should marijuana be legal for medicinal purposes persuasive essay

Argumentative Essay On Marijuana Legalization

Published by gudwriter on May 27, 2018 May 27, 2018

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Why Marijuana Should be Legalized Argumentative Essay Outline

Introduction.

Thesis: Marijuana should be legalized as it is more beneficial that it may be detrimental to society.

Paragraph 1:

Marijuana has not caused turmoil in some of the countries where it has been legalized.

• Marijuana does not increase violent, and property crimes as many suggest.
• Studies reveal that in Colorado, violent crimes have declined following the legalization of marijuana.

Paragraph 2:

Prohibiting use of marijuana does not limit its consumption.

• In spite of the many laws prohibiting the use of marijuana, it is one of the most highly abused drugs.
• 58% of young people from all over the world use marijuana.
• It has not been attributed to any health complications.

Paragraph 3:

Legalization of marijuana would help state governments save taxpayers money.

• Governments spend lots of funds on law enforcement agencies that uphold laws restricting the use of marijuana.
• They also spend vast sums of money on sustaining arrested dealers and consumers in prison.
• Legalizing marijuana would result in saving vast sums of money.

Paragraph 4:

Marijuana is less noxious than other legal substances.

• Marijuana has less health side effects than other legal substances such as alcohol and tobacco.
• Alcohol is 114 times more destructive than marijuana.

Paragraph 5:

Marijuana has been proven to have medical benefits.

• Marijuana helps stop seizures in epileptic patients.
• It helps stop nausea in cancer patients undergoing chemotherapy .

Paragraph 6:

Marijuana has been proven to be a stress reliever.

• Marijuana relieves stress and depression in their users by causing excitement.
• Its use reduces violence and deaths related to stress and depression.

Conclusion.

There are many misconceptions about marijuana existent in the modern world. People have continued to ignore health benefits linked to this substance citing their unproven beliefs. Owing to its ability to stop seizures, nausea, and stress in individuals governments should highly consider marijuana legalization. Its legalization will also help state governments reduce expenses that result from maintaining suspects convicted of marijuana possession and consumption.

Why Marijuana Should be Legalized Argumentative Essay

The argument that marijuana use should be made legal has gained momentum both in the U.S. and elsewhere in the world in recent years. This has seen the drug being legalized in some states in the U.S. such that by 2013, twenty states had legalized medical marijuana. As of the same year, Colorado and Washington had legalized recreational marijuana. The arguments behind the push for legalization majorly revolve around the idea that the drug has medicinal effects. However, there are also arguments that there are serious health effects associated with the drug and this has only further fueled the already raging debate. This paper argues that marijuana should be legalized as it is more beneficial that it may be detrimental to society.

Marijuana has not caused any notable negative effects in countries where it has been legalized. There is a general belief that marijuana consumers are violent. However, no authentic research can prove these assertions. As already seen, some states in the United States have legalized both medicinal and recreational marijuana. In spite of this, no cases of marijuana-related violence have been recorded so far in such states (Markol, 2018). Reports reveal that the rate of violence and property crimes have decreased in Colorado following the legalization of the drug. If marijuana does not increase violent crimes, there is no reason as to why it should not be legalized.

It is also noteworthy that prohibiting marijuana use does not limit its consumption. Less than 10% of countries in the world prevent the use of marijuana, but according to research, 58% of young people in most of these countries are marijuana users (Head, 2016). General reports reveal that marijuana is one of most commonly abused drug in the world. It is also readily available in most states as it is a naturally growing plant (Head, 2016). In spite of its continued use, there are few cases, if any, of marijuana-related health complications that have been reported in any of these countries (Head, 2016). Therefore, if the illegality of marijuana does not limit its consumption, then state governments should consider its legalization.

Legalization of marijuana would further help state governments save taxpayers’ money. It is widely known that in countries where marijuana is illegal, authorities are stringent and will arrest any individual found in possession of the drug (Sanger, 2017). However, as earlier mentioned, laws prohibiting the use of the drug do not prevent its consumption, and this means that many people are arrested and prosecuted for possessing it (Sanger, 2017). State governments therefore use a lot of funds to support law enforcement agencies that seek to uphold laws prohibiting the use of marijuana (Sanger, 2017). Many people have been arrested and incarcerated for either possessing or consuming the drug, and the government has to use taxpayers’ money to sustain such people in prison. Since these actions do not limit consumption of marijuana, state governments should legalize the drug so as to save taxpayers money.

Another advantage of marijuana is that it is less noxious than other legal substances. According to research, marijuana is the least harmful drug among the many legal drugs existent in the world today (Owen, 2014). There are millions of campaigns every year cautioning people against smoking cigarettes, but there has been none seeking to warn people about marijuana consumption (Owen, 2014). Lobby groups have even been making efforts to push for legalization of marijuana. If marijuana had severe health effects as many purport, state governments would be investing heavily in campaigns aimed at discouraging its consumption (Owen, 2014). According to studies, alcohol, which is legal in many countries, is 114 times more harmful than marijuana (Owen, 2014). Therefore, if such harmful substances can be legalized, then there are no justifications as to why marijuana should not be legalized.

Further, marijuana has been proven to have medicinal benefits. Several countries, particularly in Europe, and the United States have legalized both medicinal and recreational marijuana. Their move to legalize marijuana was based on medical reports that showed a variety of health benefits linked to the drug (Noonan, 2017). Research shows that marijuana can reduce seizures in epileptic persons. Several studies have also proven that the drug indeed has a variety of health benefits. For instance, Charlotte Figi, who is now aged 10, used to have more than 100 seizures every month at age three, but since Colorado legalized medicinal and recreational marijuana, her parents started treating her with the substance, and today her seizures have significantly reduced (Noonan, 2017). Marijuana has as well been proven to reduce nausea in cancer patients undergoing chemotherapy. Owing to this medicinal value, state governments should consider legalizing the drug.

Additionally, marijuana has been proven to be a stress reliever. Consumption of the drug causes excitement among its users enabling them to forget about troubling situations. Unlike alcohol which is likely to aggravate stress and depression, marijuana works wonders in alleviating anxiety and depression (Sanger, 2017). There are many health and social effects associated with stress, including mental disorders and violence against others (Sanger, 2017). To avoid cases of stress-related violence and mental disorders, state governments should make marijuana consumption legal.

There are many misconceptions about marijuana in the world today. People have continued to ignore the health benefits linked with this substance and have instead focused on citing yet-to-be proven misconceptions. Owing to the ability of the drug to stop seizures, nausea, and stress in individuals, governments should seriously consider its legalization. The legalization will also help state governments reduce expenses that result from sustaining suspects convicted of marijuana possession and consumption. So far, there is more than enough evidence proving that marijuana has lots of benefits to individuals, the society, and the government, and therefore should be legalized.

Head, T. (2016). “8 reasons why marijuana should be legalized”. ThoughtCo . Retrieved June 27, 2020 from https://www.thoughtco.com/reasons-why-marijuana-should-be-legalized-721154

Markol, T. (2018). “5 reasons why marijuana should be legalized”. Marijuana Reform . Retrieved June 27, 2020 from http://marijuanareform.org/5-reasons-marijuana-legalized/

Noonan, D. (2017). “Marijuana treatment reduces severe epileptic seizures”. Scientific American . Retrieved June 27, 2020 from https://www.scientificamerican.com/article/marijuana-treatment-reduces-severe-epileptic-seizures/

Owen, P. (2014). “6 powerful reasons to legalize marijuana”. New York Times . Retrieved June 27, 2020 from https://www.alternet.org/drugs/6-powerful-reasons-new-york-times-says-end-marijuana-prohibition

Sanger, B. (2017). “10 legit reasons why weed should be legalized right now”. Herb . Retrieved June 27, 2020 from https://herb.co/marijuana/news/reasons-weed-legalized

Why Marijuana Should be Legal Essay Outline

Thesis:  Marijuana has health benefits and should thus be legal.

Benefits of Marijuana

Marijuana slows and stops the spread of cancer cells.

• Cannabidiol can turn off a gene called Id-1 and can therefore stop cancer.
• In an experiment, researchers were able to treat breast cancer cells with Cannabidiol.

Marijuana helps with pain and nausea reduction for people going through chemotherapy.

• Cancer patients undergoing chemotherapy suffer from severe pains and nausea.
• This can further complicate their health.
• Marijuana can stir up their appetite, decrease nausea, and reduce pain.

Paragraph  3:

Marijuana can control epileptic seizure.

• Marijuana extract stopped seizures in epileptic rats in ten hours.
• The seizures were controlled by the THC.

Disadvantages of Marijuana

Marijuana is addictive.

• One in ten marijuana users become addicted over time.
• If one stops using the drug abruptly, they may suffer from such withdrawal symptoms.

Marijuana use decreases mental health.

• Users suffer from memory loss and restricted blood flow to the brain.
• Users have higher chances of developing depression and schizophrenia.

Marijuana use damages the lungs more than cigarette smoking .

• Marijuana smokers inhale the smoke more deeply into their lungs and let it stay there for longer.
• The likelihood of lung cancer can be increased by this deeper, longer exposure to carcinogens.

Why Marijuana Should Be Legal

Paragraph 7:

Improved quality and safety control.

• Legalization would lead to the creation of a set of standards for safety and quality control.
• Users would know what they exactly get in exchange for the money they offer.
• There would be no risks of users taking in unknown substances mixed in marijuana.

Paragraph 8:

Marijuana has a medicinal value.

• Medical marijuana treats a wide assortment of “untreatable” diseases and conditions.
• Public health would be improved and the healthcare system would experience less of a drain.  

Paragraph 9: 

Among the major arguments against marijuana legalization is often that legalization would yield an increase in drug-impaired driving.

• This argument holds that even now when the drug is yet to be fully legalized in the country, it is a major causal factor in highway deaths, injuries, and crushes.
• It however beats logic why marijuana is illegalized on the ground that it would increase drug-impaired driving while alcohol is legal but also significantly contributes to the same problem.

Legalization of marijuana would have many benefits. The drug is associated with the treatment of many serious illnesses including the dreaded cancer. Legalization would also save users from consuming unsafe marijuana sold by unscrupulous people.

Why Marijuana Should Be Legal Essay

There is an ongoing tension between the belief that marijuana effectively treats a wide range of ailments and the argument that it has far-reaching negative health effects. There has nevertheless been a drive towards legalization of the drug in the United States with twenty nine states and the District of Columbia having legalized it for medical and recreational purposes. It was also found by a study that there is a sharp increase in the use of marijuana across the country (Kerr, Lui & Ye, 2017). Major public health concerns are being prompted by this rise. This should however not be the case because marijuana has health benefits and should thus be legal.

Marijuana slows and stops the spread of cancer cells. A study found that Cannabidiol can turn off a gene called Id-1 and can therefore stop cancer. A 2007 report by researchers at California Pacific Medical Center in San Francisco also indicated that the spread of cancer may be prevented by Cannabidiol. In their lab experiment, the researchers were able to treat breast cancer cells with this component (Nawaz, 2017). The positive outcome of the experiment showed that Id-1 expression had been significantly decreased.

Marijuana also helps with pain and nausea reduction for people going through chemotherapy. Cancer patients undergoing chemotherapy suffer from severe pains, appetite loss, vomiting, and painful nausea. This can further complicate their already deteriorating health. Marijuana can be of help here by stirring up the appetite, decreasing nausea, and reducing pain (Nawaz, 2017). There are also other cannabinoid drugs used for the same purposes as approved by the FDA.

It was additionally shown by a 2003 study that the use of marijuana can control epileptic seizure. Synthetic marijuana and marijuana extracts were given to epileptic rats by Virginia Commonwealth University’s Robert J. DeLorenzo. In about ten hours, the seizures had been stopped by the drugs (Nawaz, 2017). It was found that the seizures were controlled by the THC which bound the brain cells responsible for regulating relaxation and controlling excitability.

