According to Pew Research Center data, over nine out of ten Americans support some form of marijuana legalization, and states are gradually legalizing cannabis for medical and recreational use. Although popular perceptions of cannabis are evolving, and the supposed medical benefits can assist ease specific medical ailments, its widespread use may have public health consequences.
Conversations between healthcare providers, patients, parents, and children will become increasingly vital as commercial cannabis becomes more widely available.
Continue reading to learn more about the current state of cannabis in the United States, as well as how to manage discussions around the drug.
An Introduction to Cannabis
Despite the fact that mail order marijuana is still illegal on the federal level, numerous states have legalized it for recreational and/or medical purposes.
Cannabidiol (CBD) is one of the two most common cannabinoids in cannabis that does not cause intoxication.
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two most frequent cannabinoids found in cannabis plants (CBD).
Cannabis: all goods derived from the Cannabis sativa plant.
Decriminalization: Laws prohibiting jurisdictions from prosecuting persons for possessing modest amounts of marijuana, particularly for the first time.
THC (tetrahydrocannabinol) is one of the two most common cannabinoids in cannabis, and it induces a high or changed state of mind.
Hemp is cannabis with a THC content of less than 0.3 percent.
Legalization refers to state-level legislation that allows for the possession, use, and/or sale of medical and recreational cannabis, as well as decriminalizing marijuana possession. Marijuana remains banned on the federal level.
Marijuana is defined as cannabis with a THC content of more than 0.3 percent.
Medical marijuana/medical cannabis: Marijuana or cannabis-derived compounds used to treat illnesses like pain, anxiety, nausea, and glaucoma.
Recreational marijuana/recreational cannabis is marijuana that is not used for medical purposes or with a prescription.
By the summer of 2021, 19 states and Washington, D.C. had established recreational marijuana markets, 40 states and territories had approved medical marijuana markets, and other states had taken steps toward decriminalizing small-scale marijuana possession.
Some states still have harsh cannabis prohibitions in place. For example, there are no public cannabis access programs for medical or recreational use in Idaho, Nebraska, or Kansas.
Medical marijuana and CBD are permitted in Alabama. Possessing any amount of marijuana for personal use, however, is a misdemeanor punishable by up to a year in prison and $6,000 in fines. Possessing any amount for any reason other than personal use is a felony punishable by a mandatory minimum penalty of one year and a day in jail, a maximum sentence of ten years in prison, or a fine of up to $15,000.
Medical marijuana and medical CBD are both legal in Florida. A individual caught with 20 grams to 25 pounds of marijuana without a prescription, on the other hand, might be prosecuted with a crime punishable by up to 5 years in prison and $5,000 in fines. Possessing less than 20 grams of marijuana is a misdemeanor punishable by up to a year in prison and a maximum fine of $1,000.
CBD is legal in Illinois, while THC is not. Possession of any amount of marijuana is a misdemeanor punishable by up to $1,000 in fines and up to 180 days in jail. Possessing less than 30 grams of marijuana is a misdemeanor punishable by up to a year in prison and $5,000 in fines. Possessing more than 30 grams is a felony punishable by fines of up to $10,000 and a sentence of up to 2.5 years in prison.
Timeline of Important and Recent Cannabis Legislation in the United States
Oregon is the first state to legalize marijuana.
California is the first state to make medical marijuana legal.
Colorado and Washington are the first states to legalize marijuana for recreational use.
Utah is the first state to authorize medical cannabis with a low THC content and a high CBD content.
Vermont is the first state to legalize marijuana through legislation rather than a ballot initiative.
Recreational cannabis is legal in New York, Virginia, New Mexico, and Connecticut.
Cannabis, Social Justice, and Health Equity
The American Public Health Association (APHA) has urged for a public health approach to cannabis regulation that promotes health equity and social justice as state-level legalization spreads.
Despite the fact that rates of cannabis usage are comparable across races, cannabis-related arrests have historically been greater in Black and Latino areas than in white communities. Individuals and entire communities may suffer negative health consequences as a result of such arrests.
Some doctors believe that cannabis regulation is necessary to improve public health and promote social justice.
In a policy statement, the APHA stated, “Racial disparities in cannabis-related criminal justice contacts are anchored in public policy.” “The decriminalization and implementation of public health regulation and enforcement systems must be based on current evidence and best practices, and public health policy and enforcement activities must prioritize health equality and social justice.”
Clinical Applications, Health Consequences, and Public Health Impacts of Cannabis
According to the Centers for Disease Control and Prevention, about 18 percent of Americans consumed marijuana at least once in 2019. According to the Cato Institute, legalizing cannabis has had no significant impact on its use or violent crime. However, the National Institute on Drug Abuse reported historically high marijuana use among college students in 2020, with about 44% of students saying they used the drug.
Because marijuana has only recently become legal for recreational use in the United States, its public health impacts are difficult to assess, and no controlled clinical trials on the long-term health risks of cannabis usage exist.
Medical Uses, Health Risks, and Public Health Consequences of Cannabis
Cannabis can be recommended to treat a variety of illnesses. However, there are some health hazards associated with cannabis use, which are discussed here.
Cannabis Use’s Health Consequences
Cannabis use in adults can lead to:
- When you smoke, you can cause lung damage.
- Chronic bronchitis that has worsened
- Cannabis addiction is a serious condition.
- Memory and attention issues
- Stroke or heart attack are examples of cardiovascular issues.
- Psychosis, anxiety, or paranoia are all symptoms of psychosis.
- Vomiting in a cycle
Infants with low birth weight or delayed brain development (for women who are pregnant or breastfeeding)
Cannabis use in adolescents can lead to:
- Neurodevelopmental changes
- Cannabis addiction is a serious condition.
- Suicidality, depression
- Toxic poisoning
The following are some of the potential public health consequences of cannabis proliferation:
- disproportionately harsh criminal penalties for people of race
- Secondhand smoke causes complications.
- Hospitalizations are more common as a result of car accidents and falls resulting in head injuries.
- Patients in significant psychological distress put a greater pressure on emergency services.
- Cannabis addiction is becoming more common (1 in 10 users become addicted).
- Communication Tips for Healthcare Providers: Talking to Youth About Cannabis
- Begin a dialogue with adolescent children.
- Ask screening questions concerning a patient’s cannabis usage, as well as their exposure to cannabis-using friends and family members.
- Discuss cannabis in a variety of situations, such as routine visits or when a patient exhibits symptoms that could indicate cannabis usage.
- Explain to young patients, even those who have never used cannabis, the legal and health consequences of doing so.
- Discuss how cannabis can cause a patient’s aims to be disrupted.
- Engage in open, nonjudgmental conversations.
- Make use of the “8 A’s.”
The “8 A’s” are protecting patient privacy, asking about cannabis use, answering inquiries, assessing cannabis use’s effects, appraising a patient’s readiness to change, assisting with goal-setting, organizing for a follow-up, and acknowledging parental concerns, as seen in the infographic above.
How Can Parents Talk to Their Kids About Cannabis?
These recommendations may help parents have continuous conversations about cannabis with their children.
- Look for opportunities to start a cannabis conversation in an informal setting.
- Give the fundamentals of cannabis and acknowledge why some individuals use it.
- If you use cannabis, be open about it.
- Make it clear what you expect from drug use.
- If you realize your child is smoking cannabis, try to figure out why.
- Make agreements with your family.
- Create an evacuation strategy for your child and let them know they can call you if they feel unsafe or coerced to use cannabis.
- Recognize if you have a history of addiction in your family.
- Keep in touch with your youngster on a regular basis.
- Continue the conversations as your child grows.