The Cannabis Debate: The Strongest Arguments For and Against Legalization

Why do people want weed to be illegal? What are the best counter-arguments? We’ve explained the points on both sides and looked at the scientific evidence.

Written by

Lee Johnson

Lee Johnson is the senior editor at CBD Oracle, and has been covering science, vaping and cannabis for over 10 years. He has a MS in Theoretical Physics from Uppsala...

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Cannabis legalization

More than any other drug, cannabis is the topic of serious debate. Barely anyone is going to seriously sit in front of you and pontificate on the virtues of cocaine for society, but people are opposed to the criminalization of marijuana on much stronger grounds.

This passion from advocates is met with equally strong statements from those who feel that marijuana use is undermining society, addicting young people and leading users to harder drugs or even crime.

If you’re unsure which side you identify more with, or want to understand why people support or oppose cannabis, we’ve collected the best arguments from both sides here, along with the evidence backing them up.

As well as a quick run-down in this post, each specific point is expanded in more detail in a separate post.


Arguments Supporting Legalization

1. Smoking Cannabis Is a Personal Freedom, and Doesn’t Harm Others

Key Points

  • John Stuart Mill’s “harm principle” asserts that people should be free to do whatever they want unless it harms another person. “Your freedom to swing your fist ends where my nose begins.”
  • Marijuana use, through edibles or smoking either privately or in an open outdoor space, doesn’t harm others.
  • In most cases, marijuana use only affects the users themselves, and so shouldn’t be subject to legal punishment. In short: why should anybody else care?

Counterpoints

  • Harm shouldn’t necessarily be defined so strictly. Is a mother not harmed by seeing her child waste opportunities because he or she decides to smoke cannabis and play video games instead? 
  • Widespread cannabis use causes societal harm. It is unreasonable to judge a behavior purely on individualistic grounds because we exist in societies and our actions impact our societies. 
  • Of course, it’s possible to use cannabis in a way that minimizes harm. But many people also use cannabis in a dangerous way, whether through exposing others to smoke or by irresponsible behavior like driving while high.

References

The Ethics Centre (2021) What is the harm principle?

About the source: 

  • Peer-reviewed? No, from the non-profit Ethics Centre, based in Australia.
  • Main points/purpose: A concise summary of the harm principle and what it means. 
  • Other notes: The point here is philosophical, not scientific, but as such there is no “evidence” offered here in the traditional sense.

2. Legalizing Cannabis Brings Economic Benefits and Raises Tons of Tax Money

Key Points

  • Legalizing cannabis benefits the economy by bringing in tax revenues and by creating business and employment opportunities.
  • Colorado and Washington, for instance, collected $423 and $559.5 million, respectively, in tax revenue in 2021.
  • For all legal cannabis sales in the US, states took $3.7 billion in tax revenue in 2021, and the cumulative total from 2017 to 2025 is estimated to reach $106 billion.
  • Although other economic benefits might be small relative to the size of the economy, Colorado’s industry employed over 41,600 in 2021, for instance.

Counterpoints

  • People would buy cocaine from legal stores if it was available and it would of course generate tax revenue. Does this mean we should also legalize cocaine? Finances are not everything.
  • Such analyses never consider increased costs in other areas – like possible increases in addiction, mental health care and traffic accidents – and how they impact the financial benefits.
  • Revenue from cannabis is generally small relative to the overall size of an economy, and so substantial economic improvement is not likely from legalization alone.

References

Krishna, M. (2022) The economic benefits of legalizing marijuana, Investopedia

About the source: 

  • Peer-reviewed? No, from Investopedia
  • Main points/purpose: To describe the economic argument for legalizing marijuana, with discussion of the economic benefits seen by states thus far. 
  • Other notes: Although it largely depends on hard figures from legal states (and these are accurate), the piece is clearly biased in favor of legalizing marijuana.

Song, B. (2018) Cannabis Taxes Could Generate $106 Billion, Create 1 Million Jobs by 2025, New Frontier Data

About the source: 

  • Peer-reviewed? No, a report from cannabis analytics company New Frontier Data.
  • Main points/purpose: Describing and forecasting the cannabis industry. As part of a larger report, they calculated that the industry will generate $106 billion in tax revenue from 2017 to 2025. 
  • Other notes: Full report available on subscription. Of course, these are projections, and won’t necessarily come true.

Dills, A. et al. (2021) The Effect of State Marijuana Legalizations: 2021 Update, The Cato Institute

About the source: 

  • Peer-reviewed? No, a report from the Cato Institute.
  • Main points/purpose: Looks over a multitude of effects (and the lack thereof) from the legalization of marijuana, in particular, the economic effects in terms of tax revenue and jobs. Tax revenue from legalization has often exceeded expectations.
  • Other notes: Points out errors from both sides of the argument. 