Some scientists claim that marijuana is addictive. According to them, one in ten marijuana users become addicted over time. They argue that if one stops using the drug abruptly, they may suffer from such withdrawal symptoms as anxiety and irritability (Barcott, 2015). However, the same argument could be applied to cigarette smoking, which is notably legal. There is need for more studies to be conducted into this claim being spread by opponents of marijuana legalization.

It is also argued that marijuana use decreases mental health. Those opposed to the legalization of recreational marijuana like to cite studies that show that users of the drug suffer from memory loss and restricted blood flow to the brain. They also argue that users have higher chances of developing depression and schizophrenia. However, these assertions have not yet been completely ascertained by science (Barcott, 2015). The claim about depression and schizophrenia is particularly not clear because researchers are not sure whether the drug triggers the conditions or it is used by smokers to alleviate the symptoms.

It is further claimed that marijuana use damages the lungs more than cigarette smoking. It is presumed that marijuana smokers inhale the smoke more deeply into their lungs and let it stay there for longer. The likelihood of lung cancer, according to this argument, can be increased by this deeper, longer exposure to carcinogens. However, the argument touches not on the frequency of use between marijuana and cigarette smokers (Barcott, 2015). It neither takes into account such alternative administration methods as edibles, tinctures, and vaporizing.

Legalization of marijuana would lead to improved quality and safety control. Purchasing the drug off the street provides end users with no means of knowing what they are exactly getting. On the other hand, legalizing it would immediately lead to the creation of a set of standards for safety and quality control (Caulkins, Kilmer & Kleiman, 2016). This would certainly work in the marijuana industry just as it is working in the tobacco and alcohol industries. Users would be able to know what they exactly get in exchange for the money they offer. Additionally, there would be no risks of users taking in unknown substances mixed in marijuana sold on the streets.

Marijuana should also be legal because it has a medicinal value. It has been proven that medical marijuana treats a wide assortment of “untreatable” diseases and conditions. These include problems due to chemotherapy, cancer, post-traumatic stress disorder, migraines, multiple sclerosis, epilepsy, and Crohn’s disease (Caulkins, Kilmer & Kleiman, 2016). Public health would be improved and the healthcare system would experience less of a drain if medical cannabis products were made available to those suffering from the mentioned conditions. Consequently, more public funds would be available for such other public service initiatives as schools and roads.

Among the major arguments against marijuana legalization is often that legalization would yield an increase in drug-impaired driving. This argument holds that even now when the drug is yet to be fully legalized in the country, it has already been cited to be a major causal factor in highway deaths, injuries, and crushes. Among the surveys those arguing along this line might cite is one that was conducted back in 2010, revealing that of the participating weekend night-time drivers, “8.6 percent tested positive for marijuana or its metabolites” (“Why We Should Not Legalize Marijuana,” 2010). It was found in yet another study that 26.9% of drivers who were being attended to at a trauma center after sustaining serious injuries tested positive for the drug (“Why We Should Not Legalize Marijuana,” 2010). It however beats logic why marijuana is illegalized on the ground that it would increase drug-impaired driving while alcohol is legal but also significantly contributes to the same problem.

As the discussion reveals, legalization of marijuana would have many benefits. The drug is associated with the treatment of many serious illnesses including the dreaded cancer. Legalization would also save users from consuming unsafe marijuana sold by unscrupulous people. There are also other health conditions that can be controlled through the drug. Arguments against its legalization based on its effects on human health also lack sufficient scientific support. It is thus only safe that the drug is legalized in all states.

Barcott, B. (2015).  Weed the people: the future of legal marijuana in America . New York, NY: Time Home Entertainment.

Caulkins, J. P., Kilmer, B., & Kleiman, M. (2016).  Marijuana legalization: what everyone needs to know . New York, NY: Oxford University Press.

Kerr, W., Lui, C., & Ye, Y. (2017). Trends and age, period and cohort effects for marijuana use prevalence in the 1984-2015 US National Alcohol Surveys.  Addiction ,  113 (3), 473-481.

Nawaz, H. (2017).  The debate between legalizing marijuana and its benefits for medical purposes: a pros and cons analysis . Munich, Germany: GRIN Verlag.

Why We Should Not Legalize Marijuana. (2010). In  CNBC . Retrieved June 25, 2020 from  https://www.cnbc.com/id/36267223 .

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Regions & Countries

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

With a growing number of states authorizing the use of marijuana, the public continues to broadly favor legalization of the drug for medical and recreational purposes. 

An overwhelming share of U.S. adults (88%) say either that marijuana should be legal for medical and recreational use by adults (59%) or that it should be legal for medical use only (30%). Just one-in-ten (10%) say marijuana use should not be legal, according to a Pew Research Center survey conducted Oct. 10-16, 2022. These views are virtually unchanged since April 2021.

The new survey follows President Joe Biden’s decision to pardon people convicted of marijuana possession at the federal level and direct his administration to review how marijuana is classified under federal law. It was fielded before the Nov. 8 midterm elections, when two states legalized the use of marijuana for recreational purposes – joining 19 states and the District of Columbia , which had already done so.

Pew Research Center asked this question to track public views about the legal status of marijuana. For this analysis, we surveyed 5,098 adults from Oct. 10-16, 2022. Everyone who took part in this survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used for this report, along with responses, and its methodology .

Over the long term, there has been a steep rise in public support for marijuana legalization, as measured by a separate Gallup survey question that asks whether the use of marijuana should be made legal – without specifying whether it would be legalized for recreational or medical use. This year, 68% of adults say marijuana should be legal , matching the record-high support for legalization Gallup found in 2021.

There continue to be sizable age and partisan differences in Americans’ views about marijuana. While very small shares of adults of any age are completely opposed to the legalization of the drug, older adults are far less likely than younger ones to favor legalizing it for recreational purposes.

This is particularly the case among those ages 75 and older, just three-in-ten of whom say marijuana should be legal for both medical and recreational use. Larger shares in every other age group – including 53% of those ages 65 to 74 – say the drug should be legal for both medical and recreational use.

Republicans are more wary than Democrats about legalizing marijuana for recreational use: 45% of Republicans and Republican-leaning independents favor legalizing marijuana for both medical and recreational use, while an additional 39% say it should only be legal for medical use. By comparison, 73% of Democrats and Democratic leaners say marijuana should be legal for both medical and recreational use; an additional 21% say it should be legal for medical use only.

Ideological differences are evident within each party. About four-in-ten conservative Republicans (37%) say marijuana should be legal for medical and recreational use, compared with a 60% majority of moderate and liberal Republicans.

Nearly two-thirds of conservative and moderate Democrats (63%) say marijuana should be legal for medical and recreational use. An overwhelming majority of liberal Democrats (84%) say the same.

There also are racial and ethnic differences in views of legalizing marijuana. Roughly two-thirds of Black adults (68%) and six-in-ten White adults say marijuana should be legal for medical and recreational use, compared with smaller shares of Hispanic (49%) and Asian adults (48%).

Related: Clear majorities of Black Americans favor marijuana legalization, easing of criminal penalties

In both parties, views of marijuana legalization vary by age

While Republicans and Democrats differ greatly on whether marijuana should be legal for medial and recreational use, there are also age divides within each party.

A 62% majority of Republicans ages 18 to 29 favor making marijuana legal for medical and recreational use, compared with 52% of those ages 30 to 49. Roughly four-in-ten Republicans ages 50 to 64 (41%) and 65 to 74 (38%) say marijuana should be legal for both purposes, as do 18% of those 75 and older.

Still, wide majorities of Republicans in all age groups favor legalizing marijuana for medical use. Even among Republicans 65 and older, just 17% say marijuana use should not be legal even for medical purposes.

While majorities of Democrats across all age groups support legalizing marijuana for medical and recreational use, older Democrats are less likely to say this. About half of Democrats ages 75 and older (51%) say marijuana should be legal for medical or recreational purposes; larger shares of younger Democrats say the same. Still, only 8% of Democrats 75 and older think marijuana should not be legalized even for medical use – similar to the share of all other Democrats who say this.

Note: Here are the questions used for this report, along with responses, and its methodology .

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Clear majorities of Black Americans favor marijuana legalization, easing of criminal penalties

Concern about drug addiction has declined in u.s., even in areas where fatal overdoses have risen the most, religious americans are less likely to endorse legal marijuana for recreational use, 6 facts about americans and marijuana, four-in-ten u.s. drug arrests in 2018 were for marijuana offenses – mostly possession, 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 .

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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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Should marijuana be legal for medicinal purposes essay sample, example.

Drug addiction is something societies all over the world rarely tolerate. Although almost every culture has a tradition of consuming narcotic substances—alcohol, in the first turn—not all of them are seen as acceptable. A person saying, “A glass of beer after a long working day is my small weakness, you know” looks normal; but an almost similar phrase, “A shot of heroin after a long working day is my small weakness, you know” will sound suspicious, to say the least, will it not?

Double standards or not, narcotics are a taboo—and still there are several kinds of drugs that societies turn a blind eye to: tobacco, the aforementioned alcohol, and marijuana. The latter is illegal in many countries, but people’s attitude to it is rather benevolent—more than to any other drug. Besides, there have been talks (for a long while) that marijuana is not only a relaxing, but also a recreational drug, and that in some cases, it can be used for medicinal purposes. The Internet is full of controversial studies, either claiming that marijuana is bliss and should be legalized everywhere, or stating directly the opposite. And although total legalization might not be the best choice, there are reasons to believe that in medicine this drug can be used rather effectively.

To start with, marijuana is not totally illegal: a number of states in the USA (Colorado, California, Washington, Arizona, New Mexico, and 16 other states), as well as several countries such as Netherlands have made it legal to smoke weed. This was not done on the basis of pure fun and carelessness, of course: the distribution of legalized drugs is easier to control, they are taxed, and their chemical compound can be standardized to minimize health risks and side effects. At the same time, numerous studies prove that marijuana—in its medical form—can be beneficial for patients suffering from serious diseases, such as cancer. To be more precise, there are several groups of diseases with symptoms that can be alleviated by marijuana:

1) In case of various inflammations, marijuana is great for treating chronic pain. Unlike opiates, which are better when there is a need to quickly alleviate acute pain, weed is safer and more effective in decreasing long-term pain. 2) The symptoms of arthritis and other autoimmune diseases can be reduced or even eliminated with the help of marijuana as well. 3) Patients with such neurological disorders as multiple sclerosis or spinal cord injuries would appreciate weed for its painkilling effect, and its ability to reduce muscle spasticity caused by damaged nerves. There have been studies about the beneficial effects of medical marijuana in patients with epilepsy. 4) Patients with cancer having to undergo numerous chemotherapy sessions often suffer from severe nausea after them; marijuana can not only eliminate this nausea, but also prevent the spreading of some forms of cancer. 5) HIV/AIDS patients often experience significant loss of weight and appetite—both due to neurological factors and multiple antibiotics taken; marijuana can increase appetite and alleviate neurological symptoms (Learn.Genetics).

According to a survey conducted by an authoritative website about medicine, WebMD, American doctors of 12 different specializations approved the usage of marijuana in medicinal purposes. During the course of the survey, more than 1,500 doctors from 48 states responded that they would advocate the legalization of medical marijuana to make it an option for patients who need it. In addition, the American Epilepsy Foundation appealed to the Drug Enforcement Administration to relax its restrictions on marijuana in order to conduct more proper studies on it. Michael W. Smith, MD, WebMD Chief Medical Editor, says that “The medical community is clearly saying they support using marijuana as a potential treatment option for any number of medical problems. In fact, many doctors already prescribe it. But health professionals are still unclear as to what the long-term effects may be. The findings would indicate a strong desire to have the DEA ease the restrictions on research so that additional studies can be done to conclusively show where medical marijuana can help and where it might not” (WebMD).

