly abused drugs.
• 58% of young people from all over the world use marijuana.
• It has not been attributed to any health complications.

Paragraph 3:

Legalization of marijuana would help state governments save taxpayers money.

• Governments spend lots of funds on law enforcement agencies that uphold laws restricting the use of marijuana.
• They also spend vast sums of money on sustaining arrested dealers and consumers in prison.
• Legalizing marijuana would result in saving vast sums of money.

Paragraph 4:

Marijuana is less noxious than other legal substances.

• Marijuana has less health side effects than other legal substances such as alcohol and tobacco.
• Alcohol is 114 times more destructive than marijuana.

Paragraph 5:

Marijuana has been proven to have medical benefits.

• Marijuana helps stop seizures in epileptic patients.
• It helps stop nausea in cancer patients undergoing chemotherapy .

Paragraph 6:

Marijuana has been proven to be a stress reliever.

• Marijuana relieves stress and depression in their users by causing excitement.
• Its use reduces violence and deaths related to stress and depression.

Conclusion.

There are many misconceptions about marijuana existent in the modern world. People have continued to ignore health benefits linked to this substance citing their unproven beliefs. Owing to its ability to stop seizures, nausea, and stress in individuals governments should highly consider marijuana legalization. Its legalization will also help state governments reduce expenses that result from maintaining suspects convicted of marijuana possession and consumption.

Why Marijuana Should be Legalized Argumentative Essay

The argument that marijuana use should be made legal has gained momentum both in the U.S. and elsewhere in the world in recent years. This has seen the drug being legalized in some states in the U.S. such that by 2013, twenty states had legalized medical marijuana. As of the same year, Colorado and Washington had legalized recreational marijuana. The arguments behind the push for legalization majorly revolve around the idea that the drug has medicinal effects. However, there are also arguments that there are serious health effects associated with the drug and this has only further fueled the already raging debate. This paper argues that marijuana should be legalized as it is more beneficial that it may be detrimental to society.

Marijuana has not caused any notable negative effects in countries where it has been legalized. There is a general belief that marijuana consumers are violent. However, no authentic research can prove these assertions. As already seen, some states in the United States have legalized both medicinal and recreational marijuana. In spite of this, no cases of marijuana-related violence have been recorded so far in such states (Markol, 2018). Reports reveal that the rate of violence and property crimes have decreased in Colorado following the legalization of the drug. If marijuana does not increase violent crimes, there is no reason as to why it should not be legalized.

It is also noteworthy that prohibiting marijuana use does not limit its consumption. Less than 10% of countries in the world prevent the use of marijuana, but according to research, 58% of young people in most of these countries are marijuana users (Head, 2016). General reports reveal that marijuana is one of most commonly abused drug in the world. It is also readily available in most states as it is a naturally growing plant (Head, 2016). In spite of its continued use, there are few cases, if any, of marijuana-related health complications that have been reported in any of these countries (Head, 2016). Therefore, if the illegality of marijuana does not limit its consumption, then state governments should consider its legalization.

Legalization of marijuana would further help state governments save taxpayers’ money. It is widely known that in countries where marijuana is illegal, authorities are stringent and will arrest any individual found in possession of the drug (Sanger, 2017). However, as earlier mentioned, laws prohibiting the use of the drug do not prevent its consumption, and this means that many people are arrested and prosecuted for possessing it (Sanger, 2017). State governments therefore use a lot of funds to support law enforcement agencies that seek to uphold laws prohibiting the use of marijuana (Sanger, 2017). Many people have been arrested and incarcerated for either possessing or consuming the drug, and the government has to use taxpayers’ money to sustain such people in prison. Since these actions do not limit consumption of marijuana, state governments should legalize the drug so as to save taxpayers money.

