Research Paper

Marijuana: The Newest Legalization Dilemma

Drug presence and legalization have been relevant topics in American history since the

establishment of the first English colony. Debate around drug legalization began with alcohol,

which was banned in the early 1900s with the 18th amendment. Because the longer-term

consequences of an increase in illegal alcohol production outweighed the short-term positive

outcomes of less crime (Reagan Library), the 21st amendment was ruled to repeal the 18th,

marking an integral part of American history. Unfortunately, this was only the start to the reality

of drugs in the country as the opioid epidemic hit later that century, which demonstrated

destructive effects to every aspect of American life. This drug crisis transformed the social and

economic cultures as well as healthcare and therapy into the complicated, multi-faceted

conditions seen today. The history of drugs in this country can provide several perspectives on

how to approach the discussion of the legalization of marijuana, a psychoactive drug derived

from the Cannabis sativa plant.

Marijuana, more commonly known as “weed” or cannabis is one of the new “it” drugs

that is interesting to many for a variety of reasons, many of which tie to health. Thus, in order to

better grasp the opposing sides to marijuana legalization, more needs to be understood about the

drug’s effect on the body. Marijuana’s main ingredient, delta-9-tetrahydrocannabinol (THC) is

known for its effect on the endocannabinoid system (ECS), which is responsible for tasks

including inflammatory and immune responses as well as pain control, sleep, emotion, memory,

and eating etc. Within this system, there are two important cannabinoid G-coupled receptors that

are stimulated by the drug: CB1 receptors that produce the stimulating effects known as a “high”
and CB2 receptors that produce side effects not usually well understood by the public including

inflammation, pain, and contractions in the intestinal and bowel regions (Grinspoon, 2021). CB1

and CB2 are differentiated largely based on distribution, where CB1 receptors are present within

the central and peripheral nervous systems while CB2 receptors are concentrated in immune cells

and tissues (Page, et al. 2020). Ultimately, neuronal interactions with these receptors allow the

endocannabinoid system to regulate homeostasis within the body (Page, et al. 2020). The body is

a system in itself, so affecting any component affects all of the rest, which is useful information

to take into consideration on the topic of drug consumption. Furthermore, route of administration

and the unique characteristics of each user are what make any drug effects highly variable (Page,

et al. 2020), a main reason why legislation of marijuana is still largely debated on.

Prior to assessment of both sides of the legalization argument, I find it useful to take note

of the public’s opinion, as these, more general perspectives can provide key insight into how

marijuana may be portrayed to others through media and marketing. One group of doctors

specialized in internal medicine administered an online probability-based study on about 8,000

U.S. adults to get a sense of public opinion after making claims that “marijuana is increasingly

available” and “aggressively marketed to the public,” (Keyhani, et al. 2018). The survey showed

that 81% of U.S. adults, generalized from the sample size, believe marijuana has at least one

benefit, most commonly cited as pain management by 66% of people, treatment of diseases such

as epilepsy and MS by 48% of people, and relief from mental health concerns by 47% of people

(Keyhani, et al. 2018). Only 17% believed marijuana to have no benefit at all, yet only about

15% of these adults reported to have used marijuana in the last year. The data demonstrates that

the benefits of marijuana are relatively well understood by the public, but understanding does not

translate as usage for many. It would be helpful to consider how many of these individuals
sampled experience the symptoms that they describe to be relieved with the use of marijuana,

though unfortunately not provided. For example, I too am aware of these benefits, but because I

do not fall under any of these cases, I do not feel the need to try marijuana. On the contrary,

about 91% of those studied believe that there is at least one risk to the drug, most commonly

identified as legal problems by 52% of people, addiction by 50% of people, and impaired

memory by 42% of people (Keyhani, et al. 2018). By comparison, it seems that most individuals

that are aware of the benefits are also aware of these risks. There could be personal factors that

influence each individual’s answer to the survey, but it can be assumed that the people may see

the benefits as not as convincing when considering the risks. Of course, to what extent can

marijuana help? If extreme pain calls for a prescription of opioids, would marijuana use be a

viable substitute? These are two essential questions when considering the treatment of each

individual. Just this study can provide insight into the divide that is undergoing between those

pro and against marijuana’s legalization.

Subsequently, upon recognizing the perspectives of the American public, research done

within recent years can help validate and direct thoughts and concerns on the topic of cannabis.

Those who are against the legalization will focus mostly on the drug’s adverse health effects.