Yet another positive effect that might come out of the legalization of medical marijuana is the decrease of opiate consumption and prescriptions. The problem with opioid painkillers is that they can cause addiction, and although they are extremely effective in alleviating pain, there has been cases of death due to overdose. The usage of marijuana as a painkiller could fix this situation—at least partially; according to one NIDA-funded study, there is a connection between medical marijuana legalization and the decrease of deaths caused by opioid overdose, opioid prescribing, self-reports of opioid misuse, and treatment admissions for opioid addiction, as well as the reduction of doses of prescribed opioids (NIDA). Although additional studies on this subject are still required, it can be seen that medical marijuana can be a healthier alternative to traditional opioid painkillers.

Drug consumption is always connected to the risk of developing an addiction. Even such “harmless” and legalized drugs as alcohol and tobacco annually cause millions of deaths worldwide. However, in the case of marijuana, there might be exceptions—given that it is prescribed for medicinal purposes, and under the control of a doctor. This drug can ease pain, help seriously ill people alleviate or eliminate their symptoms, and can even become an alternative to traditional opiate painkillers. Therefore, under certain conditions and regulations, marijuana can be used as a recreational drug.

Works Cited

“Legalize Medical Marijuana, Doctors Say in Survey.” WebMD. WebMD, 25 Mar. 2014. Web. 15 May 2017. .

“Cannabis in the Clinic? The Medical Marijuana Debate.” Learn.Genetics. N.p., n.d. Web. 15 May 2017. .

“Marijuana as Medicine.” NIDA. N.p., n.d. Web. 15 May 2017. .

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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.

Reason Why Marijuana Should Be Legal

Introduction.

• Why Marijuana should be Legalized
• Arguments Against Legalization

Why Marijuanas Should Be Legal: Essay Conclusion

Works cited.

Of all the illegal drugs in existence, Cannabis Sativa (most popularly known as marijuana) is the most commonly used substance (Iftikhar et al. 7699). The World Health Organization documents that 2.5% of the world’s population indulge in the usage of this drug, therefore making it the most popular psychoactive substance.

Despite this apparent popularity of the drug, it remains illegal in many countries, including the USA. Recent scientific research has revealed that the effect of marijuana on a person’s health may not be as potent as previously thought. With this revelation and the increased use of the drug among the population, there have been calls for the government to consider legalizing this popular recreational drug.

Calls for legalizing marijuana have been countered by vocal opposition from people advocating for the drug to be kept illegal since it has many adverse effects. This “Why Marijuanas Should Be Legal” essay will set out to argue that marijuana should be legal since the harmful effects of this substance are not as dire, and legalization would result in many benefits for society. The argumentative paper will rely on research to reinforce this claim.

Why Marijuana Should Be Legalized

Marijuana is a favored recreational drug, which means that its commercial significance is high due to the high demand for the product. Under the current situation where the drug is deemed illicit, the government cannot benefit monetarily from commerce with this drug. This is an essential consideration since data on the prevalence of Marijuana indicates that the US is still the world’s largest single market for the medication (Hammond et al. 221).

The government could gain much revenue if the drug were legal and taxes imposed. As it currently stands, the sale of the drug only benefits players in the black market who produce and sell the product. These players are primarily criminals who have become very powerful from the money obtained from commerce in marijuana.

Houston, who is an outspoken advocate for the legalization of Marijuana, confirms that marijuana is the cash cow that has made the Mexican drug cartels such a formidable force. By making the drug legal, the government would benefit from revenues obtained from its sale as well as remove the monopoly held by the criminal gangs, thus making the country safer.

The government uses significant amounts of resources in enforcing its laws against marijuana. Maintaining the status quo of marijuana as an illegal substance is an expensive operation, and the taxpayer bears the financial burden.

Green documents that the US government spends billions of dollars annually to enforce prohibition efforts on marijuana (6). This money that would otherwise have been spent on more socially constructive purposes is currently being used to fund operations ranging from the carrying out of drug raids, arrests, and prosecution of drug offenders.

The expenses do not end there, as more money is needed to maintain the convicted offenders in the country’s already overstrained penitentiaries. Making marijuana legal would mean that the government would save all the money that it currently spends on enforcing the law against marijuana. This would be a prudent step since, as it is, the efforts by the government, while prohibitively high, do not appear to have significantly reduced marijuana consumption in the country.

An obvious merit of the legal industry is that it is bound by government control, which ensures that the products sold are safe for the consumer. The government can also monitor the production process and issue guidelines to ensure the consumer is not exposed to unnecessary risks.

Since marijuana is illegal, its production and distribution are unregulated, which means that the quality of the product is unguaranteed. Part of the contamination also comes from the pesticides used on the plant. Legal crops have strict government controls on pesticides, which minimize the risks to the individual. Montoya et al. reveal that since marijuana is an illegal drug, there are no guidelines or controls for its cultivation, and it is not known whether the pesticides used are safe for humans (4).

In addition to this, the illegal status of marijuana means that most of it is grown indoors to reduce the risk of discovery by law enforcement. Indoor-grown marijuana is perceived to be more contaminated than marijuana grown naturally since indoor cultivation involves the use of additives to maximize yield (Montoya et al. 4).

Legalization of marijuana would give the government greater control over the product, which would make it safer for the user. Currently, the market is unregulated, and dealers are constantly increasing the potency of the drug to attract more customers. The potency of marijuana is changed by altering the primary active chemical in marijuana, THC, which is the component that causes the mind-altering effects of marijuana intoxication.

Montoya et al. attribute the increased potency to the popularity of indoor cultivation, which involves the practice of cloning from a variety of cannabis with high THC content (2). The more potent marijuana is, the higher the increase of cannabis-related harms such as psychotic and anxiety effects. Legalizing the drug would make it possible for the government to monitor the content of the drug just as the alcohol content in beverages is monitored. This would reduce the health risks that result from highly potent marijuana.

Marijuana has scientifically proven medical benefits for its consumers. Marijuana has been documented to improve symptoms associated with multiple sclerosis. The efficacy of marijuana in this area has been so significant that pharmaceutical companies have begun using Sativex, a derivative of cannabis, in the care of people with multiple sclerosis (Baratta et al. 3).

Clinical trial research on the therapeutic role of marijuana in pain management has shown that the drug demonstrated significant pain relief and induced relaxation, hence relieving anxiety and depression (Baratta et al. 2). These findings are corroborated by reports by the WHO, which indicate that cannabinoids alleviate symptoms such as nausea and vomiting in chronically ill patients. Making marijuana legal would ensure that it is more readily available for the sick, who would exploit it for its curative properties.

Arguments against Legalization

Despite all the advantages that can be gained from legalizing marijuana, there are critical adverse effects that opponents of legalization point to. The most significant of these claims is that marijuana results in adverse physical and mental effects on the user. Hammond et al. state that heavy marijuana use impairs a person’s ability to form memories, and users who have taken high doses of the drug may experience acute psychosis (9).

Montoya et al. proceed to state that contaminated marijuana has the potential to cause lung disease and respiratory problems (4). Considering these adverse effects, proponents of legalization assert that it would be reckless for the government even to consider making marijuana legal. While it is true that marijuana can have adverse effects, these extreme effects are mostly restricted to heavy users and those users who consume contaminated or high-potency marijuana.

A primary concern of the public is the link between drug use and involvement in crime. Opponents of legalization state that marijuana would result in citizens, especially the youth, engaging in criminal activities as a result of drug use. This stereotypical view is unfounded, as research indicates that marijuana use does not play an essential role in fostering a general involvement in crime.

A study conducted by Lu et al. on the association between cannabis use and subsequent criminal charges on an individual suggested that marijuana was associated with subsequent criminal activity (565).

However, the authors noted that the bulk of this involvement was in various types of drug-specific crime, such as possession and distribution of the drug. Marijuana does not, therefore, result in general crime involvement, and a considerable proportion of its users only get into the penal system because of the use or possession of drugs.

A common argument raised by proponents of legalizing marijuana is that its legalization would result in a phenomenal increase in the number of users. This reasoning is based on the assumption that, at present, many people who would be users of marijuana are deterred because of the legal action, such as jail time that they would suffer if they consumed the product.

Houston suggests that this argument is not based on facts since the rate of marijuana use in the Netherlands (a country reputed for its relaxed laws on marijuana, which permit the purchase and consumption of regulated portions of the drug) is significantly lower than in the US where prohibitive laws against the drug are in place.

Marijuana consumption is pervasive in the US, and this drug has become the favorite recreational drug despite measures by the government to curb its supply and discourage its usage. This has resulted in the issue of whether to legitimize marijuana or not being heavily debated in the country.

From the arguments given in this paper, it is clear that many benefits will be reaped from the legalization of marijuana. These advantages include increased access to the drug for people who require it for medical purposes, a regulated market that would make the product safer, and the financial gains that the government would achieve through taxation and savings from the money that is currently used to enforce the law against marijuana.

While proponents of legalization point to the adverse effects of the drug, this paper has shown that many research findings available today indicate that the adverse effects of marijuana are mild and that the drug has functional medicinal properties.

This paper set out to argue that the government should legalize marijuana. To this end, the paper has engaged in discussions about the merits and demerits of such a move. Overall, evidence suggests that making marijuana legal would benefit society more than having it classified as an illegal substance.

Citizens who are keen on bringing about development should, therefore, petition the government to legalize the drug so that society can enjoy the benefits stated at the same time avoiding the enormous costs incurred by efforts to keep the drug illegal.

Baratta, Francesca, et al. “ Cannabis for Medical Use: Analysis of Recent Clinical Trials in View of Current Legislation. ” Frontiers in Pharmacology , vol. 13, May 2022.

Green, Jesse. “ Federalism, Limited Government, and Conservative Outcomes: The Republican Case for Marijuana Legalization .” Social Science Research Network , Jan. 2023.

Hammond, Chris, et al. “ Cannabis Use Among U.S. Adolescents in the Era of Marijuana Legalization: A Review of Changing Use Patterns, Comorbidity, and Health Correlates. ” International Review of Psychiatry , vol. 32, no. 3, Feb. 2020, pp. 221–34.

Iftikhar, Amna, et al. “ Applications of Cannabis Sativa L. in Food and Its Therapeutic Potential: From a Prohibited Drug to a Nutritional Supplement. ” Molecules , vol. 26, no. 24, Dec. 2021, p. 7699.

Lu, Ruibin, et al. “ The Cannabis Effect on Crime: Time-Series Analysis of Crime in Colorado and Washington State. ” Justice Quarterly , vol. 38, no. 4, Oct. 2019, pp. 565–95.

Montoya, Zackary T., et al. “ Cannabis Contaminants Limit Pharmacological Use of Cannabidiol. ” Frontiers in Pharmacology , vol. 11, Sept. 2020.

World Health Organization (WHO). Management of substance abuse: Cannabis . Jan. 2010. Web.

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• Literary Analysis
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• Argument About Legalizing Marijuana in America
• Legalizing Marijuana: Pros and Cons
• History and Effects of Legalization of Marijuana
• Should Marijuana Be Legal?
• Marijuana Legalization in California
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• Legalization of Marijuana: Arguments For and Against
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Five Reasons Why We Should Legalize Cannabis

Cannabis use in the United States has had a long and complicated history. For decades, people who used cannabis were subject to social ostracization and criminal prosecution. However, attitudes toward cannabis have been evolving in recent years. An increasing number of states have started to legalize cannabis for medical or recreational use. This shift in policy has been driven by a variety of factors including changing public attitudes and the potential economic benefits of legalization. In this article, we will explore the potential benefits of legalizing cannabis in our country.

1. Legalization for the Environment

Legalizing cannabis can have significant benefits for the environment. When cannabis is grown illegally, it is often done in environmentally damaging ways, such as using chemical pesticides or clearing primary forests to make room for crops. Legalization could allow customers to support more environmental growers. This will incentivize more responsible growing practices, such as the use of organic farming methods or the use of renewable energy sources to power indoor grow operations. In addition, the culture of growing cannabis can help to discover and preserve precious marijuana seeds , increasing biodiversity and facilitating a deeper understanding of cannabis plants and their cultivation.

