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Marijuana A woman wearing glasses and a straw hat exhales smoke while holding a joint, standing among tall cannabis plants in an outdoor plantation. Close-up of green, serrated marijuana leaves on a plant growing outdoors. Reefer Madness Map of the United States displaying the legal status of marijuana by state as of late 2024. States where marijuana is legal for adult use are shaded green, states where it is illegal are shaded orange, and states with conditionally decriminalized possession are marked with a lighter orange. Additional symbols indicate where marijuana is legal for medicinal use or where only low-THC medicinal use is permitted.
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Recreational marijuana

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Con Arguments

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Con 1: Legalizing recreational marijuana comes with serious social costs.

Marijuana use harms more than just the person using the drug. The related social costs of marijuana use include paying for increased emergency room visits, medical care, and addiction treatment for the uninsured; more victims of drugged driving accidents; and workplace accidents. Legalizing marijuana would put one more harmful substance in our society that costs more than the revenue it generates. [78] [102] [129] [130] [133]

After retail marijuana stores opened in Colorado, emergency room (ER) visits related to marijuana shot up nearly 30 percent, and hospitalizations related to marijuana rose 200 percent. Karen Randall, an ER physician in Colorado, noted

The emergency department has seen increased visits for primary care needs, breathing problems related to inhalation of marijuana, including asthma, bronchitis, upper respiratory tract infections, as well as psychiatric needs, accidental or intentional overdoses and, unfortunately, increased pediatric patients with issues related to marijuana.[12] [78] [100] [102] [104] [105] [161] [171] [112]

Furthermore, people end up in the ER with anxiety attacks or psychotic-like symptoms from eating sweets infused with more marijuana than they were expecting—or, in some cases, not expecting at all. People are used to the idea that a candy bar is a single serving size, but a candy bar with marijuana could have four or more times the recommended dose of THC, depending on the state’s regulations. As a result, poison-control marijuana exposure cases for kids ages 9 and under increased more than five-fold in Colorado after legalization. [12] [78] [100] [102] [104] [105] [161] [171] [112]

According to the National Institute on Drug Abuse, as many as four million Americans meet the diagnostic criteria for a marijuana use disorder, such as abuse, dependence, or addiction. Dr. Drew Pinsky, internist and addiction medicine specialist, said,

I’ve been treating cannabis addiction for 20 years. When people are addicted to cannabis, cocaine and alcohol the drug they have the most difficult time giving up is the cannabis.[93]

A study in the Journal of Drug Issues found that the number of American daily marijuana users has risen dramatically since 2002, and now 68 percent of users report daily or near-daily use. Kevin Sabet, director of Smart Approaches to Marijuana, wrote,

The scientific verdict is that marijuana can be addictive and dangerous
. Many baby boomers have a hard time understanding this simply because today’s marijuana can be so much stronger than the marijuana of the past.[93] [95] [96] [97] [98] [160]

Marijuana-related traffic deaths rose 62 percent following the legalization of marijuana in Colorado. Jim Leal, former Chief of Police of Newark, California, said of legalizing marijuana,

You are commercializing a product that is just going to put more impaired drivers on the road, worsening a problem that we already have. What officers are seeing with THC levels being very high is they are seeing impairment being far worse than they have ever seen in the past.[78] [83]  [84] [85] [158] [127] [112]

The Highway Loss Data Institute found an increased crash risk in legal marijuana states and said collision claims in Colorado, Nevada, Oregon, and Washington increased 6 percent as compared to states that don’t have legal marijuana. A meta-study by the National Academies of Sciences, Engineering, and Medicine (NAS) concluded that “Cannabis use prior to driving increases the risk of being involved in a motor vehicle accident.”[78] [83]  [84] [85] [158] [127] [112]

Workplace incidents involving employees under the influence of marijuana increased from 6 percent to 20 percent the year after legalization in Colorado. Employees who screened positive for marijuana use had 55 percent more industrial accidents, 85 percent more injuries, and absenteeism rates 75 percent higher than those who tested negative, according to a study done on postal workers. Paul L. Bittner, partner and vice chair of the Labor and Employment Group at Ice Miller law firm, said, “You not only lose productivity, but the bigger concern for employers is potential liability if there’s an accident and someone gets hurt or killed.” [122] [124] [125] [126] [134]

Con 2: Legalizing recreational marijuana dramatically increases growth of the plant, which is bad for the environment.