Observing short-term use of marijuana, there are connections to impaired cognition for skills like

short-term memory as well as learning and retaining information. Especially considering the

uptake in use by children under the age of twenty-one, it is key to consider the young brain’s

state of “active, experience-guided development” during which it is “more vulnerable than the

mature brain to adverse long-term effects of… exposure to [THC],” (Volkow, et al. 2014). Thus,

not only can THC “[impair] neural connectivity in specific brain regions” including “subcortical

networks, which process habits and routines,” but it can also “prime the brain for enhanced
responses to other drugs,” possibly influencing addictive behaviors in adulthood (Volkow, et al.

2014). Marijuana being categorized as a “gateway drug” is crucial when taking into account the

child’s or adult’s current environment and past trauma or experiences. The experts in Adverse

Health Effects of Marijuana Use also point to the significant increase in the potency of THC in

newer marijuana samples, namely the doubling in percent from 2002 to 2012, which we can

assume stayed consistent or increased by more now, more than a decade later (Volkow, et al.

2014, Figure 1). The more THC per use will intensify adverse effects, meaning that older studies

observing negative effects of the drug may not even be fully encompassing the consequences of

the modern-day samples being distributed. Ultimately, these experts go as far to say that with

“policy shifts towards legalization of marijuana,” there will be an increase in usage that will lead

to a larger “ number of persons for whom there will be negative consequences,” (Volkow, et al.

2014).

Just like any drug or medication, while there are risks, there are also benefits. First and

foremost, cannabis is “relatively non-addicting,” with patients who stop using reporting no

withdrawal symptoms (Webb & Webb, 2014). As we dive further into its therapeutic benefits,

this aspect of marijuana is important to consider as monumental for healthcare since it provides

patients with a safer option than other medications. The most common condition for the medical

use of cannabis is relief from chronic pain (NASEM, 2017), which can help with daily motor

functions and bring back a sense of normality for an individual, helping him or her mentally and

physically. The clinical research done on medical cannabis patients in Hawai’i demonstrates that

use of the drug is responsible for a 64% average relative decrease in pain (Webb & Webb).

Although “very little is known about the efficacy, dose, routes of administration or side effects of

… cannabis products [in the treatment of pain],” it may be a possible replacement for opiates, or
conventional pain medications that are highly addictive and dangerous (NASEM, 2017). This

factor is acknowledged by the same medical cannabis patients who admit to no longer needing

oxycodone, Xanax, or morphine, either all together or significantly less in amount (Webb &

Webb, 2014). A similar trend is supported by analysis of post-legalization outcomes where

opioid usage (French, et al. 2022) and tobacco/nicotine product usage (Dave, et al. 2023) have

both declined with the new medical and recreational cannabis laws across the United States.

Additionally, marijuana is used for helping those in chemotherapy with nausea as well as

improving sleep for individuals experiencing sleep apnea, chronic pain, and multiple sclerosis

(NASEM, 2017). Nonetheless, while many articles point to benefits of marijuana usage with

other diseases, an article on the current state of evidence proves that many of these conclusions

are not justifiable by trials or studies. Because there is a “need for substantial research to provide

comprehensive and conclusive evidence on the therapeutic effects of cannabis and

cannabinoids,” previous claims cannot be fully trusted in their argument for the legalization of

marijuana (NASEM, 2017). To conclude, there are therapeutic benefits to marijuana use that

could significantly aid the lives of many, but more research needs to be done in order to make

true correlations with disease treatments to not only prove that marijuana should be legalized but

to also prove its efficacy in healthcare.

All in all, the main question still stands: are the benefits enough to outweigh the risks or

vice versa? I think that question sets up a never-ending battle. There will always be extreme

cases that call for or against the legalization of marijuana, so simply weighing the positives and

negatives of each will not provide a clear answer. What will provide an answer is an aspect of

marijuana use that many articles do not address: safety and regulation. In the same way that

illegal alcohol production made alcohol consumption extremely unsafe during the prohibition
movement, the lack of legal control with marijuana, in the way it has fostered a detrimental

environment for lacing, for instance, “has potential to do great harm to American consumers and

communities if it is not disciplined and restrained” (Scheuer, 2015). Lawyer and Professor Luke

Scheuer in The Worst of Both Worlds: The Wild West of the “Legal” Marijuana Industry agrees

with my personal stance that the best solution to this legalization conflict where some states have

already chosen to legalize the drug is not to focus on backtracking but rather “for the federal

government to end [marijuana’s] prohibition…[and ultimately,] control the direction that the

drug is developed” (Scheuer, 2015). I also believe it is imperative that the media portrays more

about the effects of the drug, particularly biologically within our bodies. With full government

responsibility, marijuana use and marketing can become a more disciplined space to make the

world more safe for all people, regardless of their experience with the drug.
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