2. Legalization for Justice

Where cannabis is illegal, people are being arrested and charged for possession or sale, which leads to costly court cases and a burden on the criminal justice system. Legalization would free up law enforcement resources to focus on more serious crimes and simultaneously reduce the number of people incarcerated for non-violent drug offenses. This could help to reduce the overall prison population and save taxpayers money.

In addition, legalization can have significant benefits for justice and equity, particularly for marginalized communities that have been disproportionately affected by the criminalization of cannabis. Communities of color have been particularly affected by the war on drugs, with Black Americans being nearly four times more likely to be arrested for cannabis possession than white Americans, despite similar rates of use.

By regulating cannabis cultivation and sales, legalization can help to eliminate the black market and reduce the involvement of criminal organizations in the cannabis industry. This can lead to safer communities and reduced drug-related violence in communities that have been most affected by the criminalization of cannabis.

3. Legalization for Public Health

Cannabis has been shown to have many beneficial and therapeutic effects on both physical and mental health. However, people may be hesitant to seek medical marijuana treatment due to fear of legal repercussions if cannabis is illegal. Legalization can allow more people to enjoy better health outcomes. It can also promote the safer use of cannabis by educating the public on appropriate cannabis use and providing quality control measures for cannabis products. Legalization can also lead to increased research into potential medical applications of cannabis and could lead to the development of innovative treatments.

Another potential perk of cannabis legalization is that it could reduce the use of more harmful drugs. In the absence of cannabis, people may turn to more dangerous drugs like heroin or fentanyl to manage chronic pain or other conditions. By legalizing cannabis, we can provide a safer alternative for these individuals and could reduce the overall demand for these more dangerous drugs. States that have legalized cannabis found a decrease in opioid overdose deaths and hospitalizations, suggesting that cannabis are an effective alternative to prescription painkillers.

4. Legalization for the Economy

The legalization of cannabis can generate significant tax revenue for governments and create new economic opportunities. When cannabis is illegal, it is sold on the black market, and no taxes are collected on these sales. However, when it is legal, sales can be regulated, and taxes can be imposed on those sales. In states that have legalized cannabis, tax revenue from cannabis sales has been in the millions of dollars , with California registering a whopping $1.2 billion in cannabis tax revenue in 2021. This impressive income can be used to reduce budget deficits, fund various public services such as education and healthcare, and create new opportunities for investment in projects that revitalize the economy.

Aside from tax revenue, legalizing cannabis can create new jobs. The cannabis industry is a rapidly growing industry, and legalization could lead to the creation of new jobs in areas such as cultivation, processing, and retail sales. This can help to reduce unemployment and create new gainful opportunities for people who may have struggled to find employment in other industries. Legalization can also lead to increased investment in related industries, such as the development of new products or technologies to improve cannabis cultivation or the creation of new retail businesses. There are now several venture capital funds and investment groups that focus solely on cannabis-related enterprises.

5. Legalization for Acceptance

Finally, legalization could help reduce the stigma surrounding cannabis use. Before cannabis legalization, people who use the plant were often viewed as criminals or deviants. Legalization can help change this perception and lead to more open and honest conversations about cannabis use. Ultimately, legalization could lead to a more accepting and inclusive society where individuals are not judged or discriminated against for their personal and healthcare choices. By legalizing cannabis, we can harness the power of a therapeutic plant. Legalization can heal not just physical and mental ailments of individuals but also the social wounds that have resulted from its criminalization.

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Medical Marijuana and Marijuana Legalization

Rosalie liccardo pacula.

1 RAND Corporation, Santa Monica, California 90407; gro.dnar@alucap , gro.dnar@tramsr

2 National Bureau of Economic Research, Cambridge, Massachusetts 02138

Rosanna Smart

State-level marijuana liberalization policies have been evolving for the past five decades, and yet the overall scientific evidence of the impact of these policies is widely believed to be inconclusive. In this review we summarize some of the key limitations of the studies evaluating the effects of decriminalization and medical marijuana laws on marijuana use, highlighting their inconsistencies in terms of the heterogeneity of policies, the timing of the evaluations, and the measures of use being considered. We suggest that the heterogeneity in the responsiveness of different populations to particular laws is important for interpreting the mixed findings from the literature, and we highlight the limitations of the existing literature in providing clear insights into the probable effects of marijuana legalization.

INTRODUCTION

Although the federal law has prohibited the use and distribution of marijuana in the United States since 1937, for the past five decades states have been experimenting with marijuana liberalization polices. State decriminalization policies were first passed in the 1970s, patient medical access laws began to get adopted in the 1990s, and more recently states have been experimenting with legalization of recreational markets. This has resulted in a spectrum of marijuana liberalization policies across the United States that is often not fully recognized or considered when conducting evaluations of recent policy changes. Consider for example the state of marijuana policies in the United States at a single point of time. As shown in Figure 1 , as of January 1, 2016, 21 states 1 have decriminalized certain marijuana possession offenses ( NCSL 2016a ), 26 states have legalized medical marijuana use, and another 16 states have adopted cannabidiol (CBD)-only laws ( NCSL 2016b ) that protect only certain strains of marijuana to be used for medicinal purposes. However, there is tremendous overlap because some states have implemented combinations of each of these policies, as shown by the fact that the five states currently legalizing recreational marijuana use (Alaska, Colorado, Oregon, Washington, and the District of Columbia) all initially decriminalized marijuana and then passed medical marijuana allowances before passing their legalization policies. Thus, the vast majority of US states have moved away from a strict prohibition position toward marijuana well before they started considering outright legalization.

State marijuana policies as of January 1, 2016. Data from the RAND Marijuana Policy Database ( Pacula et al. 2015 ) and NCSL (2016a , b) with permission. Abbreviation: CBD, cannabidiol.

A number of factors have driven the policy changes observed over the past several decades, including rising state budgetary costs associated with arresting and incarcerating nonviolent drug offenders ( Raphael & Stoll 2013 , Reuter et al. 2001 ), growing scientific evidence of the therapeutic benefits of cannabinoids found in the marijuana plant ( Hill 2015 , Koppel et al. 2014 ), and strained state budgets that have caused legislatures to look for new sources of tax revenue ( Caulkins et al. 2015 , Kilmer et al. 2010 ).

The tremendous policy variation over time and across states would appear to give researchers ample opportunities to quantitatively assess the effect of marijuana liberalization policies on a variety of health and social outcomes. However, the scientific literature has been slow to develop, and what exists in the literature offers generally mixed and largely insignificant findings. This has led many to conclude that the previous liberalization policies must be harmless and that ongoing legalization would similarly generate very little harm to society. Indeed, recent surveys of people’s attitudes about marijuana show a clear shift in favor of legalization ( Caulkins et al. 2015 ).

As we will argue throughout this article, however, at least three reasons suggest that we use caution in drawing conclusions from the mixed empirical evidence or, more importantly, in assuming that a change to legally protected commercial markets would result in outcomes similar to those of the previous experiments. First, the literature has largely treated both decriminalization and medical marijuana policies as if they were simple dichotomous choices, implemented similarly across states. Such a treatment ignores the significant heterogeneity in these policies that can differentially influence harms and benefits and also contributes to what appear to be mixed results from evaluations. Second, the vast majority of policy evaluations conducted thus far examine the effect of the policy in terms of changes in prevalence rates in the general population, which assumes that the proportion of casual and heavy users, who are pooled together in these simple prevalence rates, remains stable even as the policy changes. Finally, research has been slow to consider the extent to which these changes in policies influence the method by which the typical user consumes marijuana. The potential acute harm associated with smoking a joint is different from that associated with consuming an edible or dabbing wax, particularly given that the average potency of the product typically differs and the body’s rate of absorption of THC varies by method ( Huestis 2007 ).

In this article, we review the existing literature on the effects of decriminalization and medical marijuana laws on marijuana use and marijuana use disorders in light of these limitations. Unlike other reviews, our goal is not to summarize all the existing literature on the effects of decriminalization and medicalization. Rather, the purpose of this review is to provide a better understanding of what can be gleaned from the literature when more consideration is given to the complexities of these policies, the populations examined, and the measures of use considered. Doing so allows us to convey the need for more research, in terms of measurement and analysis, before we can truly understand the impacts of marijuana liberalization policies.

WHAT IS MEANT BY HETEROGENEOUS MARIJUANA POLICIES

Defining the policies.

It is important for any discussion of the literature to begin by defining the policies being considered. For the purposes of this review, we define four specific marijuana policies (prohibition, decriminalization, medical marijuana, and legalization) in terms of their legal definitions rather than their implementation in local communities, as the latter is often a function of the level of enforcement, which is difficult to measure in a systematic and analytic way. Prohibition, therefore, can be defined as a law that maintains the criminal status of any action related to marijuana possession, use, cultivation, sale, or distribution. The level of crime may be statutorily defined as either a misdemeanor (incurring relatively lower criminal penalties that may or may not include jail time) or a felony (entailing much more serious charges, tougher sanctions, and certain prison time), and the charge may be a function of the amount of marijuana involved or simply of the nature of the activity (e.g., sale to minors). Regardless, the emphasis is on the criminal status of the related offenses, not the degree to which local law enforcement chooses to enforce it. The US federal government, for example, retains its prohibition on all marijuana activities (possession, use, cultivation, distribution, processing, and sale) as do cities like San Francisco, although San Francisco has adopted a policy of low-priority enforcement ( Ross & Walker 2017 ).

Decriminalization is a policy that was first defined by the 1972 Shaffer Commission (also known as the National Commission on Marihuana and Drug Abuse), and it describes policies that do not define possession for personal use or casual (nonmonetary) distribution as a criminal offense. The Shaffer Commission clearly stated that policies that simply lowered the penalties without removing the criminal status of the offense were not technically decriminalized, because they maintained the substantial social harm of the associated criminal convictions ( Natl. Comm. Marihuana Drug Abus. 1972 ). This distinction between policies that simply lower penalties and those that actually change the legal status of the offense is important, and yet it is not widely understood by many researchers evaluating even the early policies. At least 2 of the 11 widely recognized decriminalized states from the 1970s and 1980s, California and North Carolina, did not remove the criminal status of the offense ( Pacula et al. 2003 , Reuter & MacCoun 1995 ). Instead, these states merely reduced the penalties associated with possession and/or use of marijuana, a policy generally known as depenalization ( MacCoun & Reuter 2001 , Pacula et al. 2005 ). Yet, individuals in depenalization jurisdictions can still face significant barriers to access work, student loans, and public assistance if caught in possession of marijuana, even if they are only charged with a small fine, because they can still get a criminal charge on their record.

Medical marijuana laws (MMLs) remove state penalties for the use of marijuana for medicinal purposes under specified conditions. Although the federal government continues to retain the 1970 classification of marijuana as a Schedule I substance with high potential for abuse and no accepted medical value (Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, P.L. 91–513, October 27, 1970, 84 Stat. 1242, 21 U.S.C. 801, et seq.), states have employed a number of regulatory approaches aimed at increasing access to marijuana for medicinal purposes since the 1970s. Early initiatives through the 1980s aimed to encourage study of the therapeutic value of marijuana, but they had little practical significance due to their heavy reliance on federal cooperation and the failure to establish a legitimate supply channel for patients ( Pacula et al. 2002 ). Initiatives passed since the 1990s have been far more comprehensive, establishing allowances for the use, possession, and supply of high (>3%) Δ 9 -tetrahydrocannabinol (THC) products for qualifying patients and their caregivers or providers. These modern MMLs have become the most commonly evaluated policies in comparative alcohol and drugs policy analysis ( Ritter et al. 2016 ), but incomplete consideration of widespread variation in how these laws have been designed and implemented has resulted in inconclusive and often contradictory findings ( Hunt & Miles 2015 ; Pacula et al. 2014a , 2015 ).