Another advantage of marijuana is that it is less noxious than other legal substances. According to research, marijuana is the least harmful drug among the many legal drugs existent in the world today (Owen, 2014). There are millions of campaigns every year cautioning people against smoking cigarettes, but there has been none seeking to warn people about marijuana consumption (Owen, 2014). Lobby groups have even been making efforts to push for legalization of marijuana. If marijuana had severe health effects as many purport, state governments would be investing heavily in campaigns aimed at discouraging its consumption (Owen, 2014). According to studies, alcohol, which is legal in many countries, is 114 times more harmful than marijuana (Owen, 2014). Therefore, if such harmful substances can be legalized, then there are no justifications as to why marijuana should not be legalized.

Further, marijuana has been proven to have medicinal benefits. Several countries, particularly in Europe, and the United States have legalized both medicinal and recreational marijuana. Their move to legalize marijuana was based on medical reports that showed a variety of health benefits linked to the drug (Noonan, 2017). Research shows that marijuana can reduce seizures in epileptic persons. Several studies have also proven that the drug indeed has a variety of health benefits. For instance, Charlotte Figi, who is now aged 10, used to have more than 100 seizures every month at age three, but since Colorado legalized medicinal and recreational marijuana, her parents started treating her with the substance, and today her seizures have significantly reduced (Noonan, 2017). Marijuana has as well been proven to reduce nausea in cancer patients undergoing chemotherapy. Owing to this medicinal value, state governments should consider legalizing the drug.

Additionally, marijuana has been proven to be a stress reliever. Consumption of the drug causes excitement among its users enabling them to forget about troubling situations. Unlike alcohol which is likely to aggravate stress and depression, marijuana works wonders in alleviating anxiety and depression (Sanger, 2017). There are many health and social effects associated with stress, including mental disorders and violence against others (Sanger, 2017). To avoid cases of stress-related violence and mental disorders, state governments should make marijuana consumption legal.

There are many misconceptions about marijuana in the world today. People have continued to ignore the health benefits linked with this substance and have instead focused on citing yet-to-be proven misconceptions. Owing to the ability of the drug to stop seizures, nausea, and stress in individuals, governments should seriously consider its legalization. The legalization will also help state governments reduce expenses that result from sustaining suspects convicted of marijuana possession and consumption. So far, there is more than enough evidence proving that marijuana has lots of benefits to individuals, the society, and the government, and therefore should be legalized.

Head, T. (2016). “8 reasons why marijuana should be legalized”. ThoughtCo . Retrieved June 27, 2020 from https://www.thoughtco.com/reasons-why-marijuana-should-be-legalized-721154

Markol, T. (2018). “5 reasons why marijuana should be legalized”. Marijuana Reform . Retrieved June 27, 2020 from http://marijuanareform.org/5-reasons-marijuana-legalized/

Noonan, D. (2017). “Marijuana treatment reduces severe epileptic seizures”. Scientific American . Retrieved June 27, 2020 from https://www.scientificamerican.com/article/marijuana-treatment-reduces-severe-epileptic-seizures/

Owen, P. (2014). “6 powerful reasons to legalize marijuana”. New York Times . Retrieved June 27, 2020 from https://www.alternet.org/drugs/6-powerful-reasons-new-york-times-says-end-marijuana-prohibition

Sanger, B. (2017). “10 legit reasons why weed should be legalized right now”. Herb . Retrieved June 27, 2020 from https://herb.co/marijuana/news/reasons-weed-legalized

Why Marijuana Should be Legal Essay Outline

Thesis:  Marijuana has health benefits and should thus be legal.

Benefits of Marijuana

Marijuana slows and stops the spread of cancer cells.

• Cannabidiol can turn off a gene called Id-1 and can therefore stop cancer.
• In an experiment, researchers were able to treat breast cancer cells with Cannabidiol.

Marijuana helps with pain and nausea reduction for people going through chemotherapy.

• Cancer patients undergoing chemotherapy suffer from severe pains and nausea.
• This can further complicate their health.
• Marijuana can stir up their appetite, decrease nausea, and reduce pain.

Paragraph  3:

Marijuana can control epileptic seizure.

• Marijuana extract stopped seizures in epileptic rats in ten hours.
• The seizures were controlled by the THC.

Disadvantages of Marijuana

Marijuana is addictive.

