legalization of medical marijuana essay

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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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Legalizing Medical Marijuana Argumentative Essay

• Author Kimberly Ball
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Disclaimer: This paper has been submitted by a student. This is not a sample of the work written by professional academic writers.

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Marijuana (Cannabis Sativa) gets its name from the Spanish word marihuana. The first time for marijuana to be used was in 1894, it came from hemp, an Asian herb. The leaves of the plant can be smoked to cause intoxication to the patient. Many people have fought against the legalization of marijuana for medical use since the use of the drug began to spread among the people. A lot of research shows that marijuana has a positive effect on the society in America. The great number of people who say that marijuana should not be legalized do so because they assume that it cannot have any good effects on the society. The fact is that they do this without having considered both sides of the debate. Although it is true that legalizing marijuana can be the cause of many crimes and injuries, the benefits that could come from it if it is authorized for use as medicine would outweigh those disadvantages. Marijuana can be used in curing deadly diseases and boost the country’s economy. This essay aims at persuading law makers in the United Sates to make the use of marijuana for both medical purposes legal.

Marijuana has been with us for many years. In the past, the plant’s leaves and flowering parts were used to treat physiological as well as psychological disorders- the seeds were used as food. Many people support the proposition that marijuana should be made legal for medicinal purposes. There are many reasons why these people do this. One such a reason is that marijuana has shown a high efficacy in the management of medical conditions. In the United States, 20 states have legalized the medical use of marijuana (Ferner 2012). The first retail stores for Marijuana in Colorado were opened for the sale of Marijuana to people who have attained the age of 21 years or higher. There are still other countries where the use of medical marijuana has been legalized. Canada is one such a country. Since its legalization, the Canadian Medical Association (CMA) has reported a number of testimonies showing the success of use of marijuana as medication. One testimony is that of Pariseau, a 30-yaer-old AIDS patient. Before starting using medical marijuana, Pariseau could keep neither food nor medication in his system. After he began using marijuana for medication, a report from his doctor stated “He is doing remarkably well because he can now digest his medication. The HIV has been suppressed because of his improved immune function, he has put on weight and he has learned to walk again -with a cane” (Gray, 1998).

Use of marijuana as medicine can help alleviate pain alongside other health benefits. In addition, there are no proven disadvantages that are associated with the use of marijuana as medicine (Barnes, 2017). Unlike some other drugs, marijuana used for medical purposes is not addictive. No research has ever shown that marijuana is an addictive drug- people simply use it to please themselves. Marijuana is a herbal drug that can be obtained naturally. It is considered to be very safe in managing the symptoms of various diseases and health conditions like HIV/AIDS, glaucoma, Arthritis, hepatitis C, Alzheimer’s disease and migraines as well as some psychological conditions. For a fact, doctors from both within and outside the United States have recommended the use of marijuana as medicine (Friese & Grube, 2013). Marijuana has not shown any long term effects on the cognitive processes of the individual. The only effects occur only for a short time after intoxication, but the brain is not damaged by this in any way.

The people who protest the use of marijuana for medication think of economic relief. They have brought the topic of economic relief from the legalization of marijuana many times. If we take a look at the current problems that the economy of the United Sates is facing, we realize that legalizing medical marijuana has the potential to help boost our economy. Since many Americans will now be free to use the herb, it is likely to funnel money into our economy. The history of the United States has seen similar incidences before. In the prohibition, the bootleggers issue resembles the one on marijuana. At that time, when the government lifted the ban on alcohol, more money came back into the economy. Although the use of marijuana should be legalized, it goes without saying that the use of marijuana needs to be regulated. Just like on cigarettes and alcohol, laws should be made to regulate the use of marijuana once it is made legal for medical use. (smokers should not operate machines). Also, smoking at the place of work should call for firing just like drinking would. Though the feelings of people on this subject are mixed, quite a large number of people believe that marijuana is harmless. The legislators should look at the fact that marijuana makes one to be relaxed and less motivated. This would somehow link to the effect that it would have on the workforce and businesses in general. Lawmakers have to make laws that will govern how businesses that plan to sell only marijuana should operate- they have to determine its use and how much the business owner is going to be taxed for selling marijuana.

The natural herb could generate a lot of money for the economy if the right infrastructure were laid down showing how the drug should be used. Therefore, lawmakers should regulate the use and the sales of the drug. Legalizing marijuana at the federal level would give a large new stream of revenue. Although it may not be possible to know the size of the market for marijuana now and what may happen to the demand and the price for the drug under different legalization levels, we know that the legalization can cause a positive effect on the revenue income and the tax from sales (Ferner, 2012).

The economic benefits of marijuana legalization are not only from taxes- both the local and state governments would save a lot of money that is being spend currently on the regulation of the use of marijuana. Colorado and Washington states (which have made it legal to use marijuana for medical purposes) will serve as the testers for the other states when it comes to the possible positive effect on the economy of the whole country if all the states make it legal to use marijuana in treatment of diseases. It is estimated that Washington will generate up to $1.9 billion in a period of five years because it made marijuana legal. Marijuana legalization, nonetheless, should be made for use as medication and also be allowed for sale in retail shops so that if one person needs to use this medication but cannot get it from the hospital because it is so expensive there that they cannot afford it, they can obtain cheaper options from the dealers and stores to manage their conditions.

Although there are states that have legalized the use of marijuana as medication and have allowed people who possess the permit to sell it to the public, the laws that allow for this in such states have been ruled out by the federal government as being unconstitutional and therefore illegal. Majority of the people in America favor the use of marijuana for medical purposes and have expresses their support by voting. However, the Drug Enforcement Administration still can arrest and impose charges on any people who are aught trading in this substance in accordance with the act that deals with controlled substances (CSA). The laws that are in place in the United States are not in support of the demands of the people. This shows that more people are involved in the use of marijuana than the records show. The problem therefore comes in that while the substance is being sold and used all over the country, nothing comes from it in terms of income tax to help in boosting the economy of the country.

Just like all controversial topics, there are opponents. The first point presented by the opponents is that when smoked, marijuana causes a number of side effects- stunted growth and cancer. However, smoking is not the only way in which marijuana can be taken, one can take it orally or intravenously. These methods of administration will get rid of the problems associated with smoking the drug. Another claim they make is that despite being natural, hemp has harmful chemicals that can damage the user. They claim that THC that is contained in marijuana is harmful to the body. They favor the use of Marinol which also contains THC. In addition, technology can be used to separate the compounds present in the plant, it can also be used to remove he chemicals that are toxic and breed plants that do not have the chemical.

The opponents also claim that the use of marijuana also results in abstinent effects. Although Renard, Krebs, Le Pen & Jayin their 2014 study that there are some short-term effects on adolescents that are associated with marijuana, other later studies contradict this. These studies claim that no clearly defined relationship has been found between the use of marijuana and rates of addiction. According to drugabuse.gov, the use of marijuana does not cause the individual to use other drugs and there are very few withdrawal symptoms associated with marijuana. It is therefore evident that the claims of the opponents are not based on facts and therefore they are not valid.

It does not seem reasonable that an herb that has been used by people since time immemorial because of its medicinal value has been made legal in the past few years just because of the people who have used it as a narcotic to harm their bodies. It is true to say that marijuana is not abused as much as other opium-derived drugs that are legal like ketamine and oxycodone. It is therefore unfair that marijuana, which is more valuable as medicine, is illegal while these other drugs are legal and are sold all over the country freely.

In conclusion, Marijuana is a very efficacious drug for medical use and therefore it needs to be legalized. We should stop grouping marijuana, a useful drug, with narcotics such as heroin and cocaine, it should instead be grouped together with other drugs that are used for the management of serious health conditions such as Adderall. Legalizing marijuana will boost the economy of our country by creating jobs to thousands of people in the United Sates who would otherwise be economically unproductive. My research shows that the positive effects of legalizing marijuana by far outweigh the negative impacts that could arise. Besides boosting the economy and keeping it strong, it can be used to manage health conditions that have previously been difficult to manage. Whether it is made legal or it remains illegal, people will still use it. Research has shown that the illegal drug whose use is commonest is marijuana. All the fifty states in the United States of America should legalize marijuana to help out people who are struggling with medical conditions that can seriously damage their health if not treated and which can be managed effectively by the use of marijuana. Marijuana can replace many things that are harmful to the environment and thus help to save the environment. There would be a tremendous decrease in violence and crime. Although a lot of people think that marijuana is harmful, I believe it can really help our society in this time of need.

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THREE ESSAYS ON THE EFFECT OF LEGALIZING MARIJUANA ON HEALTH, EDUCATION, AND SOCIAL SECURITY

The legalization of marijuana has emerged as a critical public policy issue, with far-reaching implications for health, education, and government programs at both the state and federal levels. The three essays of this dissertation show that medical marijuana legalization (MML) has a negative effect in each of these areas. The first essay shows, that the enactment of MMLs can exacerbate the crisis of overdose deaths in the United States. The study analyzes three key areas: the rate of overdose deaths caused by both legal and illegal drugs, the impact of MML on social norms regarding the perceived harm of marijuana, and an investigation into the gateway theory by examining the use of other addictive drugs. I find that MMLs increase deaths attributed to overdose by 21.5% population. MMLs s also indicate increase the number of deaths due to prescribed opioids by 44.6%, and deaths from all opioids (heroin and cocaine in addition to prescribed opioids) by 37.2 % Results suggest an overall increase in the use of marijuana, primarily due to lower perceived risk among adolescents. Additionally, results show an increase in hospital admissions due to substance abuse. The analysis suggests that legalizing medical marijuana may exaggerate the current problem of drug overdose in the United States. The second essay examines the impact of improved access to medical marijuana, measured by the proximity of schools to the nearest dispensary, on the academic performance of high school students in California. Students in schools farther from a marijuana dispensary have higher academic performance as measured through AP, ACT, SAT scores, and average GPA, and lower number of suspensions due to violence and illicit drug use. To show this, I construct the first geocoded dataset on marijuana dispensary and high school locations, use newly developed difference-in-differences estimators that rule out any bias due to heterogeneous treatment effects over time, and explore dynamic responses. This essay reveals the importance of ensuring a largest possible distance between schools and dispensaries to protect adolescents from the potential harm caused by medical marijuana. Finally, the third essay shows that in the long term, MMLs increase the number of disabled workers who receive Social Security Disability Income (SSDI) because of mental health issues. SSDI is a major social insurance program that provides benefits to workers who become disabled, and understanding how policy changes in other areas may impact this program is important. In this study, there were important differences between the results of a two-way fixed effects model and a new model by Callaway and Santa’Anna. MMLs, in theory, could either increase or decrease the number of SSDI recipients, and traditional fixed effects models suggest both could be at play; however, only the negative effect is robust to correction for heterogeneous effects. This highlights the need for future research to understand the true impact of medical marijuana legalization

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• Health economics
• Welfare economics
• Epidemiology
• Health policy
• Public policy
• Medical and health law

2018 Theses Doctoral

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.

