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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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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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The New Politics of Marijuana Legalization: Why Opinion is Changing

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William a. galston and william a. galston ezra k. zilkha chair and senior fellow - governance studies e.j. dionne, jr. e.j. dionne, jr. w. averell harriman chair and senior fellow - governance studies @ejdionne.

May 29, 2013

In less than a decade, public opinion has shifted dramatically toward support for the legalization of marijuana: A recent national survey showed a narrow national majority in favor of legalization, and its supporters translated this sentiment into ballot initiative victories in Colorado and Washington State in 2012, report E.J. Dionne, Jr. and William A. Galston.

The temptation is to conclude that the trend in favor of marijuana legalization is similar to the flow of opinion in favor of same-sex marriage, but not all hot-button social issues are created equal, Dionne and Galston write. It is much less clear that opinion on marijuana will follow the exact evolution of social issues such as marriage equality, the authors assert.

Surveying a wealth of new data on public attitudes toward marijuana legalization, this paper explains the forces and limits behind the trend toward legalization. The authors seek to answer the following: Which trajectory, that of gay marriage or abortion (if either), is more likely to augur the path that opinion on marijuana may take? And will the country see the emergence of a broad pro-legalization consensus, or rather of a durably divisive cultural disagreement?

Dionne and Galston arrive at the following conclusions:

• In a number of respects, the structure of public opinion regarding marijuana legalization is distinctive, at least in today’s political context. Among today’s divisive issues, support for marijuana legalization is unusual in cutting across party lines. Generally, broad shifts in cultural attitudes—notably the rise of the 1960s and 1970s counterculture, and then the backlash against it in the 1980s—can trump the influence of party. Gender plays a role, but not necessarily the role one might expect: women are to the “right” of men, more likely to oppose legalization. Becoming parents appeared to have moved baby boomers toward a more conservative stance on legalization, but more recent findings suggest that parenthood may not be as strong a factor in determining one’s position as previously thought. However, married parents are more likely to oppose legalization than unmarried parents.
• Attitudes toward legalization are marked by ambivalence, especially on the conservative side. Many of those who favor legalization do so despite believing that marijuana is harmful or reporting that they feel uncomfortable with its use. Among conservatives, many who believe marijuana should be illegal nonetheless support states’ right to legalize it and take a dim view of government’s ability to enforce a ban.
• Support for legalization, though growing markedly, is not as intense as opposition, and is likely to remain relatively shallow so long as marijuana itself is not seen as a positive good. Whether opinion swings toward more robust support for legalization will depend heavily on the perceived success of the state legalization experiments now under way—which will hinge in part on the federal response to those experiments.
• That said, demographic change and widespread public experience using marijuana imply that opposition to legalization will never again return to the levels seen in the 1980s. The strong consensus that formed the foundation for many of today’s stringent marijuana laws has crumbled.

Governance Studies

Morley Winograd, Michael Hais

March 28, 2024

Rachel M. Perera, Jon Valant, Nicolas Zerbino, Brock Schultz

March 2, 2024

The Brookings Institution, Washington DC

10:00 am - 11:30 am EDT

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.

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Marijuana Legalization: Impact on Physicians and Public Health

Samuel t. wilkinson.

1 Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511

Stephanie Yarnell

Rajiv radhakrishnan.

2 VA Connecticut Healthcare System, West Haven, Connecticut 06516

4 Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut 06511

Samuel A. Ball

3 The National Center on Addiction and Substance Abuse at Columbia University, New York, NY 10027

Deepak Cyril D'Souza

Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.

Introduction

Marijuana is the most commonly used illicit drug in the United States, with ∼3.1 million individuals reporting daily use in the last year and 8.1 million individuals reporting using marijuana most days in the last month in 2013 ( 1 ). Marijuana has now been legalized for medical use in 23 states and the District of Columbia. The process of legalization of marijuana for medical use is substantially different from the approval of medications by the US Food and Drug Administration (FDA): Approval occurs by popular vote or the action of a state legislature, and is thus not subject to the higher standard of evidence required by the FDA for both efficacy and safety. As of April 2015, Colorado, Washington, Alaska, Oregon, and the District of Columbia have also legalized marijuana for recreational use, with other states likely to follow. At the federal level, however, marijuana remains illegal as a schedule I controlled substance, a category reserved for substances with a high potential for abuse, lack of established safety, and no accepted medical use.

The public health impact of marijuana legalization remains a controversial issue. Advocates of legalization contend that this policy change will provide for more stringent regulation and safer use of marijuana, more efficient use of law enforcement resources, and possibly even a decline in the prevalence of marijuana use among adolescents and of the use of “harder” drugs (e.g., cocaine and heroin) ( 2 , 3 ). Those opposing legalization cite the adverse effects of marijuana and worry that legalization will lead to an increase in use, and thus an increase in health problems attributed to marijuana. The latter view is reflected in the official position statements of prominent professional medical associations such as the American Psychiatric Association, the American Society of Addiction Medicine, and the American Medical Association, which have expressed concern regarding the negative consequences of marijuana use. We review the potential impact of marijuana's legalization on public health as well as conditions for which marijuana or its constituents may be a legitimate treatment option.

Overview of Marijuana

Unlike pharmaceutical medications, marijuana is not a single-agent compound but a complex combination of more than 100 different chemicals, which include cannabinoids, flavonoids, and terpinoids. The primary psychoactive component of marijuana is delta-9-tetrahydrocannabinol (THC). However, other cannabinoid compounds—including cannabidiol (CBD), cannabinol, cannabichromene, cannabidivarin, cannabigerol, and tetrahydrocannabivarin—have their own actions on the central nervous system and may modify the effects of THC (“entourage effects”). The concentration of these compounds can vary substantially ( 4 ), making it difficult to characterize the specific positive or negative health effects of marijuana, especially in uncontrolled and epidemiological studies. In addition, the average content of THC in marijuana (as measured in confiscated marijuana samples in the United States) has increased substantially from ∼1% in the 1980s to ∼9% in 2008 ( 5 , 6 ). As THC is thought to be related to many of marijuana's adverse effects, this increase in potency means that relying on older studies for data about marijuana's safety profile may be problematic. Furthermore, given that individual cannabinoids present in whole-plant marijuana have different pharmacological effects, data on individual cannabinoids cannot necessarily be extrapolated to whole-plant marijuana and vice versa. More research is urgently needed in light of the changing legal landscape and the increasing potency of marijuana.

Routes of Administration and Indications

Marijuana is typically consumed via smoking of joints or blunts (dried marijuana leaves rolled into cigarettes or cigars, respectively). More recently, in an effort to avoid the potentially harmful byproducts of burning marijuana, use of vaporizers has increased. Although this method of cannabis consumption may theoretically avoid the inhalation of toxins, rigorous clinical studies confirming its safety have not yet been done. When smoked or given intravenously, THC is rapidly absorbed, producing physical effects within minutes. Oral doses delay the onset of effects by 30–120 min, produce lower and irregular peak plasma levels compared to smoked THC, and prolong the action of the drug ( 7 ). The inhaled route allows for real-time dose titration, whereas delayed onset with oral consumption means that the individual cannot reduce the dose once effects, including negative ones, emerge. Hence, individuals who are not familiar with the effects of THC or other cannabinoids may become overwhelmed by the effects of oral consumption.

Although marijuana remains illegal at the federal level, individual components of marijuana have been purified, tested, and approved by the FDA or similar regulatory agencies as medications for certain conditions. Oral THC is available as Dronabinol (Marinol®) and has been approved by the FDA for the treatment of HIV/AIDS cachexia ( 8 , 9 ) and nausea/vomiting related to chemotherapy ( 10 – 12 ). Nabilone (Cesamet®) is an oral THC analog that is FDA-approved for the treatment of nausea/vomiting related to chemotherapy ( 13 ). Nabiximols (Sativex®) is an admixture of THC and CBD (approximately 1:1 ratio) in an oromucosal spray formulation; it has been approved by regulatory agencies in Canada and many countries throughout Europe to treat spasticity in multiple sclerosis (MS) ( 14 , 15 ).

The list of qualifying conditions for which medical marijuana (most commonly consumed by smoking) is legal on the state level varies substantially ( Table 1 ), as does the level of evidence for each condition ( Table 2 ). Common conditions include pain, HIV/AIDS, cancer, glaucoma, epilepsy/seizures, nausea/vomiting, spasticity/MS, agitation in Alzheimer's disease, and posttraumatic stress disorder (PTSD). Although dronabinol and nabilone are both FDA-approved for HIV/AIDS cachexia and chemotherapy-related nausea/vomiting, it is not known whether marijuana is also efficacious for the treatment of these conditions. The numerous other compounds (i.e., cannabinoids, flavonoids, terpinoids) present in smoked or edible marijuana may interact with the actions of THC. Large randomized controlled trials (RCTs) have shown efficacy of nabiximols for MS-related spasticity, and at least two RCTs of smoked marijuana or an oral cannabis extract also show efficacy in this condition ( 16 , 17 ). At least three RCTs (total n = 101), designed to test the efficacy of smoked marijuana for at least five days in treating neuropathic pain, have been positive ( 18 – 20 ), with additional evidence from challenge studies. Additionally, large trials testing the efficacy of nabiximols or an oral cannabis extract in neuropathic pain have also shown benefit ( 17 , 21 , 22 ). Robust clinical evidence (i.e., large RCTs) for other indications is generally lacking ( Table 2 ). Preclinical research, however, is promising: cannabinoids have demonstrated anti-inflammatory ( 23 ) and anticonvulsant ( 24 ) properties. Furthermore, THC and CBD have been shown to enhance extinction learning, a process critical in the treatment of PTSD ( 39 , 40 ). Evidence also suggests that cannabinoids may transiently lower intraocular pressure, suggesting promise in the treatment of glaucoma ( 41 ). However, further research is needed to examine whether these preclinical findings translate into clinical efficacy and to explore the potential risks of smoked or edible marijuana compared to oral/nasal cannabis extracts.

