Sixty-three percent of Americans said they were in favor of legalizing marijuana when Gallup polled on the issue last year, up from 12 percent when the pollster first asked in 1969. This shift in perspective has been driven by the widespread acknowledgment of the medical advantages of marijuana, the negative effects of harsh drug prohibitions, and the promise of new tax income to fund widely-used public services in 21 states.
However, politicians in charge of monitoring legalization were surprisingly in the dark regarding the issue’s potential impact on public health. There has been a constant release of information on the health effects, such as emphysema in smokers and teenage learning disabilities, only recently.
The negative response from legislators to the revelation increases the risk that the unrestricted marijuana industry. which was valued at $13.2 billion in 2017 and is growing at a rate of 15 percent yearly, may feel the pinch.
Those who are most in favor of legalizing, such as Representatives Earl Blumenauer (D-Ore.) and Dave Joyce (R-Ohio), are advocating for increased regulation and stricter control. I have battled hard for the ability to legalize, regulate, and tax this substance in part because I do not want it in the hands of young people.
The unofficial cannabis czar on Capitol Hill, Blumenauer, indicated that there is evidence that using cannabis has harmful effects on a developing brain. He collaborated with Joyce last year on legislation that was ultimately successful in reducing federal barriers to medicinal marijuana research and the cultivation of research-grade cannabis.
That may lead to a more thorough comprehension of the medication. Standards for dose, mandatory child-resistant packaging for edibles, and restrictions on marketing are all being discussed with the goal of keeping drugs out of the hands of minors. The consequences of cannabis with a high THC content are also of concern to them.
There has also been action taken by federal agencies. Recently, the FDA denied petitions from cannabis product manufacturers seeking regulation under the more lax guidelines for dietary supplements. Cannabidiol, or CBD, is a key component of cannabis, and the FDA has warned that there are potential dangers associated with its usage.
Principal Deputy Commissioner Janet Woodcock stated in a statement that there is not enough information to know how much CBD can be consumed or for how long it is safe. Assistant professor at the University of Ottawa, Giselle Revah, claimed that her study published in the journal Radiology last year found a correlation between marijuana use and emphysema, despite the drug’s long history of use.
Because “it’s really hard to examine something that’s prohibited,” Revah says, “what was in the literature was extremely limited” before her study. New scientific studies, in addition to Revah’s work, have found evidence of an increase in the number of children accidentally ingesting edibles. an increase in the number of adolescents developing asthma in states where marijuana is legal, and a rise in the number of young adults who report using both alcohol and marijuana at the same time.
Sea Change
Twenty-one states have taken action to legalize marijuana, either for medical or recreational purposes, as public opinion shifts in favor of legalization. Another 16 states have legalized the use of marijuana for medical purposes. And the prevalence of marijuana use is rapidly expanding.
The present trend, as measured by the Substance Abuse and Mental Health Services Administration, indicates that by 2030, marijuana use will have surpassed cigarette use among U.S. citizens. According to SAMHSA’s National Survey on Drug Use and Health, the number of persons who used marijuana in 2020 was about 50 million, an increase of nearly 75 percent from 2009.
The effects of this meteoric rise in use on public health are only now being investigated. Federal data shows that the number of pediatric edible poisonings in the United States has increased from 207 in 2017 to 3,054 in 2021 as a result of state-level legalization of cannabis; states that have legalized cannabis, such as Colorado, have seen a greater increase in hospitalizations and poison control visits than other states.
Late December preliminary studies suggested that teen asthma rates might be rising because of the legalization of cannabis for recreational use. Asthma rates among children aged 12–17 increased “somewhat” between 2011 and 2019 in states where recreational cannabis use was permitted, compared to those where such use was prohibited.
A rise in the prevalence of asthma was also observed in children of certain racial and ethnic groups by the group of researchers from the City University of New York, Columbia University, the University of California at San Diego, and others.
This may be an indication of the knock-on consequences of legalization, according to Renee Goodwin, an adjunct associate professor at Columbia University’s Mailman School of Public Health. She suggested that parents might be smoking more at home, perhaps exposing their children to secondhand smoke.
You’re making “sweeping, very rapid changes in policy” without any scientific evidence, as Goodwin put it. For doctors to best guide parents, “accompanying clinical guidelines” are necessary. Although further research is needed, preliminary findings suggest that cannabis use may raise the risk of depression and suicide. “We really have to slow down,” said Leana Wen, a professor of public health at George Washington University and the former health commissioner of Baltimore.
We’re much ahead of where the research stands at the moment. We wrote on the “abundant data” that shows “how exposure to marijuana during childhood affects later cognitive capacity, including memory, attention, motivation, and learning” in a commentary for the Washington Post last year.
A surge in the number of people who get behind the wheel while under the influence of marijuana follows closely on the heels of its legalization. A 2021 study published in the American Journal of Public Health found that the proportion of traffic fatalities associated with cannabis use has increased by more than 100% between 2000 and 2018.
The United States Department of Transportation is launching a public service announcement campaign to counteract this trend. The number of pediatric poisonings is significantly greater in provinces in Canada where edible sales are authorized compared to a province that bans edibles, according to research released last month.
The study’s principal author, Daniel Myran, a fellow at the Ottawa Hospital Research Institute, noted that the increase in Canada occurred despite the country’s child-resistant packaging and THC content regulations. Evidence supports a rise in poisonings if cannabinoids are hidden in edibles like chocolate or sweets, according to Myran. To the regulators: “Do you need this product form?” How about giving adults the option of buying legal weed that doesn’t try quite so hard to appeal to children?
The Policy Response
This kind of inquiry brings up the possibility of increased regulation. In an effort to prevent potential risks to the liver, drug interactions, and male reproductive health, the FDA urged Congress to establish new regulations for CBD last month. These regulations would include labeling requirements, maximum CBD content, and a legal purchasing age of 21.
Blumenauer and Joyce have each stated their intention to advocate for regulations to standardize dosing and child-resistant packaging. Blumenauer argued that, in contrast to the current unregulated market, consumers should be able to easily determine the amount of THC present in the items they purchase. Experts in public health agree with this.
However, many in the field of public health are dissatisfied that policymakers hasty to implement legalization passed up an opportunity to prepare for and limit negative outcomes. Professor of health law, policy, and management at Boston University’s School of Public Health, David Jernigan, remarked, “We’re in a big natural experiment.” Are we applying what we’ve learned about regulating alcohol, cigarettes, and other narcotics to cannabis? Jernigan questioned. “Definitely not,” is an emphatic negative.
