Marijuana Legalization: Impact on Physicians and Public Health

Annu Rev Med. 2016:67:453-66. doi: 10.1146/annurev-med-050214-013454. Epub 2015 Oct 19.

Abstract

Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.

Keywords: cannabis; legalization; medical marijuana; public health.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Automobile Driving
  • Cannabis* / poisoning
  • Cognition Disorders / etiology
  • Dronabinol / administration & dosage
  • Dronabinol / pharmacology*
  • Humans
  • Illicit Drugs / legislation & jurisprudence*
  • Marijuana Abuse / epidemiology*
  • Marijuana Abuse / etiology
  • Marijuana Smoking / adverse effects
  • Marijuana Smoking / epidemiology*
  • Medical Marijuana
  • Opioid-Related Disorders / epidemiology
  • Prevalence
  • Psychotic Disorders / etiology
  • Public Health
  • United States

Substances

  • Illicit Drugs
  • Medical Marijuana
  • Dronabinol