Abbreviations: FDA, US Food and Drug Administration; MS, multiple sclerosis; RCT, randomized controlled trial; THC, tetrahydrocannabinol.

Relationship Between Legalization and Prevalence

As marijuana has well-documented adverse health effects (discussed below), one of the principal questions permeating the legalization debate is whether liberalized marijuana laws will lead to increased prevalence of use. Generally, US states that have legalized medical or recreational marijuana have higher rates of use than those where all forms of marijuana remain illegal ( 42 – 44 ). However, it is difficult to ascertain whether this is attributable to legalization or is associated with regional variation in permissive attitudes or perceived risk with regard to marijuana ( 43 ). Indeed, legal-marijuana states generally have higher rates of use even before legalization ( 42 , 43 ).

The prevalence of marijuana use in adolescents is a point of particular interest in the policy debate because many of the negative health effects of the drug (addiction/dependence, psychosis, cognitive impairment) are heightened when use begins in adolescence ( 45 – 47 ). Evidence also suggests that cannabis use in adolescence and early adulthood is associated with poor social outcomes, including unemployment, lower income, and lower levels of life and relationship satisfaction ( 48 ).

Decades' worth of data from the Monitoring the Future survey have shown a clear inverse relationship between risk perception and marijuana use among adolescents: the more risk attributed to marijuana, the lower the percent of use among young people ( 49 ). This relationship has also been seen among adults ( 50 ) and across age groups ( 51 ). It is feared that any decline in risk perception resulting from legalization will be followed by an increase in prevalence of use.

Despite these concerns, several studies have failed to find a measurable effect of legalization for medical use on adolescent prevalence using a pre–post analysis ( 43 ), a comparison with regionally proximate states ( 42 ), or a difference-in-differences analysis ( 52 ). Two of these studies, however, did not include data from marijuana-policy bellwether states such as Colorado, California, or Washington ( 42 , 52 ). Data from the Youth Risk Behavior Survey (sponsored by the Centers for Disease Control and Prevention) show an increase in youth rates of marijuana use (from 2011 to 2013) in New Mexico since medical marijuana was legalized in 2009, although this trend among adolescents has thus far not been found in other states ( 53 ).

In 2009, the Obama administration issued a memorandum (the Ogden Memo) which instructed prosecutors and law enforcement officials not to focus federal resources on individuals “whose actions are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana” ( 54 ), essentially decriminalizing medical marijuana use at the federal level. This policy shift was associated with a drastic increase in medical marijuana registration applications in Colorado ( 55 ); to our knowledge, this association has not been thoroughly evaluated in other states. As noted above, most studies in adolescents have found no measurable effect of state-level policy changes on marijuana prevalence ( 53 ); however, it is still too early to know the possible long-term consequences of legalization for individuals and society. Furthermore, almost all studies evaluating the policy effects of legalization have focused on the point in time when individual states legalized marijuana; few have focused on the policy effects of the Ogden Memo ( 56 ). Three studies that have compared pre- and post-2009 trends (in an effort to capture potential effects of the federal shift in policy) have all found measurable differences in risk perception ( 51 ), an increased number of drivers involved in motor vehicle fatalities who had positive toxicology tests for cannabis ( 55 ), and an increase in unintentional pediatric ingestions of marijuana products ( 57 ). Further research is needed to clarify the relationships among decriminalization, legalization, and prevalence.

Diversion of Legal Marijuana to Minors

Another concern regarding adolescents and the legalization of marijuana is that of drug diversion, or that adolescents will have access to cannabis from adults with legal access to medical or recreational marijuana. In a cross-sectional survey (n = 80), almost half of adolescents participating in outpatient substance-abuse treatment in Colorado reported using diverted marijuana. Compared to those who had not used diverted medical marijuana, those who had were more likely to report easy availability of marijuana, >20 times of use per month in the past year, and minimal peer disapproval of regular use ( 58 ). Another study found a similarly high rate (74%) of adolescents engaged in substance-abuse treatment who reported having used diverted medical marijuana ( 59 ).

In Colorado, the legalization of marijuana and its de facto decriminalization on the federal level have led to the emergence of pediatric (nine years of age or younger) cases of unintentional ingestion of marijuana products. From 2005 to October 2009 (prior to the Ogden Memo), there were no marijuana-related emergency room (ER) visits for unintentional ingestions in Colorado. From October 2009 through 2011 (following the Ogden Memo), there were 14 pediatric unintentional ingestion ER visits that involved marijuana products, accounting for 2.4% of all ingestion visits in the state ( 57 ). An analysis of national data from 2005–2011 found a 30% annual rate of increase of such cases in states where medical marijuana was legal prior to 2005, whereas rates in nonlegal states do not seem to be changing ( 60 ).

Marijuana and Opioid Use

Another important issue in the policy debate regarding marijuana legalization is the relationship between marijuana and opioid use. Evidence suggests that marijuana and/or cannabinoids can effectively mitigate some forms of pain or discomfort. It is an empirical question whether medical marijuana would allow those prescribed opioid analgesics to taper off or at least reduce the dose of their traditional pain medications ( 61 ). To our knowledge, no clinical trial evaluating the efficacy of cannabis or cannabinoids for chronic pain has shown that cannabis use allows patients to lower their dose of opioid analgesics. Also, cannabis use has traditionally been associated with an increased use of opioids ( 62 ). However, one recent study suggests that the passage of medical marijuana laws may be associated with a decrease over time in opioid overdose mortality compared to estimates of overdose mortality had these laws not been passed. Notably, states with medical marijuana laws have higher rates of age-adjusted opioid overdose mortality than do states without such laws ( 63 ). Further research is needed from epidemiological studies (to examine the relationship between the passage of medical marijuana laws and prevalence of opioid use) and from clinical trials (to investigate whether marijuana used to treat pain can allow patients to lower their opioid analgesic doses and maintain similar rates of analgesia).

Marijuana and Driving

With recent changes in its legal status, the impact of marijuana on driving ability is increasingly relevant. Marijuana is the most common illicit drug reported in motor vehicle accidents (MVA) ( 45 ). However, it is difficult to ascertain a causal contribution in many of these accidents as marijuana has substantially varied effects on driving abilities due to factors such as tolerance, differences in smoking techniques, and differences in absorptions of THC ( 64 ). Evidence has shown that the potential negative effects of marijuana on driving may disappear after controlling for other risky driving behaviors ( 65 ). Epidemiological studies attempting to characterize the relationship between acute marijuana intoxication and MVA culpability have been mixed and are not as strong as the relationship between alcohol intoxication and MVAs ( 66 ).

Experimental studies indicate that acute intoxication with marijuana affects a number of cognitive and motor skills that are relevant to driving, including reaction time, attention, signal detection, information processing speed, spatial working memory, verbal learning and recall, procedural memory, tracking accuracy, time and distance estimation, set shifting, motor coordination, and danger perception ( 46 ). Results from driving simulator studies suggest that the effects of marijuana on driving may be dose dependent, with minimal to no impairment at low doses ( 67 , 68 ) and progressive impairment with increasing dose ( 64 ). Also, the effects of marijuana may be more pronounced as the complexity of tasks increases ( 69 ). Notably, heavy users may exhibit minimal functional impairment in selected driving tasks ( 64 , 70 ), presumably due to tolerance.

Whereas alcohol intoxication leads drivers to underestimate their impairment (resulting in speeding and other forms of increased risk taking), marijuana generally leads drivers to overestimate their impairment (resulting in slower driving speeds despite explicit instructions to maintain a particular speed). However, the combined effects on driving ability of marijuana and alcohol do not nullify each other. Evidence suggests that impairment as a result of both substances is greater than either alone ( 64 ) and may be more than additive ( 71 ).

The number of fatal cannabis-associated MVAs may be increasing. One Colorado study suggests that the number of fatal MVAs in which the driver was cannabis positive has increased with legalization, particularly with the change in federal policy in 2009; no such trend was seen in states without medical marijuana laws ( 55 ). However, given that the number of fatal MVAs has been on the decline in Colorado since 2004 ( 55 ), the perceived increase in marijuana-positive MVAs may merely reflect the general increase in cannabis use in Colorado over the study period. Further, as discussed above, the finding that a driver is marijuana positive at the time of a MVA does not indicate that marijuana was the cause of the accident ( 64 ).

Adverse Health Effects

Marijuana use is linked to several adverse health outcomes, including addiction, impaired cognition, pulmonary effects, mental illness, and other problems ( 45 ).

Addiction/Dependence

Approximately one in ten adult users of marijuana develops addiction, and this number is higher among adolescents ( 72 ). The lifetime dependence rate of marijuana is generally lower than the rates of other drugs, including alcohol, heroin, and cocaine ( 73 ). However, marijuana dependence is the most prevalent substance-abuse diagnosis, excepting alcohol and tobacco dependence ( 1 ).

Impaired Cognitive Abilities

Acute effects.