• One in ten marijuana users become addicted over time.
• If one stops using the drug abruptly, they may suffer from such withdrawal symptoms.

Marijuana use decreases mental health.

• Users suffer from memory loss and restricted blood flow to the brain.
• Users have higher chances of developing depression and schizophrenia.

Marijuana use damages the lungs more than cigarette smoking .

• Marijuana smokers inhale the smoke more deeply into their lungs and let it stay there for longer.
• The likelihood of lung cancer can be increased by this deeper, longer exposure to carcinogens.

Why Marijuana Should Be Legal

Paragraph 7:

Improved quality and safety control.

• Legalization would lead to the creation of a set of standards for safety and quality control.
• Users would know what they exactly get in exchange for the money they offer.
• There would be no risks of users taking in unknown substances mixed in marijuana.

Paragraph 8:

Marijuana has a medicinal value.

• Medical marijuana treats a wide assortment of “untreatable” diseases and conditions.
• Public health would be improved and the healthcare system would experience less of a drain.  

Paragraph 9: 

Among the major arguments against marijuana legalization is often that legalization would yield an increase in drug-impaired driving.

• This argument holds that even now when the drug is yet to be fully legalized in the country, it is a major causal factor in highway deaths, injuries, and crushes.
• It however beats logic why marijuana is illegalized on the ground that it would increase drug-impaired driving while alcohol is legal but also significantly contributes to the same problem.

Legalization of marijuana would have many benefits. The drug is associated with the treatment of many serious illnesses including the dreaded cancer. Legalization would also save users from consuming unsafe marijuana sold by unscrupulous people.

Why Marijuana Should Be Legal Essay

There is an ongoing tension between the belief that marijuana effectively treats a wide range of ailments and the argument that it has far-reaching negative health effects. There has nevertheless been a drive towards legalization of the drug in the United States with twenty nine states and the District of Columbia having legalized it for medical and recreational purposes. It was also found by a study that there is a sharp increase in the use of marijuana across the country (Kerr, Lui & Ye, 2017). Major public health concerns are being prompted by this rise. This should however not be the case because marijuana has health benefits and should thus be legal.

Marijuana slows and stops the spread of cancer cells. A study found that Cannabidiol can turn off a gene called Id-1 and can therefore stop cancer. A 2007 report by researchers at California Pacific Medical Center in San Francisco also indicated that the spread of cancer may be prevented by Cannabidiol. In their lab experiment, the researchers were able to treat breast cancer cells with this component (Nawaz, 2017). The positive outcome of the experiment showed that Id-1 expression had been significantly decreased.

Marijuana also helps with pain and nausea reduction for people going through chemotherapy. Cancer patients undergoing chemotherapy suffer from severe pains, appetite loss, vomiting, and painful nausea. This can further complicate their already deteriorating health. Marijuana can be of help here by stirring up the appetite, decreasing nausea, and reducing pain (Nawaz, 2017). There are also other cannabinoid drugs used for the same purposes as approved by the FDA.

It was additionally shown by a 2003 study that the use of marijuana can control epileptic seizure. Synthetic marijuana and marijuana extracts were given to epileptic rats by Virginia Commonwealth University’s Robert J. DeLorenzo. In about ten hours, the seizures had been stopped by the drugs (Nawaz, 2017). It was found that the seizures were controlled by the THC which bound the brain cells responsible for regulating relaxation and controlling excitability.

Some scientists claim that marijuana is addictive. According to them, one in ten marijuana users become addicted over time. They argue that if one stops using the drug abruptly, they may suffer from such withdrawal symptoms as anxiety and irritability (Barcott, 2015). However, the same argument could be applied to cigarette smoking, which is notably legal. There is need for more studies to be conducted into this claim being spread by opponents of marijuana legalization.

It is also argued that marijuana use decreases mental health. Those opposed to the legalization of recreational marijuana like to cite studies that show that users of the drug suffer from memory loss and restricted blood flow to the brain. They also argue that users have higher chances of developing depression and schizophrenia. However, these assertions have not yet been completely ascertained by science (Barcott, 2015). The claim about depression and schizophrenia is particularly not clear because researchers are not sure whether the drug triggers the conditions or it is used by smokers to alleviate the symptoms.