Legalization removes criminal and monetary penalties for the possession, use, and supply of marijuana for recreational purposes. Whereas decriminalized countries such as the Netherlands have histories of de facto legalization, and medical marijuana programs are often regarded as thinly veiled recreational legalization ( Fischer et al. 2015 , Haney & Evins 2016 ), de jure legalization is a relatively new phenomenon. The November 2012 ballot initiatives passed by voters in Colorado and Washington marked the first time that any jurisdiction worldwide has legally regulated marijuana. Much attention has been given to the recently created retail markets for legal marijuana in these two states, but the commercial model is but one regulatory option for legal production, and a number of alternative strategies are available ( Caulkins et al. 2015 ). Research has not yet assessed the consequences of legalization, but the effects on the prevalence of marijuana use and use disorders will depend largely on the specific state-level regulations adopted as well as the response of the federal government.

Establishing clear definitions for decriminalized, medicalized, and legalized states is not merely a semantic exercise; rather, it highlights the different mechanisms through which policies may influence use, including changes in perceptions of risk or social disapproval, changes in product availability and variety, and changes in production methods or costs that reduce prices. Although it is tempting to use evaluations of decriminalization and medical marijuana policies to shed light on the likely consequences of legalization, the experiences of these states may not fully reflect the changes in price, potency, and product variety that will likely result from increased commercialization and promotion under legalization ( Caulkins et al. 2012 ). Additionally, prior research on decriminalization and MMLs has suffered from serious limitations due to an overreliance on crude indicators that do not account for the complex and varied ways in which states have designed and implemented their policies ( Pacula & Sevigny 2014a , b ; Pacula et al. 2005 ). Although the existing literature may be limited in answering how legalization will affect marijuana use and associated outcomes, it offers significant insights into how we should evaluate the effects of marijuana policy changes in a rapidly evolving and multilayered policy environment.

Decriminalization and Definitional Problems

As stated previously, much of the scientific research evaluating the impacts of decriminalization in the United States has ignored the legal definition provided by the Shaffer Commission. In an examination of the original 11 statutes passed shortly after the Shaffer Commission, Pacula and colleagues (2003) discovered that 2 of the 11 widely recognized decriminalized states (California and North Carolina) retained the criminal status of marijuana possession offenses. Moreover, the reduced penalties in 4 of the original 11 states (Minnesota, Mississippi, Nebraska, and North Carolina) only applied to first-time offenders, a distinction not consistent with the spirit of the Shaffer Commission definition. A comparison of state statutory penalties in so-called nondecriminalized states and in decriminalized states reveals that it is not possible to uniquely distinguish the two groups ( Pacula et al. 2003 , 2005 ). As early as 2001, there were 7 so-called nondecriminalized states that had removed the criminal status of all marijuana possession offenses and another 13 states that allowed for the reduced penalties and expungement of the criminal offense for first-time offenders ( Pacula et al. 2005 ). Yet, research continued to use the decriminalization variable to identify differences in state marijuana policies that were not truly based on the criminal status or level of penalties.

Given that most US studies have made use of a single dichotomous measure that cannot uniquely differentiate states with lower penalties and reduced criminal status, it is not surprising that they had mixed results. Even early studies examining immediate changes in laws using data from the 1970s and 1980s did not generate consistent findings. Although several studies making use of population survey data found no statistically significant impact of decriminalization on general prevalence rates of marijuana use ( Johnston et al. 1981 , Maloff 1981 , Single 1989 ), one study looking at emergency room episodes found that cities in states that had decriminalized had higher marijuana-involved episodes than cities in nondecriminalized states ( Model 1993 ). More recent studies that analytically relied on cross-sectional variation in decriminalization status in the late 1980s and 1990s also produced mixed findings. For example, studies examining self-reported use among youth and young adults that only included the single dichotomous measure for marijuana decriminalization found no statistical association with measures of past-year or past-month use ( DiNardo & Lemieux 2001 , Pacula 1998 , Thies & Register 1993 ). Yet analyses of the adult household population ( Saffer & Chaloupka 1999 ) and studies examining youth but incorporating other measures of legal risk ( DeSimone & Farrelly 2003 , Pacula et al. 2003 ) did find evidence of a positive association between decriminalization status and prevalence of use. MacCoun et al. (2009) note that the fact that the state decriminalization indicator remains positive and significant in analyses that also include additional controls for the statutory penalties for these offenses suggests that this measure is picking up something other than a signal related to a reduction in the legal risk. Hypotheses offered include a proxy of broader social acceptance of marijuana use and an advertising effect of the reduced policies.

Even beyond the problem of policy measurement, results from US studies evaluating the impact of marijuana decriminalization need to be interpreted with caution for several reasons. First, in many studies, marijuana possession penalties do not vary substantially over time, which analytically confounds the effects of unobserved state characteristics (e.g., tough-on-crime lawmakers) with differences observed in the level of penalties. Second, because there is no comprehensive data source reporting the actual penalties incurred by offenders, these studies have all relied on proxies, such as maximum or median fines as indicated by statutory laws. These statutory penalties may or may not accurately reflect the true severity of the penalties imposed in a jurisdiction. Last, evidence has shown that citizens have relatively limited knowledge as to the statutory penalties and policies for marijuana possession in their states ( MacCoun et al. 2009 ), which makes it difficult to interpret evidence showing that removal of such penalties has a significant causal effect on marijuana consumption.

Medical Marijuana Laws in a Complex and Dynamic Policy Environment

In 1996, California became the first state to pass what is now commonly recognized as an MML. As of January 2016, 25 additional states have passed similar legislation. Empirical evidence consistently shows a strong correlation between MMLs and the prevalence of marijuana use and marijuana use disorders ( Cerdá et al. 2012 , Wall et al. 2011 ), but studies have not consistently supported a causal interpretation ( Anderson et al. 2015 , Hasin et al. 2015b , Lynne-Landsman et al. 2013 , Wen et al. 2015 ).

One explanation for the inconsistent findings from causal studies is that the specific provisions of state MMLs have varied widely both among states and within any given state over time ( Pacula et al. 2014a , b ). The use of a single dichotomous indicator for the initial passage of an MML in policy evaluation obscures both types of variation. Because the effects of any policy will depend on the specific statutory provisions and their implementation, studies examining outcome data covering different time frames are in fact evaluating the effects of very different policies. Further confounding comparison of prior estimates is the fact that the federal enforcement position has changed over time, and state MML provisions have adapted alongside changes in the federal stance.

When one takes a historical look at how MMLs have evolved since the passage of California’s law in 1996, it becomes easy to understand how a single dichotomous measure falls short of describing these policies within a state and across states over time. We broadly categorize state policies into three waves, each initiated by an important political change: the ballot era (1996–2000), the early legislative era (2000–2009), and the late legislative era (2009–present).

The ballot era states are the first seven states that enacted policies through ballot initiatives (whether subsequently contested by state courts or not). These early laws aimed to protect the rights of patients who used medical marijuana and their caregivers who assisted in that use. Federal opposition to these policies was explicit, and one month after Proposition 215 passed in California, then-drug czar Barry McCaffrey threatened to arrest any physician who recommended cannabis to a patient ( Pertwee 2014 ). The threat of federal enforcement created an important barrier to establishing clearly defined legal access to medical marijuana. Early MMLs during the ballot era were often vague, defining medical use broadly to include consumption, home cultivation, production, transportation, and acquisition. Most of the laws were ambiguous as to the legality of group growing or storefront dispensaries, resulting in confusion among law enforcement, patients, and caregivers as to what constituted legal participation in the medical marijuana market. Furthermore, the uncertainty of the federal response to these state experiments meant that ballot era policies rarely mandated patients to register with a state authority, making it even more difficult for law enforcement to differentiate legitimate medical users from recreational users. It is thus unsurprising that research examining the effects of the early state ballot laws on marijuana use has found insignificant effects ( Gorman & Huber 2007 , Khatapoush & Hallfors 2004 ).

With the passage of S.B. 862 in 2000, Hawaii became the first state to pass an MML through the state legislature rather than by ballot initiative. Learning from the frustrating experiences of patients and law enforcement under the earlier state policies, states that passed laws during this early legislative era (2000–2009) made more explicit allowances regarding the supply chain. Most laws passed during this period included patient registry provisions, allowances for home cultivation, and limits on the amount of marijuana that patients or caregivers could possess and grow. In addition, many states that had initially passed laws through ballot initiatives (e.g., California and Oregon) made further policy changes through their state legislatures during this period in an attempt to clarify issues and address tensions that had emerged.

Although MMLs during this early legislative era established clearer definitions of what constituted legal supply, uncertainty about the federal response to these policies inhibited a formal state regulation of producers. For instance, Colorado’s 2001 law did not explicitly sanction cooperative growing, but the ambiguity of the law allowed for its de facto operation. Through S.B. 420, California amended its initial MML to explicitly allow for cooperative cultivation, but regulatory discretion was left to local governments. New Mexico was the only state in the early legislative era to establish legal provisions for state-licensed dispensaries in its initial legislation in July 2007, but threats of federal prosecution led to indefinite delays in licensing ( Baker 2007 ).

Protracted legal disputes about the legitimacy of retail outlets under state law combined with tremendous uncertainty about the federal response led to the slow development of medical marijuana markets throughout many states during the early legislative era, which helps explain why many studies evaluating MMLs from this period find insignificant effects on prevalence of marijuana use ( Anderson et al. 2012 , 2015 ; Harper et al. 2012 ; Lynne-Landsman et al. 2013 ; Pacula et al. 2015 ). Whereas norms may have been changing in response to these laws, direct access through markets was not necessarily increasing ( Smart 2016 ). Yet, two studies making use of data from only this time period find a significant positive effect of MML enactment on use among specific high-risk populations ( Chu 2014 , Pacula et al. 2010 ). Making use of quarterly data from the 2000–2003 Arrestee Drug Abuse Monitoring (ADAM), Pacula et al. (2010) find a positive association between MML and self-reported marijuana use (confirmed through urine samples) among adult male arrestees. Chu (2014) similarly found significant positive effects of MML policies on marijuana possession arrests and marijuana-related treatment admissions, though the results are sensitive to model specification. These studies may indicate that increased medical marijuana supply in an uncertain policy environment primarily affected marijuana consumption among an at-risk population of heavy users. However, the results are also consistent with endogenous responses by police enforcement or treatment facilities and may not reflect actual changes in use.

In 2009, the uncertainty about the federal government’s response was seemingly resolved. Shortly following the inauguration of President Barack Obama, Attorney General Eric Holder issued a statement that federal authorities would cease interfering with medical marijuana dispensaries operating in compliance with state law ( Johnston & Lewis 2009 ). On October 19, 2009, Deputy Attorney General David Ogden formalized this policy of federal nonenforcement with a memorandum stating that federal prosecutors “should not focus federal resources … on individuals who are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana” ( Ogden 2009 , pp. 1–2).

The clarification of the federal position dramatically changed the regulatory structure of state medical marijuana supply channels. State MMLs passed during the late legislative era (2009–present) established far more comprehensive and explicit regulations regarding medical marijuana distribution, often requiring elaborate systems that would take years to fully implement. Several early-enacting states (e.g., Oregon and Maine) amended their laws to formally allow and regulate state-licensed dispensaries. State regulatory authorities became more prominently involved in the production and distribution of marijuana by overseeing the dispensing, manufacturing, and labeling of cannabis-derived products.

Following the Ogden Memo, requirements for the registration of patients and caregivers became far more standard in state policies, and the participation of both increased dramatically in state medical marijuana programs ( Fairman 2015 , Sevigny 2014 ). States that had delayed the implementation of formal supply channels (e.g., New Mexico) moved quickly to license dispensaries, and other states began to resolve legislative disputes about what constituted legally protected sources of supply. Alongside this expansion of medical marijuana markets during this period, media attention toward the issue of legal marijuana also increased markedly ( Schuermeyer et al. 2014 , Stringer & Maggard 2016 ).

