The health risks of legalizing marijuana

A marijuana cigarette wrapper sits on dried cannabis flowers on April 30, 2024 in San Anselmo, California. The U.S. Drug Enforcement Administration has announced plans to reclassify marijuana as a less dangerous drug and designate it as a Schedule III controlled substance instead of a Schedule I drug where it is currently listed. Credit – Justin Sullivan – Getty Images

IFollowing a dramatic example of a government caving to public opinion, the Senate has introduced legislation to legalize cannabis at the federal level. While passage before the November elections is unlikely, this long-awaited legislative action seeks to update and better reflect a statute that stems (pun intended) from the demonized image of marijuana depicted in the 1936 documentary film “Reefer Madness.” of public opinion and liberal social trends. Currently, under the Federal Controlled Substances Act (CSA) of 1970, cannabis is considered to have “no accepted medical use” and a high potential for abuse and physical or psychological dependence. This federal statute stands in stark contrast to the claims of therapeutic benefits of cannabis’ biochemical constituents such as cannabidiol and THC (tetra-hydro-cannabinol), while the only FDA indication for their use is a rare seizure disorder in children (Lennox -Gasteau) is.

Although the scientific information to officially endorse cannabis products as having therapeutic benefits is lacking, a recent Pew Research Center survey found that 88 percent of Americans thought marijuana should be legal for medical or recreational use. This wave of public opinion has led to the approval of marijuana in 38 states for medical use, in 24 states for recreational use, and to decriminalization in an additional seven states.

Who could have foreseen that in less than twenty years a naturally grown recreational intoxicant, cannabis sativa, would go from demonization (ash) to mainstream, causing a tsunami of popular demand for legalization and a gold rush of commercialization fueled by 61 billion dollars? of investments. Some may see this as an impressive demonstration of social progress, while others see it as the result of reckless and ill-conceived policies that have created a confused matrix of laws and conflicting incentives based on muddled logic and incomplete knowledge.

Americans now have access to a recreational intoxicant that is demonstrably no more dangerous than alcohol or tobacco, without fear of the disproportionately harsh penalties previously imposed on those arrested for possession and use. But at the same time, there are countless inconsistencies and conflicting purposes that are integral to the legalization and commercialization of cannabis products. The most obvious of these is the fact that federal law considers the use, sale, and possession of cannabis to be illegal.

Read more: What marijuana reclassification means for the United States

The consequence of the latter was not only that the exaggerated therapeutic claims did not stem from scientific research, but that it served as a “Trojan horse” to galvanize public opinion and further the ultimate goal of unfettered access to cannabis. This came to fruition when Colorado and Washington state legislatures voted to legalize the commercial production and sale of cannabis products in 2012. This led to a stunning demonstration of states’ rights, with a majority of states following suit by liberalizing their cannabis laws despite federal action. forbidden.

The legislative conflict between federal and state laws is not ideal, but in large part it is not a serious problem because the conflict is tolerated and not enforced. More serious is the conflict that has arisen between legal reforms and public health. By pandering to public opinion and making false claims about beneficial effects, state governments expose their constituents to health hazards. These misguided policies are compounded by the fact that state governments are incentivized by the prospect of higher tax revenues.

In a glaring recent example of government missteps, Governor Kathy Hochul on March 17 declared New York State’s commercialized cannabis licensing and distribution system “a disaster” and announced “a top-to-bottom review of the NYS Cannabis Control Board and his system. for regulating legalized cannabis products.” The main goal of the review was to process applications faster and ensure that more cannabis retailers could open their doors. Just weeks before Hochul’s executive order, which was intended to give New Yorkers better access to cannabis, the American Heart Association had issued a warning about the higher risks of cardiovascular disease associated with heavy cannabis use. This was based on a National Institutes of Health (NIH)-funded study of nearly 435,000 American adults, reported last November, which found that “Daily use of cannabis –– was associated with a 25% increased risk of heart attack and 42 % increased risk of heart attacks.” of stroke compared to not taking the drug.”

Before that, the NIH issued the following warning: “Regular recreational marijuana users had higher rates of psychotic disorders than any other recreational drug. More than cocaine, methamphetamine, amphetamine, LSD, PCP or alcohol. The risk of negative mental health consequences increases approximately five times with regular use of high-potency marijuana.” High potency refers to the fact that the commercialized marijuana sold legally today is not the same naturally grown marijuana smoked by members of the counterculture.

Such health hazards are not some abstract possibility or unconfirmed scientific speculation, but a growing current reality. As a practicing psychiatrist, I have witnessed these effects firsthand, as a growing number of cannabis-induced medical and mental disorders—particularly in young people—are showing up in our hospital emergency rooms and being referred to me for consultation. And while the increasing numbers of adverse outcomes occurring as a result of legislative reform are troubling, they are not surprising. They were expected earlier.

At the beginning of the movement to liberalize access to cannabis in 2014, Roger Dupont, the founder and director of the National Institute of Drug Abuse, and I published an article in the medical journal Science predicting such adverse effects. “The debates over legalization, decriminalization, and medical use of marijuana in the United States are missing a vital piece of information: scientific evidence about the effects of marijuana on the adolescent brain,” we wrote. “Much is known about the effects of recreational drugs on the brains of adults, but no serious research has been done on the risks of marijuana use in younger users.”

Part of the argument for legalizing cannabis was that it was no more dangerous than other legal recreational intoxicants such as alcohol and tobacco. But as Kevin Sabet, National Drug Control Policy Advisor in the Bush and Obama administrations, noted in his book SmokeScreen: What the Marijuana Industry Doesn’t Want You to Know, lawmakers did not expect the commercialization of cannabis to lead to to unimaginably high potencies (with THC concentrations in some products approaching levels of up to 99.9%, compared to less than 10% in naturally grown cannabis sold on the black market).

This was revealed in an NBC News report on states that passed legislation to legalize cannabis in April 2022: “When we were voting (in 2012) we didn’t know we were voting on anything other than the plant,” says Dr. Beatriz Carlini, a research scientist at the Addictions, Drug & Alcohol Institute at the University of Washington. She has led efforts in Washington state to research high-potency marijuana and is now exploring policy options to limit access. Her team concluded in 2020 that “high-potency cannabis can have lifelong mental health consequences.”

So while the potential therapeutic value has been the leverage, tax revenues for states and profits for new industries – as a result of broad access – have clearly become the goal, with unsuspecting users as potential victims. This is the template that is now driving the rapid legalization of a host of previously banned recreational drugs, including MDMA (ecstasy) and psychedelics.

There are reasons to believe in and support the therapeutic potential and safe recreational use of cannabis. However, it is imperative that accurate knowledge resulting from research conducted with scientific rigor, objectivity, and sobriety informs the legislation and policies that will impact the lives of millions of Americans, especially young people. Until we have this knowledge, we must be prepared to temper the irrational exuberance of proponents of unrestricted recreational use and restrain commercial interests from expanding the user base and potency of cannabis products. The responsibility for this lies with the government. Governors and legislators must hold the line and not succumb to the pressure of public opinion and the lure of additional tax revenue.

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