It is further claimed that marijuana use damages the lungs more than cigarette smoking. It is presumed that marijuana smokers inhale the smoke more deeply into their lungs and let it stay there for longer. The likelihood of lung cancer, according to this argument, can be increased by this deeper, longer exposure to carcinogens. However, the argument touches not on the frequency of use between marijuana and cigarette smokers (Barcott, 2015). It neither takes into account such alternative administration methods as edibles, tinctures, and vaporizing.

Legalization of marijuana would lead to improved quality and safety control. Purchasing the drug off the street provides end users with no means of knowing what they are exactly getting. On the other hand, legalizing it would immediately lead to the creation of a set of standards for safety and quality control (Caulkins, Kilmer & Kleiman, 2016). This would certainly work in the marijuana industry just as it is working in the tobacco and alcohol industries. Users would be able to know what they exactly get in exchange for the money they offer. Additionally, there would be no risks of users taking in unknown substances mixed in marijuana sold on the streets.

Marijuana should also be legal because it has a medicinal value. It has been proven that medical marijuana treats a wide assortment of “untreatable” diseases and conditions. These include problems due to chemotherapy, cancer, post-traumatic stress disorder, migraines, multiple sclerosis, epilepsy, and Crohn’s disease (Caulkins, Kilmer & Kleiman, 2016). Public health would be improved and the healthcare system would experience less of a drain if medical cannabis products were made available to those suffering from the mentioned conditions. Consequently, more public funds would be available for such other public service initiatives as schools and roads.

Among the major arguments against marijuana legalization is often that legalization would yield an increase in drug-impaired driving. This argument holds that even now when the drug is yet to be fully legalized in the country, it has already been cited to be a major causal factor in highway deaths, injuries, and crushes. Among the surveys those arguing along this line might cite is one that was conducted back in 2010, revealing that of the participating weekend night-time drivers, “8.6 percent tested positive for marijuana or its metabolites” (“Why We Should Not Legalize Marijuana,” 2010). It was found in yet another study that 26.9% of drivers who were being attended to at a trauma center after sustaining serious injuries tested positive for the drug (“Why We Should Not Legalize Marijuana,” 2010). It however beats logic why marijuana is illegalized on the ground that it would increase drug-impaired driving while alcohol is legal but also significantly contributes to the same problem.

As the discussion reveals, legalization of marijuana would have many benefits. The drug is associated with the treatment of many serious illnesses including the dreaded cancer. Legalization would also save users from consuming unsafe marijuana sold by unscrupulous people. There are also other health conditions that can be controlled through the drug. Arguments against its legalization based on its effects on human health also lack sufficient scientific support. It is thus only safe that the drug is legalized in all states.

Barcott, B. (2015).  Weed the people: the future of legal marijuana in America . New York, NY: Time Home Entertainment.

Caulkins, J. P., Kilmer, B., & Kleiman, M. (2016).  Marijuana legalization: what everyone needs to know . New York, NY: Oxford University Press.

Kerr, W., Lui, C., & Ye, Y. (2017). Trends and age, period and cohort effects for marijuana use prevalence in the 1984-2015 US National Alcohol Surveys.  Addiction ,  113 (3), 473-481.

Nawaz, H. (2017).  The debate between legalizing marijuana and its benefits for medical purposes: a pros and cons analysis . Munich, Germany: GRIN Verlag.

Why We Should Not Legalize Marijuana. (2010). In  CNBC . Retrieved June 25, 2020 from  https://www.cnbc.com/id/36267223 .

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More Reasons States Should Not Legalize Marijuana: Medical and Recreational Marijuana: Commentary and Review of the Literature

Recent years have seen substantial shifts in cultural attitudes towards marijuana for medical and recreational use. Potential problems with the approval, production, dispensation, route of administration, and negative health effects of medical and recreational marijuana are reviewed. Medical marijuana should be subject to the same rigorous approval process as other medications prescribed by physicians. Legalizing recreational marijuana may have negative public health effects.