Compared to earlier time periods, in the late legislative era marijuana use might respond more significantly to changes in policy as the availability and potency of the drug evolved with the changing structure and size of medical marijuana markets ( Sevigny et al. 2014 ). Indeed, the one study to evaluate the effects of MML passage using only policies enacted in the early and late legislative eras ( Wen et al. 2015 ) found a significant positive effect of MML enactment on the probability of recent marijuana use (14%), daily marijuana use (15%), and marijuana use disorders (10%). More studies focused on these later laws are needed to assess if these findings are robust.

Perhaps because of the federal permission for states to regulate medical marijuana more directly, medical marijuana policies adopted by states for the first time during this postlegislative era (e.g., by New York, Massachusetts, Illinois) contain a variety of features that differ considerably from those of the laws of early adopting states. For example, all MMLs passed after 2009 have established a state-licensed dispensary system and do not allow personal cultivation by patients or their caregivers, except under narrowly defined circumstances. Moreover, since 2010, states have adopted medical marijuana policies that are more consistent with traditional medical care and pharmaceutical regulation ( Williams et al. 2016 ). For example, all require testing and labeling of marijuana cannabinoid profiles in addition to a bona-fide clinical doctor-patient relationship requiring the ongoing management of the condition.

Evidence that MML statutes are continuing to move in a more medicalized direction is evident by the growing number of high CBD-only laws since 2014. CBD is a naturally occurring nonpsychoactive compound in cannabis that has been demonstrated in a variety of clinical studies not only to have therapeutic effects but also to counter the intoxicating effects of THC ( Koppel et al. 2014 , Russo et al. 2007 , Whiting et al. 2015 ). These new laws allow qualifying patients to use CBD extract, mostly in oil form, with minimal THC content, and its use is generally only allowed for a narrow range of medical conditions. Sixteen states have passed CBD laws since 2014, but these policies have been largely ignored by advocacy groups, and no research is studying their impacts ( NCSL 2016b ). With some exceptions, there is still limited regulation on potency (THC concentration) and other cannabinoids, medical product testing, and methods of consumption.

Considering Heterogeneous Implementation of Legalization

As of July 2016, five states have policies legalizing the possession of specified quantities of marijuana by adults aged 21 and older for recreational purposes. 2 Voters in Colorado and Washington approved legalization initiatives in November 2012, and additional policies were passed in Alaska, Oregon, and the District of Columbia in November 2014. The current regulatory environment is complex and dynamic, as state and local governments are continually adapting legislation to evolve along with the industry ( Subritzky et al. 2016 ). The effects of these policies on marijuana use and use disorders will be determined by how the design and implementation of the legal regulatory framework influence market structure, price and availability, and perceptions of risk and social approval. As research moves forward in evaluating the effects of recreational legalization, consideration needs to be given to differences and similarities in the regulatory frameworks established by each state.

The District of Columbia is the only legalized jurisdiction in the United States that does not allow the sale of marijuana for recreational use. Under DC’s law, adults can legally grow up to six plants (of which no more than three can be mature) in their primary residence and transfer up to 1 ounce of marijuana to another adult aged 21 and older if there is no remuneration. Sale of any amount of marijuana remains a criminal offense, punishable by up to six months in jail and a fine of $1,000 ( Marijuana Work. Group 2016 ). In contrast, policies in Colorado, Washington, Oregon, and Alaska establish commercialized models of marijuana regulation. Retail sales in Colorado and Washington began respectively in January and July 2014, and Oregon began allowing sales for recreational use from medical marijuana dispensaries in October 2015. Alaska began licensing retail and product manufacturers in September 2016 ( Hall & Lynskey 2016 ). Relative to the home cultivation model of the District of Columbia, commercialization is expected to substantially reduce production costs and generate incentives for legal suppliers to promote heavy consumption ( Caulkins & Kilmer 2016 ).

However, the commercial model of legalization also offers increased scope for regulation, and each state has crafted its own collection of regulatory guidelines and legal provisions that could have important implications for the markets that develop within them. For example, whereas all states require separate licenses for cultivators, manufacturers or processors, and retailers, as well as licensing or certification for testing facilities, Washington alone has adopted regulations restricting the number of licenses a single firm can own. Moreover, Washington prohibits license holders from being involved in both production and retail, in an effort to forbid vertical integration and the efficiencies in production and distribution that can come with it. Washington has further limited the number of retail store licenses available to avoid issues related to overproduction; the other states have not. However, all states except Alaska restrict the size of cultivation facilities, and Washington has an additional cap on total statewide production. In addition to this policy heterogeneity at the state level, local municipalities have some discretion in determining the number of establishments permitted, the strictness of zoning requirements, and the time and manner in which businesses are allowed to operate. These differences in the structure of the market should theoretically influence the availability and cost of marijuana in each state, for reasons described in greater detail below.

Other important legal differences exist across states in terms of the allowance for a nonretail market. Washington is the only state that requires all marijuana for recreational use to be purchased through state-licensed retailers; no home cultivation is allowed. The other three states permit home cultivation by adults subject to specified plant limits (as in the District of Columbia). There are also different approaches to taxation. Currently, the three states with operating retail markets (Colorado, Washington, and Oregon) have instituted ad valorem taxes specific to marijuana, ranging from 17% in Oregon to 37% in Washington. In contrast, Alaska’s policy establishes a tax on cultivation, imposing a $50 per ounce tax on marijuana bud (i.e., flowers) and a $15 per ounce tax on other parts of the plant (stems and leaves).

Differences in how state and local governments regulate the commercial market will generate heterogeneous effects on the retail price of marijuana, which will have important consequences for both the extensive and intensive margins of use and abuse ( Pacula & Lundberg 2014 , Pacula et al. 2014b ). Moreover, because marijuana is involved in a variety of forms and potencies, choices about the tax level, base, and point of collection can also influence the products and potencies available to consumers and the prices they face ( Caulkins et al. 2015 ). Currently, retail stores are allowed to offer marijuana flowers, concentrates, and infused products in solid and liquid form. The original legalization measures in Colorado and Washington did not explicitly distinguish between product types when establishing consumer purchase limits. As marijuana concentrates and infused products have captured an increasing share of legal retail sales, regulations have had to expand. Effective October 2016, adult residents in Colorado are limited to purchasing 1 ounce of marijuana flower, 8 g of concentrates, or 80 10-mg servings of THC in infused product form. In Washington and Alaska, consumers can purchase 1 ounce of marijuana flower, 7 g of marijuana concentrates, 16 ounces of infused product in solid form, or 72 ounces in beverage form. Oregon’s regulations are similar, except for a stricter limit of 5 g for marijuana concentrates. Alaska’s rules also limit buyers to 5,600 mg of THC in a single purchase.

Due to concerns regarding accidental ingestion of edibles by children, states have further regulated marijuana-infused products by implementing stricter packaging and labeling requirements and designating potency limits for individual serving sizes. Washington and Colorado designate individual serving sizes of 10 mg of THC and 100 mg total for an individually wrapped package. In Colorado, products that cannot be stamped, such as drinks or granola, must contain no more than a designated individual serving, effectively banning many of the high-potency marijuana-infused beverages currently sold. Oregon and Alaska have more conservative requirements, designating individual serving sizes of 5 mg of THC and 50 mg total for an individually wrapped package. Still, no state has capped the potency of marijuana products. A measure to limit the THC content of all marijuana products sold at retail stores in Colorado to 16% (Initiative 139) was withdrawn by the Healthy Colorado Coalition in 2016 due to the emergence of a well-funded opposition campaign ( Armbrister 2016 ). In Alaska, a proposal to cap marijuana product potency at 76% THC was also voted down. The lack of restrictions on potency enables the marketing of products with very high (and often uncertain) levels of THC.

Increased marketing has been an important concern under the commercial model, because advertising can be used to promote harmful use and has been shown to influence adolescent marijuana use and intention to use ( D’Amico et al. 2015 ). Colorado’s regulations prohibit Internet pop-up advertisements and advertisements that target children. Washington allows retailers to have only two signs (not to exceed 1,600 square inches) at their place of business, but the signs cannot contain marijuana-themed imagery nor can marijuana-related imagery be featured in window displays. Alaska and Oregon continue to revise rules for marijuana marketing. The strictness of state regulations for advertising and the way they are enforced can partly mediate the extent to which legalization influences perceptions and consumption behaviors among legal consumers as well as adolescents. However, these potential benefits of advertising restrictions must be balanced against potential efficiency costs resulting from information asymmetries between suppliers and consumers.

As was the case with decriminalization and MMLs, legalization is not a binary policy variable. The home cultivation model of the District of Columbia will have very different implications for supply than the commercialized models of Colorado, Washington, Oregon, and Alaska. Within commercialized states, heterogeneity in how production and price are regulated will lead to different consequences for consumption by legal adult users and spillovers to adolescent markets. Restrictions placed on advertising could limit youth exposure to messaging that could encourage experimentation, but only if the regulations are enforced. The way in which product availability and potency are regulated will have important effects on the total quantity of marijuana consumed by users and their level of intoxication, which will in turn influence the prevalence of marijuana use disorders. Legalized states have chosen different ways of regulating, and this policy heterogeneity will need to be considered in future work when assessing the effects of legalization on use.

WHAT IS MEANT BY HETEROGENEOUS POPULATIONS

The previous section focused on the heterogeneity of the policies being implemented. However, the effects of these diverse policies may well vary depending on the population group studied. Heterogeneous effects across population subgroups may be driven by differences in budget constraints ( Markowitz & Taurus 2009 ), price elasticities ( Pacula & Lundberg 2014 ), preferences for risk ( Fox & Tannenbaum 2011 ), or search costs ( Galenianos et al. 2012 , Pacula et al. 2010 ), to name a few. Mixed findings in the current literature with respect to the impact of prior liberalization policies may thus reflect legitimate differences in the populations being studied.

Past research has generally attempted to accommodate this potential heterogeneity by stratifying analyses by age (e.g., adolescents, young adults, older adults) and, to a lesser extent, frequency of use (number of times used in the past month/year or near-daily use). The potential effects on youth consumption have been of particular concern in the literature, because evidence suggests that use of marijuana during early adolescence predicts increased risk of dependence, lower educational attainment, and cognitive impairment ( Hall 2009 , 2015 ). Limiting the analysis to adolescents, research shows that MML enactment has largely insignificant or even negative effects on youth marijuana use measures ( Anderson et al. 2015 , Choo et al. 2014 , Gorman & Huber 2007 , Harper et al. 2012 , Hasin et al. 2015b , Lynne-Landsman et al. 2013 ), with only Wen et al. (2015) finding a significant increase in the probability of past-year initiation among youths aged 12–20. The results of the few studies that have focused on changes in marijuana consumption among adults have been more mixed, with some showing no effect of MML passage on measures of use ( Gorman & Huber 2007 , Harper et al. 2012 ) and others finding significant positive effects ( Chu 2014 , Wen et al. 2015 ).

Yet, as noted above, the use of a dichotomous MML variable misses important variations in the specific implementation of supply channels, which may be particularly important in determining the extent to which medical marijuana is diverted to adolescent markets ( Boyd et al. 2015 , Nussbaum et al. 2015 , Salomonsen-Sautel et al. 2012 ). When studies focus on the effects of dispensary legalization, there is some evidence of a significant increase in youth consumption ( Pacula et al. 2015 , Wen et al. 2015 ), though other studies find no effect ( Hasin et al. 2015b ). Even within the same study, estimated effects switch sign depending on whether consumption is measured by past-month use, frequency of use, or dependence ( Pacula et al. 2015 , Wen et al. 2015 ). Similar inconsistencies exist in studies of the effects of specific dimensions of MML policy on measures of marijuana use in the general population ( Anderson & Rees 2014 , Choi 2014 , Pacula et al. 2015 ). Thus, age alone is clearly not an adequate way of capturing population heterogeneity.