According to an environmental review,

Results show that both indoor and outdoor cannabis growing is water-intensive. The high water demand leads to water pollution and diversion, which could negatively affect the ecosystem. Studies found out that cannabis plants emit a significant amount of biogenic volatile organic compounds, which could cause indoor air quality issues. Indoor cannabis cultivation is energy-consuming, mainly due to heating, ventilation, air conditioning, and lighting. Energy consumption leads to greenhouse gas emissions. Cannabis cultivation could directly contribute to soil erosion. Meanwhile, cannabis plants have the ability to absorb and store heavy metals.[87]

Additionally, marijuana cultivation results in deforestation, habitat destruction, and river diversion. [140] [142]

Cannabis plants require nearly double the amount of water needed to grow grapes or tomatoes. As Rosamond Naylor, senior fellow at the Stanford Woods Institute for the Environment, explains,

Taking water directly from rivers and streams in the summer [to grow marijuana] not only reduces the water available for agriculture but also threatens wildlife species.
 Regardless of the legal status of marijuana, the way we are currently managing its impacts on water and wildlife in California just doesn’t work.[142] [144] [145]

Because marijuana remains an illegal drug at the federal level, “the United States Environmental Protection Agency (EPA) has not approved any pesticides for use on the plant.” This lack of guidance has resulted in some growers using “banned pesticides and blood thinners/rat poisons against crop-eating mammals” and not properly disposing of chemicals and waste. Further, growing marijuana results in a number of waste streams, including waste similar to food manufacturers, agricultural waste, mercury-containing waste (as a result of UV light use), toxic and flammable waste from THC extraction chemicals. Uneducated growers, or those without state-supported guidelines may be destroying their local environments. [86]

Legal indoor growing also requires a lot of electricity for lighting, heating, and ventilation. These “heavy-load electric devices” include UV lights that are powered on 16 or more hours daily, irrigation systems, HVAC (air conditioning and heating) systems, and air filter systems. In just three years after legalization, Denver growers doubled their electric use, accounting for almost 5 percent of the 2.8 million city residents’ power use. [86]

Derek Smith, executive director of the non-profit Resource Innovation Institute, explains,

The reality is this industry has been in the shadows for a long time [and thus, many newly legal growers are as well] 
 using, in some cases, the same technology that was used in basements in the black market days just blown up to 50,000 square feet—very hot lights, very inefficient HVAC, very little ventilation. [82]

Not only do old and new technologies seriously strain an already struggling power grid, but the energy consumption from growing marijuana also produces an amount of greenhouse gas emissions equal to that of 3.3 million cars each year. As a Mother Jones article jabs, “Dude, your cannabis habit has an epic carbon footprint.” The article notes,

Studying more than 1,000 locations across the United States, researchers from Colorado State University calculated the median emissions of growing one kilogram of cannabis to be about 3,600 kilograms of CO2 equivalent emissions. The amount varies from roughly 2,300 to 5,200 kilograms of emissions per kilogram grown depending on location. To put that in perspective, a kilogram of tomatoes grown in a British Columbia [Canada] greenhouse heated with natural gas emits roughly two kilograms.[141] [81]

Con 3: Legalizing recreational marijuana creates a “Big Marijuana” industry, while boosting illegal marijuana sales and use.

“Big Marijuana” is already using similar tactics to “Big Tobacco,” which marketed cigarettes using ads that appealed to kids, including the Joe Camel cartoon character. Likewise, marijuana food products are frequently colorful, sweet, or branded with cartoons to attract children. Marijuana is available in kid-friendly forms such as gummy bears and lollipops, and products sometimes resemble familiar brands, such as “Buddahfinger” or “KeefKat” in wrappers that look like a Butterfinger or KitKat candy bar. The vaping industry has followed this same kid-friendly marketing strategy, with candy-flavored vapes. [103] [129] [134] [149] [167]

Mark A. R. Kleiman, the late drug policy expert, said, “if you’re in the [for-profit] cannabis business, casual users aren’t much use to you while heavy users are your best customers, accounting for the bulk of your sales 
 the commercial interest demands maximizing [use].” Rosalie Liccardo Pacula, senior economist at RAND Corporation, agrees, noting that heavy marijuana users account for the “vast majority of the total amount sold and/or consumed.” [147] [148]