• Cannabis--Law and legislation
• Marijuana industry
• Drug legalization
• Drugs--Economic aspects

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How To Write an Essay About Marijuana Legalization

Introduction to marijuana legalization.

When embarking on an essay about marijuana legalization, it's crucial to begin with a comprehensive overview of the topic. Marijuana legalization is a multifaceted issue that encompasses legal, medical, social, and economic dimensions. Your introduction should briefly touch upon the history of marijuana use and its legal status over time, setting the stage for a deeper exploration of the arguments for and against legalization. Establish your thesis statement, outlining the specific aspect of marijuana legalization you will focus on, whether it's the potential medical benefits, the social implications, or the economic impact of legalizing marijuana.

Examining the Arguments for Legalization

In this section, delve into the arguments commonly made in favor of legalizing marijuana. These arguments often include the potential medical benefits of marijuana, such as its use in pain management and treatment of certain medical conditions. Discuss the viewpoint that legalization could lead to better regulation and quality control of the substance, as well as potentially reduce crime rates related to illegal drug trade. It's also important to consider the economic aspect, such as the revenue generated from taxing legal marijuana sales. Provide well-researched evidence and examples to support these arguments, ensuring that your essay presents a balanced and informed perspective.

Exploring the Counterarguments

Next, address the arguments against marijuana legalization. These may include concerns about the health risks associated with marijuana use, such as potential impacts on mental health and cognitive function, especially among young people. Discuss the fears that legalization might lead to increased usage rates, particularly in adolescents, and the potential for marijuana to act as a gateway drug. There's also the argument regarding the challenges of enforcing regulations and controlling the quality and distribution of legal marijuana. Like the previous section, ensure that you present these counterarguments with supporting evidence and a fair analysis, demonstrating an understanding of the complexities of the issue.

Concluding the Essay

Conclude your essay by summarizing the main points from both sides of the argument. This is your opportunity to reinforce your thesis and provide a final analysis of the issue based on the evidence presented. Reflect on the potential future of marijuana legalization, considering the current trends and policy changes. A well-crafted conclusion should provide closure to your essay and encourage the reader to continue contemplating the nuanced aspects of marijuana legalization. Your concluding remarks might also suggest areas for further research or consideration, underscoring the ongoing nature of the debate surrounding marijuana legalization.

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Introduction

Medical benefits, social attitude towards legalization of marijuana, disadvantages of legalization of marijuana, works cited.

The issue of Marijuana legalization has long been a very debatable topic for discussion among the governmental institutions and different social layers. It has to be noticed that the legalization of Cannabis sativa is a very controversial topic that may arouse arguing opinions. However, marijuana has been known for centuries to help the medical care procedures. For instance, ancient Chinese writings have cannabis’ medical use recorded back in 2700 BC. Contemporary perception of Marijuana has altered with the span of time and use of it as a drug. Unfortunately, the understanding and application of cannabis has altered and now it is taken as a dramatic damage to society, which is definitely partially true. Nevertheless, it has to be mentioned that legalization of marijuana could have dragged much more beneficial and prolific results for the government and medicine, respectively. The government can earn money from taxes on cannabis’ sale and the medicine get much more benefit that outweighs its abuse outcomes. So, legalization should be regarded as a plan for action despite the claims of organizations that consider legalization to cause drug crimes rates’ increase.

Cannabis originates from South and Central Asia. This is one of those significant plants that have several forms to be distributed in. Unprocessed, it comes in form of dried leaves; processed, it is kief – the powder sifted from flowers and leaves. “It is rich in trichomes and is consumed in its powder form” (Rose 73). When compressed it is used to make balls of hashish, which can be chewed or smoked. Marijuana users usually smoke resin at times when cannabis is not available (Marshall 126). The ancient Assyrians were the first to smoke marijuana. In the United States it is used illegally. There are furious debates over its harmful and useful features, both of which have significantly outweighed each other. Overall, people continue to use marijuana illegally despite its prohibition and the harsh laws that have been laid by various governments against its use (Marshall 128).

For many decades it has been deemed that legalization can have seriously terrible consequences. However, people forget that governmental prohibition acts in the beginning of 1900s caused the actual drug abuse and turning decent and loyal citizens into lawbreakers. So, this is a very debatable topic: whether it is marijuana abuse that was first or the governmental prohibition law in 1919. It has to be noticed that marijuana unlike cigarettes and alcohol is no as harmful as people are used to think. Moreover, the role of the government in forming such a dreadful opinion about marijuana is underestimated. Statistics shows that there are many more car accidents (hence lethal outcomes) because of alcohol than there are caused by hemp. In fact, marijuana is the safest therapeutically active medical substance humanity has ever known. Therefore, marijuana could be safely used in medical treatment though with supervised directions. Within the debates over marijuana abuse, it has to be mentioned for the sake of justice that there are over 400,000 deaths from alcohol poisoning in the United States annually. So, it is hard to determine if the Government gains anything from prohibitions of marijuana. Besides, the government has no right to dictate when one should give up his her own freedom (Marshall 127). The pros and cons of consuming alcohol need to be discussed here, therefore. Heavy drinkers are likely to be helpless when drunk, they will probably need someone to take them home because the Central Nervous System gets frustrated and a person cannot walk. However, the extreme amount of smoking marijuana puts a person to sleep, nothing more. Of course, this debate may lead to discussing the following circumstances and being asleep while driving is a bad thing, too because it can cause death as well as alcohol does. However, compare and contrast of alcohol vs. marijuana is brought up to show unconditional direct consequences the person undergoes. Namely, alcohol poisons your liver and kills you, while marijuana does neither of such impacts. Marijuana is not completely healthy, of course. “The only well confirmed negative effect of marijuana is caused by the smoke, which contains three times more tars and five times more carbon monoxide than tobacco. But even the heaviest marijuana smokers rarely use as much as an average tobacco smoker” (Grinspoon 179).

Contemporary medicine has gone very far and it is much more advanced today than it used to be several decades ago. However, there are those cases in medicine that desperately need the use of marijuana for treatment. For example, it does reduce nausea when a cancer patient takes up chemotherapy. Marijuana is used to treat patients with AIDS and sclerosis. The medical effect of marijuana is significant on patients with glaucoma – it lowers down the eye pressure. Therefore, if the government of the United States took action today, we would see the results immediately. The patients with different illnesses ranging from manic depression to Multiple Sclerosis will feel better. Once marijuana is legalized, it may become the most useful thing on the planet and the government could have got lots of money from taxes into the state’s budget.

Of course, people who have never consumed marijuana are frightened at the possibility to have marijuana legalized. They are scared because it has been announced that marijuana users are criminals and unworthy people. “For instance all forms of violence are associated with drug use, family break up and children negligence” (Katel 123). The listed above consequences are regarded as the result of marijuana and other drugs’ abuse. However, as it was mentioned before many people have no other choice than become the criminals because of the law that does not allow buying marijuana freely. That is why the society undergoes dreadful results of hypnotism that marijuana brings only grief and destruction. Unfortunately, majority of people do not understand how destructive other forms of addictions may be for the society, whereas marijuana is the mean to make patients’ lives easier. Moreover, the mass opinion of the United States citizens about marijuana usage influences the overall adaptation of the legalization since we live in the democratic society, although nobody pays attention that this very opinion has been initially formed by the actual government. Therefore, according to the societal views, there is practically no chance to exercise new social politics as per the usage of marijuana. Thus, this is a very slight chance for the medical branch to use marijuana legally and give an opportunity to earn on taxes and hence invest back in medicine. Unfortunately, this alternative was not voiced widely to people and not everyone is aware of this opportunity. Namely, very few people understand that legalization of marijuana will lead to reforms in medical treatment, hence overall economical changes for better, and ultimately the actual social and medical level upraise.

Marijuana’s medicamentous advantages are evident. For example, researchers suggest that numerous medicinal properties of marijuana protect the body against a number of malignant tumors. Cannabis has also proved to be beneficial to a gamut of conditions ranging from depression to multiple sclerosis (Asenjo 112). However, there is a definite opposition to all of the advantages that cannabis offers – the societal changes that may result from marijuana’s legalization. Since it will become available to everyone, more addicts will appear, given that marijuana is an addictive dug. Thus, more people will get addict and more of the population of the United States will become unable to carry out aware and mature decisions as per the social behavior. This way, the society can be changed and perhaps not for better. However, this issue may be immediately argued with the help of the right for freedom of speech. America is a free country with the freedom of choice and the freedom of speech; thereby authorities take this right away by not letting the choice to appear.

Legalization of marijuana has long been a very debatable issue among political authorities and the US nation overall. It is evident that medical treatment with the use of marijuana would be beneficial for both: patients and the government because of the opportunity to earn on taxation. This, in its turn, will suppose the government to invest money elsewhere including the medical sphere. So, ultimately the government not only reduces the rate of crimes and levels up budget amount, it is also a very good opportunity to show people marijuana is not a threat, rather it is a way out of economical and moral crisis.