Among infrequent (nondaily) users, marijuana causes impairment in the areas of attention and concentration, impulse control, planning, decision making, and working memory 0–6 h after use ( 46 , 74 ). Marijuana use results in slower response time in tasks of simple reaction time, visuospatial selective attention, sustained attention, divided attention, and short-term memory, as well as impairment on a task of motor control ( 75 ). In chronic, daily users of cannabis, acute abstinence results in greater cognitive impairment than acute use. In fact, marijuana may normalize the cognitive dysfunction seen with cannabis withdrawal; however, this likely represents a lower level of cognitive function compared to that prior to onset of use ( 74 ). No significant differences were observed for critical-tracking or divided-attention task performance in a cohort of heavy, chronic cannabis smokers ( 76 ).

Persistent effects

Chronic marijuana use is associated with persistent impairment of attention, verbal memory, working memory, decision making, and executive function ( 46 , 74 ). Although early evidence (using traditional neuropsychological assessments) showed that cognitive deficits associated with marijuana use resolved by day 28 of abstinence ( 77 ), more recent data show subtle, persistent cognitive deficits despite prolonged abstinence ( 78 , 79 ). In support of these data is the finding of a dose-dependent effect on cognition, such that early and greater quantity of marijuana use results in greater cognitive deficits ( 80 ). This is particularly true for adolescents who begin smoking marijuana in their early teens. In one study, adolescents who began smoking cannabis early (14–22 years of age) and stopped by age 22 had significantly greater cognitive deficits at age 27 than nonusing peers ( 81 ). About 10% of cannabis-dependent adolescents report experiencing a “serious problem” with memory loss ( 82 ). In a longitudinal birth cohort comprising 1,037 individuals followed through 38 years (the Dunedin study), persistent marijuana use was associated with a six-point decline in intelligence quotient; these deficits were greater (eight points) when use began in adolescence, and, importantly, these declines did not reverse after the cessation of marijuana use ( 47 ).

Marijuana intoxication is associated with transient psychosis-like effects, including paranoia, ideas of reference, flight of ideas, pressured thought, disorganized thinking, persecutory or grandiose delusions, and auditory/visual hallucinations ( 46 ). Chronic daily use of marijuana has been associated with the emergence of a persistent psychotic disorder indistinguishable from schizophrenia ( 46 ), although a causal link remains controversial. The current evidence suggests that marijuana use may be a “component cause” in that it is neither necessary nor sufficient to cause schizophrenia ( 83 ). Like other negative effects of cannabis, the risk of psychosis appears to be heightened by heavy and early use ( 84 ). Large epidemiological studies have shown a dose-dependent risk for chronic psychosis as a result of marijuana exposure ( 83 ). Clearly, most people who consume marijuana do not experience psychosis; the marijuana–psychosis link may be mediated through genetic [COMT mutation ( 85 )] and environmental [childhood maltreatment ( 86 )] factors. With the rising potency of marijuana strains, there is some evidence that rates of first-episode psychosis are also rising ( 87 ). Further, among persons with established psychotic disorders, marijuana use is associated with a worse course of illness ( 88 ). Chronic, daily cannabis use is also associated with the emergence of amotivational syndrome, characterized predominantly by a lack of motivation and drive ( 46 ).

Pulmonary Effects

Although marijuana smokers generally consume their cigarettes (joints) at a fraction of the quantity seen in tobacco smokers, legitimate concerns persist about the pulmonary effects of cannabis smoke, especially given that some evidence suggests higher levels of carcinogens and tars in cannabis cigarettes than in tobacco cigarettes ( 89 ). After adjusting for tobacco use and other potential confounders, some ( 90 , 91 ) but not all ( 92 ) studies implicate cannabis consumption as a risk factor for lung cancer. Chronic cannabis use may lead to symptoms of bronchitis ( 93 ), although moderate marijuana use does not seem to be associated with these symptoms ( 94 ). Cannabis vaporizers are becoming increasingly popular and have been purported to decrease the amount of toxins delivered; thorough research investigating the comparative safety of marijuana smoking versus vaporization has not been done.

Interactions With Other Drugs

In vitro studies have shown that cannabinoids can inhibit a number of hepatic enzymes that metabolize common drugs, including CYP2D6 ( 95 ), CYP2C19 ( 96 ), CYP2C9 ( 97 ), and CYP3A4 ( 98 ). Other evidence in humans suggests that marijuana may also interfere with the drug concentrations of warfarin ( 99 ) and antiretroviral therapies ( 100 ). Further research is needed to explore how components of marijuana might interact with other medications in a clinical setting.

The legal status of marijuana is rapidly changing, with important implications for public health and physician practice. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in MS. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. States with legalized marijuana do have higher rates of use than nonlegal states, but these higher rates are generally found even prior to legalization.

As states continue to proceed with legalization for both medical and recreational use, a number of public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary problems. In light of the rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.

Acknowledgments

This work was supported in part by NIMH grant 5R25MH071584-08 (S.T.W. and R.R.) and 5T32MH019961-18 (S.Y.).

Disclosure Statement : The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review.

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Pros and Cons of Legalizing Marijuana

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

• Scientific Evidence

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

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

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

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

Several possible health benefits of medical marijuana have been proposed:

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

And arguments in favor of using medical marijuana include:

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

Recreational Marijuana

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

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

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

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

Scientific Evidence Remains Limited

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

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

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

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

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

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

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

A Word From Verywell

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

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

National Conference of State Legislatures. State medical marijuana laws .

United States Drug Enforcement Administration. Drug scheduling .

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

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

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

American Cancer Society. Marijuana and Cancer .

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

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

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

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

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

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

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

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

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

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

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

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

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

Marijuana Legalization Controversies: Arguments For and Against

Introduction.

The topic of marijuana legalization has always been a subject of numerous heated debates for decades. The legislative measures and methodological tools to study both positive and negative effects are present. However, the social attitude towards cannabis is gradually shifting with an increased amount of acceptance and understanding. The given research paper analyses the current argumentative basis of marijuana legalization. The detailed study of the problem included a thorough description of people’s arguments and reasons for and against the legalization of marijuana. Each opposing side of the subject was granted an equal amount of expression and representation, which promoted an unbiased observation. The aim is to create a full comprehension of the issue and an overview of the social stigma surrounding the topic. The outlook and review of international experience are important to use as an illustration. The conclusive statement revolves around unbiased research and analysis of societal attitudes towards the topic.

The fight against drug addiction and drug trafficking in the world is conducted in various ways and means; methods of struggle are usually divided into three distinct groups according to the degree of stringency of legislation in relation to this social phenomenon: countries of moderate control, countries with tough policies, states of a liberal approach. At the same time, in some countries, the fight against drug trafficking began to change its forms, choosing more progressive approaches to solving this issue. The beginning of the process of legalization of marijuana in Canada and Georgia provoked heated discussions not only at the public but also at the government level, which is associated with the expansion of the geography of countries in which the use of the drug in question has become legal. The main goal of the given research study is to overview and analyze the arguments regarding marijuana decriminalization and how they affect social perception. These given disputes will be a demonstrative basis for the development of a full understanding of the marijuana legalization controversy.

The methodological approach of the given research study involved detailed analysis and overview of the current state of affairs regarding the controversy over marijuana legalization. The objective observation tools and unbiased argumentation instruments were applied in order to deliver thorough results and information for further discussion. The study was designed on the parallel model, where each side of an issue is considered. Population and sample strategy subjects of representative legislative initiatives were collected from all over the globe, including Canada, Uruguay, and the US. The main variables were argument details and number, which indicated overall social attitude towards the controversy. Data was collected through analysis and overview of the current knowledge basis and research studies. Systematic overview and argumentation gathering were used as primary methods of analysis and observation.

Extensive research resulted in a thorough analysis of current social shifts in attitudes towards cannabis legalization and the controversy over it. The report includes information from the US, Uruguay, Canada, Ireland, Australia, and Germany. The data collection showed that several nations possess the problem of objectively addressing the issue of drug criminalization. The main finding is that in the United States, the cannabis legalization movement is currently in full swing: in 2016, states like California, Massachusetts, Maine, and Nevada joined Washington and Colorado to legalize marijuana. Other states, such as Florida, Arkansas, Montana, and North Dakota, also followed suit, but the consumption of marijuana was legalized only in cases of medical use. Thus, now more than half of the states have decriminalized the use of cannabis in full or limited medical volume (Maier, Mannes, & Koppenhofer, 2017). However, speaking of the movement for the jurisdictional allowance of the use of soft drugs, it is important to note that in the United States, as in many other states, there is a fairly broad movement opposing legalization, justifying this position with a lengthy list of arguments and arguments.

The process of legalizing cannabis is not an exceptional phenomenon, characteristic only for the United States. A secondary finding is that currently, 21 states have legalized marijuana in whole or in part for medical and adult-use (Maier et al., 2017). Relatively recently, Georgia has also embarked on the path of partial cannabis legalization, which has thus become one of the first countries in the international space in which cannabis consumption and its cultivation for its use has ceased to be a criminal offense (Onders, Casavant, Spiller, Chounthirath, & Smith, 2015). In 2016, Uruguay and Canada began the process of legalizing marijuana through legal regulation of the main provisions on the use of this type of drug while maintaining restrictions on the production and sale (Cruz, Queirolo, & Boidi, 2016.) Ireland, Australia, Germany, and Jamaica approved laws that recognize medical marijuana; however, the use of marijuana in other cases continues to be an offense and can be punished, including the application of criminal law. Medicinal use of marijuana involves its use to combat the individual symptoms and effects of a number of diseases, is allowed only with the appropriate prescription of the doctor, excluding the possibility of free distribution of the drug.