Colorado Marijuana Enforcement Division (2021) Regulated Marijuana License Demographic Information

About the source: 

  • Peer-reviewed? No, a collection of data from Colorado’s Marijuana Enforcement Division.
  • Main points/purpose: 41,639 people are currently employed in the state’s marijuana industry.
  • Other notes: Raw numbers without context of overall working population. 

3. Enforcing Criminal Laws Against Cannabis Is Expensive and Problematic

Key Points

  • It’s expensive to prosecute people for marijuana, and in practice there is almost always a racial bias. And for what benefit, exactly?
  • The US would save at least $7.7 billion on enforcement if marijuana was legalized nationwide, based on analysis conducted before any states legalized.
  • Black people are 3.64 times more likely to be arrested for marijuana possession, despite using at similar rates to white people (actually at slightly lower rates, as of 2018).
  • While legalization doesn’t fully rectify this disparity, it’s clear that the war on drugs disproportionately affects non-white communities.

Counterpoints

  • Marijuana enforcement costs don’t end with legalization. Every legal state has possession limits, requirements for selling (and punishments for unauthorized sales), bans on driving high and more. These must also be enforced, so all of these problems would persist to some degree.
  • It obviously costs money to enforce the law. This is not a sufficient argument for removing the law. If marijuana is dangerous, the cost is arguably justified.

References

Cost of Prohibition

Miron, J.A. (2005) The Budgetary Implications of Marijuana Prohibition. rep. Marijuana Policy Project

About the source:

  • Peer reviewed? No, report funded by the Marijuana Policy Project and written by Jeffrey A. Miron, economics professor at Harvard University.
  • Main points/purpose: To detail the expenses and lost income associated with the prohibition of cannabis. He estimates savings of $7.7 billion per year if marijuana is legalized nationwide (vs. it being illegal everywhere, as it was in 2005). 
  • Other notes: This is very dated, but still one of the only genuine estimates of the cost of prohibition available. 

Race and the Drug War

Edwards, E. et al. (2020) A Tale of Two Countries: Racially Targeted Arrests in the Era of Marijuana Reform. rep. American Civil Liberties Union.

About the source:

  • Peer reviewed? No, a report from the American Civil Liberties Union.
  • Main points/purpose: There are substantial racial disparities in marijuana arrests which persisted from 2010 to 2018, and which are not substantially improved by legalization.
  • Other notes: Available data were limited, with only 49 states (and not DC, either) providing information and some counties aren’t adequately covered by reporting agencies. The available data also focused on black and white Americans, with insufficient information to compare Latino and Latina Americans with white Americans.

Drug Policy Alliance (2022) Race and the Drug War.

About the source:

  • Peer reviewed? No, a web page from the Drug Policy Alliance.
  • Main points/purpose: Describing the history of race and the drug war. 
  • Other notes: Clearly an advocacy piece, but gives a good overview of the inherent racism within the war on drugs. 

4. Cannabis Is Safer Than Alcohol (and Most Other Drugs)

Key Points

  • Cannabis is safer than alcohol. 140,000 Americans died from drinking from 2015 to 2019, compared to a literal few – potential, not confirmed – deaths from cannabis.
  • Based on “margin of exposure” analysis, alcohol sits with cocaine and heroin in the “high risk” category while marijuana is “low risk.”
  • If the deadly, high risk product is OK with society, what possible reason could there be for banning low risk, rarely (if ever) fatal cannabis?

Counterpoints

  • Death is not the only negative consequence possible from cannabis use, so focusing on it ignores many valid concerns. 
  • Drug law is not and should not be purely based on personal risks to users. The risks to society are also important, and legalizing marijuana may falsely send the message that marijuana is safe. 
  • If cannabis is safer than alcohol, this doesn’t mean cannabis should be legal. Perhaps, instead, alcohol should simply be banned too. 

References

Basic Stats

CDC (2022) Deaths from excessive alcohol use in the United States, Centers for Disease Control and Prevention.

About the source:

  • Peer reviewed? No, but from the Centers for Disease Control and Prevention (CDC).
  • Main points/purpose: Provides statistics on deaths from excessive alcohol consumption, with an average of 140,000 deaths per year from 2015 to 2019.

Johnson, J. (2019) Can marijuana kill you?, Medical News Today.

About the source:

  • Peer reviewed? No, a page from Medical News today. Medically reviewed in-house by a pharmacist.
  • Main points/purpose: Describes recent cases where marijuana is said to have played a role in deaths, and concludes that these cases are inconclusive, as well as far less numerous than alcohol or other drug-related deaths. 
  • Other notes: Cites some case reports, but the details are less important for this argument than the overall numbers. 

Risk Comparisons

Lachenmeier, D.W. and Rehm, J. (2015) “Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach,” Scientific Reports, 5(1).

About the source: 

  • Peer reviewed? Yes, published in Nature Scientific Reports
  • Methodology: Using already existing data to compare average human intake of substances to their LD50 (the lethal dose for 50% of people). 
  • Main results: Alcohol, nicotine, cocaine and heroin are “high risk” while cannabis is “low risk.”
  • Other notes: LD50 is a fairly extreme benchmark for comparison, since drugs also have negative effects before becoming fatal to users. However, this was all the authors could find.