Asenjo, Bill. Marijuana, Ed. Jacqueline L. Longe. Vol 3 . 2nd Ed. Detroit: Gale, 2006. Print.

Grinspoon, Lester. Marihuana: The Forbidden Medicine. New Heaven: Yale University Press, 1997. Print.

Katel, Peter. “Legalizing Marijuana. Should Not Be Treated Like Alcohol and Taxed?” The CQ Researcher , 2009. Web.

Marshall, Patrick. “Marijuana Laws, Should state and federal marijuana laws be reformed?” The CQ Researcher 15. (2005): 125-148.

Rose, Kenneth. Prohibiting and Temperance . Detroit: Charles Scribner’s Son, 2004. Print.

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IvyPanda. (2022, April 25). Pros and Cons of Legalization of Medical Marijuana. https://ivypanda.com/essays/the-legalization-of-medical-marijuana/

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IvyPanda . 2022. "Pros and Cons of Legalization of Medical Marijuana." April 25, 2022. https://ivypanda.com/essays/the-legalization-of-medical-marijuana/.

1. IvyPanda . "Pros and Cons of Legalization of Medical Marijuana." April 25, 2022. https://ivypanda.com/essays/the-legalization-of-medical-marijuana/.

Bibliography

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ENACT: The Educational Network for Active Civic Transformation

The ethics of legalizing medical marijuana.

Ethical Inquiry is a monthly series that examines ethical questions, highlighting a broad array of opinion from journalism, academia and advocacy organizations. Our intent is to illuminate and explore the complexity of some of the most vexing ethical questions of our time.

In this installment of “Ethical Inquiry” inquiry we explore the ethical implications of legalizing medical marijuana.

Impact on Health

The movement toward legalization of marijuana for medical purposes is based in part on the belief that the substance has beneficial medical effects. But there is debate on this point.

The debate over legalizing medical marijuana centers squarely on the definition of a Schedule I drug and whether cannabis should still be considered as such. According to the Controlled Substances Act , passed by Congress and signed into law by President Nixon in 1970, a Schedule I drug has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and lacks acceptable safety for use under medical supervision.

Marijuana was included in the “Hallucinogenic Substances” category as a Schedule I substance, so the sale, purchase, or consumption of marijuana became illegal. Thus the legal status of medical marijuana is determined by whether or not it has an “accepted medical use in treatment in the United States.”

The California Medical Association suggests marijuana could play a role in treatment of serious medical conditions.

In 2011, the California Medical Association (CMA) Council on Scientific and Clinical Affairs issued a set of recommendations for the use of marijuana for medicinal purposes. Pursuant to California law, a doctor may prescribe marijuana for patients suffering from AIDS, anorexia, arthritis, cancer, migraine headaches, seizures, severe nausea, glaucoma, and chronic pain.

While the CMA declares the evidence supporting the medical value of marijuana is inconclusive, they assert that marijuana is most efficacious when used to manage neuropathic pain, a form of “severe and often chronic pain resulting from nerve injury, disease, or toxicity,” and can be used effectively for “analgesia, appetite stimulation and cachexia; nausea and vomiting following chemotherapy; neurological and movement disorders, and glaucoma.”

The CMA asserts that there is plenty of anecdotal evidence to buttress the case of medical marijuana.

Popular singer/songwriter Melissa Etheridge famously discussed her own use of marijuana to “relieve the nausea, [and] relieve the pain” caused by chemotherapy treatment for her breast cancer. According to Etheridge, the marijuana was not addictive, nor did it create a high for her. Rather, it allowed her to “get out of bed” and “go see [her] kid.”

However the California Medical Association also cautions that there is a dearth of research in this field and that more conclusive evidence will require more data.

The American College of Physicians also suggests that more research is needed. In a position paper calling for the support of programs and funding for the research of potential therapeutic benefits of medical marijuana lead researcher Tia Taylor contends that there are many medical benefits of marijuana use. However, Taylor states that there is little evidence to support this because of the classification of marijuana as a Schedule I drug. According to Taylor, with the reclassification of marijuana, and greater research into its therapeutic benefits, scientists and doctors will be able to better analyze the benefits and harmful side effects of marijuana use.

The research already available regarding the potential medical uses of marijuana has found that:

Both oral and smoked marijuana stimulate appetite, increase caloric intake, and result in weight gain among patients experiencing HIV wasting.

Marijuana has been shown to have neuroprotective properties and to reduce high intraocular pressure, pupil restriction, and conjunctival hyperemia, all of which results in glaucoma.

Smoked marijuana provides relief of spasticity, pain, and tremor in some patients with multiple sclerosis (MS), spinal cord injuries, or other trauma.

According to this research, many of the negative side effects of marijuana — including increased risk of cancer, lung damage, bacterial pneumonia, poor pregnancy, among others — can be removed if marijuana is administered via methods other than smoking. For instance, Sativex, an oromucosal spray of natural cannabis, was approved in June 2006 for prescription use in Canada to treat neuropathic pain in patients with multiple sclerosis. The vaporization of marijuana provides the same therapeutic benefits of smoked marijuana without the negative consequences of administering marijuana via smoking.

Though the California Medical Association issued recommendations for the use of medical marijuana, the CMA references multiple health risks associated with marijuana use.

Addiction: 9% of adult marijuana users are addicted; this risk is heightened if the individual began marijuana use before age 18.

Short Term Cognitive Effects: intoxication causes impairments of memory, sense of time, sensory perception, attention span, problem solving, verbal fluency, reaction time, and psychomotor control.

Long Term Cognitive Effects: loss in the ability to learn and remember new information.

Adolescents and Young Adults: have greater vulnerability to the toxic effects of marijuana on the brain, at increased risk of addiction, at risk of developing mental illness, and at risk of performing more poorly at school and work.

Psychiatric Conditions: marijuana can cause transient mood, anxiety, schizophrenia.

Obstructive Lung Disease: increased risk of chronic obstructive pulmonary disease (COPD).

Reproductive Risks: marijuana use during pregnancy is associated with developmental delay and behavioral problems.

The American Cancer Society (ACS) concludes in a position paper on the medical use of marijuana, that marijuana delivers harmful substances to the body, similar to many of the cancer-causing substances found in tobacco smoke.

However, the American Cancer Society also states that marijuana can treat patients suffering from pain in ways that traditional medicine fails at doing. The ACS states that marijuana has potential to treat those suffering from pain, nausea, vomiting, poor appetite, and AIDS. According to their position paper on marijuana, “the ACS is supportive of more research into the benefits of cannabinoids. Better and more effective treatments are needed to overcome the side effects of cancer and its treatment. [However], the ACS does not advocate the use of inhaled marijuana or the legalization of marijuana.”

Some opponents contend that there will be negative impacts on health because medical marijuana will be [more easily accessible and therefore more] abused. In a letter to the editor of the Denver Post, Dr. Christian Thurstone, the director of an adolescent substance abuse treatment program, recounts a story about the ability of a 19-year-old he was treating for severe addiction to easily procure marijuana under the guise of medical need:

"He recently showed up at my clinic with a medical marijuana license. How did he get it? He paid $300 for a brief visit with another doctor to discuss his 'depression.' The doctor took a cursory medical history that certainly didn’t involve contacting me. The teenager walked out with the paperwork needed not only for a license to smoke it, but also for a license permitting a 'caregiver' to grow up to six marijuana plants for him. My patient, who had quit using addictive substances after a near-death experience, is back to smoking marijuana daily, along with his caregiver. However, because of the classification of marijuana as a Schedule I drug, little research has been done to prove definitively that the use of marijuana for medical purposes has no value."

Unintended Consequences ... And Incidental Benefits?

Whatever the medical benefits or harms of marijuana, there is also discussion of unintended consequences — both good and bad — of legalizing marijuana for medical use.

In Colorado, more than a dozen young children have been unintentionally poisoned with marijuana as a result of children consuming marijuana-laced cookies, brownies, sodas, and candy, according to researcher Dr. George Sam Wang of the Rocky Mountain Poison and Drug Center in Denver. Because of the perceived stigma attached to the use of marijuana, many parents are unwilling to report its use to health care providers when questioned regarding the child’s poisoning. Before the legalization of medical marijuana in Colorado, there were no reported instances of children being poisoned with the drug.

Some are concerned that legalization of medical marijuana will lead to wider acceptance of illegal drugs, that marijuana will serve as a “gateway” to other drugs.

According to a report published by the Yale Medical School, frequent marijuana use among young adults significantly increases the risk of greater involvement with other illegal drugs.

Further, another study performed by the Yale Medical School found that adolescents who use marijuana are at a greater risk for subsequent abuse of prescription opioids, more commonly known as pain killers.

Others hope that legalization of medical marijuana will lead to general legalization of marijuana. In November 2012 Colorado, a state that had legalized the medical use of marijuana, became one of the first states in the nation — together with Washington — to legalize the recreational use of marijuana .

However, this puts these states in direct contradiction to federal drug laws, and will ultimately depend on the federal government’s level of enforcement of current drug laws. In Colorado, and in the other states that permit the use of medical marijuana, the federal government has largely left its medical marijuana practice alone. In 2009, the Department of Justice issued a memorandum to the states that allow the use of marijuana for medicinal purposes indicating that the federal government would not interfere in their states’ marijuana policies (pdf) .

Though not a case of direct harm to individuals using marijuana for medical purposes, a recent New York Times article, “Marijuana Crops in California Threaten Forests and Wildlife” reports that the cultivation of marijuana in California, a state where medical marijuana is legal, has led to the death of weasels, spotted owls, among other animals. Mourad Gabriel, a scientist from the University of California at Davis found that the contamination of the local environment originated with marijuana growers in deep forests spreading d-Con rat poison to protect their plants from wood rats. The growing of marijuana for medical purposes in California has also resulted in the leveling of hilltops, landslides caused by bulldozers, severe logging, clogging of streams with dislodged soil, and the decimation of streams caused by the sapping of the local water supply.

