Is Marijuana as Safe as We Believe? Experts Discuss What Remains Uncertain

Marijuana was once depicted as a significant adversary in the narrative of American drug policy, demonized by anti-drug initiatives and sensational advertisements that portrayed teenage dealers leading their peers into destruction.

However, following the legalization of medical marijuana in California in 1996 and the subsequent legalization of recreational marijuana in several states in 2012, cannabis has transformed its image and garnered greater public acceptance.

A Gallup poll conducted in 2023 indicated that 70% of Americans now favor the legalization of marijuana, with cannabis usage among adults aged 35 to 50 reaching a record high of 28% in 2022, a notable increase from just 13% a decade prior.

This change in public perception is driven by assertions regarding the various health benefits of marijuana, which include its ability to alleviate anxiety, relieve chronic pain, and address mental health issues such as PTSD. These promising characteristics have contributed to the widespread acceptance and demand for marijuana.

Despite its growing popularity, there remains a scarcity of evidence regarding the safety of marijuana consumption. Recent studies indicate that both recreational and medicinal cannabis use may carry significant risks, including cardiovascular issues such as heart attacks and strokes, as well as potential adverse effects on brain development in both adolescents and adults. Furthermore, marijuana has been associated with decreased male fertility and possible harm to the immune system.

Does this imply that all forms of marijuana use are detrimental? Not necessarily, according to R. Lorraine Collins, a psychologist at the University at Buffalo and director of its Center for Cannabis and Cannabinoid Research. “It’s a complex issue,” Collins states. “It’s not a straightforward yes or no answer. Cannabis presents a mixed bag of effects.”
Marijuana comprises over 100 chemical compounds known as cannabinoids, with cannabidiol (CBD) and tetrahydrocannabinol (THC) being the most prominent. THC is primarily responsible for the psychoactive effects associated with marijuana, whereas CBD does not produce such effects. Initial studies indicated that CBD might mitigate some of the adverse effects of THC, including anxiety and paranoia. However, more recent research suggests that high concentrations of CBD could inhibit the metabolism of THC, potentially prolonging its effects.

Cannabinoids engage with the body’s endocannabinoid system (ECS), an essential cellular signaling network that plays a crucial role in maintaining equilibrium within the brain and body. The discovery of ECS receptors in the late 1980s coincided with the understanding that the human body naturally produces cannabinoids, referred to as endocannabinoids.

Some studies indicate that cannabinoids like THC and CBD may provide therapeutic advantages. For instance, cannabis has demonstrated efficacy in alleviating nausea and vomiting associated with cancer treatments. A synthetic variant of THC, known as dronabinol, received FDA approval in 1985 for this specific use. Additionally, there is emerging evidence suggesting that marijuana may assist in controlling seizures, which contributed to the FDA’s approval of Epidiolex, an oral CBD formulation for severe epilepsy, in 2018.

Conversely, the evidence regarding the use of cannabis for chronic pain remains ambiguous. Two systematic reviews published in the 2017 Annals of Internal Medicine determined that there is inadequate scientific evidence to endorse the effectiveness of cannabis in treating neuropathic pain or PTSD, a conclusion that has been previously highlighted by Inverse.

Collins notes that “Federal regulations have been a significant obstacle to human research, resulting in much of the current research being conducted on animals, particularly concerning the effects of cannabis on fetal development.”
In summary, although marijuana has significantly improved its public image and garnered considerable support, the evidence regarding its safety and effectiveness remains ambiguous. Advocates highlight various health benefits, including its potential to alleviate anxiety, manage chronic pain, and address specific mental health disorders, which have contributed to its acceptance in society. Nevertheless, recent studies indicate possible risks linked to its consumption, such as cardiovascular issues, developmental concerns, and negative impacts on male fertility and the immune system.

Experts, including R. Lorraine Collins, emphasize that the situation is not straightforward, recognizing that cannabis is a multifaceted substance with both advantages and disadvantages. The absence of extensive human studies, primarily due to federal restrictions, has resulted in a significant gap in knowledge that hampers our comprehension of marijuana’s overall effects. While there is encouraging evidence for certain medical applications, such as alleviating nausea in cancer patients and managing seizures, many fields—particularly chronic pain and PTSD treatment—still lack conclusive scientific validation.

As research progresses, it is essential for both lawmakers and the public to approach cannabis with prudence and acknowledge the necessity for more comprehensive scientific inquiry. Until we attain a clearer understanding of the long-term consequences of marijuana use, it is vital to balance the potential benefits against the associated risks and remain cognizant of the uncertainties that continue to surround this commonly utilized substance.