The discussion is aimed to derive the entire argumentative basis of the controversy of the cannabis legalization issue. The major finding is that the argumentative basis for the controversy is large and includes numerous similarities across the nations. The main results are arguments that are emphasized by supporters of the legalization of marijuana include social causes, legal reasons, and fiscal arguments. First, the marijuana ban is unreasonable government intervention in the individual freedom of choice; thus, a person is free to decide for himself what and how to do, what to use, and in what sizes.

In addition, marijuana is no more harmful to human health than alcohol or tobacco, which is legal and widely used and regulated by the government, which, through the introduction of a system of excise taxes, uses the sale of alcohol and tobacco products to replenish the state budget (Stringer & Maggard, 2016). Cannabis provides medical care to patients suffering from a multitude of diseases, including cancer, AIDS, and glaucoma (Doussard, 2017). Crime and violence rates, both in the country and at its borders with neighboring countries, are significantly increased due to the illegal sale and purchase of marijuana. Legalization would logically stop the need for such criminal behavior, translating the entire shadow business. The suggested policy is to create an unbiased platform for a thorough discussion of the issue. Practical implications are observations on the social scale, where the emerging arguments shift the social stigma around controversy.

Furthermore, there a significant amount of legal reasons to decriminalize marijuana consumption. Statistics show that crimes related to the acquisition, storage, sale, and distribution of drugs account for a significant proportion of the total amount of crimes committed, exceeding the quantitative indicators for other types of crimes. As a result, the number of such crimes has a significant burden on the activities of law enforcement agencies, as well as on the workload of the judicial and penitentiary systems. In addition, young people between the ages of 18 and 30 who are sentenced to sufficiently severe punishment, up to imprisonment, are charged with drug-related cases (Stringer & Maggard, 2016). As a result, convicts are subjected to significant social harm, and society receives people who, at the time of their maturation, have lost the opportunity to be part of the culture.

Moreover, fiscal reasons play a critical role in the topic of controversy. For instance, fighting marijuana requires substantial financial expenses from the state, which are necessary for law enforcement, judicial and penal systems, as well as the subsequent re-socialization of those who have served their sentences (Stringer & Maggard, 2016). The legalization of marijuana will be the impetus for the development of legal business, the emergence of new jobs, which will inevitably lead to an increase in tax revenues, as well as the removal of part of the money from the black market.

Nevertheless, the controversy over cannabis legalization is fueled by the arguments of the opposing side. The main reasons against the legalization of marijuana are also social, legal, and fiscal (Ward, Lucas, & Murphy, 2018). The main cultural cause is that one of the reasons is the moral component of this issue since the legalization of a “light” drug as marijuana raises the question of the immorality of this decision (Cruz et al., 2016). Since people are talking about drugs, the use of which is considered shameful and reproachful, makes it possible and permissible to discuss further the possibility of legalizing other drugs.

Furthermore, there is an assertion that regular use of marijuana can lead to the use of heavier, more dangerous drugs, such as heroin and cocaine, because this is how many people become and become addicts, and drug addicts tend to seek and repeat the first sensations caused by use narcotic drugs (Ward, Lucas, & Murphy, 2018). Additionally, the opponents of legalizing marijuana believe that individuals involved in the illegal purchase and sale of drugs are more likely to be involved in other crimes, indicating a close relationship between these types of crimes (Doussard, 2017). The legalization of marijuana will lead to the creation in the country of a whole network of legally operating organizations that can simultaneously carry out illegal activities to sell other types of drugs, hiding behind the sale of marijuana. The strength of the study is the availability of the given information and consequent improvement with alterations. However, the major limitation is a practical implementation and continuous observation of social influences. In addition, the given research includes many variable elements which affect the results.

In conclusion, the controversy over marijuana use is greatly influenced by the social stigma around the topic. Therefore, it is highly important to fully understand the argumentative basis for the dispute. The arguments “for” and “against” the legalization of marijuana are mutually exclusive, and the strength of the position of one party or another in a given dispute depends more on the socio-political situation in each specific state. However, it is clear that legalization in certain regions will lead to positive consequences. It should be noted that the overwhelming number of countries in the world consistently oppose this process, and most countries in which marijuana legalization occurred, conducted this process only partially, which means that they allowed restricted medical use of marijuana, while another is still recognized as an administrative or criminal offense.

Cruz, J. M., Queirolo, R., & Boidi, M. F. (2016). Determinants of public support for marijuana legalization in Uruguay, the United States, and El Salvador. Journal of Drug Issues, 46 (4), 308-325.

Doussard, M. (2017). The other green jobs: Legal marijuana and the promise of consumption-driven economic development. Journal of Planning Education and Research, 39 (1), 79-92.

Maier, S. A., Mannes, S., & Koppenhofer, E. L. (2017). The implications of marijuana decriminalization and legalization on crime in the United States. Contemporary Drug Problems, 44 (2), 125-146.

Onders, B., Casavant, M. J., Spiller, H. A., Chounthirath, T., & Smith, G. A. (2015). Marijuana exposure among children younger than six years in the United States. Criminal Justice Policy Review, 55 (5), 428-436.

Stringer, R. J., & Maggard, S. R. (2016). Reefer madness to marijuana legalization: Media exposure and American attitudes toward marijuana (1975-2012). Journal of Drug Issues, 46 (4), 428-445.

Ward, K. C., Lucas, P. A., & Murphy, A. (2018). The impact of marijuana legalization on law enforcement in states surrounding Colorado. Police Quarterly, 1 (1), 1-9.

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103 Marijuana Legalization Essay Topic Ideas & Examples

🏆 best marijuana legalization topic ideas & essay examples, 👍 good essay topics on marijuana legalization, ⭐ most interesting marijuana legalization topics to write about, ✅ simple & easy marijuana legalization essay titles.

