Changes in marijuana policies across states for legalizing marijuana for medical and/or recreational use suggest that marijuana is gaining acceptance in society. People use marijuana for many reasons: to feel good, to feel better, to fit in, or feel different. No matter the reason, it is very important to understand what is known about both the potential therapeutic benefits and adverse health effects associated with marijuana. While many of nature’s plants have positive health effects, it is myth that because something is “natural” it is harmless. In fact, there are many “natural” plants that are poisonous, harmful, and cause negative effective.

After alcohol, marijuana is the most commonly used psychoptropic drug in the United States. Marijuana has a psychoactive chemical called tetrahydrocannibinol, or THC. When smoked, the THC and other chemicals enter into the bloodstream and they are rapidly carried through the body and to the brain. Effects are experienced almost instantly. Many people experience a sense of relaxation and euphoria, reduced nausea for cancer patients, or decreased pain. However, effects vary. Many people experience increased appetite, altered perception of time, loss of motivation and interest to do things, aggression, paranoia, increased anxiety or panic, fear, and heightened sensory perception such as seeing bright colors, among others. 

The psychoactive chemical in marijuana, THC, affects brains areas that influence pleasure, memory, thinking, concentration, movement, coordination, sensory and time perception. THC also activates the brain’s reward system, which includes enhancing pleasure behaviors, such as sex or eating. It also floods the brain with a hormone called dopamine that makes a person feel high or “stoned”. 

Marijuana use causes impaired thinking and interferes with a person’s ability to learn and perform complicated tasks. THC impairs parts of the brain that regulate balance, coordination, reaction time, and judgement. Fatal car crashes involving marijuana have tripled during the past decade. Currently, one of nine drivers involved in fatal crashes tests positive for marijuana and the level of THC is found to be directly related to the impairment of the driver. 

The dangers of drinking and driving are well known and uncontested. There are clear, strict laws with large fines and penalties for violators operating a vehicle when over the legal blood alcohol limit. Moreover, drunk drivers can be held civilly liable for any accidents caused as a result of their drunk driving. A recent study reviewed fatal accidents over a 10-year period in a state with legal marijuana use: five years before and five years after the legalization was official. It found a clear increase in drivers who tested positive for THC. Most alarming, alcohol use is normalized typically to evening and night and those under the influence of alcohol mainly drive alone or with other adults. However, society is accepting the use of marijuana for all times of day and nearly 14% of those confirmed to be using marijuana had a child in their vehicle while driving under the influence of marijuana. 

Marijuana and THC have widespread use among adolescents and teens. Teens perceptions of the risks of marijuana have steadily declined over the past several years. In 2019, a survey found that 28.8% of 10th graders and 35.7% of 12th graders used marijuana in the past year, and 18.4% of 10th graders and 22.3% of 12th graders used in the past month. As vaping has grown in popularity, teens have started vaping THC. In fact, 4% of 12th graders in the survey reported vaping THC daily. Research shows that using marijuana before age 18 are 4 to 7 times more likely to develop a drug problem.

Marijuana is likely linked to a decrease in IQ. A 2012 study completed over 20 years found that when people use marijuana for a period of time prior to their 18th birthday, they have a permanent and significant decrease in their IQ. Persistent marijuana use disorder with frequent use starting in adolescence was associated with a loss of an average of 6 or up to 8 IQ points when measured in mid-adulthood. 

Some studies suggest regular marijuana use in adolescence is associated with altered connectivity and reduced volume of specific brain regions involved in memory, learning, and impulse control compared to people who do not use. Many choose to use THC while pregnant or around children soon after birth. This has been found to cause evident problems with specific learning and memory tasks later in life. Marijuana use has been linked to less career success and lower salaries. 

Marijuana use is linked to increased chances for mental illness, including depression, anxiety, and schizophrenia, especially for those with risk factors already present. Overall, it is also linked to increased risk for health issues, such as chronic bronchitis, and pulmonary issues similar to tobacco use. A recent study in animals even found that secondhand marijuana smoke can affect heart and blood vessels as much as secondhand tobacco smoke. Some evidence shows that in the first hour after smoking marijuana, the risk for heart attack increased by five times. 

Whether smoking or consuming marijuana has therapeutic benefits that outweigh health risks is still undetermined. It is important to note that any substance or drug, including marijuana, tobacco, and caffeine, can interact with other medications you are taking. There is growing research that finds evidence for the efficacy and safety of marijuana derived compounds, such as CBD, which are not psychoactive. Science is still investigating ways TCH, marijuana, or other components can be used in healthcare. It is important to consider all benefits versus risks and stay up to date on research as marijuana gains acceptance and use in society.

Megan Stukenholtz, ARNP, PMHNP-BC, FNP-BC