political | 11.05.2018

What effect is cannabis legalization having on public health?

Adrian Daniel Schramm


Cannabis has been undergoing major changes in legal status as well as public opinion since before the United States was even a country.

1619: The Virginia assembly voted to require farmers to grow hemp.

1700-1900: Hemp production continues to grow.

1937: Marijuana was outlawed, and will continue to be illegal for adult use everywhere in the country until 2014, when Colorado passed Amendment 64.

Fast forward to 2018, and the pendulum is swinging toward nationwide legalization.

But what does legalization of cannabis mean for public health?

Doctors at Doctor’s For Cannabis Regulation (DFCR) argue that prohibition is actually far more detrimental to public health than legalization.

“We should have learned from the alcohol prohibition of the 1920s that you can’t legislate against something that otherwise law-abiding citizens are going to be doing anyway,” David L Nathan, MD, the president of DFCR, told MD Magazine.

Plenty of Americans are all aboard the legalization train, but widespread marijuana use is not without its downsides. According to the Centers for Disease Control and Prevention (CDC), Marijuana is the most commonly used illegal drug in the United States, with 37.6 million users in the past year. They cite various findings related to its use on their website:

Marijuana’s effects on the mind and body


1 in 10 marijuana users will become addicted.

1 in 6 users will become addicted if the user is under 18 years of age when they start.

People who are addicted to marijuana may also be at a higher risk of other negative consequences of using the drug, such as problems with attention, memory, and learning.

Brain Health

Heavy users of marijuana can have acute problems with attention, memory, and learning, which can affect relationships and mood.

When marijuana users begin using as teenagers, the drug may reduce attention, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions.

Marijuana use by mothers during pregnancy may be linked to problems with attention, memory, problem-solving skills, and behavior problems in their children.

Developing brains, which can be defined as younger than 18*, are especially susceptible to the harmful effects of marijuana. However, the impact depends on many factors and will vary from person to person.

*Brains may continue to develop into the early 20’s

Heart Health

Using marijuana makes the heart beat faster which can lead to other issues.

Marijuana is associated with increased risk of stroke and heart disease, though most of the scientific studies linking marijuana to heart attacks and strokes are based on smokers alone and don’t include those who ingest it.

It’s hard to separate the effects of the compounds in marijuana on the cardiovascular system from the hazards posed by the irritants and other chemicals contained in the smoke. More research is needed to understand the full impact of marijuana use on the circulatory system to determine if marijuana use leads to higher risk of death from these causes.

Lung Health

Smoked marijuana delivers delivers harmful substances to users and those close by, including many of the same substances found in tobacco smoke, which are harmful to the lungs and cardiovascular system.

Smoked marijuana, in any form (joints, pipes, bongs, etc.), can harm lung tissues and cause scarring and damage to small blood vessels.

Smoking marijuana can lead to a greater risk of bronchitis, cough, and phlegm production.

The known health risks of secondhand exposure to cigarette smoke raise questions about whether secondhand exposure to marijuana smoke poses similar health risks. Recent studies have shown a strong correlation between households that have one or more smokers and detectable levels of THC in the children that live in that household, suggesting that secondhand marijuana smoke could be a serious issue for children.

(Read more of our coverage on lung health here: The Relationship Between Cannabis and Lung Health)

Mental Health

Frequent marijuana use and use in high doses can cause disorientation and unpleasant thoughts or feelings of anxiety and paranoia.

Marijuana users are significantly more likely than nonusers to develop temporary psychosis (inability to distinguish reality from imagination) and long-lasting mental disorders, including schizophrenia.

Another interesting fact is that marijuana use is linked to anxiety, depression, and suicide among teens but it is entirely unclear as to whether teens with these mental problems seek out marijuana or marijuana causes these problems in teens after they become users. Further research is needed to determine the causal relationship.

However, the health risks associated with marijuana are far less than those associated with alcohol and prescription painkillers.

Legalization solves problems

One such benefit to legalization is the fact that states who legalized have experienced a drop in painkiller related deaths. Considering that opioid overdose killed 49,000 Americans last year and it is nigh impossible to kill yourself via marijuana overdose, this a huge benefit to the legalization of marijuana.

Additionally, vices like alcohol and tobacco already make tons of money for state governments and businesses and marijuana would be no different.

Despite the fact that the risks listed above will still be present if marijuana is legal, legalization has a ton of upside without any additional downside that we don’t already experience. 

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