Thayer, R.E. et al. (2017) “Structural neuroimaging correlates of alcohol and cannabis use in adolescents and adults,” Addiction, 112(12), pp. 2144–2154.

About the source:

  • Peer reviewed? Yes, published in Addiction
  • Methodology: Looking at gray matter volume and white matter integrity in users of cannabis and alcohol.
  • Number of participants: 853 adults (18-55 years) and 439 adolescents (14-18 years). 
  • Main results: The severity of alcohol use is linked to lower gray matter volume and white matter integrity, but cannabis showed no association.
  • Other notes: There were relatively few users who only consumed cannabis (5 adults, 35 teens) and the authors report that cannabis use of the sample was low overall.

Nutt, D.J., King, L.A. and Phillips, L.D. (2010) “Drug harms in the UK: A multicriteria decision analysis,” The Lancet, 376(9752), pp. 1558–1565.

About the source:

  • Peer reviewed? Yes, published in The Lancet.
  • Methodology: Members of the Independent Scientific Committee on Drugs scored 20 drugs on 16 different harm criteria, 9 for harm to users and 7 for harm to others.
  • Main results: Heroin, crack cocaine and methamphetamine were judged as the most harmful to users, and alcohol, heroin and crack were the most harmful to others. Overall, alcohol was the most harmful (harm score 72 out of 100) and cannabis was eighth (20 out of 100). 
  • Other notes: Although the analysis was performed by experts using objective measures, the scoring has an unavoidable element of subjectivity. It is essentially expert opinion, not hard evidence. Also, harms are rated based on their availability and consequences for their use, so the harms resulting from prohibition (or, social acceptability) are included. 

5. Cannabis Has Many Medical Benefits

Key Points

  • 37 states, three territories and D.C. allow medical marijuana, for conditions such as chronic pain, nausea, glaucoma, PTSD and many others.
  • This clearly contradicts the classification of marijuana as a Schedule I controlled substance.
  • Moreover, if marijuana helps someone with chronic pain, for instance, and he or she uses responsibly, what is the justification for restricting access?
  • Purely medical marijuana laws may enable states to meet this need, but this creates a two-tier system where one citizen can possess marijuana while another can’t.

Counterpoints

  • The evidence for marijuana helping many of the listed conditions is mixed at best. The FDA has approved some marijuana medicines for limited purposes, and these are the only ones which are valid medical treatments. 
  • Some people having a medical need for marijuana does not mean anybody should be able to consume it. Many drugs are available medically but not recreationally, such as oxycodone. 
  • The push for medical marijuana is a wedge issue, bringing well-meaning people over to begrudging acceptance of something else entirely, recreational use.

References

NCSL (2022) State Medical Cannabis Laws, National Conference of State Legislatures.

About the source:

  • Peer reviewed? No, from the National Conference of State Legislatures.
  • Main points/purpose: Tracking state medical marijuana laws.

Grinspoon, P. (2020) Medical marijuana, Harvard Health.

About the source:

  • Peer reviewed? No, but a blog from Harvard Medical School, written by a physician and cannabis specialist.
  • Main points/purpose: An overview of medical marijuana, what it is used for how patients can discuss it with their doctors. 
  • Other notes: More of an overview with reference to the general body of evidence, without getting into specifics.

DEA (2018) Drug scheduling, Drug Enforcement Agency.

About the source:

  • Peer reviewed? No, from the Drug Enforcement Agency (DEA).
  • Main points/purpose: Explaining the U.S. drug scheduling system. 

Arguments Opposing Legalization

1. Cannabis Is a Dangerous and Addictive Drug

Key Points

  • Although cannabis isn’t as dangerous or addictive as other drugs, it is still dangerous and addictive.
  • Smoking marijuana exposes users to many of the same chemicals as tobacco smoke and has negative effects on the respiratory system.
  • Cannabis can trigger and worsen schizophrenia, and negatively affects people with anxiety and mood disorders.
  • Around 9% of cannabis users become addicted, as well as 17% of people who started using as teens.
  • Of people who use cannabis every day, researchers estimate that between 25 and 50% are addicted.
  • With all of these risks, how can we sanction or even encourage people to partake?

Counterpoints

  • The fact that cannabis isn’t as dangerous or addictive as other drugs is exactly why we should legalize. We accept the (larger) risks of alcohol, so why is weed still illegal?
  • Smoking cannabis is less dangerous to users than smoking tobacco.
  • People with schizophrenia or risk factors should avoid marijuana, but that doesn’t mean that adults with no mental health problems should. Some people have medical reasons for avoiding caffeine, but it doesn’t mean it should be banned. 

References

Respiratory Effects:

Martinasek, M.P., McGrogan, J.B. and Maysonet, A. (2016) “A systematic review of the respiratory effects of inhalational marijuana,” Respiratory Care, 61(11), pp. 1543–1551.