However, the San Francisco Bay Guardian found that moving the cultivation of marijuana from indoors to outdoors would help reduce the carbon footprint of marijuana cultivation. This would require less strict laws governing the production of marijuana and would happen only if marijuana be decriminalized or legalized. At present, “indoor pot production accounts for about 8 percent of California household energy use, costing about $3 billion annually and producing about 4 millions tons of greenhouse gases each year, the equivalent of 1 million automobiles.” Proponents of marijuana argue that a simple solution to this is to grow the plant outdoors, thereby reducing the carbon footprint of marijuana cultivation and lessening the detrimental impact on the environment.

Ethical And Religious Considerations

There is a debate based on issues other than pure medical effects of marijuana. Many individuals champion their own ethical or religious reasons for supporting or opposing the use of medical marijuana.

Bob Enyart, the pastor of the Denver Bible Church, makes a theological case opposing the use of marijuana, writing in the Huffington Post “It's wrong to get high. For in doing so you reject the counsel of the God who made you. And by intoxication you lose what should be a full control of your mental and moral faculties. You become a threat to yourself and a risk to those around you.” Here, the pastor makes a case in opposing any sort of drug that alters one’s brain chemistry, as that loss of control over thought in itself is contrary to the wishes of God.

Meanwhile, the American Civil Liberties Union issued a report (pdf) in June 2013 bemoaning the racial prejudice in arrests for possession of marijuana. According to the study, blacks are 3.73 times more likely than whites to be arrested for marijuana possession, even though blacks and whites use marijuana at comparable rates. To combat this discrepancy, the ACLU recommends the legalization of marijuana use and possession, basing its finding on the inequality that persists in the prosecution of individuals who use marijuana.

Political Questions

The debate over legalization of medical marijuana has a political dimension as well. The trajectory of public opinion trends towards greater acceptance for the use of marijuana, while most politicians, including the president continue to oppose the legalization of medical marijuana.

The White House’s Office of National Drug Control Policy continues to oppose the use of marijuana. According to the White House’s website, the Obama administration opposes marijuana because of its addictive properties, the chemicals inside it that change brain chemistry, its use resulting in respiratory and mental illness, among many other reasons. While the administration opposes the legalization of marijuana, it joins “major medical societies in supporting increased research into marijuana’s many components, delivered in a safe (non-smoked) manner, in the hopes that they can be available for medical professionals to legally prescribe if proven safe and effective.” This ultimately leaves the White House open to the use of medical marijuana, once they deem it haven been proven safe for medical use.

While the White House and most politicians continue to oppose the use of marijuana, the vast majority of Americans (77%) believe that doctors should be allowed to prescribe marijuana for serious illnesses.

However, full legalization of marijuana enjoys less public support, with a slight majority of Americans (52%) supporting marijuana legalization. Public support for marijuana legalization has grown in recent years, as “most Americans no longer see marijuana as a ‘gateway’ to more dangerous drugs, and most no longer see its use as immoral.” Moreover, most Americans believe that the federal government’s enforcement of its marijuana policies “cost more than they are worth.”

International Perspective

There are other countries that have liberalized marijuana policies. For example , in Peru “individuals are allowed up to 8 grams of cannabis in their possession as long as they don’t possess another drug,” and in Argentina the Supreme Court “legalized the private use of marijuana in small amounts, ruling that it would be ‘unconstitutional’ to ban it.”

In Portugal, the use of marijuana among youth actually fell between 2002 and 2006 after the country legalized marijuana in 2001. In addition to the decline in drug use , there was a subsequent reduction in drug deaths, and a lower prevalence of drug use in Portugal than in other European countries.

Final Thoughts

In recent years, the legal landscape in the United States regarding medical marijuana has shifted considerably, but the question of whether legalization is the right path is far from settled. Do detrimental effects outweigh therapeutic benefits? Are there nonmedical factors that justify one approach or another? How should competing concerns be reconciled?

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Six policy lessons relevant to cannabis legalization

Chelsea l. shover.

Stanford University, Palo Alto, California

Keith Humphreys

Veterans Affairs Health Care System and Stanford University, Palo Alto, California

Background:

Cannabis (marijuana) has been legalized for recreational and/or medicinal use in many U.S. states, despite remaining a Schedule-I drug at the federal level. As legalization regimes are established in multiple countries, public health professionals should leverage decades of knowledge from other policy areas (e.g., alcohol and tobacco regulation) to inform cannabis policy.

Objectives:

Identify policy lessons from other more established policy areas that can inform cannabis policy in the U.S., Canada, and any other nations that legalize recreational cannabis.

Narrative review of policy and public health literature.

We identified six key lessons to guide cannabis policy. To avoid the harms of “a medical system only in name”, medical cannabis programs should either be regulated like medicine or combined with the recreational market. Capping potency of cannabis products can reduce the harms of the drug, including addiction. Pricing policies that promote public health may include minimum unit pricing or taxation by weight. Protecting science and public health from corporate interest can prevent the scenarios we have seen with soda and tobacco lobbies funding studies to report favorable results about their products. Legalizing states can go beyond reducing possession arrests (which can be accomplished without legalization) by expunging prior criminal records of cannabis-related convictions. Finally, facilitating rigorous research can differentiate truth from positive and negative hype about cannabis’ effects.

Conclusion:

Scientists and policymakers can learn from the successes and failures of alcohol and tobacco policy to regulate cannabis products, thereby mitigating old harms of cannabis prohibition while reducing new harms from legalization.

Introduction

The normative debate about whether governments should legalize medical and/or recreational cannabis (aka “marijuana”) remains high profile and vitriolic in multiple countries, and because of its political nature can at most be only partially informed by science ( 1 ). However, a less noticed but equally important discussion occurs beyond the click-worthy headlines and passionate op-eds: Given that medical and recreational cannabis legalization are already a reality in some countries (e.g., Canada, Uruguay) and over half of U.S. states and will likely become a reality in others, what lessons can we draw from other policy areas that will help regulatory systems maximize public health ( 2 , 3 )? Public health research can and should play a large role in this discussion particularly given the availability of decades of evidence on the impact and regulation of other potentially addictive or otherwise harmful consumables (e.g., alcohol, tobacco, prescription opioids, sodas, nutritional supplements) ( 4 , 5 ).

We write as scientists, policy analysts, and public health professionals, and make no effort in this paper to persuade anyone to vote for or against marijuana legalization. We hope that those who support legalization will find the foregoing discussion of value because they care about public health. After all, no one supports legalization hoping it will lead to more cannabis-induced auto accidents, for example. We hope that those who oppose cannabis legalization will also find our analysis of value because even when the overall policy framework is not to one’s liking, there are usually still ways of making it better (or at least less objectionable) including in ways that a legalization opponent would approve. Though many of our examples draw from the U.S. setting, we aim for recommendations that could apply in other countries considering or implementing cannabis legalization.

We recognize that efforts to address public health concerns regarding legal cannabis will meet with some political resistance, particularly in the corporate-friendly United States Cannabis industry players typically aim to maximize profits even it if harms public health. For their part, voters and advocacy groups often care about things other than public health (e.g., their views on personal freedom, their religious and cultural values). But the fact that a public health agenda under cannabis legalization will be difficult to achieve is not a reason to abandon it. Our six lessons are thus explicitly aspirational.

Although we believe the lessons presented here could be applied in many countries, we focus mainly on the United States both because we know it the best and because its cannabis regulation framework is unusually fluid due to the federal-state conflict in law, and the ongoing march of cannabis legalization across state after state (most recently, in November 2018 Michigan legalized recreational marijuana and Utah and Missouri legalized medical marijuana).. In the U.S., cannabis remains a Schedule I substance and illegal at the federal level, but memos issued during the previous presidential administration effectively left enforcement up to the states ( 6 ). A January 2018 memo from the current Department of Justice (DOJ) formally rescinded this policy, and at this writing it remains unclear whether or how the Trump administration will respond to cannabis legalization ( 7 ). Further complicating the legal landscape, the cannabis plant contains over 100 different cannabinoids, and there is presently one case where cannabinoids with different properties are subject to different regulations. Medication containing the non-psychoactive cannabidiol (CBD) and no more than 0.1% of the psychoactive constituent tetrahydrocannabinol (THC) were recently down-scheduled to Schedule V ( 8 ). All of this complexity, contradiction, and ferment makes it particularly important and opportune in the U.S. to inject public health concerns into the debate in the hopes of shaping the future.

1. Do not have a medical marijuana system that is not truly medical

Medicine has status, trust and privilege in society because of what it can accomplish and also because of how tightly it is regulated. Proponents of medical cannabis has attempted to gain similar status, trust and privilege, without the matching responsibilities of being carefully regulated. Indeed, if cannabis is indeed a medical drug, it is the least regulated medical drug in the U.S..

The experience of other unregulated quasi-medical industries, for example the patent medicines that thrived in the 19 th century and the supplements hawked on late night cable television, indicate that substantial harm can be done to the public by products that claim medicine’s mantle while evading its standards. The lesson for medical cannabis is that public health will be maximized if it either truly functions as medicine (e.g., with specified conditions, specific indications, and tight regulations), or, is folded into the recreational system.

To date, most “medical” cannabis has been sold with almost no medical oversight, with the role of physicians limited to writing a recommendation letter for patients. Physicians do not prescribe cannabis, nor do they provide it. Medical cannabis clients must take the physician recommendation letter to a separate dispensary, which is staffed by “budtenders” who typically do not have medical training. At the dispensary, clients choose from products of varying potency and content. Medical recommendation letters are often provided by physicians at clinics that solely provide medical cannabis recommendations, rather than primary care providers. Because the recommendation letter can sometimes be renewed over the phone or online without speaking to a clinician, medical oversight can easily be limited to the brief initial consultation. “Budtenders” can give any medical advice they wish, and this includes advice that is almost surely harmful to health, e.g., encouraging pregnant women to regularly smoke cannabis to reduce cramping ( 9 ).