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• Marijuana Legalization and Consumption Among Youth The most popular excuse among drug consumers is the instrumental use of the drug. As long as the drug influence is undermined, the number of college students willing to experience the marijuana effects will be […]
• Legalization of Medical Marijuana: Help or Harm? Nowadays, a majority of people worldwide support the legalization of marijuana, and it is possible to predict that this support will keep getting stronger in the future.
• Medical Marijuana Legalization Concerns This change raises political concerns and requires the government to review its economy to adapt to the use of MM. The representation of the legal process highlighted the history of previous legislations and reported on […]
• Medical Marijuana: Legal and Research Concerns However, while the purpose of recreational marijuana is often disconnected from its long-term effects on people’s health in scholarly discussions, the use of medical marijuana is viewed from the point of patient’s health and the […]
• Should Marijuana Be Legalized? Marijuana legalization is a topic of social trends and beliefs that are based not only on health but political and economic factors as well.
• Marijuana Legalization and Its Benefits for Society The example of several states that have already introduced the appropriate law provides the ground for vigorous debates about the absence of the expected deterioration of the situation and emergence of multiple problems associated with […]
• Marijuana Legalization in 5 Policy Frameworks The legalization of marijuana is still one of the debatable issues at the federal and state levels. For instance, the use of marijuana is prohibited at the federal level while the recreational and medical use […]
• Marijuana Legalization in California The muscle relaxation effect of marijuana also appears to be a positive effect that should be used to argue for its legalization.
• Legalization of Marijuana in the United States It should not be forgotten that it is a cause of numerous tragedies. Also, some studies show that the use of marijuana is especially dangerous for young people.
• Medical Marijuana Legalization by National Football League However, it must be realized that some of these players are usually in excruciating pain to the point that some may have lost consciousness.
• Medical Marijuana Legalization Rebuttal The claim of fact is that A.C.A.continues to be beneficial despite the arguments of Republican politicians and current challenges. The claim of policy is the appeal to Republicans and Democrats to work together on the […]
• Legal Marijuana Market Analysis and Taxes Impact Consequently, the primary goal of this paper is to understand the impact of taxes on the financial stability of the market for legal marijuana with the help of the law of supply and demand and […]
• Controversy Around Medical Marijuana Legalization The consideration of the problem of marijuana legalization from the perspective of public safety involves such points as crime rates and traffic accidents. The fact of economic benefits of the Cannabis legalization is also apparent: […]
• The Legalization of Marijuana: Regulation and Practice It is imperative to note that legalization of marijuana is a topic that has been quite controversial and has led to numerous discussions and disagreements.
• Concepts of Legalizing Marijuana Although in most cases, most individuals associate Marijuana with numerous health complications and social problems, for example, brain damage, and violent behavior hence, supporting its illegalization, such individuals take little consideration of its significance in […]
• Marijuana Legalization in Illinois The case for legalization of marijuana in Colorado evidences the need to alter federal laws prohibiting marijuana for its legalization law to have both statutory and federal backing in the state of Illinois.
• Public Safety and Marijuana Legalization Some of the states have failed to tax marijuana. Hence, it is difficult to get the precise figures in terms of tax values that states could collect from marijuana.
• History and Effects of Legalization of Marijuana As predicted, the legalization of marijuana in several states has led to an increase of marijuana abuse among youngsters Studies have shown a pattern of the use of cannabis and risky behavior of the individuals.
• Debates Around Legalization of Medical Marijuana The supporters and opponents of the legalization of marijuana have opted to focus on either the positive or the negative aspects of the effects of the drug to support their views on policies to legalize […]
• Should Marijuana Be Legal? It is perhaps very essential to be acquainted with an account of laws that surround marijuana in order to understand the reasons why the drug ought to be legalized.
• How New York Would Benefit From Legalized Medical Marijuana The arrests resulting from possession of marijuana in New York is quite huge compared to those in California and New Jersey states in America.
• Should Be It Legal to Sell the Marijuana in the United States? What I want to know is the reasons of why so many people use such serious psychoactive drug as marijuana of their own accord and do not want to pay special attention to their activities […]
• Supporting of Marijuana Legalization Among the Adult Population Proponents argue that legalization of marijuana will lead to increased revenues for the government amid economic challenges. Legalizing marijuana will not lead to cancer and deaths but will spark the debate for apparent effects of […]
• Marijuana: The Issues of Legalization in the USA To understand all the possible effects of the marijuana legalization, it is necessary to pay attention to the definition and classification of the drug with references to determining the most important social and legal aspects […]
• Reasons for Legalization of Marijuana The legalization of the drug would bring to an end the discrimination of the African Americans in marijuana-related arrests, reduce the sales of the drug and its use among teenagers, encourage the development of hemp […]
• Legalizing Marijuana: Arguments and Counter-Arguments On the other hand, many groups have outlined that the legalization of marijuana would lead to an increase in the rate of crime in addition to opening up of the gateway to the abuse of […]
• Should We Legalize Marijuana For Medical Use? In addition to that, the use of Marijuana especially by smoking either for medical reasons or to heal ailments, is a social activity that will help bring them together and improve their social ties.
• Why Marijuana Should Be Legalized? The government should save that money it uses in prohibiting the use of marijuana as it has no proved harm to the users.
• Arguments on Why Marijuana Should Be Illegalized The greater part of the population believes that the sustained use of this product is beneficial in numerous ways. Therefore, it is clear that the negative effects of the drug outdo the constructive ones.
• A Case for Legalizing Marijuana Marijuana is one of the drugs that the government policy targets and as it currently stands, the government uses a lot of resources in prosecuting and punishing marijuana consumers through the legal system.
• Federal Government Should Not Legalize the Use of Marijuana On the other hand the use of marijuana actually increased in the country. It is not only the DEA or the federal government that is reluctant in the legalization of marijuana.
• Issues with Marijuana Legalization in the United States This is the reason why the debate on the legalization of marijuana has been on the increase since the past 10 years.
• Does Legalizing Marijuana Help or Harm the United States? The latter measure is not merely being advocated by the proponents of marijuana use since the legalization of marijuana has been supported by NAACP not because it fully backs the smoking of marijuana.
• The Debates on the Legal Status of Marijuana This means that the use of marijuana encourages the consumption of other drugs such as alcohol and cigarettes. Additionally, the use of marijuana is associated with increase in crime and consumption of other illicit drugs.
• Argument About Legalizing Marijuana in America Therefore, if at all the government of the United States is to prohibit the use of marijuana in the country, it should be ready to cater for the high costs that come in hand with […]
• The Moral and Ethical Reasons Why Marijuana should be legal It is my humble opinion that the billions of dollars being spent on the war against marijuana should be diverted to more useful projects like feeding the less fortunate in the society.
• The Problem of Legalization of Marijuana and Hemp Many individuals tend to believe that the use of Marijuana is morally wrong as it alters the mental state of the user and leads to dangerous addictions and actions in the end.
• Minor and Major Arguments on Legalization of Marijuana Premises 1: If marijuana were to be legalized it would be impossible to regulate its’ sell to, and use by the minors. Making marijuana illegal is denying them a right to the use of this […]
• The Reasons Why Marijuana Should be Made Legal Among the reasons that support the legalization of marijuana include: the medical basis that marijuana has some benefits and that the state could gain revenue from the trade of marijuana as opposed to the costs […]
• Why Is Marijuana Legalized In Some States And Not Others? I consider the legalization of marijuana to be a positive step as its prohibition entails intrusion of personal freedom and just like any other substance it is only harmful when it is not taken in […]
• The Effect of Legalization of marijuana in the Economy of California It has been predicted that if the government legalizes the drug, there will be a lot of changes pertaining to the demand for the drug in the market and as a result, there will be […]
• Marijuana Must Not Be Legalized According to the national institute of drug abuse, the active chemical in marijuana, tetrahydrocannabinol, act on the region of the brain responsible for time awareness, sensory, attention, thoughts, memory and pleasure.
• Policy Brief: Why Marijuana Use Should Be Legalized in the Us In this perspective, it is valid to argue that marijuana users may be undergoing long incarcerations in US jails due to the misconceived fantasies that took root in the public mind in the 1930’s, and […]
• Analyzing Arguments Against Marijuana Legalization
• America Requirements Medicinal Weed: Marijuana Legalization
• Arguing for Medical Marijuana Legalization
• Benefits Associated With Marijuana Legalization
• Analysis of Marijuana Legalization in Canada
• The Relationships Between Marijuana Legalization and the DEA
• Governmental Regulation of the Marijuana Legalization
• Exploring the Pros and Cons of Marijuana Legalization
• Defining the First Steps Toward Marijuana Legalization
• Going Green: Analyzing Marijuana Legalization
• How Marijuana Legalization Will Affect Public Health
• Debate on Whether It’s Time for Marijuana Legalization
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• Marijuana Legalization and How It Affects the GDP
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• The Relationships Between Marijuana Legalization and Taxation
• Marijuana Legalization: Arguments and Criticism
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• The Link Between Modern Liberalism and Marijuana Legalization
• Marijuana Legalization Could Reduce the Amount of Money the Government Spends on Prisons
• Principles of State and Federal Marijuana Legalization
• Marijuana Legalization: Good for the Nation?
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• The Cross-Border Spillover Effects of Recreational Marijuana Legalization
• Marijuana Legalization: Should the Federal Government Legalize the Use of Marijuana?
• The Debate Over the Controversial Subject of Marijuana Legalization in the U.S.
• Marijuana Legalization: PREPARE and IMAGINE Models
• Overview of Medical Marijuana Legalization Initiative
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• Chicago (A-D)
• Chicago (N-B)

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9 facts about americans and marijuana.

The use and possession of marijuana is illegal under U.S. federal law, but about three-quarters of states have legalized the drug for medical or recreational purposes. The changing legal landscape has coincided with a decades-long rise in public support for legalization, which a majority of Americans now favor.

Here are nine facts about Americans’ views of and experiences with marijuana, based on Pew Research Center surveys and other sources.

As more states legalize marijuana, Pew Research Center looked at Americans’ opinions on legalization and how these views have changed over time.

Data comes from surveys by the Center,  Gallup , and the  2022 National Survey on Drug Use and Health  from the U.S. Substance Abuse and Mental Health Services Administration. Information about the jurisdictions where marijuana is legal at the state level comes from the  National Organization for the Reform of Marijuana Laws .

More information about the Center surveys cited in the analysis, including the questions asked and their methodologies, can be found at the links in the text.

Around nine-in-ten Americans say marijuana should be legal for medical or recreational use,  according to a January 2024 Pew Research Center survey . An overwhelming majority of U.S. adults (88%) say either that marijuana should be legal for medical use only (32%) or that it should be legal for medical  and  recreational use (57%). Just 11% say the drug should not be legal in any form. These views have held relatively steady over the past five years.

Views on marijuana legalization differ widely by age, political party, and race and ethnicity, the January survey shows.

While small shares across demographic groups say marijuana should not be legal at all, those least likely to favor it for both medical and recreational use include:

• Older adults: 31% of adults ages 75 and older support marijuana legalization for medical and recreational purposes, compared with half of those ages 65 to 74, the next youngest age category. By contrast, 71% of adults under 30 support legalization for both uses.
• Republicans and GOP-leaning independents: 42% of Republicans favor legalizing marijuana for both uses, compared with 72% of Democrats and Democratic leaners. Ideological differences exist as well: Within both parties, those who are more conservative are less likely to support legalization.
• Hispanic and Asian Americans: 45% in each group support legalizing the drug for medical and recreational use. Larger shares of Black (65%) and White (59%) adults hold this view.

Support for marijuana legalization has increased dramatically over the last two decades. In addition to asking specifically about medical and recreational use of the drug, both the Center and Gallup have asked Americans about legalizing marijuana use in a general way. Gallup asked this question most recently, in 2023. That year, 70% of adults expressed support for legalization, more than double the share who said they favored it in 2000.

Half of U.S. adults (50.3%) say they have ever used marijuana, according to the 2022 National Survey on Drug Use and Health . That is a smaller share than the 84.1% who say they have ever consumed alcohol and the 64.8% who have ever used tobacco products or vaped nicotine.

While many Americans say they have used marijuana in their lifetime, far fewer are current users, according to the same survey. In 2022, 23.0% of adults said they had used the drug in the past year, while 15.9% said they had used it in the past month.

While many Americans say legalizing recreational marijuana has economic and criminal justice benefits, views on these and other impacts vary, the Center’s January survey shows.

• Economic benefits: About half of adults (52%) say that legalizing recreational marijuana is good for local economies, while 17% say it is bad. Another 29% say it has no impact.

• Criminal justice system fairness: 42% of Americans say legalizing marijuana for recreational use makes the criminal justice system fairer, compared with 18% who say it makes the system less fair. About four-in-ten (38%) say it has no impact.
• Use of other drugs: 27% say this policy decreases the use of other drugs like heroin, fentanyl and cocaine, and 29% say it increases it. But the largest share (42%) say it has no effect on other drug use.
• Community safety: 21% say recreational legalization makes communities safer and 34% say it makes them less safe. Another 44% say it doesn’t impact safety.

Democrats and adults under 50 are more likely than Republicans and those in older age groups to say legalizing marijuana has positive impacts in each of these areas.