About the source: 

  • Peer reviewed? Yes, published in Respiratory Care
  • Methodology: Systematic review of existing studies on the respiratory effects of marijuana. In particular, they looked at lung cancer, emphysema/COPD and other respiratory symptoms.
  • Sample size: 48 peer-reviewed articles.
  • Main result: There is a risk of lung cancer, and it’s associated with pneumothorax, bullous emphysema, or COPD. Marijuana smokers also report respiratory symptoms such as wheezing.
  • Other notes: Many studies didn’t separate out the effects of tobacco smoking from those of marijuana, making the results difficult to interpret. The authors conclude that more data is needed. 

Tashkin, D.P. (2013) “Effects of marijuana smoking on the lung,” Annals of the American Thoracic Society, 10(3), pp. 239–247.

About the source: 

  • Peer reviewed? Yes, published in Annals of the American Thoracic Society.
  • Methodology: Non-systematic review of evidence on marijuana and lung illness.
  • Main result: No risk of lung cancer for mild to moderate users, unclear for heavy, long-term users. Despite some signs, evidence for other respiratory issues is mixed and unclear. Marijuana, even when used heavily, has much lower pulmonary risks than tobacco.
  • Other notes: As with the review above, not all studies were of high quality and in many cases, more evidence is needed to confirm many of the points.

Mental Health:

Uritz, I. et al. (2020) “Cannabis Use and its Association with Psychological Disorders,” Psychopharmacology Bulletin, 50(2), pp. 56–67.

About the source: 

  • Peer reviewed? Yes, published in Psychopharmacology Bulletin
  • Methodology: Non-systematic review of the evidence on cannabis and psychological disorders. 
  • Main result: Evidence suggests that cannabis can worsen or trigger psychosis and schizophrenia, but evidence is mixed for depression and anxiety.
  • Other notes: The evidence around cannabis, schizophrenia and psychosis tends to show associations, not (necessarily) causality.

Mammen, G. et al. (2018) “Association of cannabis with long-term clinical symptoms in anxiety and mood disorders,” The Journal of Clinical Psychiatry, 79(4).

About the source: 

  • Peer reviewed? Yes, published in the Journal of Clinical Psychiatry
  • Methodology: Systematic review of studies looking at cannabis use and outcomes for patients with an anxiety or mood disorder. 
  • Sample size: 12 studies with a total of 11,959 participants. 
  • Main result: 11 of 12 studies found that those who used cannabis recently experienced more symptoms, and 10 of 12 found an association with worse treatment outcomes.
  • Other notes: Study designs varied, some samples were collected in a biased fashion and there was (unavoidable) variation in the cannabis participants used.

Di Forti, M. et al. (2019) “The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-gei): A multicentre case-control study,” The Lancet Psychiatry, 6(5), pp. 427–436.

 About the source: 

  • Peer reviewed? Yes, published in the Lancet Psychiatry.
  • Methodology: Case control study. Patients with first-episode psychosis were surveyed about their cannabis (and other drug) use habits, then compared with controls. THC levels in local cannabis samples were also incorporated. 
  • Sample size: 901 patients and 1,237 matched population controls.
  • Main result: Cannabis users were 3 times more likely to have psychotic disorder, compared to non-users. If high-potency cannabis were not available, 12% of cases of first-episode psychosis could be prevented. 
  • Other notes: Researchers didn’t consider CBD quantities in cannabis (because data is hard to find for many countries), and causality was assumed rather than proven. 

Addiction:

Volkow, N.D. et al. (2014) “Adverse health effects of marijuana use,” New England Journal of Medicine, 370(23), pp. 2219–2227.

About the source:

  • Peer reviewed? Yes, published in the New England Journal of Medicine.
  • Methodology: Narrative review of the evidence on cannabis’ adverse health effects
  • Main result: 9% of overall users and 17% of those who start during adolescence. Long-term risks are increased for adolescents.
  • Other notes: The data reviewed is pretty old now, and includes debatable claims, such as a decline in IQ for teen users, which has since been called into question.

Gorelick, D.A. et al. (2012) “Diagnostic criteria for cannabis withdrawal syndrome,” Drug and Alcohol Dependence, 123(1-3), pp. 141–147.

 About the source:

  • Peer reviewed? Yes, published in Drug and Alcohol Dependence
  • Methodology: Self-reported questionnaire, asking about potential withdrawal symptoms, taken from the literature. 
  • Sample size: 384 adult, lifetime cannabis users who were not seeking treatment. Asked about their “most difficult” quit attempt.
  • Main result: 41% of participants met the DSM-V definition for withdrawal, which was more likely for more intensive users. These participants were less likely to stay abstinent.
  • Other notes: Helps establish some “standard” withdrawal symptoms, but authors point out more data is needed. 