Currently, a number of states operate separate medical and recreational cannabis markets (e.g., Colorado, Maine, Oregon) whereas others have combined the recreational and medical markets (e.g., Washington, California) ( 10 – 15 ). Acknowledging that something that is not regulated as medicine is not the same as medicine as commonly understood is good for public health. Combining programs may also streamline regulation and increase tax benefits to the state by preventing recreational users from entering the more lightly taxed medical system. Additionally, combining programs removes the incentive for youth to seek medical use to avoid higher age limits for recreational sales.

Medical and recreational use overlap, with most people who use medical cannabis also reporting recreational use ( 16 ). In a survey of a nationally representative panel of adults, only 10% of those who currently or ever used cannabis used it only for medical reasons ( 17 ). By way of comparison, consider how few people who take antibiotics, aspirin, or insulin to manage or cure disease would also use these drugs recreationally. Furthermore, with a few exceptions (e.g. CBD oils), the products available in medical and recreational outlets are the same. There is no reason the public should subsidize recreational drug use by making it tax-free, because lower prices feed over-consumption that harms public health (and also of course, imposes more costs on the public purse).

One concern about combining the two systems is that sick people will have to pay taxes on a medical product. But many products that can promote health are not tax-exempt (e.g. exercise equipment, cranberry juice for preventing bladder infections, over the counter medications in most states). As therapeutic uses for cannabis are identified with high-quality empirical data, relevant components or resulting medications can enter the medical system like any other drug, proceeding through FDA approval. As cannabinoid-derived drugs are approved, they can be covered by insurance or become available over the counter, where their potency and components will be regulated.

2. Protect science, regulation, and public health from corporate influence

When many people think of cannabis legalization, they envision a world where cannabis is sold by small operations owned by anti-corporate hippies who donate a portion of their profits to save the whales ( 18 ). In reality, legalization in the U.S. is leading to corporate cannabis run largely by hard-charging white guys in business suits who have MBAs and JDs and think of hippies with distaste if they think of them at all. The tobacco industry has been poised to capitalize on legal cannabis ( 19 ), as are the sugary beverage and alcohol industries ( 20 ). All scientists are aware of the potentially corrupting influence of industries in funding studies to support preferred conclusions and lobbying to promote industry’s business interests. For example, soda companies have long sponsored nutrition studies and legislation ( 21 ).

Protecting science and public health from corporate influence could take several forms. Full disclosure of cannabis industry-related conflicts of interest by researchers and journals should be standard ( 22 ). Robust non-corporate funding for cannabis research is also important, along the lines of California’s Tobacco Related Diseases Research Program which now funds proposals related to cannabis as well as tobacco.

Advertising regulations like those in place for tobacco products – e.g., advertising cannot target children, limits on where and when advertisements can be displayed or aired – may also be a key tool to promote public health. Currently, the industry in the U.S. complains that its advertising expenses are not tax deductible whereas those of the alcohol and tobacco industry are. The industry’s lobbyists are correct that this is an inconsistency, but from a public health viewpoint the best approach would be to subject alcohol and tobacco to the same restrictions rather than use public funds to subsidize sale of addictive products.

Evidence-informed public health education campaigns about cannabis are needed. Public health messages should take care not to exaggerate risks, lest they lose credibility in the face of the observation that many people do use cannabis without developing a use disorder or experiencing even the harms associated with over-consumption of alcohol. Ad campaigns similar to public health campaigns about alcohol – covering topics like getting help when use is out of control, abstaining during pregnancy and while trying to become pregnant, not using while driving, and not selling to minors – could promote public health.

Public health promoting regulations are more likely to be implemented if policymakers prevent the foxes from guarding the hen house. Multiple states give individuals from marijuana corporations seats on regulatory commissions, and do not require sufficient disclosure of marijuana industry-related conflicts of interest, for example when inviting “independent experts” to comment on developing legislation and regulations. The ballot initiative process is a particularly tempting opportunity to achieve regulatory capture, because industry players can potentially encode pro-profit, anti-public health, rules into the law for the long term. For this reason, even legislature members who oppose marijuana legalization might consider legislating their own framework when facing a corporate-written and funded legalization ballot initiative that seems likely to pass.

Last but most assuredly not least, non-corporate models should be considered by legalizing states and countries, as has been adopted in some Canadian provinces ( 5 , 23 ). For example, the state monopoly system used to sell alcohol in many U.S. states significantly reduces sales to youth and alcohol related harm ( 24 , 25 ). The same should be considered for cannabis, as should restricting the sale to non-profits and coops.

3. Cap the potency of cannabis products

Some drug policy analysts used to speak of the “Iron Law of Prohibition” which maintained that drugs become more potent over time because they are illegal. This is simply incorrect as tobacco, alcohol, and pharmaceuticals have all become substantially more potent since their development while being legal. Legality per se does nothing to limit potency unless there is a law that caps it.

Just as tobacco became more potent and more addictive in the 1900s– the same has happened with cannabis ( 26 , 27 ). Illegal cannabis smoked on college campuses in the 1970s had 3–5% THC, whereas legal cannabis sold in Washington State today averages 20% THC ( 28 ). Higher potency is concerning because of greater risk of adverse psychiatric effects and greater potential to transition light users into daily users and cannabis use disorders ( 29 – 31 ). For example, a study in the Netherlands found first-time drug treatment admissions for cannabis rose following increasing cannabis potency ( 32 ). If more potent cannabis is more addictive, increased availability post-legalization may increase the number of individuals who develop cannabis use disorder. Additionally, though cannabis poses essentially no fatal overdose risk, cannabis ingestion poses health threats to children, and this risk increases with increased potency. Increased potency can also magnify the indirect harms of cannabis intoxication, such as impaired driving and accidental injuries.

Because cannabis today has dramatically higher THC levels than in prior era, past research may understate health effects. Capping potency of cannabis products can limit the as yet unknown effects of more potent cannabis while the science can catch up to nature of modern products. Of course, cannabis is not just flowers and leaves: concentrates, oils, dabs, topicals, and products yet to be invented are likely to grow in popularity after legalization. States can mitigate these concerns by capping potency of cannabis products, just as they do certain classes of alcoholic beverages: To call something beer for example, requires abiding by certain limits to ethanol concentration ( 33 ). Similarly, cannabis oils or concentrates would reasonably have a higher potency limit per ounce than flowers—just as spirits can have a higher ethanol content than beer—but would still be restricted to a limited amount of THC per package. The limits recommended by California Department of Public Health – which include limiting THC content per package and limiting potency of inhaled products – are a good start ( 34 ). For oils and other smokeless cannabis products, the per-package limits would need to be set by regulatory bodies of scientists rather than industry, as discussed earlier. Banning smokeless cannabis products would likely result in increasing use of smoked cannabis and all of the attendant smoke-related health complication. Entirely banning high-potency products legal cannabis market may also have the unintended consequence of pushing consumers to the illicit market ( 35 ). Therefore, we do not at the present time advocate banning high-potency cannabis products like dabs, oils, or concentrates, but rather tailored and enforced regulations for labeling and packaging. In addition to capping potency, regulators have the opportunity to reduce harms of co-use of alcohol or tobacco with cannabis by explicitly banning products that combine cannabis and alcohol (as in, cannabinoids in alcohol) or cannabis and nicotine. Requiring every cannabis product sold for smoking or in smokable form to carry the message “Caution; cannabis smoke contains carcinogens” would communicate the risks of smoking specifically that may differ other cannabis products. Finally, regardless of what level of THC cap is in place, governments might consider setting taxes higher for high THC products. We explore other ways to use price setting to promote public health in the next section.

4. Price may be the most effective lever to promote public health

There’s an old saw that “Addicts will do anything to get their fix” but experimental and epidemiological research conducted in dozens of countries has established the opposite: Drug use is responsive to price, even for the heaviest drug users ( 36 ).

This observation is critical for understanding cannabis legalization because nothing the government does raises the price of the drug as high as does prohibition, which poses enormous costs on business ( 37 ). This is why the removal of cannabis prohibition has produced a price collapse in state after state, including a 70% drop of wholesale prices in 4 years in Colorado and even steeper drops in Oregon and Washington ( 38 , 39 ). Cannabis is called “weed” because it is very easy to grow, and easy to grow, legal crops in America (e.g., wheat) are very cheap. Legal prices are falling about 1% every 2–4 weeks and their natural bottom could be as low as a nickel per joint, such that cannabis becomes like beer nuts – a complimentary offering by restaurants and bars.

Health taxes have effectively reduced consumption of tobacco, alcohol, and sugar-sweetened beverages ( 36 , 40 ). Raising taxes on alcohol has also been demonstrated to reduce serious harms including death and injury due to motor vehicle accidents ( 41 , 42 ).

Sales of retail cannabis have typically been subject to sales and excise tax, but rates vary significantly between states ( 40 ). Because these taxes are generally set as a percent of price and the price is rapidly collapsing, the ability of such taxes to raise revenue and deter excessive use is thus waning almost every day ( 38 , 39 ). A more effective alternative is to tax the raw cannabis (i.e., flowers, leaves) by weight as California has always done and Maine has just begun to do ( 43 ). This raises fear of potency soaring as producers try to pack more THC in every ounce, but this can be countered by implementing potency caps, as discussed earlier. In the case of products that contain cannabis and other ingredients – e.g., brownies, lemonade, lattes – the amount of cannabis that can be included (in terms of potency) would be set by potency caps, and the tax could be based on the weight or unit of cannabis, not the entire product.

Minimum unit pricing of cannabis also merits serious consideration. This approach is used for alcohol in British Columbia and was also recently implemented in Scotland ( 44 ). It is not a tax, but rather a floor price below which a product cannot be sold. Implementing it for alcohol reduces emergency room admissions, alcohol-related arrests and injuries, and deaths ( 45 ). Public health benefits would also be expected from implementing such a minimum unit pricing policy for cannabis.