The percentage of 12- to 17-year-olds using marijuana is higher in every legal marijuana state than the national average. For example, 16.21 percent of Colorado teens and 18.86 percent of teens in Alaska reported marijuana use in the past year, compared to an average of 12.29 percent for the United States overall in 2015-2016. Colorado past-month teen marijuana use jumped 20 percent in the two-year average after marijuana was legalized for adults. [39] [78]

Further, creating a commercialized, legal market has actually enhanced opportunities for the illegal market, because prices charged by state-licensed sellers can easily be undercut by cartels. A drug dealer told Vice News, “Right now with the way the tax structure is in Washington, the black market is going to thrive.” [134] [135] [173]

In Colorado, a sharp increase in marijuana-related charges filed under the state’s Organized Crime Control Act coincided with the legalization of marijuana, indicating a rise in organized crime. Local officials said that Mexican cartels were growing marijuana under the cover of legal operations in Colorado and using that to fuel the black market in other states. The Colorado Attorney General’s office stated that legalization

has inadvertently helped fuel the business of Mexican drug cartels 
 cartels are now trading drugs like heroin for marijuana, and the trade has since opened the door to drug and human trafficking.[102] [134] [174]

Additionally, three United Nations treaties set worldwide drug controls. As a party to the treaties, the United States has agreed to limit the use of marijuana “exclusively to medical and scientific purposes.” The move by some U.S. states to legalize adult-use marijuana has upset the U.N. monitoring organization, which stated that legalization “cannot be reconciled with the legal obligation” to uphold the Single Convention treaty. Legalizing marijuana puts the United States in a position of weakness when we need to hold other nations accountable to legal agreements. [136] [137] [138] [139]

Con 4: Health experts do not believe recreational marijuana should be legal, because marijuana isn’t safe.

Smoking marijuana can damage lung tissues and cause respiratory problems; secondhand marijuana smoke is also dangerous. Research shows that smoking one marijuana joint is as damaging to the lungs as five tobacco cigarettes. Marijuana may contain five times as much carbon monoxide concentration and three times as much tar as tobacco. There is a higher risk of heart attacks and strokes in the hours immediately after smoking cannabis. Vaping is also dangerous and “likely leads to enhanced ingestion of toxic ammonia known to result in neurobehavioral impairment.” Ammonia ingested while vaping can result in lung irritation, nervous system effects, and asthma attacks.[114] [115] [116] [118] [119] [120] [134] [162] [164]

Some of the public health associations that oppose legalizing marijuana for recreational use include the American Medical Association (AMA), the American Society of Addiction Medicine, the American Academy of Child and Adolescent Psychiatry, and the American Academy of Pediatrics. [94] [151] [152] [153] [154]

While the AMA acknowledges marijuana’s potential for medicinal benefits, it

continues to oppose legalization of cannabis. Legalization of cannabis for adult use is associated with increased traffic fatalities, exposures reported to poison control (including infants and children), emergency department visits, and cannabis-related hospitalizations. [91]

State-by-state recreational marijuana laws

Please consult the state for the most recent information. All state marijuana laws include the minimum age of 21 for use.