2. Legalizing Cannabis Use Is Bad for Society

Key Points

  • Legalizing cannabis leads to negative societal outcomes, in particular in terms of widespread use and people driving high.
  • Cannabis use increases when it’s legalized. Based on a study of twins in different states, legalization makes people use weed 20% more than they would otherwise.
  • If cannabis is dangerous and addictive, this is a very bad thing. More use means more risk.
  • Although driving while high isn’t as bad as driving drunk, it still increases your risk of an accident.
  • Studies have mixed results but one example shows a 6.5% increase in accidents causing injury after legalization, and a 2.3% increase in fatal crashes.
  • We could be moving towards a Brave New World in which addiction is normalized and stoned driving accidents are seen as the acceptable price for our “freedom.”

Counterpoints

  • Cannabis use increases when it’s legalized because people want to use it. This isn’t a bad thing just because you don’t want them to. The question is whether these people should be considered criminals, not whether you like it.
  • There is no state, nor advocate, who claims we should be able to drive high. People will do it, but people do it anyway. We need to enforce these important laws to save people’s lives, not prohibit the whole substance just in case. 
  • Legalization also has positive impacts for society, as mentioned above. Focusing purely on the negatives is dishonest. 

References

Effects of Legalization:

Zellers, S.M. et al. (2022) “Impacts of recreational cannabis legalization on cannabis use: A longitudinal discordant Twin Study,” Addiction, 118(1), pp. 110–118.

About the source:

  • Peer reviewed? Yes, published in Addiction.
  • Methodology: Longitudinal discordant twin study, including some where each twin lived in different states. Authors compared cannabis use for legal vs. illegal states.
  • Sample size: 1,425 in legal states, 1,996 in illegal states, with 111 monozygotic pairs of twins living in different states.
  • Main results: There is a roughly 20% increase in the frequency of cannabis use after recreational legalization.
  • Other notes: Authors point out that existing differences may have caused one twin to move and made it more likely they’d use weed, not the legalization itself. They also note that “cannabis legalization is unlikely to cause initiation in individuals who were life-time abstainers prior to legalization.”

Martins, S.S. et al. (2021) “Racial and ethnic differences in cannabis use following legalization in US states with Medical Cannabis Laws,” JAMA Network Open, 4(9).

About the source:

  • Peer reviewed? Yes, published in JAMA Network Open
  • Methodology: Used data from the National Survey on Drug Use and Health to look at cannabis use statistics before and after adult-use cannabis laws were enacted, focusing on the racial and ethnic differences. 
  • Sample size: 838,600 participants
  • Main results: After adult use laws were enacted, use increased in hispanic, non-hispanic white and “other” racial and ethnic groups. Use among non-hispanic black people did not increase. 
  • Other notes: The authors point out that the results depend on self-reporting, with people possibly being more honest after legalization. Additionally, states were simply classed as “recreational” or not, with no consideration for the number of dispensaries e.t.c.. 

Road Traffic Fatalities and Legalization

Farmer, C.M., Monfort, S.S. and Woods, A.N. (2022) “Changes in traffic crash rates after legalization of marijuana: Results by crash severity,” Journal of Studies on Alcohol and Drugs, 83(4), pp. 494–501.

About the source:

  • Peer reviewed? Yes, published in the Journal of Studies on Alcohol and Drugs
  • Methodology: Quarterly rates of car accidents were compared state-by-state, accounting for differences in alcohol use rate, seat belt use rate and so on, looking at differences in legal vs. illegal states. 
  • Sample size: Data from 11 states, from 2009 to 2019.
  • Main results: Legalization of marijuana was associated with a 6.5% increase in crashes resulting in injury and a 2.3% increase in fatal crashes.
  • Other notes: Authors just assumed legalization meant increased use, with no measure of this or other factors such as how many regions have dispensaries. The study can’t clearly establish a causal relationship because there are many unexplored factors. 

Aydelotte, J.D. et al. (2017) “Crash fatality rates after recreational marijuana legalization in Washington and Colorado,” American Journal of Public Health, 107(8), pp. 1329–1331.

About the source:

  • Peer reviewed? Yes, published in the American Journal of Public Health
  • Methodology: Looked at year-on-year changes in fatal crash rates in Colorado and Washington, compared with 8 control states, between 2009 and 2015. 
  • Sample size: Data from 10 states. 
  • Main results: There was no significant difference between changes in fatal crash rates between Colorado and Washington and control states, either pre or post legalization.
  • Other notes: Authors chose control states that didn’t have medical marijuana either, to maximize the contrast. They note that other, state-specific factors could have played a role, and point out that Colorado and Washington were grouped together despite some clear differences.

3. Cannabis Is a Gateway Drug

Key Points

  • A hypothesis from the 1970s asserts that there is an “invariant sequence” for first-time drug users: alcohol/tobacco, to cannabis, and then to “harder” drugs.
  • Therefore, marijuana is a key step on the path to dangerous drug use, so encouraging it would bring significant risks.
  • In future research, the same author found that even after controlling for adolescent behavior, peer group influences and mental health, cannabis use still predicted progression to other drug use.
  • There are some potential mechanisms for gateway effects too. Nicotine exposure has been shown to encourage mice to self-administer cocaine.
  • Researchers also pointed out that using one drug “may remove the fear and perceived risk associated with the use of other drugs” and thus encourage experimentation.