Most Americans support easing penalties for people with marijuana convictions, an October 2021 Center survey found . Two-thirds of adults say they favor releasing people from prison who are being held for marijuana-related offenses only, including 41% who strongly favor this. And 61% support removing or expunging marijuana-related offenses from people’s criminal records.

Younger adults, Democrats and Black Americans are especially likely to support these changes. For instance, 74% of Black adults  favor releasing people from prison  who are being held only for marijuana-related offenses, and just as many favor removing or expunging marijuana-related offenses from criminal records.

Twenty-four states and the District of Columbia have legalized small amounts of marijuana for both medical and recreational use as of March 2024,  according to the  National Organization for the Reform of Marijuana Laws  (NORML), an advocacy group that tracks state-level legislation on the issue. Another 14 states have legalized the drug for medical use only.

Of the remaining 12 states, all allow limited access to products such as CBD oil that contain little to no THC – the main psychoactive substance in cannabis. And 26 states overall have at least partially  decriminalized recreational marijuana use , as has the District of Columbia.

In addition to 24 states and D.C.,  the U.S. Virgin Islands ,  Guam  and  the Northern Mariana Islands  have legalized marijuana for medical and recreational use.

More than half of Americans (54%) live in a state where both recreational and medical marijuana are legal, and 74% live in a state where it’s legal either for both purposes or medical use only, according to a February Center analysis of data from the Census Bureau and other outside sources. This analysis looked at state-level legislation in all 50 states and the District of Columbia.

In 2012, Colorado and Washington became the first states to pass legislation legalizing recreational marijuana.

About eight-in-ten Americans (79%) live in a county with at least one cannabis dispensary, according to the February analysis. There are nearly 15,000 marijuana dispensaries nationwide, and 76% are in states (including D.C.) where recreational use is legal. Another 23% are in medical marijuana-only states, and 1% are in states that have made legal allowances for low-percentage THC or CBD-only products.

The states with the largest number of dispensaries include California, Oklahoma, Florida, Colorado and Michigan.

Note: This is an update of a post originally published April 26, 2021, and updated April 13, 2023.  

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

Religious americans are less likely to endorse legal marijuana for recreational use, four-in-ten u.s. drug arrests in 2018 were for marijuana offenses – mostly possession, two-thirds of americans support marijuana legalization, most popular.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

Alcohol Vs. Marijuana

This essay about the comparative merits of alcohol and marijuana provides a comprehensive examination of their health implications, social consequences, and legal considerations. It discusses how alcohol’s legal status contrasts with its significant health risks and social issues, while marijuana’s illegal status obscures its potential benefits. The essay emphasizes the need for nuanced perspectives and informed decision-making, advocating for harm reduction strategies and public health-focused policies.

How it works

In contemporary society, discussions surrounding substance use often revolve around the comparative merits and demerits of alcohol and marijuana. As students, we find ourselves at the crossroads of exploration, where decisions about indulgence are paramount to our well-being. Within this discourse, the debate on whether weed is better than alcohol echoes loudly. This essay endeavors to delve into this debate with a critical lens, considering aspects ranging from health implications to social consequences, aiming to shed light on the complexities inherent in making informed choices regarding substance use.

Health Implications:

The health ramifications of alcohol and marijuana use are multifaceted and deserve meticulous examination. Alcohol, a legal and socially accepted intoxicant, is associated with a plethora of adverse health effects. Chronic alcohol abuse can lead to liver cirrhosis, cardiovascular diseases, neurological impairments, and addiction, culminating in alcoholism—a debilitating condition with dire consequences for individuals and society as a whole.

Conversely, marijuana, although illegal in many jurisdictions, has garnered attention for its purported medicinal properties and relatively lower health risks compared to alcohol. While chronic marijuana use may impair cognitive function and respiratory health, it lacks the acute toxicity and risk of fatal overdose associated with alcohol. Moreover, certain cannabinoids found in marijuana have shown promise in alleviating symptoms of chronic pain, epilepsy, and nausea, further complicating the narrative surrounding its health implications.

Social Consequences:

Beyond individual health, the social ramifications of alcohol and marijuana use shape communal dynamics and cultural norms. Alcohol, deeply ingrained in social rituals and festivities, often serves as a facilitator of social interaction. However, its disinhibiting effects can lead to a myriad of social issues, including aggression, violence, and impaired judgment, contributing to accidents and interpersonal conflicts.

Contrastingly, marijuana’s social impact varies widely depending on cultural norms and legal frameworks. In regions where it is decriminalized or legalized, marijuana consumption may be normalized and integrated into social settings akin to alcohol. Proponents argue that marijuana fosters relaxation and camaraderie without the aggression and volatility often associated with alcohol. However, in conservative societies or jurisdictions where marijuana remains illegal, its use may carry stigma and legal repercussions, exacerbating social inequalities and reinforcing punitive approaches to drug policy.

Legal and Policy Considerations:

The legal landscape surrounding alcohol and marijuana is a testament to the complexities of substance regulation and public health policy. Historically, alcohol prohibition in the early 20th century in the United States underscored the limitations of outright prohibition, leading to its eventual repeal due to rampant illicit production and organized crime. In contrast, marijuana prohibition persists in many jurisdictions despite shifting public attitudes and mounting evidence of its comparatively lower societal harm.

Recent efforts to legalize marijuana in various jurisdictions have sparked debates on regulation, taxation, and harm reduction strategies. Proponents of legalization argue for the implementation of stringent regulatory frameworks to mitigate underage access, promote public education, and redirect resources from enforcement towards treatment and prevention. Conversely, opponents raise concerns regarding the normalization of drug use, potential increases in youth consumption, and conflicts with international drug control treaties.

Conclusion:

In navigating the discourse surrounding alcohol versus marijuana, it becomes evident that simplistic dichotomies fail to capture the nuances inherent in substance use and regulation. While alcohol’s legality and cultural acceptance belie its profound health and social repercussions, marijuana’s illicit status obscures its potential therapeutic benefits and comparatively lower harm profile. As responsible students and members of society, it behooves us to critically evaluate the evidence, challenge prevailing norms, and advocate for harm reduction approaches that prioritize public health and social equity. Ultimately, the journey towards healthier choices necessitates an ongoing dialogue informed by science, compassion, and a commitment to collective well-being.

Cite this page

Alcohol vs. Marijuana. (2024, Apr 07). Retrieved from https://papersowl.com/examples/alcohol-vs-marijuana/

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• Anniston/Gadsden

Archibald: Alabama House passed controversial – but bipartisan – grass bill

• Published: Apr. 11, 2024, 6:50 a.m.

This is little bluestem 'Standing Ovation' with its blue upright blades.

• John Archibald | [email protected]

This is an opinion column.

Lost in the insanity, the inanity, the inhumanity of the 2024 Alabama Legislative Session was HB 229 . About Alabama’s favorite grass.

No, no, no. Don’t confuse this grass with marijuana legalization, or with anything by the Alabama Medical Cannabis Commission, which is still more messed up than Uncle Jim was at that Widespread Panic Concert in 2002. Which is saying something.

This bill, sponsored by Northport Republican Rep. Rob Bolton, would designate Alabama’s official state grass.

Not Southern Sativa or Krimson Kush. Not that kind of grass at all. It would name Little Bluestem – schizachyrium scoparium – as the “official state native grass of Alabama.”

This, I suppose, is not as controversial as in 2016, when the Legislature declared the little-known Lane Cake as the official state cake, simply because it appeared in the text of To Kill a Mockingbird. The grass bill did make it out of the House, even if it didn’t win in a landslide.

Which is fitting, for a grass known to prevent soil erosion.

It was touch and go in the House, despite the bill’s assertion that “Little Bluestem’s distinctive blue-green foliage and reddish-brown seed heads offer unique aesthetic benefits for the residents and visitors of Alabama by adding to the inherent beauty of Alabama’s landscapes and natural areas.”

The bill passed with 63 yeas, 11 abstentions and 22 nays. Thirteen Democrats and nine Republicans voted against.

What was the controversy? That the grass is not exactly a household name? That it is native to 48 states and parts of Canada, and is only special to Alabama in the sense that it appears here, as everywhere else? Like oxygen and … institutional racism?

Maybe none of the above. One Democrat admitted sheepishly that there was a good bit of confusion when the grass bill came up for a vote last week, and when he saw other Democrats voting against it he simply followed suit.

“I saw it was about state symbols and just hit no,” he said. “I was worried it was some Confederate thing.”

Which on another day might have been reasonable. But on this day it was just grass. And confusion. Which again seems to be a theme.

So the bill goes on to the Alabama Senate for consideration, along with the claim that “Little Bluestem fosters healthier Alabama ecosystems by maintaining ecological balance and creating and enhancing habitats that support environmental heterogeneity.”

It has a good chance, based on previous bills, as Alabama is all about the hetero.

But I jest. In other sessions bills declaring new state symbols – naming the black bear as the state mammal instead of, say, the Alabamian – may have generated more controversy. Some people even yammered about the sweet potato’s ordination as the official state vegetable in 2021.

But thank heavens for the grass. If only because it gives us cover.

This session will be remembered for efforts to ban diversity programs and control who can read what. It will be recalled as the year of the frozen embryo, a war against wokeness, a cultural food fight that makes history a “divisive concept” and made hay on bathroom bills and don’t-say-gay-anywhere-any-way (especially in a library).

I mean, the governor has already signed laws to keep people from helping others register to vote, and to give public money for students to attend private schools . Multiple bills target gay and transgendered people . From that vantage point, this grass looks a good bit greener.

So it’s a good day when all one has to complain about is which is the best plant that holds our ground together.