Introduction

Recent years have seen a cultural shift in attitudes towards marijuana. At the time of this writing, medical marijuana is legal in 20 states and the District of Columbia; recreational marijuana is now legal in Washington and Colorado. A substantial and growing literature documents legalized marijuana may have adverse effects on individual and public health.

Medical Use of Marijuana

The term ‘medical marijuana’ implies that marijuana is like any other medication prescribed by a physician. Yet the ways in which medical marijuana has been approved, prescribed, and made available to the public are very different from other commercially available prescription drugs. These differences pose problems unrecognized by the public and by many physicians.

Lack of Evidence for Therapeutic Benefit

In the United States, commercially available drugs are subject to rigorous clinical trials to evaluate safety and efficacy. Data appraising the effectiveness of marijuana in conditions such as HIV/AIDS, epilepsy, and chemotherapy-associated vomiting is limited and often only anecdotal. 1 , 2 To date, there has been only one randomized, double-blind, placebo- and active-controlled trial evaluating the efficacy of smoked marijuana for any of its potential indications, which showed that marijuana was superior to placebo but inferior to Ondansetron in treating nausea. 3 Recent reviews by the Cochrane Collaboration find insufficient evidence to support the use of smoked marijuana for a number of potential indications, including pain related to rheumatoid arthritis, 4 dementia, 5 ataxia or tremor in multiple sclerosis, 6 and cachexia and other symptoms in HIV/AIDS. 2 This does not mean, of course, that components of marijuana do not have potential therapeutic effects to alleviate onerous symptoms of these diseases; but, given the unfavorable side effect profile of marijuana, the evidence to justify use in these conditions is still lacking.

Contamination, Concentration & Route of Administration

Unlike any other prescription drug used for medical purposes, marijuana is not subject to central regulatory oversight. It is grown in dispensaries, which, depending on the state, have regulatory standards ranging from strict to almost non-existent. The crude marijuana plant and its products may be contaminated with fungus or mold. 7 This is especially problematic for immunocompromised patients, 8 including those with HIV/AIDS or cancer. 9 Furthermore, crude marijuana contains over 60 active cannabinoids, 10 few of which are well studied. Marijuana growers often breed their plants to alter the concentrations of different chemicals compounds. For instance, the concentration of tetrahydrocannabinol (THC), the principal psychoactive ingredient, is more than 20-fold more than in marijuana products used several decades ago. Without rigorous clinical trials, we have no way of knowing which combinations of cannabinoids may be therapeutic and which may be deleterious. As marijuana dispensaries experiment by breeding out different cannabinoids in order to increase the potency of THC, there may be unanticipated negative and lasting effects for individuals who smoke these strains.

Marijuana is the only ‘medication’ that is smoked, and, while still incompletely understood, there are legitimate concerns about long-term effects of marijuana smoke on the lungs. 11 , 12 Compared with cigarette smoke, marijuana smoke can result in three times the amount of inhaled tar and four times the amount of inhaled carbon-monoxide. 13 Further, smoking marijuana has been shown to be a risk factor for lung cancer in many 14 , 15 but not all 16 studies.

High Potential for Diversion

In some states, patients are permitted to grow their own marijuana. In addition to contributing to problems such as contamination and concentration as discussed above, this practice also invites drug diversion. Patients seeking to benefit financially may bypass local regulations of production and sell home-grown marijuana at prices lower than dispensaries. We do not allow patient to grow their own opium for treatment of chronic pain; the derivatives of opium, like marijuana, are highly addictive and thus stringently regulated.