State How passed Law Possession limits: Usable marijuana Possession limits: plants Possession limits: Hash and concentrates
1. Alaska Ballot Measure 2
Approved November 4, 2014 by 53 percent of voters		 Alaska Statute Chapter 17.38: The Regulation of Marijuana
Effective: February 24, 2015		 up to 1 oz up to 6 plants with no more than 3 mature plants Possession of hash and concentrates is illegal. Possession of up to 3 g is a misdemeanor, more is a felony.
2. Arizona Smart and Safe Arizona Act (Prop 207)
Approved November 3, 2020 by 59.95 percent of voters		 Smart and Safe Arizona Act
Effective: November 30, 2020; sales March 2021		 up to 1 oz Up to 6 plants per person; up to 12 plants for a single residence with more than one 21+ resident up to 5 grams
3. California Proposition 64: The Adult Use Marijuana Act
Approved November 9, 2016 by 57 percent of voters		 Control, Regulate and Tax Adult Use of Marijuana Act
Effective: November 9, 2016 (revised penalties); January 1, 2018 (retail sales); 2023 (restrictions to be lifted on large-scale corporations)		 up to 1 oz up to 6 plants, including the harvest from those 6 plants up to 8 g (more than 8 g is a misdemeanor)
4. Colorado Amendment 64
Approved November 6, 2012 by 55 percent of voters		 Colorado Constitution: Article 18, section 16
Effective: December 10, 2012 (revised penalties) January 1, 2014 (commercial sales)		 up to 1 oz up to 6 plants with no more than 3 mature plants up to 1 oz
5. Connecticut SB 1201
signed by Governor Ned Lamont on June 22, 2021		 SB 1201
Effective: July 1, 2021 (revised penalties); May 2022 (commercial sales); July 2023 (growing plants)		 up to 1.5 oz; up to 5oz in a locked container up to 6 plants with no more than 3 mature plants up to 7.5 g (up to 750 mg of THC); 25 g  (up to 2,500 mg of THC) in a locked container
6. Delaware HB1 & HB2
No action taken by Governor John Carney, allowing bills to become law		 Amendments to Titles 4, 11, 16, & 30 of the Delaware Code
Effective: April 23, 2023		 up to 1 oz possessing or growing plants remains illegal until the state’s Marijuana Mart is opened on August 1, 2025 12 grams or less of concentrated cannabis, or cannabis products containing 750 milligrams or less of delta-9-THC
7. D.C. Initiative 71 (65 percent)
Approved November 4, 2014 by 64.87 percent of voters		 Marijuana Legalization and Regulation Act of 2015 (retail sales are not allowed)
Effective: February 26, 2015		 up to 2 oz up to 6 plants per person with no more than 3 mature plants; up to 12 plants (no more than 6 mature) for a single residence with more than one 21+ resident  Possession of hash and concentrates is illegal and punishable with 180 days in jail and a $1,000 fine.
8. Illinois HB 1438
Governor JB Pritzker signed the bill on June 25, 2019		 Cannabis Regulation and Tax Act
Effective: January 1, 2020		 up to 1 oz (30 g) for residents and 500 milligrams of THC contained in a cannabis-infused product for state residents (15 g/250 mg non-residents) none up to 5 g (2.5 g non-residents)
9. Maine Question 1
Approved December 17, 2016 by 50.26 percent of voters		 The Marijuana Legalization Act
Effective: January 30, 2017 (grow and possess)		 up to 2.5 oz up to 3 flowering plants, 12 immature plants, unlimited seedlings, and all marijuana produced from the plants up to 5 g
10. Maryland Maryland Question 4 (Marijuana Legalization Amendment)
Approved November 8, 2022
HB 837
Effective: On or after July 1, 2023		 Chapter 45, Article XX – Cannabis 1.5 oz up to two cannabis plants in their homes for their own personal use 12 grams of cannabis concentrates
11. Massachusetts Question 4
Approved November 8, 2016 by 53.66 percent of voters		 Regulation and Taxation of Marijuana Act
Effective: December 15, 2016		 up to 1 oz up to 6 plants; no single residence may exceed 12 plants up to 5 g. Possession of hash is illegal though decriminalized for possession of up to 1 oz.
12. Michigan Proposal 1
Approved November 6, 2018 by 56 percent of voters		 Effective: January 2020 2.5 oz; up to 10 ounces at home, but amounts over 2.5 ounces must be kept in locked containers up to 12 plants 15 grams of marijuana may be in the form of marijuana concentrate