Perhaps Alabama lawmakers really should spend more time on grass, and less on the things that drive people apart.

John Archibald is a two-time Pulitzer winner for AL.com.

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THE MANY SINS OF MOSCOW�S NEW ST. ANDREWS COLLEGE

by Nick Gier

For a full accreditation report on NSA see this link .  For articles on the Wilson Saga click this link .

        In April 2000, I gave a talk to the students and faculty of New St. Andrews College (NSA), a small Calvinist college established in Moscow in 1994.  At that time I congratulated Douglas Wilson, founder of the college, on the success of both NSA and his K-12 Logos School.  Wilson appeared to enjoy a story I told about him as a student in the philosophy department, and it got a good laugh from the audience. I also announced that I was prepared to help NSA students with their senior theses.  In the previous year I had spent about 60 hours helping a bright NSA student with a thesis on Buddhism.

    In December 2002, I invited NSA faculty and students to the regional meeting of the American Academy of Religion.  It was held in Moscow in May 2003, and 40 percent of the papers were presented by faculty from conservative Christian colleges.  NSA president Roy Atwood defended their absence by saying that they �had better things to do.�

    Wilson wrote an article �Why Evangelical Colleges Are Not� in Chronicles (September, 1998), the journal of the far right Rockford Institute. The hostility displayed against reputable evangelical colleges in this article not only shows blatant disrespect for these fine schools, but it manifests shameful disregard for the entire academic enterprise.

    In a letter to the Moscow-Pullman Daily News on May 23, 2003, Atwood wrote that his college was an accredited institution. At a legal hearing before the Latah County Commissioners in April 2003, the NSA attorney also testified that NSA was accredited. The problem, however, is that NSA did not receive its accreditation until November 29, 2005.

    In October, 2003, the community learned of the existence of Wilson�s booklet on slavery in the Antebellum South in which he stated that �there has never been a multi-racial society which has existed with such mutual intimacy and harmony in the history of the world" (p. 24). It was later discovered that 20 percent of this text was lifted from another book. When two UI history professors wrote a paper criticizing Wilson, his reaction was to write Governor Kempthorne and request that the professors be disciplined.

    Only recently did I learn that NSA faculty celebrated April Fools of 1999 by stealing letterhead from the UI provost�s office to distribute an announcement of visiting feminist scholars who would give their presentations topless. There is nothing wrong with a good joke, but one usually tries to avoid criminal activity in pulling stunts such as this.    Recently Wilson defended this action in his blog: �By the time you receive this, our local police will probably have forgotten all about it, so a little bragging is now safe. . . . [My son-in-law], . . . encouraged by some winks and nudges from me, . . . made up a flyer which announced a topless and proud lecture series by topless feminist scholars.� 

An important academic virtue is �collegiality,� which consists of respect for, and cooperation with, all members of the academic community.  I believe that we can conclude from NSA�s actions that it has not been a very good academic citizen. The supreme irony is that 9 of the15 NSA faculty have, or are expecting, 13 UI degrees.

The following are some more disturbing NSA facts:

Only 27 percent of the college�s faculty have PhDs. NSA has the resources to hire PhDs, but evidently chooses not to do so. Their less than prestigious accrediting agency requires that only one third of the faculty have the doctorate.

Two of the college�s senior fellows, presumably equivalent to full professors, do not have PhDs. Generally, a PhD is required at the lowest rank of assistant professor.

Although full resumes are not available on NSA�s website, it appears that a majority of the faculty�s published books are from Canon Press, Wilson�s own creation and the publisher of the infamous slavery booklet.

Of special concern is the fact that Wilson�s brother, his son, and his son-in-law are on the college�s faculty.

 Steve Wilkins and George Grant are regular speakers at Wilson�s annual conferences in Moscow. Grant has a mail order doctorate and Wilkins is a conservative Calvinist minister from Louisiana. Wilkins is a founding director of the League of the South, which has been declared a hate group by the Southern Poverty Law Center. The Confederate flag used to hang in Wilson�s office and Logos School displayed it at its social functions.

When a Moscow journalist interviewed Wilson, Grant, and Wilkins in February, 2004, they each proudly affirmed their belief that only propertied males should vote.  Always the jokester, Wilson said that democracy was just like two coyotes and a lamb voting on what to have for lunch.

There are well qualified students at NSA and some competent faculty, just as there are good, decent people who attend Wilson�s 800-member Christ Church.  One can usually spot these people because they frequently speak of Wilson�s goal of achieving �truth, goodness, and beauty.� These fine folks need to be reminded that their leaders have not always told the truth, that condoning slavery is not good, and that calling for the execution of homosexuals is just plain ugly.

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The Battle Over Zaza Waza: A Lifelong Liberal Joins New York’s Weed War

When an illegal smoke shop opened across the street, Gale Brewer, a local councilwoman, vowed to close it. What happened next was “like a Fellini movie.”

Gale Brewer said she had never seen “anything so intractable” as the explosion of illegal cannabis shops in her district on the Upper West Side of Manhattan. Credit... Amir Hamja/The New York Times

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By Nicholas Fandos

• April 12, 2024 Updated 9:13 a.m. ET

The informal walking tour came to a pause on Amsterdam Avenue, outside a brick building where a beloved Upper West Side pizzeria had recently been replaced by yet another rogue weed shop.

The store was called Holiday Candy Convenience. But to the local councilwoman, Gale Brewer, it was simply No. 23 — an entry on an oversize spreadsheet tracking the explosion of unlicensed cannabis stores in her district since New York legalized the drug in 2021.

An aide, Sam Goldsmith, inspected the shelves, stocked with flavored vapes and edibles. “These guys are currently out of compliance with absolutely everything,” he muttered before moving on to the next shop.

At last count, there were 56 unlicensed shops within about 200 square blocks , twice as many as a year ago. But to understand how Ms. Brewer, a 72-year-old former Manhattan borough president, came to be a leading combatant in New York’s madcap battle against illegal weed, you need to know about just one: Zaza Waza.

It started almost by accident. The city and state were failing to stop blatant disregard for the law. Ms. Brewer, a tireless tinkerer, believed she could help find a better way. And Zaza Waza, just across Columbus Avenue from her district office, presented the perfect test case.

But the harder she pulled, the more entrenched the problem appeared. The little shop with the neon lights in the window became Ms. Brewer’s bête noire. Her obsession pitted her against a mysterious operator with a shockingly cavalier approach to rules and eventually involved an indifferent Police Department, nearly a dozen other government agencies, trash bags filled with confiscated edibles, a couple of padlocks and what must have been a pretty good saw.

By the end, it was not clear if Ms. Brewer had prevailed, but she had begun to doubt what winning even meant. She had set out to prove how the power of government could solve one of the city’s fastest-growing problems. Now she feared she had just more vividly demonstrated its failure instead.

“It’s like the Wild West,” she said on the walking tour. “I’ve never seen anything so intractable. I don’t know whether to laugh or cry.”

An Unlikely Adversary in Pearls

It is important at this point to clarify that Ms. Brewer has never really been opposed to cannabis. She does not use the stuff herself. “I don’t like vegetables,” she explained.

As a child of the 1960s, she came of age politically protesting the war in Vietnam. And since getting her first government job in Mayor John Lindsay’s parks department at age 20, she has proudly identified as an unapologetic big-city Democrat.

Ms. Brewer grew up on Massachusetts’s North Shore, the pearl-wearing daughter of moneyed Boston Brahmin stock . But in adulthood she has come to so perfectly represent the Upper West Side’s particular brand of New Yorker — exceedingly liberal, notoriously opinionated — that constituents often affectionately misidentify her as a Jewish native of the city. Her predecessor once called her a “walking information kiosk,” and indeed, few city officials know the obscure levers of power better.

“She is sort of like politics on speed,” said Ruth W. Messinger, who hired Ms. Brewer in the 1970s as an aide in the City Council office Ms. Brewer now occupies. “She has a particular feel for the people who are the most screwed.”

When New York became the 15th state to legalize cannabis, Ms. Brewer enthusiastically supported the law. She was serving as borough president at the time, something like the mayor for Manhattan, and shared the goal of bringing the drug trade out of the shadows.

Legalization accomplished that, but not in the way ruling Democrats had promised. As state officials in Albany made painfully slow progress toward standing up a full legal market, they created a vacuum for rogue shops like Zaza Waza, which the law had not foreseen.

To customers eager for a legal high, stores like Zaza Waza — slang for top-shelf weed — looked every bit the real deal. It did business out in the open, had velvet rope lines and hundreds of products, from edibles claiming 250 milligrams of THC to pre-rolled joints.

But without state licenses, the shops were playing by their own set of rules — no testing, slapdash labeling, no taxes — which even the staunchest legalization advocates feared could choke out the nascent legal industry. When the authorities failed to close the first ones, the model exploded, on a scale no other state has seen.

By some counts, there are now as many as 2,000 bodegas, delis and smoke shops illegally selling cannabis products from the north Bronx to the outskirts of Queens — roughly 50 for every licensed seller. Gov. Kathy Hochul, a Democrat, has called the rollout a “disaster.”

Ms. Brewer began hearing first from parents and principals who said the shops were selling to their underage children , opening their doors before the first school bells and often using cartoons to market the product. But soon entrepreneurs trying to win legal licenses were sounding alarms, too; even Ms. Brewer’s own cousin, who had signed up to be a licensed grower upstate, gave her an earful.

“For me, I needed to respond to the parents, and I began to see this is much bigger than what we thought,” she said.

