Citation

Barry RA. J. Adolesc. Health 2019; 65(1): 5-6.

Affiliation

Global Public Health Unit, School of Social & Political Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.jadohealth.2019.04.020

PMID

31229055

Abstract

The legalization and regulation of the adult-use marijuana market is an important public health issue, particularly as this relates to the potential impacts of increasing access to a previously illegal market on adolescent health. As of 2018, drug policy reform nongovernmental organizations in the U.S., namely the Drug Policy Alliance, Marijuana Policy Project, and the American Civil Liberties Union, among others, have orchestrated eight successful ballot initiative campaigns to legalize, regulate, and tax adult-use marijuana such as alcohol, with Uruguay and Canada passing similar national legislation in 2013 and 2018, respectively [1, 2, 3, 4, 5, 6]. In the U.S. case, at least, the negative effects of drug prohibition on marginalized communities have largely fueled such efforts—namely the disproportionate burdens of enforcement on young black and Latino men who experience higher arrest rates and arbitrary detention sentences, with some individuals serving lifelong sentences for possession of minor amounts [1, 7, 8, 9]. Surprisingly, however, there has been little attention paid to the potential consequences of such legislative changes on the health and well-being of those who were or potentially could have been affected by discriminatory law enforcement practices. This raises serious concerns surrounding the underlying objectives of those pushing for increasing access to the adult-use market, which may inadvertently send the message to the public that marijuana use is not harmful, and indeed may be beneficial to health, with the potential to reduce risk perceptions and increase use among youth. This last point is particularly salient to the U.S. case where prolegalization campaign messages have tended to focus on marijuana's therapeutic benefits rather than the potential risks for dependence or differential harms of various delivery systems on physical health, for example, smoking marijuana flower [10, 11].
Indeed, marijuana use is not harmless and is associated with a number of adverse health problems, including physical, psychological, and mental health conditions and impairments [12, 13, 14]. There are obvious concerns that early initiation of cannabis use may increase the risk for dependence. In high-income countries, heavier and long-term cannabis use is a condition that primarily affects young adults, the long-term effects of which on brain development, respiratory, or cardiovascular health are largely unknown, although there is some evidence to suggest that the impacts of cannabis use on cognitive function may be irreversible, particularly if initiation begins in adolescence ...

Language: en