5. Look beyond reducing marijuana possession arrests

Wanting to reduce marijuana possession arrests is a weak rationale for legalization. Decriminalizing marijuana possession in California for example dropped both adult and adolescent possession arrests by over 60% in just 12 months ( 46 ). Arrests can be dramatically curtailed without creating a corporate industry that sells marijuana.

In contrast, legalization is an excellent opportunity to reduce the damage of prior criminal penalties by expunging the records of individuals arrested for possession as well as low-level dealing. This group is disproportionately poor and minority, and their arrest record limits their ability to obtain housing, work, and education ( 47 ). It also keeps people with expertise out of the emerging and overwhelmingly white-dominated, cannabis industry.

Currently, the process to get records updated in California requires an individual to hire a lawyer to get a possession record expunged or a felony for selling downgraded to a misdemeanor, but a bill introduced in the state senate would automate this process ( 48 ). One way to fund this effort in California as well as in other legalization states would be to designate some tax revenue from retail cannabis sales for this purpose.

6. Facilitate rigorous research

“More research is needed” has become a tired academic cliché, but it’s nonetheless applicable to cannabis legalization. Debate about the health benefits and risks of all manner of products is a commonplace of modern life and is certainly the case with cannabis. In political debates, the drug is characterized as extremely dangerous by some activists and as harmless – indeed extraordinarily therapeutic – by others. There is evidence for some harms and some benefits, although in neither case does the limited evidence available support more extreme assessments in either direction. In terms of benefit, a 2017 report by The National Academies of Sciences, Engineering, and Medicine concluded that there is substantial evidence that cannabis is an effective treatment for some chronic pain conditions in adults, and spasticity symptoms in multiple sclerosis, as well as conclusive evidence of efficacy in treating nausea and vomiting induced by chemotherapy ( 49 ). Other reviews have been more cautious in their conclusions, noting that the research base is old, includes many comparisons of cannabis to drugs which are no longer used because more effective ones have become available, and have small sample sizes ( 50 ).

In terms of harms, fairly rigorous quasi-experimental work indicates that greater access to cannabis leads to lower educational achievement ( 51 ). U.S. prevalence estimates of cannabis use disorder among people reporting past-year cannabis use vary in recent nationally representative surveys, with estimates ranging from 12% in the 2013 National Survey on Drug Use and Health to 31% in the 2012–13 National Epidemiologic Survey of Alcohol and Related Conditions ( 29 , 52 ). But whether cannabis use disorder is becoming more of less prevalent is not clear ( 29 , 52 ). On the one hand the proportion of cannabis users who used the drug every day or nearly every day is increasing sharply ( 53 ), but on the other hand with legalization and normalization, some of the negative effects of frequent cannabis use may be waning (e.g., problems with employers, conflicts with family members who disapprove of cannabis).

The obvious lesson to draw from all other putatively medical products as well as other addictive drugs is that empirical claims about health or social effects and should be investigated empirically. The U.S. has a careful system for studying and approving medications in place and it should be used for cannabis-related medicines as well. Only through rigorous research can effective therapies derived from cannabis be approved and regulated by the Food and Drug Administration (FDA). Properties should be investigated in controlled studies and resulting therapies should proceed through FDA approval process as have one CBD-derived medication and two medications derived from synthetic cannabinoids ( 54 ). It should be noted that the FDA approval process may be particularly difficult for a botanical cannabis product (as opposed to a chemical extract), due to variation in concentration of cannabinoids between plants. However, the FDA currently regulates several plant-matter botanical drug products in its over-the-counter review (e.g., psyllium, cascara, senna) and has approved two botanical products for marketing as prescription drugs ( 55 ).

One regulatory reform that has been considered in Congress is to alter the Controlled Substances Act (CSA) such that Schedule I drugs with therapeutic potential could be more easily studied ( 56 ). Creating a “Schedule I-R” would allow researchers and regulators to treat cannabis and its addictive constituent tetrahydrocannabinol (THC) as a lower-schedule substance when obtained for the purposes of advancing science ( 8 ). The recent downscheduling of a CBD extract formulation (Epidiolex) is an important step, but the rescheduling is currently limited to drugs that have already been approved by the FDA: “As further indicated, any material, compound, mixture, or preparation other than Epidiolex that falls within the CSA definition of marijuana set forth in 21 U.S.C. 802( 16 ), including any non-FDA-approved CBD extract that falls within such definition, remains a schedule I controlled substance under the CSA.” ( 8 ). Establishing a Schedule I-R would facilitate research on other cannabis products, other cannabinoids, and even other CBD-based formulations, all of which are currently still Schedule I ( 8 ).

A second reform that would improve the quantity and quality of cannabis research is to allow more farms to grow cannabis for research purposes rather than having only the federal monopoly provider in Mississipi. It seems bizarre for example that states can operate medical cannabis programs that give the drug to sick patients, but are not allowed to run medical cannabis research programs. In 2016 the Drug Enforcement Agency expanded the number of authorized manufacturers of cannabis for National Institute on Drug Abuse-funded research, but none of the organizations that applied for a license has been granted one by the Trump Administration ( 54 ).

For findings to be relevant, and to determine how differing modes of use or potency may modify health effects, at least some research on cannabis must be conducted on consumer cannabis products. Combustible may still be most common mode of use ( 17 ), but as retail markets expand researchers need to evaluate edible, vaporized, topical, and other smokeless products.

Currently, one topic that is especially relevant and contentious is whether cannabis legalization can decrease use of opioids. Some evidence suggests that medical cannabis can be opioid sparing ( 57 , 58 ), but studies have been limited by small sample size (e.g., Abrams’ clinical trial of 21 patients) or self-reported exposure and outcomes (e.g., Boenkhe’s was an online survey of clients of a medical cannabis dispensary). A systematic review found some pre-clinical evidence of “opioid sparing” effects, but clinical evidence was lacking ( 59 ). Epidemiological studies show state-level correlations between cannabis legalization and lower opioid overdoses, but such ecological studies have serious, well-known, flaws ( 60 ). Even individual-level studies showing that cannabis use and opioid use are positively correlated should not be taken as proof of a causal relationship ( 61 ). Yet medical cannabis use is associated with higher rates of prescription drug use and misuse ( 62 ). Furthermore, a recent four-year prospective study in Australia found no evidence that cannabis use improved patient outcomes in patients prescribed opioids for chronic, non-cancer pain ( 63 ). Clinical trials, and large-scale records-based studies with data at an individual level are warranted.

Change in other non-cannabis substance use after cannabis legalization could also be positive or negative. Some studies suggest that youth smoke cannabis as a precursor to tobacco – this order of events could potentially reverse advances in tobacco control measures ( 64 , 65 ). Broader availability of cannabis could theoretically reduce alcohol-related harms if alcohol and cannabis are substitutes. Conversely, it’s possible that legalized cannabis will augment societal harms caused by alcohol use if the two drugs are complements– this line of research needs to be continued. Further research on the relationship between cannabis use and use of tobacco, alcohol, and other substances can clarify this. The urgency of policy research on new cannabis laws should be balanced with the need to gather enough data for careful assessment. There is a risk policy evaluations conducted too soon after cannabis legalization will fail to detect midterm and longer term adverse outcomes.

Conclusions

In summary, cannabis legalization may have positive and negative impacts on public health, and policies should aim to maximize the former and minimize the latter. There are many other important topics we have not covered – e.g., public consumption, strategies to reduce and detect impaired driving, rules on pesticides, fraud detection – and the future will likely raise other concerns which no one is aware of at this moment. We recommend continued, rigorous research, by scientists who report results in an objective and balanced manner, free from corporate influence. With the benefit of decades of observation about policy successes and failures in regulating other drugs, policymakers can promote policies that rectify harms of cannabis prohibition, and policies that strive to minimize harms of legalization. Public health professionals and scientists have a role to play in conducting rigorous research, disseminating results in an objective and balanced manner, and contributing to making evidence-informed policy.

Acknowledgments

Authors’ Note: Chelsea L. Shover was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number T32 DA035165 . Research reported in this publication was supported by the National Institute The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Keith Humphreys was supported by a Senior Career Research Scientist Award from the Veterans Health Administration, Stanford Neurosciences Institute, and the Esther Ting Memorial Professorship at Stanford University. Any views expressed are the responsibility of the authors and do not necessarily reflect policy positions of their employers. The authors report no relevant financial conflicts.

Financial disclosures and funding information: The authors report no conflicts of interest. The authors were supported by the National Institute on Drug Abuse, the Veterans Health Services Research and Development Service, and [blinded] Neurosciences Institute. Research reported in this publication was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Number [blinded]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Contributor Information

Chelsea L. Shover, Stanford University, Palo Alto, California.

Keith Humphreys, Veterans Affairs Health Care System and Stanford University, Palo Alto, California.

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The Benefits of Medical Marijuana, Essay Example

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Marijuana has been used in many spiritual healings and for recreational use for many years. Marijuana has been used as early as 2900 BC when Chinese Emperor Fu His referenced marijuana (Cannabis) as a popular medicine of the time. According to Richard Boire, and Kevin Feeney (2007), “In the 19th Century, marijuana emerged as a mainstream medicine in the West. Studies in the 1840s by a French doctor by the name of Jacques-Joseph Moreau [a French psychiatrist] found that marijuana suppressed headaches, increased appetites, and aided people to sleep.” (“Medical Marijuana,” 2009, n.p.).However, not until recently had it even crossed the minds of many medical professionals to be used in order to help patients who have been diagnosed with many diseases where relief is very seldom. It is now being legalized in many states in order to help with many medical diseases and chronic pain.“Medical marijuana clinics operate in 20 states and the District of Columbia, and its recreational use is now legal in Colorado and Washington” (Brody, 2013, n.p.). Even with the many medical clinics supporting the use of medicinal marijuana, there are still many different views by different people on whether marijuana should be used for medical purposes. Many believe that it shouldn’t be used as it is still considered a drug that may have adverse effects on the brain and other organs in the body. However, there are many people who support the use of marijuana as long as it is used for medical purposes. It is all a matter of opinion for many at this point. However, there are many benefits for the use of marijuana in the medical field today.