Widespread “Off-label” Use

FDA-approved forms of THC (Dronabinol) and a THC-analog (Nabilone), both available orally, already exist. Indications for these drugs are HIV/AIDS cachexia and chemotherapy-associated nausea and vomiting. Unlike smoked, crude marijuana, these medications have been subject to randomized, placebo-controlled, clinical trials. Yet despite these limited indications where marijuana compounds have a proven but modest effect in high-quality clinical trials, medical marijuana is used overwhelmingly for non-specific pain or muscle spasms. Recent data from Colorado show that 94% of patients with medical marijuana cards received them for treatment of “severe pain.” 17 Similar trends are evident in California. 18 Evidence for the benefit of marijuana in neuropathic pain is seen in many 19 - 21 but not all 22 clinical trials. There is no high-quality evidence, however, that the drug reduces non-neuropathic pain; this remains an indication for which data sufficient to justify the risks of medical marijuana is lacking. 4 , 23 – 25

If marijuana is to be ‘prescribed’ by physicians and used as a medication, it should be subject to the same rigorous approval process that other commercially available drugs undergo. Potentially therapeutic components of marijuana should be investigated, but they should only be made available to the public after adequately powered, double-blind, placebo-controlled trials have demonstrated efficacy and acceptable safety profiles. Furthermore, these compounds should be administered in a way that poses less risk than smoking and dispensed via standardized and FDA-regulated pharmacies to ensure purity and concentration. Bypassing the FDA and approving ‘medicine’ at the ballot box sets a dangerous precedent. Physicians should be discouraged from recommending medical marijuana. Alternatively, consideration can be given to prescribing FDA-approved medicines (Dronabinol or Cesamet) as the purity and concentration of these drugs are assured and their efficacy and side effect profiles have been well documented in rigorous clinical trials.

Recreational Marijuana

The question of recreational marijuana is a broader social policy consideration involving implications of the effects of legalization on international drug cartels, domestic criminal justice policy, and federal and state tax revenue in addition to public health. Yet physicians, with a responsibility for public health, are experts with a vested interest in this issue. Recent legislation, reflecting changes in the public’s attitudes towards marijuana, has permitted the recreational use of marijuana in Colorado and Washington. Unfortunately, the negative health consequences of the drug are not prominent in the debate over legalizing marijuana for recreational use. In many cases, these negative effects are more pronounced in adolescents. A compelling argument, based on these negative health effects in both adolescents and adults, can be made to abort the direction society is moving with regards to the legalization of recreational marijuana.

Myth: Marijuana is Not Addictive

A growing myth among the public is that marijuana is not an addictive substance. Data clearly show that about 10% of those who use cannabis become addicted; this number is higher among adolescents. 26 Users who seek treatment for marijuana addiction average 10 years of daily use. 27 A withdrawal syndrome has been described, consisting of anxiety, restlessness, insomnia, depression, and changes in appetite 28 and affects as many as 44% of frequent users, 29 contributing to the addictive potential of the drug. This addictive potential may be less than that of opiates; but the belief, especially among adolescents, that the drug is not addictive is misguided.

Schizophrenia and Other Psychotic Disorders

Marijuana has been consistently shown to be a risk factor for schizophrenia and other psychotic disorders. 30 – 32 The association between marijuana and schizophrenia fulfills many, but not all, of the standard criteria for the epidemiological establishment of causation, including experimental evidence, 33 , 34 temporal relationship, 35 – 38 biological gradient, 30 , 31 , 39 and biological plausibility. 40 Genetic variation may explain why marijuana use does not strongly fulfill remaining criteria, such as strength of association and specificity. 41 , 42 As these genetic variants are explored and further characterized, marijuana use may be shown to cause or precipitate schizophrenia in a genetically vulnerable population. The risk of psychotic disorder is more pronounced when marijuana is used at an earlier age. 32 , 43

There is some evidence that compounds naturally found in marijuana have therapeutic benefit for symptoms of diseases such as HIV/AIDS, multiple sclerosis, and cancer. If these compounds are to be used under the auspices of ‘medical marijuana,’ they should undergo the same rigorous approval process that other medications prescribed by physicians, including randomized, placebo- and active-controlled trials to evaluate safety and efficacy, not by popular vote or state legislature.