Counterpoints

  • Data for this argument is lacking. While many people do follow the progression, most marijuana users don’t go on to use harder drugs, and the “invariant progression” is culturally biased to the US, and essentially absent in countries like Japan.
  • Alternative explanations depend on common factors (such as psychological differences) that may explain both the cannabis use and the harder drug use.
  • The entire idea that weed is a “gateway” is borne of an implicit understanding that it isn’t that dangerous on its own. Without a legitimate argument, people were left to claim that stoners would graduate to heroin and then talk about how bad that would be. It is primarily a rhetorical trick, not a factual argument.

References

Intro to Gateway Effect and Basic Results:

Lynskey, M.T. and Agrawal, A. (2018) “Denise Kandel’s classic work on the Gateway Sequence of drug acquisition,” Addiction, 113(10), pp. 1927–1932.

About the source:

  • Peer reviewed? Yes, published in Addiction
  • Methods: Looks at the original “gateway sequence” paper and describes subsequent efforts to confirm or deny it.
  • Main results: While the presence of a “sequence” is often confirmed, many authors believe both behaviors are the result of pre-existing factors, not accounted for by Kandel’s hypothesis.
  • Other notes: This is really more of a “storytelling” piece than traditional research. 

Secades-Villa, R. et al. (2015) “Probability and predictors of the Cannabis Gateway Effect: A National Study,” International Journal of Drug Policy, 26(2), pp. 135–142.

About the source:

  • Peer reviewed? Yes, published in the International Journal of Drug Policy
  • Methods: Tested the gateway hypothesis using data from the National Epidemiological Survey on Alcohol and Related Conditions, from participants who started using cannabis before any other drug. 
  • Sample size: 6,624
  • Main results: 45% of participants with lifetime cannabis use progressed to other illicit drug use.
  • Other notes: The presence of a “progression” is not evidence that cannabis caused the progression. In short, this does not refute the alternative hypothesis. However, it does confirm the existence of the progression.

Other Causes for “Gateway” Progressions

Leece, P. and Paul, N. (2019) Q&A is cannabis a gateway drug, Public Health Ontario.

About the source:

  • Peer reviewed? No, it’s an informational Canadian public health document. 
  • Methods: Use pre-existing data to produce a simple “explainer” of the gateway hypothesis.
  • Main results: The gateway hypothesis has not been proven, and likely stems from psychological factors and simple availability of different substances. 
  • Other notes: Not a study, but covers relevant data in an accessible and understandable format. 

Degenhardt, L. et al. (2010) “Evaluating the drug use ‘gateway’ theory using cross-national data: Consistency and associations of the order of initiation of drug use among participants in the WHO world mental health surveys,” Drug and Alcohol Dependence, 108(1-2), pp. 84–97.

About the source:

  • Peer reviewed? Yes, published in Drug and Alcohol Dependence
  • Methods: Used data from WHO World Mental Health surveys to look at the order of the “sequence” for different countries.
  • Sample size: 85,088, from 17 countries.
  • Main results: They found some variation in the sequence by country. The authors write, “the “gateway” pattern at least partially reflects unmeasured common causes rather than causal effects of specific drugs on subsequent use of others.”
  • Other notes: Variations in the sequence in different countries don’t necessarily show that cannabis isn’t a “gateway drug,” but it does call the hypothesis into question.

Key Points

  • Advocates of marijuana often argue that legalization will kill the black market, but cases like California show that this isn’t always true.
  • According to Leafly’s “Opt Out Report,” 55% of cannabis sales in California and 80% in New Jersey are through the black/gray market.
  • If a city doesn’t vote for legal weed, either states have to force them to have dispensaries, or black market sellers will capitalize.
  • If anything, legal weed makes it easier for illicit sellers because cops can’t stop people for simple possession.  
  • And illicit sales carry all of the usual downsides. Legalization advocates claim it will help stop sales to youth, for example, because dispensaries can check ID. But with a strong black market still operating, this goal is not achieved. 

Counterpoints

  • Black markets persist in legal systems when there is insufficient coverage of dispensaries. The solution to black markets is still widely available legal cannabis. Some states not providing this doesn’t show legalization doesn’t work. 
  • There are black markets in illegal states too. So the worst case scenario for legalization is actually the current status quo, which this argument is apparently defending.
  • Some people will always try to make money illegally, whether it’s selling counterfeit cigarettes or setting up a gray market weed stall. The fact that they exist doesn’t mean we should keep marijuana illegal.

References

Shen-Berro, J. and Young, S. (2022) The Black Market strangled California’s legal weed industry. now it’s coming for New York, POLITICO.