Besides, Ms. Brewer is not the kind of person who can leave a pressing problem to someone else. During the crack cocaine epidemic of the 1980s and ’90s, she and her husband fostered close to 30 children.

Like other Democrats, she was determined not to encourage a full-scale backlash on looser marijuana laws. She simply wanted to close the shops so a healthy, regulated industry could grow up in its place.

She had taken on mayors and pushed noisy bars into line. How hard could it be?

“Maybe I sound like a prude,” she said. “But you’re not supposed to sell illegal stuff!”

‘This Insane Game of Whac-a-Mole’

In Zaza Waza, she was up against a formidable adversary. Mr. Goldsmith, a bespectacled former tabloid journalist who serves as Ms. Brewer’s communication director and de facto cannabis czar, had dug up court records suggesting the shop was more than your neighborhood mom-and-pop.

Ms. Brewer walked in the day it opened in summer 2022. She remembered greeting a “nice young man behind the counter,” and telling him, “Be sure you’re legal.”

There was little chance of that. The man who signed the store’s lease, Abrahim Kassim, appears to be the same one who pleaded guilty in 2016 to conspiring to smuggle cigarettes over state lines. Last fall, not long after Mr. Kassim purchased a $2 million Long Island mansion, the federal government indicted someone with the same name on charges of running a food stamp fraud ring at a deli in the Bronx. He pleaded not guilty.

Court records show that no fewer than eight landlords have gone to court against businesses that are connected to Mr. Kassim — some after receiving notice that they were illegally selling tobacco and cannabis products.

But when it came to closing them, Mr. Goldsmith and Ms. Brewer found their own partners in government acting unusually fecklessly. Everyone agreed the ad hoc dispensaries were openly breaking the law, but one by one, agencies looked at the crimes and either shrugged off responsibility or conceded they were simply not equipped to help.

“I wouldn’t have believed it if I wasn’t living it,” Mr. Goldsmith, 40, said.

The state’s recently created Office of Cannabis Management gained explicit jurisdiction over the unlicensed sellers in 2023 and wanted them snuffed out. But it was so overworked and understaffed that of the millions of dollars in fines it had issued, the agency had collected only about $22,500 . As of April, its 16 statewide inspectors had padlocked only one unlicensed store in New York City, according to a spokeswoman.

The Police Department, which has 36,000 officers dedicated to enforcing the law, was even less help. After decades of aggressive tactics related to marijuana, the state had taken a new approach to cannabis that was explicitly designed to decriminalize recreational use and move enforcement away from the police.

Mayor Eric Adams has argued that has left the department without the authority it needs to police the shops, and some Democrats wary of reviving those rough bygone days are insistent on keeping it that way.

But Ms. Brewer was a member of another bloc that believed City Hall could be pushing more aggressively. It remains a crime to possess marijuana with the intention to sell without a license. The police seem content to let business go on uninterrupted.

On a recent afternoon, two officers standing outside Bing Bong, another unlicensed shop in Midtown Manhattan tied to Mr. Kassim, said confidently that the business was legally selling cannabis.

“Yeah, 90 percent of the storefronts you see are legal,” one said incorrectly, comparing them with liquor stores.

In January 2023, it looked like there might be a breakthrough when the Office of Cannabis Management and the New York City sheriff, Anthony Miranda, raided Zaza Waza. They brought TV news cameras along , and Ms. Brewer helped haul out 17 trash bags filled with some tobacco and a stoner’s dream stash.

But Zaza Waza simply restocked, and the sheriff’s office, strapped for employees, moved on to other neighborhoods.

“It’s just this insane game of Whac-a-Mole,” said State Senator Liz Krueger, a friend of Ms. Brewer’s and the coauthor of the state legalization bill, who has pushed for more aggressive enforcement.

Months dragged on. Ms. Brewer and Mr. Goldsmith scoured for creative workarounds. They asked the city health department to enforce food safety rules at stores that sell edible cannabis products. The answer was no. They tried working with the Manhattan district attorney’s office to pressure landlords to evict scofflaw tenants, but many of the owners simply ignored them; others got tied up in court.

Then Mr. Goldsmith tried one last idea, one that would cinematically escalate the fight.

Finally, a Victory?

In the bureaucratic labyrinth of New York City, the Department of Consumer and Worker Protection is little more than a blip. It has only a couple hundred employees working in licensing and enforcement to “protect and enhance the daily economic lives of New Yorkers.”

On paper, the agency has nothing to do with cannabis. But it can regulate tobacco. And since Zaza Waza and most of its competitors sold both products without a license, Mr. Goldsmith realized the little-known agency could shut down the place if no one else would.

In mid-March, 14 months after the sheriff’s raid, its agents placed padlocks on Zaza Waza for the first time — not because of the pot, but because of cigarettes.

Ms. Brewer was elated. By then, “UPPER WEED SIDE: Gale Brewer vs. Zaza Waza” was getting the tabloid treatment , and the mayor had dubbed her “smoke shop lady.” She called a news conference for the next morning.

But by the time she and Mr. Goldsmith showed up to take their victory lap, Zaza Waza had sawed the fastenings clear off.

“I didn’t know whether to be embarrassed or angry,” Ms. Brewer recalled. She said what came next was “like a Fellini movie.”

City agents returned with bigger locks. Zaza Waza paid $108,000 in fines, and Consumer and Worker Protection agents had no choice under current law but to remove the locks. Two days later, inspectors returned to find more unlicensed tobacco products and padlocked again.

Lawyers representing Mr. Kassim in several cases declined to comment. A man who identified himself as the owner of Zaza Waza refused to answer questions when reached by telephone.

“Don’t waste your time,” he said. “Bye.”

Ms. Brewer was initially doubtful the closure would last. But when she returned to Zaza Waza a few weeks later in April, it was still dark.

“Still closed! Still closed,” Ms. Brewer cheered as she approached. “Yay, Sam! Yay, Sam!”

Back in her office across the street, Ms. Brewer and Mr. Goldsmith debated the lessons of Zaza Waza over coffee.

Political forces seemed to be galvanizing: Ms. Hochul was pushing for changes to state law designed to make shutting the shops easier, and giving local lawmakers like Ms. Brewer greater power to legislate solutions. Mr. Adams promised ( not for the first time ) to crack down.

“It’s going to take a ton of work, a ton of coordinated persistent work by multiple entities, including the D.A.s,” Mr. Goldsmith said. “But I think we’ve shown it’s not impossible.”

Ms. Brewer was more pessimistic, though. It felt like the shops themselves were still one step ahead, and even if officials found a formula to close them, she wondered who would actually have the wherewithal to shutter a couple thousand.

“I don’t quite see the light at the end of the tunnel,” she said.

She was also thinking of one last twist in the case of Zaza Waza. The day after the dispensary was padlocked for the last time, Ms. Brewer’s office received a cold call from a landlord in her district.

The woman explained that she had recently rented out a storefront she owned on Ninth Avenue for use as a deli. But her tenant had gone rogue, converting the space into an unlicensed weed shop instead, and then locked her out of her own building.

It felt like déjà vu. An intern for Ms. Brewer asked the woman for the tenant’s name.

She said it was Abrahim Kassim.

Jack Begg contributed research.

Nicholas Fandos is a Times reporter covering New York politics and government. More about Nicholas Fandos

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Supporters urge SC representatives to take up medical marijuana bill soon

COLUMBIA, S.C. (WCSC) - Every year for the last few years, one of the most closely watched and most controversial bills at the South Carolina State House is the one to legalize medical marijuana.

And every year, the bill has fallen short, despite significant bipartisan support.

Supporters of the push to make South Carolina the 40th state to make medical cannabis legal remain hopeful that won’t be the case this year, but time is running out.

The legislature will only be at work in Columbia for about another month before heading home for the rest of the year.

Anything lawmakers fail pass before then dies, and they must start the legislative process over again when they return in January.

Medical marijuana is among those bills that now hang in the balance.

“It’s been nearly a decade we’ve been fighting for this, and I think that especially I say this for many of the veterans: We’re tired of fighting,” David Newsom, a supporter of legalization, said at a news conference Tuesday at the State House.

Newsom was among a group that included veterans, parents, nurses, and pharmacists gathered at the State House, urging state representatives to take up the bill to legalize medical marijuana in South Carolina.

“My daughter was 6 when we started this. She’s 16 now. So this is well over half her life that I’ve been trying to get legal access to this medication that I know works for her,” said Jill Swing, the founder of the SC Compassionate Care Alliance, which advocates for the legalization of medical cannabis in the state.

The bill, called the  “Compassionate Care Act,”  only allows for use in oils, salves, patches, and vaporizers, so smoking marijuana would still be illegal.

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A sunset provision would also allow the legislature to evaluate how the program is doing after five years.

“It is the most conservative, tightly regulated medical cannabis bill in the country,” Sen. Tom Davis (R-Beaufort) and the lead sponsor of the legislation, said.

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House Majority Leader Davey Hiott (R-Pickens) said Tuesday that this bill has not yet come up for discussion within the Republican caucus, and he doesn’t feel there is a huge urge within that group to take it up.

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Davis said Tuesday that she is in the process of forming a special committee of some fashion to hear testimony on this bill, and she anticipates that will get started before the session ends next month.

Copyright 2024 WCSC. All rights reserved.

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Migration and Hybrid Political Regimes: Navigating the Legal Landscape in Russia

Urinboyev, R., 2020. Migration and Hybrid Political Regimes: Navigating the Legal Landscape in Russia. Oakland, CA: University of California Press.

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Home — Essay Samples — Geography & Travel — Travel and Tourism Industry — The History of Moscow City

The History of Moscow City

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