Perhaps a more relevant dimension of population heterogeneity pertains to differentiating casual or light users from high-risk consumers, often identified in this literature as arrestees ( Chu 2014 , Pacula et al. 2010 ), polysubstance users ( Wen et al. 2015 , Williams & Mahmoudi 2004 ), or those admitted to treatment ( Pacula et al. 2015 ). Only a few studies have focused on high-risk users, but those that have tend to find more consistent evidence that marijuana liberalization significantly increases use ( Chu 2014 ; Model 1993 ; Pacula et al. 2010 , 2015 ; Wen et al. 2015 ). The response of high-risk users to marijuana policy changes will likely differ from that of casual users or nonusers due to differences in price sensitivity ( Pacula & Lundberg 2014 , Sumnall et al. 2004 ), knowledge of the policy environment ( MacCoun et al. 2009 ), engagement with drug markets ( Pacula et al. 2010 ), and perceived social or physical harms from use ( Haardörfer et al. 2016 , Kilmer et al. 2007 ). By examining how marijuana liberalization policy affects the prevalence of marijuana use, many past evaluations have conflated changes in the consumption of casual users with changes in the consumption of regular or heavy users. Because casual users represent a larger proportion of the total number of users, such analyses will discount the behaviors of heavy users, who account for a larger proportion of the total quantity of marijuana consumed ( Burns et al. 2013 , Davenport & Caulkins 2016 ).

The overreliance on using prevalence measures as the outcome of interest in past work is largely a consequence of limited data availability, but as legal markets for marijuana develop, there is an urgent need to assess the alternative measures of use that are more relevant for understanding potential harms. Nationally representative data show that the number of daily or near-daily (DND) users has increased approximately sevenfold since 1992 ( Burns et al. 2013 ), and the prevalence of marijuana use disorders has almost doubled since 2001 ( Hasin et al. 2015a ). Simultaneous use of marijuana with other substances (e.g., tobacco and alcohol) is common and has been shown to be associated with increased risk of adverse consequences ( Subbaraman & Kerr 2015 , Terry-McElrath et al. 2014 ). Currently, we have little evidence to indicate how marijuana liberalization policies will affect these outcomes ( Wen et al. 2015 ). Moving forward, it will be important to develop more comprehensive data collection and sampling designs to assess how marijuana liberalization policies affect populations at risk for problematic use as well as the use of particularly dangerous products or methods of consumption.

WHAT IS MEANT BY HETEROGENEOUS PRODUCTS

Past research has generally focused on how liberalization affects the prevalence of marijuana use and has paid less attention to how liberalization affects the type of marijuana used or the way in which it is consumed. But marijuana is not a uniform product. The cannabis plant itself can develop in a number of different ways, depending on the genetic variety, temperature, culture condition, and lighting it receives. The potency of the consumable product, typically measured by concentration or level of THC, will vary by strain, cultivation technique, and method of processing. There are also a variety of ways to consume marijuana, with the most common methods including smoking, vaporization, and ingestion of edible products ( Schauer et al. 2016 ).

Both potency and methods of consumption have evolved over time. Decriminalization occurred during a time when marijuana was largely smoked, which facilitated comparisons of marijuana use rates between decriminalized and nondecriminalized states. Medical marijuana brought with it new products (e.g., oils and edibles), new methods for consuming it (e.g., dabbing, vaping), and new techniques for controlling potency ( Pacula et al. 2016 , Rendon 2013 ). Legalization only extends these new products to even more users. It is difficult to predict the extent to which legalization will increase product innovation, as growth in the industry will promote the development of new methods for extracting and synthesizing the hundreds of chemicals in the cannabis plant, of which relatively little is known ( Caulkins et al. 2015 ).

Systematic data collection on methods of use and potency is limited, but available evidence indicates that marijuana users in states with medical or recreational legalization consume a different product mix than users in other states. Individuals living in MML states, particularly in states with greater access to dispensaries, have significantly higher likelihood of vaporizing or ingesting marijuana products compared to individuals in states without MMLs ( Borodovsky et al. 2016 ). Evidence also suggests that states that legally permit medical marijuana dispensaries experience significant increases in average marijuana potency ( Sevigny et al. 2014 ). Within states with legalized dispensaries, adults who use marijuana for medicinal purposes are significantly more likely to vaporize it or consume edibles than individuals who use it for recreational purposes ( Pacula et al. 2016 ).

It is complicated to assess the impact of policy on use if the product being consumed or the method of consumption changes in line with the policy. Outcomes such as level of intoxication or dependency may well vary according to the type and method of marijuana consumption, and simply comparing use in legalized states to use in nonlegalized states will not reflect these differences. Changes in product variety will not threaten the identification of changes on the extensive margin of use (meaning any use or prevalence), because existing survey measures can provide information on the number of people who transition from nonusers to users and those who continue using rather than quitting. However, most of the adverse physical and behavioral consequences associated with marijuana use come from heavy users ( Gordon et al. 2013 , Hall 2015 , Volkow et al. 2014 ). Proper evaluation of the public health consequences of legalization relies on the ability of research to estimate the effects of marijuana policy changes on the intensive margin of use.

Data on quantity of marijuana used are surprisingly limited, and researchers have yet to construct a standardized measure for the unit of marijuana consumption (as exists with alcohol). Prior research has examined changes on the intensive margin through self-reported data on frequency of use, measured by days of use in the past month or past year. The implicit assumption has been that more days of use accurately proxies for higher intensity of use ( Temple et al. 2011 ). Yet, marijuana consumption among DND users can vary from smoking a single low-THC joint each day to using high-THC products multiple times per day via multiple delivery methods ( Hughes et al. 2014 , Zeisser et al. 2012 ). Given the variety of delivery devices, strains, and cannabinoid concentrations that become available as the legal industry expands, measuring changes in days of use will fail to capture a number of individuals who transition from occasional to heavy users.

Heterogeneity of marijuana products presents further problems for understanding how medical and recreational legalization affect marijuana use disorders. Previous research examining patterns of use and the development of dependence may not generalize to a legal environment in which there is greater social acceptance, fewer perceived risks and harms, and a wider variety of product types and potencies ( Asbridge et al. 2014 ). Although the definition of marijuana use disorder is evolving ( Compton & Baler 2016 , Hasin et al. 2013 ), there has been little clinical assessment of whether the use of different marijuana products carries different risks of dependence or harms. Some evidence suggests that vaporizing hash oil or dabbing is more positively associated with tolerance and withdrawal among adults compared to smoking marijuana ( Loflin & Earleywine 2014 ), but there may be differential effects for adolescents. As marijuana product diversity expands, there is a need for a more comprehensive understanding and analysis of consumption to accurately evaluate changes in use prevalence, intensity of use, and risk for marijuana use disorder.

AN ALTERNATIVE PERSPECTIVE FOR EVALUATING THE EFFECTS OF MEDICAL MARIJUANA LAWS AND LEGALIZATION

In light of the substantial variation underlying the policies being evaluated, the populations considered, and the products consumed, it is not surprising that the scientific literature evaluating the impact of these policies is inconclusive. The decisions made by researchers to focus on specific time periods, states, populations, and/or outcome measures have often been driven by what data were available and not by a careful consideration of the mechanisms by which these policies are expected to influence marijuana use or use disorders among various populations. As this article has established, these decisions can influence the likelihood of finding—or not finding—specific effects because of the heterogeneity of these policies and of the markets that are emerging in light of them.

The program evaluation literature has widely recognized the time it takes between the passing of new policies and their full implementation as a problematic issue ( Hunt & Miles 2015 , King & Behrman 2009 ). A common empirical strategy for accommodating delays in implementation is the inclusion of lagged policy variables, and this approach has been explored in a few articles from the medical marijuana literature ( Anderson et al. 2013 , Bachhuber et al. 2014 , Chu 2014 ). However, assuming a constant allowance for lagged effects obscures the fact that these delays are not random but are correlated with the specific provisions established by state law, the broader federal policy environment, and the setting in which the policy change occurs.

The relationship between state policy heterogeneity and variation in how long it takes for markets to emerge is something that is just beginning to receive the attention it deserves in the literature ( Collett et al. 2013 , Smart 2016 ). As explained by Smart (2016) , patient registration rates do a better job than simple dichotomous policy variables at capturing the extent to which medical marijuana markets are operating throughout a state. Smart notes that despite the adoption of early policies by many states, the relative size of the associated markets, as measured by registered patients, remained small in most states until federal enforcement policy was clarified in 2009, at which time markets in all states grew substantially faster. In an analysis that explicitly accounts for changes in the size of medical marijuana markets, Smart (2016) finds statistically more robust and consistent evidence of the impacts of these markets on various measures of consumption across users from all age groups.

The consideration of the relative size of these markets across states highlights the necessity to consider the issue of dynamics. Whereas some aspects of medical marijuana and legalization policies can have immediate impacts (e.g., on the criminalization of marijuana use or the ability to grow it at home), other effects of these policies take time to occur or disseminate. In the case of markets, for example, it takes time for regulations to develop regarding how many businesses are allowed, who is allowed to operate a business, and where those businesses are allowed to operate. It takes even longer once those rules are passed for businesses to obtain permits and begin distribution. Thus, it should not be surprising that after the passing of marijuana legalization measures in Colorado and Washington in November 2012, it took at least 18–20 months for retail stores to open. Data on the consequences of the opening of these stores beyond sales and tax revenues are just beginning to become available, which is why rigorous scientific evaluations of the impact of these policies have been slow to develop.

What that means is that researchers working in this space need to pay far greater attention to the specific mechanisms that different types of policies are likely to influence and to consider them within the proper timeframe when assessing impacts on specific populations. We show in Figure 2 some of the primary mechanisms discussed in the literature through which these changes in policies might impact use (i.e., perceived harm, disapproval of regular use, legal risk of use, ease of access and price) as well as the hypothesized effects of various types of policies on each. For simplicity, we consider each mechanism separately, though it is important to note that these are likely not independently determined (e.g., changes in legal risk may influence perceived harms, or changes in ease of access may influence disapproval). A small, medium, or large arrow (pointing up or down) in each cell indicates the relative magnitude and direction of the hypothesized effect. Shading represents the availability of empirical evidence to support the theoretical prediction, with white indicating an absence of existing studies and darker shades representing greater and more consistent support for the hypothesized effect. We provide three simplified versions of a medical marijuana policy and a legal recreational market to illustrate a wider range of policies that would to varying degrees influence the general size of the associated markets (in terms of both users and sellers).

Mechanisms through which marijuana policies might affect marijuana use and use disorders. This simple illustration shows that even within a single policy area (e.g., medical marijuana), the different variations of the policy can differentially influence each of the mechanisms related to use. For example, we hypothesize that medical marijuana policies will ceteris paribus have a larger impact on people’s perceptions about the drug (perceived harm and disapproval of regular use) than they will have on the legal risk and ease of access to marijuana regardless of policy, assuming that only medical users are provided access and legal protections. Relatedly, because these markets serve a relatively smaller group of users, the overall impacts on price are presumed to be small, although they might increase with the third type of MML, which could allow for competitive forces among suppliers to start influencing price ( Anderson et al. 2013 , Humphreys 2016 , Pacula et al. 2010 ) and potency ( Sevigny et al. 2014 ) in these markets. The existing evidence generally suggests that the passage of any type of MML significantly lowers perceived harms among adults ( Choi 2014 , Khatapoush & Hallfors 2004 ) but not among adolescents ( Choi 2014 , Keyes et al. 2016 ). However, the expansion of commercial medical marijuana markets and increased exposure to medical marijuana after 2009 have been associated with significant reductions in adolescent perceptions of harm or disapproval associated with marijuana use ( Miech et al. 2015 , Schuermeyer et al. 2014 , Sobesky & Gorgens 2016 , Thurstone et al. 2011 ).