13. Minnesota HF100
Signed by Governor Tim Walz on May 30, 2023		 Session Law Chapter: 63
Effective: August 1, 2023		 up to 2 oz in public; up to 2 pounds at home up to eight cannabis plants, with no more than four being mature up to 800 mg of THC in edibles; up to 8 grams of concentrate
14. Missouri Amendment 3
Approved November 8, 2022		 Article XIV, Sections 1 & 2
Effective: by February 7, 2023		 up to 3 oz up to six flowering plants, six immature plants, and six plants under 14 inches for personal use n/a
15. Montana Initiative I-190
Approved November 3, 2020 by 56.89 percent of voters
CI-118: Allow for a Legal Age for Marijuana
Approved November 3, 2020 by 57.82 percent of voters		 Effective: January 1, 2021 up to 1 oz up to 4 mature plants and up to 4 seedlings up to 8 grams
16. Nevada Question 2
Approved November 8, 2016 by 54.47 percent of voters 		Nevada Revised Statutes, Chapter 453D – Regulation and Taxation of Marijuana
Effective: January 1, 2017		 up to 1 oz up to 6 plants; no single residence may exceed 12 plants up to 3.5 g
17. New Jersey New Jersey Marijuana Legalization Amendment
Approved November 3, 2020 by 66.88 percent of voters		 Amendment to Article IV, Section VII of the New Jersey Constitution
Effective: January 1, 2021		 up to 1 oz n/a n/a
18. New Mexico House Bill 2
signed by Governor Michelle Lujan Grisham on April 12, 2021		 Cannabis Regulation Act
Effective: June 29, 2021; commercial sales began in April 2022		 up to 2 oz up to 6 plants per person with no more than 12 per household Up to 16 grams of concentrated marijuana, and 800 milligrams of edible cannabis
19. New York Senate Bill S854A
Passed Senate and Assembly, and signed into law by Governor Cuomo on March 31, 2021		 Marihuana Regulation and Taxation Act
Effective: March 31, 2021		 up to 3 oz up to 12 plants with no more than 6 mature plants and 6 immature per residence  up to 24 g concentrated cannabis
20. Ohio Issue 2
Approved November 7, 2023 by 57 percent of voters		 Chapter 3780
Effective: December 7, 2023		 up to 2.5 oz up to 6 plants per individual; up to 12 plants per household collectively up to 15 g of concentrates
21. Oregon Measure 91
Approved November 4, 2014 by 56.11 percent of voters		 Oregon Revised Statutes Chapter 475B – Cannabis Regulation: Recreational Use of Cannabis
Effective: March 29, 2016		 up to 1 oz in public; up to 8 oz homegrown at home up to 4 plants per residence up to 16 oz solid infused at home; up to 72 oz liquid infused at home; up to 1 oz extract at home
22. Rhode Island Rhode Island Cannabis Act
Signed by Governor Dan McKee on May 25, 2022		 Rhode Island Cannabis Act
Effective: May 25, 2022		 up to 1 oz in public; up to 10 oz at home up to 3 mature plants and 3 immature plants per residence up to 5 g concentrate
23. Vermont Legislative Bill H.511
Approved January 22, 2018		 An Act Related to Eliminating Penalties for Possession of Limited Amounts of Marijuana by Adults 21 Years of Age or Older
Effective: July 1, 2018		 up to 1 oz up to 6 plants per household (no more than 2 mature), and all marijuana produced from the plants 5 g
24. Virginia Senate Bill 1406
House Bill 2312
Governor’s amendments to law approved April 7, 2021 by House and Senate		 Effective: July 1, 2021 (possession and growing plants); commercial sales TBD
On March 1, 2022, the Virginia House of Delegates subcommittee killed a bill that would have accelerated the commercial sales legalization, enforcement measures, regulation, and tax revenue of adult-use marijuana in Virginia. The bill was originally slated to be passed by 2024. Sales and purchases of adult-use marijuana remain illegal in the state until legislation is passed.		 up to 1 oz Up to 4 plants n/a
25. Washington Initiative 502
Approved November 6, 2012 by 55.7 percent of voters		 Revisions to the Uniform Controlled Substances Act, chapter 69.50
Effective: December 6, 2012		 up to 1 oz Plants are illegal. Any amount is a felony. up to 16 oz marijuana-infused product in solid form; up to 72 oz marijuana-infused product in liquid form; up to 7 g marijuana concentrate

