It wasn’t long ago that marijuana was portrayed as a villain in the American drug policy narrative, vilified by anti-drug campaigns and exaggerated advertisements showing teenage dealers leading their peers to ruin.
However, after the legalization of medical marijuana in California in 1996 and recreational marijuana in various states in 2012, cannabis shed its negative image and gained increasing public acceptance.
A 2023 Gallup poll revealed that 70% of Americans now support the legalization of marijuana, with cannabis use among adults aged 35 to 50 reaching an all-time high of 28% in 2022, compared to just 13% a decade earlier.
This shift in perception is fueled by claims of marijuana’s numerous health benefits, including its potential to reduce anxiety, alleviate chronic pain, and treat mental health conditions such as PTSD. These promising attributes have helped make marijuana widely accepted and highly sought after.
Despite this widespread popularity, there is still limited evidence supporting the safety of marijuana use. New studies suggest that both recreational and medicinal use of cannabis may pose significant risks, including cardiovascular problems such as heart attacks and strokes, as well as possible negative effects on brain development in adolescents and adults. In addition, marijuana has been linked to reduced male fertility and potential damage to the immune system.
So does this mean that all forms of marijuana use are harmful? Not necessarily, says R. Lorraine Collins, a psychologist at the University at Buffalo and director of its Center for Cannabis and Cannabinoid Research. “It’s a complex issue,” Collins explains. “It’s not a simple yes or no answer. Cannabis is very much a mixed bag.”
Marijuana contains more than 100 chemicals known as cannabinoids, with two of the most well-known being cannabidiol (CBD) and tetrahydrocannabinol (THC). THC is responsible for most of marijuana’s psychological effects, while CBD is non-psychoactive. Earlier research suggested that CBD counteracts the negative effects of THC, such as anxiety and paranoia, but more recent studies suggest that high doses of CBD may actually prevent the breakdown of THC, causing the drug’s effects to last longer.
Cannabinoids interact with the body’s endocannabinoid system (ECS), a vital cellular signaling network necessary to maintain balance in the brain and body. Receptors for the ECS were discovered in the late 1980s along with the realization that our bodies naturally produce cannabinoids known as endocannabinoids.
Some research has found that cannabinoids such as THC and CBD may offer therapeutic benefits. For example, cannabis has been shown to help prevent nausea and vomiting caused by cancer treatment. In fact, a synthetic version of THC, dronabinol, was approved by the FDA in 1985 for this purpose. There is also preliminary evidence that marijuana can help control seizures, which led the FDA to approve Epidiolex, an oral CBD solution for severe epilepsy, in 2018.
However, when it comes to chronic pain, the evidence is less clear. Two systematic reviews published in the 2017 Annals of Internal Medicine concluded that there is insufficient scientific evidence to support the effectiveness of cannabis for the treatment of nerve pain (neuropathic pain) or PTSD, a finding previously reported by Inverse.
“Federal regulations have been a major barrier to human research, so much of the research being done involves animals, especially in areas like the effects of cannabis on fetal development,” says Collins.
In conclusion, while marijuana has certainly shed much of its negative reputation and gained widespread public support, the evidence for its safety and efficacy remains inconclusive. Health benefits touted by proponents—such as its ability to reduce anxiety, manage chronic pain, and treat certain mental health conditions—have led to its mainstream acceptance. However, emerging research points to potential risks associated with its use, including cardiovascular problems, developmental problems, and adverse effects on male fertility and the immune system.
Experts, like R. Lorraine Collins, stress that the issue is far from black and white, acknowledging that cannabis is a complex substance with potential benefits as well as risks. The lack of comprehensive human studies, largely due to federal regulations, has created a significant knowledge gap that continues to hinder our understanding of the full impact of marijuana. Although there is promising evidence for certain therapeutic uses, such as managing nausea in cancer patients and controlling seizures, many areas—especially chronic pain and PTSD treatment—still lack definitive scientific support.
As research continues to evolve, it is critical that both policymakers and the public approach cannabis with caution and recognize the need for more robust scientific evidence. Until we have a clearer picture of the long-term effects of marijuana use, it’s important to weigh the potential benefits against the risks and be aware of the uncertainties that still surround this widely used substance.