About the source:

  • Peer reviewed? No, a piece from Politico. 
  • Main points/purpose: Describing the situation in New York as of late 2022, and how the black market will likely continue to flourish there as it has in California. 
  • Other notes: While this shows issues with black markets in legal states, it’s important to note that these issues appear to be related to the availability of legal weed. In short, if the legal system doesn’t provide adequate opportunities to buy, it is essentially a tolerated black market. See the Leafly reference below for more.

Barcott, B. and Whitney, B. (2022) Opt-Out Report 2022. rep. Leafly.

 About the source:

  • Peer reviewed? No, a report from Leafly.
  • Main points/purpose: Describe and evaluate the problems caused by localities “opting out” of legal weed markets. Notably, for example, Montana has 39 dispensaries per 100,000 residents, and 78% of sales are legal, while New Jersey has 0.3 dispensaries per 100,000, and only 20% of sales are legal.
  • Other notes: Clearly the intent of the report is to criticize “opt out” clauses in adult use marijuana laws, but the data is valid and cannot be simply discounted because of this underlying bias.

5. Cannabis Is Dangerous for Youth

Key Points

  • Young people are particularly at risk from cannabis use.
  • Weekly marijuana use increases the risk of anxiety, depression and suicide attempts. A meta-analysis found that the risk of depression increased 37% and the risk of suicidal ideation increased 50% in marijuana users, relative to non-users.
  • Teens who use marijuana are more likely to get addicted, with 17% being addicted compared to 9% of marijuana users overall.
  • The risks of psychosis and schizophrenia are largest for young users.
  • Some studies suggest an IQ decline for teen stoners, but there are contradictory findings that make conclusions hard to draw.
  • If legalizing weed increases teen use, there could be many unintended consequences because of these points.

Counterpoints

  • Young people are at risk from cannabis, and this is why we should regulate and control the market to make it harder for them to access it. Street dealers don’t check IDs.
  • Again, potential risks to some groups doesn’t mean no group should have access. Alcohol and tobacco are also particularly dangerous to youth, but we minimize the risk that they get access, not ban the substances. 

References

Mental Health Effects

Patton, G.C. (2002) “Cannabis use and mental health in Young People: Cohort Study,” BMJ, 325(7374), pp. 1195–1198.

About the source:

  • Peer reviewed? Yes, published in BMJ
  • Methodology: Cohort study taking place over 6 years, starting with 14 – 15 year old high school students, and measuring depression and anxiety at the end of the study period.
  • Sample size: 1,601
  • Main results: Daily use in young women was associated with a 5.6-fold increase in depression and anxiety, and weekly (or more) use in teenagers doubled anxiety and depression risk. 
  • Other notes: There was a significant difference between the results for males and females, which isn’t explained by the authors.

Gobbi, G. et al. (2019) “Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood,” JAMA Psychiatry, 76(4), p. 426.

About the source:

  • Peer reviewed? Yes, published in JAMA Psychiatry
  • Methodology: Systematic review and meta-analysis, specifically looking at longitudinal and prospective studies on adolescent cannabis use and depression, anxiety or suicidal ideation in adulthood.
  • Sample size: 11 studies with a total of 23,317 participants.
  • Main results: Cannabis users had a 37% greater chance of developing depression and a 50% greater chance of suicidal ideation, compared to non-users, with no difference for anxiety.
  • Other notes: Different studies in the analysis accounted for different potentially confounding factors (e.g. taking other drugs) and the exact quantity of cannabis was not measured, particularly considering the range of THC levels in different strains. Causality was not proven.

Lawn, W. et al. (2022) “The CannTeen study: Cannabis use disorder, depression, anxiety, and psychotic-like symptoms in adolescent and adult cannabis users and age-matched controls,” Journal of Psychopharmacology, 36(12), pp. 1350–1361.

About the source:

  • Peer reviewed? Yes, published in the Journal of Psychopharmacology
  • Methodology: Cross-sectional analysis (i.e. analyzed at a single point in time) from the CannTeen study, looking at cannabis use and psychological issues.
  • Sample size: 274 participants (76 adolescent users, 71 adult users, 63 adolescent controls and 64 adult controls). 
  • Main results: Adolescent users were more likely to have cannabis use disorder, users (overall) had more psychotic-like symptoms than non-users, and adolescent users had more than adult users. No link to depression or anxiety was found.
  • Other notes: The analysis was cross-sectional (a single time point), so it may miss effects that would occur in future. For example, depression could be more likely after a few years of use, but equally likely before that. Likewise, causality generally cannot be determined by cross-sectional studies: you can’t see what happens after someone starts smoking cannabis, just that they do smoke and have a certain condition.

Malone, D.T., Hill, M.N. and Rubino, T. (2010) “Adolescent cannabis use and psychosis: Epidemiology and Neurodevelopmental Models,” British Journal of Pharmacology, 160(3), pp. 511–522.