Marijuana studies

Below, organized by publication date, are select recent medical studies on the effects of marijuana.

February 20, 2026 - Teen cannabis use tied to increased risk of psychiatric disorders

The authors concluded,

To our knowledge, this is among the largest longitudinal studies to examine cannabis use in adolescence and its association with the incidence of clinician-diagnosed psychiatric disorders into young adulthood. Using population-level, EHR-based [electronic health records-based] clinical data, we found that adolescent cannabis use was associated with an increased risk of multiple psychiatric disorders by early adulthood. Associations were stronger for psychotic and bipolar disorders. Together, these results are consistent with cannabis being a risk factor for or exacerbating the risk of psychiatric disorders rather than only resulting from preexisting psychiatric conditions. These findings reinforce the need for early prevention efforts, stronger public health messaging, and policy strategies that limit youth exposure in the context of expanding cannabis legalization.[87]

November 26, 2025 - Review of 15 years of cannabis research reveals little evidence of medical benefit and an increase in medical problems

The meta-study found that “evidence from randomized clinical trials does not support the use of cannabis or cannabinoids for most conditions for which it is promoted, such as acute pain and insomnia.”

Furthermore, the authors noted:

29% of individuals who used cannabis for medical purposes met criteria for cannabis use disorder. Daily inhaled cannabis use compared with nondaily use was associated with an increased risk of coronary heart disease (2.0% vs 0.9%), myocardial infarction (1.7% vs 1.3%), and stroke (2.6% vs 1.0%).[64]

November 18, 2025 - Cannabis use may lead to decreased alcohol use

The study found that cannabis with 7.2 percent THC “reduced alcohol urge immediately after smoking. Participants consumed significantly less alcohol after smoking cannabis with 3.1% THC and 7.2% THC, reducing consumption by 19% and 27%, respectively.”

But the authors caution,

Research on whether cannabis increases or decreases alcohol use is inconclusive, in part because of substantial variability in cannabinoid composition (i.e., THC-to-cannabidiol ratio); individual differences in alcohol treatment-seeking status and substance use disorders; motives for cannabis, alcohol, and simultaneous use; and patterns of co-use (i.e., the order in which cannabis and alcohol are used first on a given occasion).[84]

October 28, 2025 - Smoking cannabis in youth associated with more medical problems later in life

The authors concluded,

Findings of this birth cohort study indicated that early-onset and frequent cannabis use was associated with greater medical care utilization for both mental and physical health conditions in young adulthood. These findings support the relevance of delaying initiation and reducing intensity of cannabis use during adolescence.[85]

October 2025 - American College of Obstetricians & Gynecologists advise against cannabis use during pregnancy

The professional organization’s Committee on Clinical Consensus–Obstetrics concluded,

Cannabis refers to all products derived from the plants Cannabis sativa, Cannabis indica, and Cannabis ruderalis and is the most commonly used illicit drug under U.S. federal law. With increasing social acceptability, accessibility, and legalization in many states, the prevalence of cannabis use among pregnant and lactating individuals has increased significantly. Substance use in pregnancy, including cannabis use, has been associated with adverse outcomes such as spontaneous preterm birth, low birth weight, and developmental delay. Obstetrician–gynecologists and other obstetric health care professionals should be aware of the possibility of pregnant and lactating patients’ use of cannabis and be prepared to counsel and screen all patients and use evidence-based strategies to reduce cannabis use.[88] [89]

September 30, 2025 - Cannabis extract better than opioids for back pain

The authors concluded that “VER-01 [a cannabis extract] demonstrated superiority over opioids in treating CLBP, both in terms of efficacy and gastrointestinal tolerability.”[20]

September 29, 2025 - Cannabis extract shown to help chronic low back pain

The study used

“VER-01 
 a standardized full-spectrum extract derived from the patented Cannabis sativa L. strain DKJ127. The botanical raw material of VER-01 consists of the unfragmented, dried C. sativa DKJ127 L. flowers. The full-spectrum extract of the botanical raw material is manufactured in a Good Manufacturing Practice (GMP) certified facility and standardized to 5% tetrahydrocannabinol (THC).”

The authors concluded,

The results of the VER-CLBP-001 trial demonstrate that VER-01 provides meaningful pain reduction compared to the placebo, accompanied by distinct improvements in physical function and sleep quality, two key factors that contribute to participants perceiving the effects of VER-01 as clinically meaningful. Additionally, participants in the VER-01 arm required substantially lower rescue medication use less rescue medication.[35]

June 17, 2025 - Cannabis use associated with major adverse cardiovascular events

This systematic review and meta-analysis uses an original approach centred on real-world data. The findings reveal positive associations between cannabis use and MACE [major adverse cardiovascular events]. These findings should encourage investigating cannabis use in all patients presenting with serious cardiovascular disorders.[65]

June 2, 2025 - Marijuana use among older adults has increased

The study found that past-month use among adults 65 and older rose from under 1 percent in 2005 to 4.2 percent in 2018.

People with chronic diseases, particularly multiple chronic diseases, also had an increased prevalence in use. The substantial increased prevalence in states with legalized medical cannabis highlights the importance of structural educational support for patients and clinicians in those states. The use of cannabis products, especially with psychoactive properties, may complicate chronic disease management among older adults. As previously reported, prevalence of tobacco and excess alcohol use continues to be high among older adults who use cannabis.[66]

June 1, 2025 - Cannabis hospitalizations associated with increased risk of new dementia diagnosis

 Individuals with cannabis use severe enough to require hospital-based care were at increased risk of a new dementia diagnosis compared with those with all-cause hospital-based care or the general population. These findings have important implications considering increasing cannabis use among older adults.[67]

May 28, 2025 - Chronic cannabis use associated with endothelial dysfunction

Stanford Medicine defines endothelial dysfunction as

a type of non-obstructive coronary artery disease (CAD) in which there are no heart artery blockages, but the large blood vessels on the heart’s surface constrict (narrow) instead of dilating (opening).