The real use of medicinal marijuana was introduced by W.B. O’Shaughnessy, a surgeon who learned that marijuana could be used to help alleviate pain and many other medical problems. According to the National Cancer Institute (2013), “its use was promoted for reported analgesic, sedative, anti-inflammatory, antispasmodic, and anticonvulsant effects” (p. 1).Cancer is one of the largest medical problems in our society today and many clinical trials of medical marijuana have shown that it helps with the effects of chemotherapy such as vomiting and nausea under a generic name called dronabinol (National Cancer Institute, 2013). “Clinical trials determined that dronabinol was as effective as or better than other antiemetic agents available at the time” (National Cancer Institute, 2013, p. 1). Cancer and chemotherapy are just two of the aspects of the medical field that marijuana benefits. According to the former US Surgeon General, Jocelyn Elders (2004), “the evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS — or by the harsh drugs sometimes used to treat them” (“Medical Marijuana,” 2009, n.p.). Not only does marijuana help with the side effects of chemotherapy, but there is evidence that a chemical that is found in marijuana stops cancer from spreading. In 2007, the California Pacific Medical Center in San Francisco did a study that proved that cannabidiol prevents cancer cells from spreading (Astaiza, 2012). Astaiza (2012) states that cannabidiol by turning off the Id-1 gene in the person’s body. “The researchers studied breast cancer cells in the lab that had high expression levels of Id-1 and treated them with cannabidiol. After treatment the cells had decreased Id-1 expression and were less aggressive spreaders” (Astaiza, 2012, n.p.).

Many individuals are living with pain each and every day of their lives. This pain can stem from the smallest things such as back aches and headaches to larger problems such as multiple sclerosis as stated above. Randy Astaiza (2012) states the following in reference to how marijuana helps patients with multiple sclerosis:

Jody Corey-Bloom studied 30 multiple sclerosis patients with painful contractions in their muscles. These patients didn’t respond to other treatments, but after smoking marijuana for a few days they were in less pain. The THC in the pot binds to receptors in the nerves and muscles to relieve pain. Other studies suggest that the chemical also helps control the muscle spasms (n.p.).

Pain management is one of the largest parts of the medical field as well and many are beginning to say that marijuana helps alleviate much of the pain that patients feel. According to Jane E. Brody (2013), “the strongest evidence for the health benefits of medical marijuana or its derivatives involves the treatment of chronic neuropathic pain and the spasticity caused by multiple sclerosis” (p. 1).One of these pains, among many, is peripheral neuropathy which consists of many symptoms that can significantly deteriorate a person’s quality of life. According to Igor Grant (2013), this is something that can be treated by the use of medical marijuana. Grant (2013) describes painful peripheral neuropathy in the following paragraph:

Painful peripheral neuropathy comprises multiple symptoms that can severely erode quality of life. These include allodynia (pain evoked by light stimuli that are not normally pain-evoking) and various abnormal sensations termed dysesthesias (e.g., electric shock sensations, “pins and needles,” sensations of coldness or heat, numbness, and other types of uncomfortable and painful sensations). Common causes of peripheral neuropathy include diabetes, HIV/AIDS, spinal cord injuries, multiple sclerosis, and certain drugs and toxins (p. 466).

Many individuals that are suffering from these diseases attempt to get treatment and sometimes that treatment does work. However, many scientists and doctors that support the use of medical marijuana state that many of these patients would have better results if prescribed marijuana is small doses. In addition, researchers and physicians are also beginning to state that marijuana helps those patients with arthritis. This drug alleviates pain and discomfort as well as reduces the inflammation that many arthritis patients deal with on a daily basis. For example, “Researchers from rheumatology units at several hospitals gave their patients, sativex, a cannabinoid-based pain-relieving medicine. After a two week period, people on Sativex had a significant reduction in pain and improved sleep quality compared to placebo users” (Astaiza, 2012, n.p.).

In addition, marijuana can help with diseases such as epilepsy, anxiety disorders, and Alzheimer’s disease.  According to Astaiza (2012), “Cannabinoids like the active ingredient in marijuana, tetrahydrocannabinol (also known as THC), control seizures by binding to the brain cells responsible for controlling excitability and regulating relaxation” (n.p.). This is one of the most amazing benefits of medicinal marijuana as there are many individuals that suffer from epileptic seizures on a daily basis. It is also said that marijuana helps reduce anxiety. According to researchers at the Harvard Medical school, marijuana helps a person’s mood and “acts as a sedative in low doses” (Astaiza, 2012, n.p.). Finally, it is said that marijuana helps slow the process of Alzheimer’s disease. Astaiza (2012) states the following to prove this:

The 2006 study, published in the journal Molecular Pharmaceutics, found that THC, the active chemical in marijuana, slows the formation of amyloid plaques by blocking the enzyme in the brain that makes them. These plaques are what kill brain cells and cause Alzheimer’s (n.p.).

Many focus on the fact that marijuana is an illegal drug, that it can be addictive, and that many individuals will abuse the use of the drug if it is ever legalized (either recreationally or through medical use). When looking at only the negative aspects of something, it is not easy to approach a concept with a positive means of change.Many people are not taking the time to look at the benefits that it may have on the people who have to deal with chronic pain and irreversible diseases. These individuals go day to day with pain that they are not able to relieve even with legalized medications. The more research and studies that are done can certainly help make believers out of those that are against the use of marijuana for medical purposes. If a substance can be used to alleviate discomfort and pain, where there are proven studies that show its positive effects, many would think that the drug should be used to help patients. Unfortunately, too many people are focusing on the negative effects that this drug could have on a person’s body. One must open his or her mind to the idea that something could be beneficial even if they do not completely believe in its use.

In conclusion, marijuana can be very beneficial for the chronically ill. It also has benefits for those individuals that deal with chronic pain and other diseases such as epilepsy, AIDS, multiple sclerosis, fibromyalgia and much more. If used in a medical sense, with the right amount of dosage and the proper treatment by a physician, the use of marijuana could change the lives of many who are suffering. Unfortunately, this takes the work of many doctors, nurses, government officials, and supporters that will back up the ideas and the many negative contradictions with positive feedback about the drug when used properly. If this could take place and many could see the actual benefits, the use of marijuana in the medical field could help many individuals who continue to suffer on a daily basis.

Astaiza, R. (2012, November 08). All the reasons pot is good for you. Business Insider , Retrieved from http://www.businessinsider.com/health-benefits-of-medical-marijuana-2012-11?op=1

Brody, J. E. (2013, November 04). Tapping medical marijuana’s potential. The New York Times . Retrieved from http://well.blogs.nytimes.com/2013/11/04/tapping-medical-marijuanas-potential/?_php=true&_type=blogs&_php=true&_type=blogs&_r=1

Grant, I. (2013). Medicinal cannabis and painful sensory neuropathy. American Medical Association Journal of Ethics , 15(5), 466-469. Retrieved from http://virtualmentor.ama-assn.org/2013/05/oped1-1305.html

Medical marijuana. (2009, May 06). Retrieved from http://medicalmarijuana.procon.org/view.resource.php?resourceID=000141

National Cancer Institute. (2013, November 21). Cannabis and Cannabinoids . Retrieved from http://www.cancer.gov/cancertopics/pdq/cam/cannabis/healthprofessional/page2

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Breadcrumbs

One-year high: the impacts of maryland’s legalization of marijuana.

Mario Macis, professor of economics, health, and management and organization at the Johns Hopkins Carey Business School, shares how tax revenue is up, crime is down, and a recent gubernatorial declaration changes thousands of lives.

Nearly a year after legalizing marijuana in Maryland, some of the early effects of this legislation are beginning to show, marking just the beginning of a broader understanding of its impacts.

On July 1, 2023, Maryland legalized the recreational use of marijuana for individuals 21 years and older. This significant change, affirmed by 67% of voters in the November 2022 Question 4 referendum, comes more than a decade after the state initially authorized medical marijuana use in 2012. Under the new legislation, individuals are allowed to possess up to 1.5 ounces for personal use, cultivate up to two plants at home, and gift cannabis to others without monetary compensation. 

Erasing crime?

On June 16, 2024, Maryland Governor Wes Moore announced pardons for 175,000 persons convicted of crimes related to the possession of cannabis and cannabis paraphernalia. The governor’s action is in line with other governors who have previously legalized marijuana. This provision has important societal implications, influencing the broader opportunities and life outcomes for convicted individuals and their families. 

In Maryland, the pardon applies to everyone convicted of marijuana possession—a population that is  disproportionately Black. Although Black and African American persons make up 33% of Maryland's population, they comprise 70% of persons incarcerated in the state. This has real impacts in Black communities. Convictions on-record make it harder for someone to obtain housing, employment, and education, all of which are crucial for achieving financial stability and building long-term wealth for future generations.

The legislation sparked extensive debates. Detractors express concerns about increased consumption—particularly among youth—a rise in addiction, and elevated crime rates. Proponents counter these arguments by referencing historical events like the Prohibition Era, where criminal activities burgeoned due to the illegal alcohol trade. In fact, legalizing and regulating marijuana can decrease organized crime, enhance consumer safety, and ensure product quality.

Evidence from states where marijuana has been previously legalized tends to support these counterarguments, as detailed in studies such as the one published in the Journal of Economic Literature in 2023 by economists Mark Anderson and Daniel Rees, titled "The Public Health Effects of Legalizing Marijuana." This research contributes to the understanding of the broader impacts of marijuana legalization on public health, crime, and other outcomes, although it is difficult to draw firm conclusions for most outcomes without more post-reform data.