About the source:

  • Peer reviewed? Yes, published in the British Journal of Pharmacology.
  • Methodology: Narrative review
  • Main results: Cannabis is a risk factor for schizophrenia, and for those with a predisposition, it exacerbates symptoms and makes their prognosis worse. 
  • Other notes: Many gaps remain in the picture, for example, evaluating teens before they start using marijuana to look for pre-existing differences. 

IQ Decline Study and Critique

Meier, M.H. et al. (2012) “Persistent cannabis users show neuropsychological decline from childhood to midlife,” Proceedings of the National Academy of Sciences, 109(40).

About the source:

  • Peer reviewed? Yes, published in Proceedings of the National Academy of Sciences.
  • Methodology: Cohort study, from birth to age 38. Neuropsychological tests were conducted at ages 13 and 38, and cannabis use was determined at 18, 21, 26, 32 and 38.
  • Sample size: 1,037
  • Main results: Persistent cannabis use was associated with neuropsychological decline, even after controlling for years of education. Those who started in adolescence had the biggest decline.
  • Other notes: There could be other factors at play. Although they controlled for many factors, these weren’t exhaustive and there could still be bias. 

Pearlson, G. (2020) Marijuana may not lower your IQ, Scientific American.

About the source:

  • Peer reviewed? No, it’s from Scientific American, but was written by a professor of psychiatry and neuroscience.
  • Main results: Pearlson outlines the research into marijuana use and IQ decline, discussing the limitations of Meier’s 2012 study (above). In particular, he notes that controlling for confounding variables removes the apparent association, and that twin studies show no such effects. 
  • Other notes: This is primarily included for a more accessible explanation of the limitations of Meier’s study than would be found in academic literature. 

Meier, M.H. et al. (2017) “Associations between adolescent cannabis use and neuropsychological decline: A longitudinal co-twin control study,” Addiction, 113(2), pp. 257–265.

About the source: 

  • Peer reviewed? Yes, published in Addiction.
  • Methodology: Longitudinal study, using pairs of twins as control and experimental groups. They found out about cannabis use at age 18, and checked IQ at ages 5, 12 and 18. Executive functioning was also checked at 18.
  • Sample size: 1,989 twins
  • Main results: While cannabis users overall had lower IQs than non-users, for example (including prior to using cannabis), there was no evidence of a decline in twins who use cannabis compared to non-using twins. 
  • Other notes: By analyzing twin pairs, many environmental, genetic and psychological factors have already effectively been controlled for. However, the authors point out that the number of “discordant” twin pairs (where one used cannabis and the other didn’t) was small. 

Jackson, N.J. et al. (2016) “Impact of adolescent marijuana use on intelligence: Results from two longitudinal twin studies,” Proceedings of the National Academy of Sciences, 113(5).

About the source: 

  • Peer reviewed? Yes, published in Proceedings of the National Academy of Sciences.
  • Methodology: Longitudinal study using two cohorts of twins and triplets, where intelligence was measured between ages 9 and 12, then again at 17 to 20. Marijuana use was reported at both time points and in the intervening time.
  • Sample size: 789 and 2,277. 
  • Main results: While marijuana users had lower IQs than non-users, the size of decline was not related to the amount used, and there was no difference when cannabis-using twins were compared to their abstinent siblings. 
  • Other notes: The authors note that their results suggest that the differences seen in studies like Meier (2012) are due to confounding factors, not an effect of marijuana. However, they do point out that they didn’t follow subjects for as long. 

How We Produced This List

Coming up with a list of the best and most common arguments for and against cannabis is not a simple matter. Different people have different views and different arguments that appeal to them.

However, there are some points that are made more frequently than others, and ones that resonate with people more. A 2019 Gallup poll asked 1,017 American adults (aged 18 or over) whether they favor or oppose legalizing marijuana and why, with 633 being in favor and 364 being opposed. The most commonly-cited reasons were prioritized for this list, supplemented by other online sources where people make arguments for and against legalization. 

The arguments themselves also haven’t been repeated verbatim. Each argument rests on some claims, and these claims were investigated based on available evidence.

Where possible, we used peer-reviewed scientific evidence to back up or refute claims. Where not possible or not applicable, we used appropriate non peer-reviewed sources. If some element of the original claim was incorrect or unproven, we either explicitly stated this or simply made the best possible version of the original argument (we made a “steel man” argument). 

It’s also crucial to note that not all sources are equally valid, even if they are peer-reviewed. With this in mind, we’ve included some brief information about each source and comments on its validity. For example, a self-reported study with 15 participants is better than what an unknown author wrote on his blog, but much worse than a randomized controlled trial or large cohort study.

The overall aim, as always, was to provide an objective look at the topic to the best of our ability. 

Conclusion

We aren’t here to tell you what to think about marijuana. People have personal reasons for liking and disliking something, and just like whom you choose to support politically, there must be a degree of acceptance that other people don’t see issues in the same way you (or we) do.

However, understanding both points of view and the evidence that supports (or contradicts) them is a vital step towards understanding the impact cannabis has on society, and why the debate around the topic is still so active and heated.

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