The study found that:

chronic cannabis smoking and THC ingestion were associated with endothelial dysfunction similar to that observed in tobacco smokers, although apparently occurring via distinct mechanisms.[68] [69]

May 14, 2025 - Cannabis use and cannabis use disorder common among older veterans

The study found that 10 percent of veterans aged 65 to 84 years old had used cannabis in the last 30 days and of those 36 percent had “cannabis use disorder” (CUD), an addiction to and growing tolerance of the drug, which can lead to greater use.

The prevalence of past 30-day cannabis use was close to tobacco use prevalence, and risk factors for cannabis use were similar to those observed in other populations. Frequent and inhaled cannabis use was associated with higher odds of any CUD. Routine health screening for cannabis use in Veterans Health Administration clinical settings is necessary to identify older adults with cannabis use.[70]

April 10, 2025 - Smoking remains most popular method of cannabis consumption

The CDC study aimed to understand cannabis use patterns in order to better understand related health outcomes.

Among the 15.3 percent of respondents who reported current marijuana use, smoking was the most frequent route (79.4 percent), followed by eating (41.6 percent), vaping (30.3 percent), and dabbing (inhaling heated concentrated cannabis) (14.6 percent). Vaping and dabbing were most prevalent among persons aged 18–24 years.[71]

February 6, 2025 - Cannabis use disorder hospitalizations linked to premature death

In this cohort study of all residents of Ontario, Canada, individuals with incident hospital-based CUD [cannabis use disorder] care were at markedly increased risk of death compared with the general population. These findings suggest important clinical and policy implications, given global trends toward cannabis legalization and market commercialization accompanied by increasing cannabis use and CUDs.[72]

February 4, 2025 - Cannabis use disorder association with schizophrenia has increased

In this cohort study of individuals aged 14 to 65 years in Ontario, Canada, the proportion of incident cases of schizophrenia associated with CUD almost tripled during a period of substantial liberalization of cannabis policy. Ongoing research is indicated to understand the long-term associations of cannabis policy with the prevalence of psychotic disorders.[73]

January 28, 2025 - Heavy marijuana use associated With lower brain activation during working memory tasks

The authors concluded,

lifetime heavy cannabis use history was associated with lower brain activation related to working memory, with a small to medium effect size. Before adjustment for covariates and correction for multiple comparisons, recent and lifetime cannabis use were associated with poorer behavioral performance on the theory of mind task; therefore, theory of mind should be examined in future studies. Evidence supported that both recent and heavy lifetime cannabis use were associated with diminished brain activation and cognitive performance during working memory. These findings suggest that large, longitudinal studies are needed to assess the causality of cannabis use toward altering brain function and the duration over which these effects persist.[86]

January 2025 - Cannabis use linked to arrhythmias

Epidemiological data and multiple studies indicate a significant association between cannabis use and various arrhythmias, particularly atrial fibrillation. The risk is notably higher among younger users and males. Additionally, case reports have linked cannabis use to other arrhythmias such as ventricular tachycardia and ventricular fibrillation, especially in individuals with underlying cardiac abnormalities 
 Despite some studies suggesting no significant difference in arrhythmia burden between cannabis users and nonusers, the preponderance of evidence supports a correlation between cannabis use and increased arrhythmia risk. Given the rising tetrahydrocannabinol content in cannabis products and the limited data on the long-term cardiovascular effects, this review underscores the need for large-scale prospective studies. Until more comprehensive data are available, it is advisable for patients with channelopathies, structural heart disease, or prior myocardial infarction to avoid cannabis use.[74]

June 18, 2024 - Cannabis-related healthcare encounters increased

The study found that “rates of health care encounters with cannabis-related disorders increased from 2017 through 2022, irrespective of state or territory cannabis legal status.” However,

Rates were greatest in states or territories with both adult and medical use legalization . . . followed by states or territories with medical legalization . . . and states or territories where cannabis use was illegal. . . . We noted the greatest increasing trends in nonemergency department (ED) outpatient settings across all legalization categories. We observed higher average annual increases among beneficiaries enrolled in MA [Medicare Advantage] than those enrolled in FFS [Fee-for-Service].[75]