Statistics reveal that crime rates don't necessarily surge post-legalization. This could be because states reallocate law enforcement resources to more severe criminal activities. Various studies have also attempted to shed light on the impact of medical and recreational marijuana legalization on consumption patterns and public health. Youth consumption has not been shown to increase significantly after legalization. Meanwhile, marijuana appears to be a substitute for alcohol, leading to decreased consumption and instances of binge drinking.

That makes a difference, because alcohol is correlated with violence. Several studies suggest that legalization could reduce non-drug related crimes, such as homicides, assaults, rapes, and thefts. The decrease in crime following marijuana legalization can be attributed to a few key factors, including the potential reduction in alcohol use, as well as the elimination of illicit marketplaces that often lead to violence and criminal activity, and the reallocation of law enforcement resources towards more serious offenses. However, the effects of opening and closing dispensaries on crime rates and other societal factors still require more rigorous investigation.

As for the notorious “gateway drug” theory, the evidence doesn't convincingly connect marijuana legalization to increased usage of other, “harder” drugs. In fact, preliminary studies suggest a reduction in opioid use post-legalization. However, these findings require further research to confirm.

Market and tax impacts

The law is reshaping Maryland's cannabis market. In March 2024, Maryland regulators awarded 174 adult-use marijuana social equity licenses from a pool of 1,515 eligible applicants. This was part of a lottery conducted on March 14, which included six different license types, reflecting the state's effort to ensure equitable distribution of licenses in the burgeoning industry. The state distributed licenses across 44 geographic pools, with the number of licenses per area varying based on population density and demand. 

A sales tax on marijuana products has generated significant revenue for the state. According to the Marijuana Policy Project, from July 1, 2023, through March 2024, tax revenues from cannabis sales totaled $40,230,000. In addition to tax revenues, the state benefits from the redirection of resources previously expended on law enforcement, court proceedings, and imprisonment associated with marijuana consumption, letting the state spend more on societal needs.

Public and mental health

Marijuana has shown positive impacts on mental health, with some studies indicating a decrease in prescription medications for mental health conditions. Additionally, while the effect of recreational marijuana on road safety remains under examination, some evidence points to improved road safety following the legalization of medical marijuana.

What to Read Next

career outcomes

Maryland's journey toward fully understanding the ripple effects of marijuana legalization is just beginning. The state's focus on regulation, equity, and a data-driven approach aims to guide the comprehensive exploration of the benefits and potential hurdles brought about by this new cannabis policy era. However, the post-legalization data is still limited, preventing firm conclusions and highlighting the need for ongoing research and monitoring to fully assess the effects of the new regulations.

Authored by Mario Macis, PhD

Mario Macis, PhD , is a professor of economics at the Johns Hopkins Carey Business School. He is an applied economist who studies the role of incentives in shaping pro-social behavior, attitudes toward morally contentious exchanges and, more generally, the determinants of social support for market-based solutions to social problems. He is also interested in various topics in health, development, labor and organizational economics. 

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The Real Problem With Legal Weed

New York is trying to treat an addictive substance just like any other product.

Credit... Illustration by Luca Schenardi

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By Charles Fain Lehman

Charles Fain Lehman is a fellow at the Manhattan Institute, a contributing editor of City Journal and a 2023-24 Robert Novak Journalism Fellow with the Fund for American Studies.

• July 3, 2024

When New York legalized recreational marijuana in 2021, the future seemed bright. “It has been a long road to get here, but it will be worth the wait,” State Senator Liz Krueger, a sponsor of the legislation, told New Yorkers. Legalization, she and others said, meant a wave of new jobs and new tax revenue. It meant an end to racist policing of marijuana and the start of equity, with rules that put those harmed by prohibition at the front of the line for licenses. And it meant easy-to-buy weed for the 1.6 million adult New Yorkers who already partook.

Listen to this article, read by Cody Sloan

Three years later, things are not going to plan. Gov. Kathy Hochul has called New York’s legalization rollout “a disaster.” Mayor Eric Adams has spent months demanding that Albany fix the current system. “What happened?” The New Yorker recently asked in a feature on the collapse of the state’s marijuana “revolution.” Many New Yorkers are asking the same thing.

There are around 140 recreational dispensaries operating statewide — about one for every 148,000 New Yorkers. Instead of shopping legally, New Yorkers tend to get their weed from the illegal shops that now blanket the state. Estimates suggest that there are anywhere from 2,000 to 8,000 in New York City alone, with uncounted more from Ithaca to Oneonta. Recent crackdowns have temporarily sealed more than 400 stores — only a small fraction of the total in the city.

These shops undercut the legal stores, offering the same high at a fraction of the price. And they attract crime: There were 736 robbery complaints at unlicensed shops last year, according to the New York Police Department. Shootings are not uncommon, including the killing of a 36-year-old man captured on video last April.

They also sell to teenagers, as The Times has reported . Teachers, prevention experts and pediatricians have raised the alarm about high schoolers smoking or vaping marijuana at school. “Kids will do it in the bathrooms,” one student in Westchester says, “and it’s become a pretty normal occurrence for you to walk into a bathroom and you can smell it.” Disciplinary incidents involving drugs and paraphernalia rose 17 percent in the 2022-23 school year, according to New York City officials.

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Maryland medical panel shares concerns ahead of July 1 recreational marijuana legalization

by Megan Clarke

COLLEGE PARK, Md. (7News) — On July 1, recreational marijuana will become legal in Maryland, and ahead of that change, a group of medical experts are now calling for more research.

They say the goal is not to criminalize, but instead, to safely guide the public through this new chapter.

"When something gets legalized, people think it’s OK, and it’s safe, and there are no issues," Associate Director of the Kahlert Institute for Addiction Medicine at the University of Maryland School of Medicine Doctor Eric Weintraub said. "And I just think we’re trying to bring out, in certain populations, there are problems with this."

READ | Maryland House advances recreational marijuana bill

Among the questions faculty want to answer: How marijuana could impact the developing brain, with lasting effects?

"An increased risk of learning disabilities, increased risk of autism, ADHD, sensory processing disorders and psychiatric disturbances," Neurobiology and Associate Director of the Kahlert Institute for Addiction Medicine at the University of Maryland School of Medicine Doctor Asaf Keller said. "And these are thought to last throughout life."

As well as questions about how marijuana can permeate a pregnant woman’s placenta.

Other faculty raised concerns about how product quality will be monitored, and whether or not ERs could see more traffic.

Doctor Daniel Gingold said other states that have legalized marijuana have seen increases specifically in pediatric overdoses with edibles, ages 2 to 4 years old.

"This age group is likely to get into lots of food, they’re able to climb up on shelves, and they don’t necessarily read the packaging," Gingold said.

Once in the ER, Gingold, the Assistant Professor of Emergency Medicine at the University of Maryland School of Medicine, said while fatality is very rare, the incident can be distressing for families and the child. He said the child may not be able to articulate what they ingested or any other needs, and the process can require a lot of medical staff to help.

Gingold also said older adults make up another "special population" that could face a higher risk of an emergency room visit. Gingold attributed this to a variety of reasons, from underlying conditions, and combined use of cannabis and other medications, to an unfamiliarity with new cannabis products.

Gingold did note doctors most commonly see frequent cannabis users in the ER, and risk-taking behaviors are more associated with alcohol use. Still, he said the impacts of legalization remain to be seen.

ALSO READ | After voters approved it, Maryland takes steps to legalize recreational marijuana in 2023

At the crux of it all, doctors explain getting answers is complicated, as they say, marijuana is federally classified as a Schedule I drug.

According to the Drug Enforcement Administration, the classification is afforded to substances "with no currently accepted medical use and a high potential for abuse." The list includes heroin, LSD and ecstasy.

"Under federal law, physicians are not allowed to prescribe and not allowed to transfer cannabis across state lines, and therefore you cannot perform, or it’s very difficult to perform a clinical study under those conditions because you’re violating [the] law," Keller said. "Unless you go through very complex and time-consuming regulatory approvals to make that possible."

As July 1 approaches, the faculty still agree criminalizing marijuana is not the answer, but considering the concerns at hand is.

"The harm caused by criminalizing cannabis on so many years, on social and personal levels, and especially on minoritized communities, far outweighs the medical concerns that we’re raising here, in my mind," Keller said.

If your child or pet ingests any edibles, the doctors remind parents to be honest with first responders about what happened--saying children react differently to substances than adults.

Angel Bivens with the Maryland Poison Center said the center is open 24 hours a day, 7 days a week, to connect families with medical professionals to help.

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ANTI-SEMITIC ATTITUDES OF THE MASS PUBLIC: ESTIMATES AND EXPLANATIONS BASED ON A SURVEY OF THE MOSCOW OBLAST

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JAMES L. GIBSON, RAYMOND M. DUCH, ANTI-SEMITIC ATTITUDES OF THE MASS PUBLIC: ESTIMATES AND EXPLANATIONS BASED ON A SURVEY OF THE MOSCOW OBLAST, Public Opinion Quarterly , Volume 56, Issue 1, SPRING 1992, Pages 1–28, https://doi.org/10.1086/269293

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In this article we examine anti-Semitism as expressed by a sample of residents of the Moscow Oblast (Soviet Union). Based on a survey conducted in 1920, we begin by describing anti-Jewish prejudice and support for official discrimination against Jews. We discover a surprisingly low level of expressed anti-Semitism among these Soviet respondents and virtually no support for state policies that discriminate against Jews. At the same time, many of the conventional hypotheses predicting anti-Semitism are supported in the Soviet case. Anti-Semitism is concentrated among those with lower levels of education, those whose personal financial condition is deteriorating, and those who oppose further democratization of the Soviet Union. We do not take these findings as evidence that anti-Semitism is a trivial problem in the Soviet Union but, rather, suggest that efforts to combat anti-Jewish movements would likely receive considerable support from ordinary Soviet people.

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