Medical marijuana use is currently legal in 39 states and the District of Columbia, and 19 states (plus D.C.) have legalized recreational use. As cannabis is legalized in more states, marijuana use is rising sharply across the U.S. A recent poll showed that nearly half of American adults have tried cannabis at some point in their lives, and about 18 percent of Americans 12 and older reported using it at least once in the past year. Marijuana use appears to be getting increasingly more common, but its effects on the body – and whether or not it is ‘safe’ – remain up for debate.

In one camp, some marijuana advocates claim it’s the natural cure for many ailments, providing relief for anxiety, pain, depression, post-traumatic stress disorder and even cancer without any harm. On the other hand, some marijuana opponents claim it’s just as dangerous as fentanyl and using it leads to poor work performance, ruined relationships, lung disease and a lower IQ. The truth about cannabis most likely falls somewhere between these two. Much of the current research on cannabis’ health effects is contradictory, inconclusive or shows both potential benefits and risks. Many scientists support further research on the drug and suggest that anyone considering using it discuss the risks and potential benefits with their doctor beforehand. Users and lawmakers alike need to be aware of the risks in order to make informed choices, especially as claims of health benefits become increasingly common.

“Cannabis is not the root of all evil, nor is it the cure for all diseases,” said Andrew Monte, a medical toxicologist at the University of Colorado. “You’ve got to understand what the good is and what the bad is, and then make a balanced decision.”

Known Risks

There’s a common misconception that because it’s found in nature, cannabis is harmless. However, as more research is done, more evidence suggests significant risks associated with regular marijuana use. Studies have shown that regular use can cause brain changes that negatively affect learning and memory, worsen symptoms of depression and anxiety, increase risk of stroke, increase risk of car accidents and raise the risk of psychosis in those who are predisposed to the condition. Additionally, despite misconceptions that say otherwise, marijuana users can develop an addiction to the substance. According to some estimates, as many as 30 percent of people who use cannabis will develop symptoms consistent with addiction, such as cravings, damaged relationships, impacts on job performance, loss of motivation and even withdrawal symptoms.

Cannabis use is especially risky for people under 19, pregnant women, those with existing mental health conditions and those who are at risk for certain mental health conditions. Ultimately, the risks associated with cannabis depend heavily on dosage and frequency of use. In most healthy adults, occasional use shouldn’t cause harm.

“I compare it to alcohol,” said Earl Miller, a cognitive neuroscientist at MIT. “Too much or the wrong situation can be bad, but in other situations it can be beneficial. I think we’re going to find the same thing with cannabis.”

Potential Benefits

While there are definite risks to using cannabis, there may also be some benefits. In a recreational setting, people commonly use cannabis to sleep, improve mood, relax, relieve stress and anxiety, as a substitute for alcohol and even to foster creativity. In medical settings, cannabis has been shown to be effective in managing chronic pain, making it a notably less dangerous alternative to prescription opioids. It can also be used to treat muscle spasticity in patients with multiple sclerosis, provide seizure relief to people with certain rare forms of epilepsy, help relieve nausea and vomiting associated with cancer treatments like chemotherapy and be used to stimulate appetite in patients with wasting conditions. In many cases, cannabis isn’t meant to treat the main symptoms of an ailment, but to help improve a patient’s quality of life and manage discomfort.

Employer Considerations

Regardless of whether marijuana is safe to use as prescribed by your doctor for certain conditions, being under the influence of marijuana is considered impairment on the job and poses significant safety risks. With broadening state legalizations, it’s usually up to private employers to develop their own drug policies and use their discretion on whether to test employees for cannabis.

Drug testing for marijuana is becoming less common. The number of urine tests to screen for the drug declined by five percent between 2015 and 2020. It’s important for employers to have a clear drug-free workplace policy that all employees are aware of and to educate employees on the impacts of marijuana use, especially as it relates to the jobsite.

There’s evidence for both the harms and health benefits of using marijuana, but more research is needed to draw conclusions. Abstaining altogether is the safest option to avoid any negative health consequences, but if you do choose to use cannabis, it’s safest to first discuss with your doctor, purchase from a regulated legal retailer (like a dispensary) and start with a low dosage.

[Hannah Sabitoni]