March 9, 2024 - Cannabis flowers’ THC content regularly mislabeled in dispensaries

The results of this study indicate that there is a need for more stringent regulations to ensure that product labeling is accurate, as over 70 percent of the evaluated products did not meet the ± 20 percent acceptance criteria. It is noted that out of all samples that were found to be mislabeled (outside of ± 20 percent difference between claimed values and analytical values), only one sample (#13, Table 5) was under labelled, while all others were over labelled. That might be because of the higher economic gain by stating a higher Δ9-THC content. Another possibly reason for the overstated values could be the loss of THC content as a result of storage under unfavorable conditions. That possibly was not considered because all products were analyzed prior to the stated expiration date. [76]

February 28, 2024 - Cannabis use associated with adverse cardiovascular outcomes

The study concluded that cannabis use may be a risk factor for both cardiovascular disease and premature cardiovascular disease.

Past 30-day cannabis use was associated with MI [myocardial infarction], stroke, and composite outcomes of CHD (coronary heart disease), MI (myocardial infarction), and stroke among adults 18 to 74 years old, controlling for tobacco smoking status, age, sex, race and ethnicity, body mass index, diabetes, alcohol use, educational attainment, and physical activity. This effect exhibited a dose–response relationship, with more days of use associated with higher risks (Figure). Among adults at risk for premature cardiovascular disease, cannabis use was associated CHD, MI, stroke, and composite of CHD, MI, and stroke when controlling for the same variables.[77]

August 1, 2023 - Daily cannabis smoking perceived as safer than daily tobacco smoking

This study found that US adults increasingly perceived daily smoking and secondhand exposure to cannabis smoke as safer than tobacco smoke from 2017 to 2021. Given that these views do not reflect the existing science on cannabis and tobacco smoke, the findings may have important implications for public health and policy as the legalization and use of cannabis increase.[78]

May 4, 2023 - Young men with cannabis use disorder have increased risk of developing schizophrenia

Researchers found strong evidence of an association between cannabis use disorder and schizophrenia among men and women, though the association was much stronger among young men. Using statistical models, the study authors estimated that as many as 30 percent of cases of schizophrenia among men aged 21-30 might have been prevented by averting cannabis use disorder.[79] [80]

April 2023 - Cannabis-related ER visits increased

The study found an increase of cannabis-related emergency room (ER) visits among all groups, but especially among adults 65 and older (from 21 per 100,000 visits to 395 per 100,000 visits).

Cannabis-related ED [Emergency Department] visits are increasing among older adults in California and are an adverse effect of cannabis use. Asking about cannabis use and providing education about its use should be a part of routine medical care for older adults.[81]

May 26, 2021 - Perceived risk of regular cannabis use declines among older adults

The study found that the perceived risk of regular cannabis use decreased among adults 65 and older from 52.6 percent to 42.7 percent.

Decreases in perceived risk were detected in particular among those never married (a 32.6 percent decrease), those who binge drink (a 31.3 percent decrease), use tobacco (a 26.8 percent decrease), have kidney disease (a 32.1 percent decrease), asthma (a 31.7 percent decrease), heart disease (a 16.5 percent decrease), chronic obstructive pulmonary disease (a 21.5 percent decrease), two or more chronic conditions (a 20.2 percent decrease), and among those reporting past-year emergency department use (a 21.0 percent decrease) (ps<0.05).[82]

Assessment quiz

After reading the above debate, take our assessment quiz to test your knowledge of marijuana and its uses. Good luck!

1-minute survey

After reading this debate, take our quick survey to see how this information affected your opinion of this topic. We appreciate your feedback.

Discussion questions

  1. Should recreational marijuana be legal? Why or why not?
  2. Should medical marijuana be legal? Why or why not?
  3. Should other recreational drugs be legal? Explain your answer.
  4. What questions do you have after reading the debate above? Where might you find answers?
  5. What was the most interesting thing you learned from this debate?
  6. Consider how you felt about the issue before reading this article. After reading the pros and cons on this topic, has your thinking changed? How and why?. If your thoughts have not changed, explain how and why you better understand the other side of the debate.
  7. Push for the position and policies you support by writing local officials, U.S. senators and representatives, or other people in a position to make the change you champion.

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