Effects on Cognition

Early studies suggested cognitive declines associated with marijuana (especially early and heavy use); these declines persisted long after the period of acute cannabis intoxication. 44 – 46 Recently, Meier and colleagues analyzed data from a prospective study which followed subjects from birth to age 38; their findings yielded supportive evidence that cannabis use, when begun during adolescence, was associated with cognitive impairment in multiple areas, including executive functioning, processing speed, memory, perceptual reasoning, and verbal comprehension. 47 Rogeberg 48 criticized the study’s methodology, claiming that the results were confounded by differences in socioeconomic status; this claim, however, was based on sub-analyses that used very small numbers. Additional sub-analyses 49 of the original study cohort showed that marijuana was just as prevalent in populations of higher socioeconomic status, suggesting that socioeconomic status was not a confounding variable. Any epidemiological study is subject to confounding biases and future research will be needed to clarify and quantify the relationship between cognitive decline and adolescent marijuana use. However, the findings of the original study by Meier et al show there is indeed an independent relationship between loss of intelligence and adolescent marijuana use. This finding, moreover, is consistent with prior studies. 44

Other Negative Health Effects

Substantial evidence exists suggesting that marijuana is harmful to the respiratory system. It is associated with symptoms of obstructive and inflammatory lung disease, 11 , 50 an increased risk of lung cancer, 14 , 15 and it is suspected to be associated with reduced pulmonary function in heavy users. 51 Further, its use has been associated with harmful effects to other organ systems, including the reproductive, 52 gastrointestinal, 53 and immunologic 10 , 54 systems.

Social Safety Implications: Effects on Driving

Marijuana impairs the ability to judge time, distance, and speed; it slows reaction time and reduces ability to track moving objects. 55 , 56 In many studies of drug-related motor vehicle fatalities, marijuana is the most common drug detected except for alcohol. 57 , 58 Based on post-mortem studies, Couch et al determined that marijuana was likely an impairing factor in as many fatal accidents as alcohol. 59 One study showed that in motor vehicle accidents where the driver was killed, recent marijuana use was detected in 12% of cases. 57 Other research confirms a significantly increased risk of motor vehicle fatalities in association with acute cannabis intoxication. 60

Risk Perception and Use in Adolescents

Marijuana use among adolescents has been increasing. Data that has tracked risk perception and use of marijuana among adolescents over decades clearly shows an inverse relationship; as adolescent risk perception wanes, marijuana use increases. 61 As more states legalize medical and recreational marijuana, risk perception is expected to decrease, causing the prevalence of use among adolescent to continue to rise. This is among the most concerning of issues about the drug’s legalization because so many of the negative effects of marijuana—including cognitive impairment and risk for short- and long-term psychosis— are heightened when used during adolescence.

There is some evidence that compounds naturally found in marijuana have therapeutic benefit for symptoms of diseases such as HIV/AIDS, multiple sclerosis, and cancer. If these compounds are to be used under the auspices of ‘medical marijuana,’ they should undergo the same rigorous approval process that other medications prescribed by physicians, including randomized, placebo- and active-controlled trials to evaluate safety and efficacy, not by popular vote or state legislature. Furthermore, these therapeutic compounds should be administered via a route that minimizes long-term health risk (i.e., via oral pill) and should be dispensed by centrally regulated pharmacies to ensure the purity and concentration of the drug and allow for the recall of contaminated batches.

Marijuana for recreational use will have many adverse health effects. The drug is addictive, with mounting evidence for the existence of a withdrawal syndrome. Furthermore, it has been shown to have adverse effects on mental health, intelligence (including irreversible declines in cognition), and the respiratory system. Driving while acutely intoxicated with marijuana greatly increases the risk of fatal motor vehicle collision. Legalization for recreational use may have theoretical (but still unproven) beneficial social effects regarding issues such as domestic criminal justice policy, but these effects will not come without substantial public health and social costs. Currently there is a lack of resources devoted to educating physicians about this most commonly used illicit substance. The potential benefits and significant risks associated with marijuana use should be taught in medical schools and residency programs throughout the country.

Samuel T. Wilkinson, MD, is in the Department of Psychiatry at the Yale School of Medicine, New Haven, Ct.

Contact: [email protected]

None reported.