Of course, under a policy of legalization, the hypothesized effects on some of the mechanisms (perceptions and legal risk) are larger and more immediate. Preliminary evidence from Colorado and Washington shows that commercial legalization has significantly reduced perceived harms and disapproval of marijuana use ( Kosterman et al. 2016 , Sobesky & Gorgens 2016 ), and marijuana-related arrests have plummeted ( Gettman 2015a , b ). Access and prices, however, will likely still be differentially influenced by the regulations that shape the market structure and the level of competition in the market ( Caulkins et al. 2015 , Smart 2016 ). The overall impact on consumption, then, would depend on ( a ) the relative importance of perceptions and legal risk vis-à-vis access and price for the specific population being evaluated, and ( b ) whether one is evaluating an immediate (short-run) response to the policy or a long-run effect that is inclusive of market mechanisms.

Another important consideration for interpreting findings when evaluating legalization effects is the baseline policy in place prior to legalization. Because most careful evaluations are done based on marginal changes over time, the baseline policy in the states that subsequently legalize will determine the extent to which a particular mechanism is impacted by the change in formal policy. States like Washington and Colorado, for example, which moved to legalization from a medical marijuana policy that already provided broad access and loose regulation of dispensaries, will likely experience far less of an impact on perceptions and access than states starting from a more restrictive medical marijuana policy or no law at all. Generalization of findings from these two state experiences, therefore, would not necessarily apply to states that may be considering a move to legalization without first allowing medical marijuana markets.

Thus far we have discussed heterogeneous policies, populations, and products as limitations that complicate the evaluation of how marijuana liberalization policies affect marijuana use and marijuana use disorders. However, Figure 2 suggests that this rich variation also offers unique opportunities for future research. By carefully considering the specific aspects of legalization statutes in the context of existing state policies, researchers have increased the scope for determining the mechanisms that are most important for influencing marijuana use among different populations. As more comprehensive data on marijuana prices and products become available, future work can examine not only whether liberalization affects marijuana use, but also whether it affects who uses marijuana, what products are used, and how these products are consumed. The literature has shown that not all marijuana liberalization policies are created equal, but by exploiting this variation we will be able to better evaluate which policy designs will maximize the potential benefits of legalization while minimizing potential harms.

The variety of marijuana liberalization policies across the US states is often ignored or inadequately considered when assessing the impacts of further policy reform. Despite the widespread state experimentation with alternative marijuana policies since the 1970s, our knowledge of the impact of these liberalization policies on the consumption of marijuana, and its benefits and harms, is far less developed than one would expect. There are a number of reasons for this, including, particularly, lack of attention to the heterogeneity of existing policies, the specificity of the populations examined, and modes of consumption.

Although findings tend to be mixed when we look at the literature as a whole, some consistent themes seem to emerge when we consider the literature with an eye toward differences between policies and populations. For example, studies that are attentive to the development of medical marijuana markets (e.g., through measures of the presence of active dispensaries or the size of the market) seem to consistently show a positive correlation of liberalization policies with use among high-risk users (arrestees, people in need of treatment, and polysubstance users). Similarly, many studies have shown a positive association with adult use of marijuana, whereas most have found no association with youth prevalence or frequency of use in general school populations. The extent to which these findings can be drawn on to make inferences about the potential impact of legalization on these same populations is not clear. Just as it took time for researchers to pay more careful attention to the differential effects of policy elements over time ( Hasin et al. 2015b , Pacula et al. 2015 , Smart 2016 , Wen et al. 2015 ), as well as possible heterogeneous responses by different types of users ( Pacula et al. 2015 , Wen et al. 2015 ), it will take time for research to emerge that fully reconsiders these associations in light of the full policy dynamics (i.e., changes in a policy within a single state over time and duration of exposure of a population to a given policy type). As more studies account for and consider these heterogeneous effects and dynamics, we may get better clarity regarding the margins on which particular types of policies do or do not influence behavior, and for whom.

Because legal markets will continue to evolve before these questions are fully answered, the real work that lies ahead relies on obtaining more accurate information on the amount and type of products that various people are consuming. Imagine trying to communicate to the public health field the health benefits or harms of alcohol consumption without being able to indicate specific levels or amounts that translate into impairment in well-understood dose-response relationships. Or imagine trying to assess the harmful effects of smoking without being able to differentiate an experimental or occasional smoker from someone who smokes a pack a day. Yet, that is exactly where the science is today in terms of our measurement of marijuana consumption. Precise data on things such as a standardized dose, regular versus experimental use, heavy use, episodic impairment, or even simultaneous use of marijuana and alcohol are not yet captured in most of the data tracking systems used to evaluate the impact of these policies, and they are desperately needed. If marijuana is anything like alcohol, little harm will come from casual, occasional use by mature adults, and indeed such use might generate considerable benefits. Moreover, it is also possible that marijuana, like alcohol, generates positive benefits for one population (mature adults) while also causing negative harms for another population (youth and young adults). Scientific research needs to be mindful of this heterogeneity.

SUMMARY POINTS

• State policies legalizing marijuana are part of the evolution of state liberalization policies that has taken place since the 1970s.
• Existing studies evaluating the impacts of prior state experimentation have generated inconclusive findings, and only recently has research attempted to understand the reasons for these mixed results.
• One should be cautious when interpreting the evidence from all studies pooled together, because studies are not equivalent in their attention to policy heterogeneity, policy dynamics, and population heterogeneity.
• The literature has largely treated both decriminalization and medical marijuana policies as if they were simple dichotomous choices, when in fact there can be substantial variation in the implementation of these policies that influences how adults or youth respond.
• Relatively few studies evaluating the impact of MMLs give adequate consideration to the fact that some aspects of liberalizations policies are realized immediately (e.g., ability to grow one’s own), whereas other aspects may take time to evolve (e.g., opening of a market) or change in response to future state and federal policies.
• Studies that focus on how marijuana liberalization policies influence past-month or past-year prevalence conflate changes in consumption among light and casual users with changes in consumption among regular and heavy users.
• Although relatively few in number, studies that focus on high-risk users (arrestees, poly-substance users, heavy users) tend to find more consistent evidence that medical marijuana policies increase use, suggesting that this segment of the population is particularly sensitive to policy changes.

FUTURE ISSUES

• As legal markets for marijuana develop, there is an urgent need to assess the consequences of liberalization on alternative measures of use that are relevant for understanding potential harms; this requires developing better measures of standardized dose, heavy use, episodic impairment, and simultaneous use.
• Research needs to pay more attention to the influence of these policies on the types of products consumed, the amount of THC being consumed in different products, and product development.
• Future work also needs to give stronger consideration of the baseline from which new state policies are being evaluated. For example, legalization is likely to generate smaller population changes in medical marijuana states that already have active dispensaries than in states with no prior medical marijuana stores.
• Researchers need to pay far greater attention to the specific mechanisms different types of policies are likely to influence and to consider them within the proper timeframe when assessing impacts on specific populations because not all users will respond in the same ways.

ACKNOWLEDGMENTS

This article was supported by a grant from the National Institute on Drug Abuse to the RAND Corporation (R01DA032693). The article benefited from research assistance provided by Anne Boustead, Ervant Maksabedian, and Gabriel Weinberger. We should also give credit to several of our DPRC colleagues whom we have been fortunate enough to conduct research with and who have influenced our thinking on this literature, including Jonathan Caulkins, Beau Kilmer, Mark Kleiman, Mireille Jacobson, Priscillia Hunt, David Powell, Paul Heaton, Eric Sevigny, Peter Reuter, and Rob MacCoun. All errors in the article are our own.

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.

1 For simplicity, this article refers to the District of Columbia (DC) as a state.

2 Uruguay also legalized recreational marijuana in 2013, and Canada’s prime minister is working on a formal proposal expected to be delivered to the Canadian Parliament in April 2017. We are focusing on the US experience here because no formal stores are open in either Uruguay or Canada at this time.

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Legalizing Medical Marijuana Argumentative Essay

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

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

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

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

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

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

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

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

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

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

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

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Should Marijuana be Legalized for Medical Purposes - Essay Example

• Subject: Health Sciences & Medicine
• Type: Essay
• Level: College
• Pages: 3 (750 words)
• Downloads: 2
• Author: ivarussel

Extract of sample "Should Marijuana be Legalized for Medical Purposes"

There are many who argue that this drug does not cause death and when something as dangerous as tobacco can be legalized then why not marijuana? Tobacco is legal in many countries; several people smoke tobacco and consume it in other forms. Tobacco is consumed by several people in Asia and Europe, one can find so many people on the streets in India and Pakistan smoking and consuming tobacco in several other forms. It is a proven fact that smoking causes lung damage and it is also a proven fact that chewing tobacco over a prolonged period results in mouth cancer but in spite of this it is very legal and very widely used by several people in several countries.

Marijuana on the other hand causes brain damage but it is yet to be proven that this drug is capable of taking lives away but it surely affects the overall functioning of the brain and this is something which most people are really scared of. Marijuana should not be legalized because it is drug which can easily be abused and it has been abused by several people, the results of drug abuse have been devastating, one can go on a rampage should he be drugged and marijuana is certainly a very powerful drug and this is why it should not be legalized, legalizing it would have serious ramifications and it can easily put the lives of others in serious jeopardy.

“At the same time, it is estimated that pot is the largest cash crop in California, with annual revenues approaching $14 billion. A 10% pot tax would yield $1.4 billion in California alone. And that's probably a fraction of the revenues that would be available — and of the economic impact, with thousands of new jobs in agriculture, packaging, marketing and advertising.” (Why Legalization Makes Sense) Marijuana should be legalized because it is really helpful in treating a few diseases but it should be ensured that it is not abused because abusing a drug can have very serious ramifications on the health of the abuser, the abuser may have to be checked into a rehab should he abuse marijuana.

“But there are big issues here, issues of economy and simple justice, especially on the sentencing side. As Webb pointed out in a cover story in Parade magazine, the U.S. is, by far, the most "criminal" country in the world, with 5% of the world's population and 25% of its prisoners. We spend $68 billion per year on corrections, and one-third of those being corrected are serving time for nonviolent drug crimes. We spend about $150 billion on policing and courts, and 47.5% of all drug arrests are marijuana-related.

 (Why Legalization Makes Sense) To conclude it is very fair to say that marijuana is like a double edged weapon, no harm in legalizing it but it is really harmful when people start abusing it and there have been cases in the past where people who have abused this drug have landed themselves and others in serious trouble, considering the fact that it can easily cause a lot of ruckus it is safe to conclude that marijuana should not be legalized and if it legalized there must be procedures to ensure that it is not abused by people who are consuming it. 

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Should Marijuana Be Legal for Medicinal Purposes

• Categories: Marijuana Marijuana Legalization Medical Marijuana

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Published: Jan 4, 2019

Words: 842 | Pages: 2 | 5 min read

• In case of various inflammations, marijuana is great for treating chronic pain. Unlike opiates, which are better when there is a need to quickly alleviate acute pain, weed is safer and more effective in decreasing long-term pain.
• The symptoms of arthritis and other autoimmune diseases can be reduced or even eliminated with the help of marijuana as well.
• Patients with such neurological disorders as multiple sclerosis or spinal cord injuries would appreciate weed for its painkilling effect, and its ability to reduce muscle spasticity caused by damaged nerves. There have been studies about the beneficial effects of medical marijuana in patients with epilepsy.
• Patients with cancer having to undergo numerous chemotherapy sessions often suffer from severe nausea after them; marijuana can not only eliminate this nausea, but also prevent the spreading of some forms of cancer.
• HIV/AIDS patients often experience significant loss of weight and appetite—both due to neurological factors and multiple antibiotics taken; marijuana can increase appetite and alleviate neurological symptoms (Learn. Genetics).

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