Cannabis



It's good for the flu Good for asthma, Good for tuberculosis, Even…

Cannabis (also commonly known as Marijuana) is a plant (Cannabis spp.) that contains a complex of psychoactive substances, the most notable of these being tetrahydrocannabinol (usually shortened to THC). The primary species used as drugs are C. indica and C. sativa. C. ruderalis, which has a low THC content, has been used in some cross-breeding.

Marijuana woo is an umbrella term for various claims regarding the positive effects of marijuana cultivation and use. These generally fall into three basic areas: In the United States, marijuana currently falls into a legal gray-area: it is illegal at the federal level, but it is legal in 23 states (e.g., Colorado) as well as Guam, DC, the Northern Mariana Islands, and the U.S. Virgin Islands and decriminalized in another 8. Medical marijuana is fully legal in 15 other states that don't have legal recreational marijuana, as well as in Puerto Rico. Hemp-derived products are federally legal following the passage of the although states may have their own laws regarding these. So far, the only countries that have legalized recreational use nationwide are Uruguay, Canada, South Africa, Georgia (no, not that one), Malta, Mexico, and Thailand. In some other countries, such as the Netherlands, it is not legal but it is tolerated.
 * Claims concerning psychoactivity (occasionally extending all the way to -esque soul-babble)
 * Health claims (often promoted as a panacea, sometimes amounting to a quack cancer cure)
 * Ecological claims (positive instead of negative predictions from the same scientific illiterates who detest GMO's)

Marijuana woo has been associated with other types of woo, such as aromatherapy and chakras.

Marijuana fans claim a startling assortment of things that marijuana is just about the best thing ever for, and none of this is because they want to get high as hell, maaaaan. (Of course, getting high might make you feel like your problems are solved, or alleviated.) Those who choose not to light up, yet have to contend with the stench and the people who get stoned, may be somewhat less starstruck.

Health claims
Health claims, particularly in the medical marijuana jurisdictions, tend towards the dietary supplement realm even though marijuana is not covered by the Dietary Supplement Health and Education Act of 1994 (DSHEA) because it is illegal at the Federal level. Some health claims even have the Quack Miranda Warning, which was a byproduct of DSHEA.

Let's start with some background on marijuana chemistry. Relevant chemicals in marijuana fall into two broad classes: cannabinoids (which in plants are specific to the Cannabis genus) and terpenoids (which are widespread in many plants). Humans and other animals, produce endocannabinoids, which are different than but in the same chemical class as those cannabinoids found in marijuana. The main psychoactive chemical in marijuana is tetrahydrocannabinol (THC). Another important cannabinoid is cannabidiol (CBD), which is not psychoactive but has many claimed health benefits. Terpenoids in marijuana include ocimene, myrcene, β-caryophyllene, limonene, pinene, myrcene, linalool.

There are two major problems with evaluating medical claims for marijuana:
 * 1) There is a large variability of the chemical content of marijuana, particularly since marijuana has been bred for different pharmacological properties. From the medical marijuana supplier perspective, this ranges from plants with high-THC/low-CBD to low-THC/high-CBD, as well as variations in terpenoid content. These chemicals may have either synergistic or antagonistic effects with regard to a particular medical treatment, so assessing the effectiveness of medical marijuana as a whole is difficult due to the quantitative chemical variability.
 * 2) In general, the quality of medical evidence forms a scale, or hierarchy of evidence, ranging from in vitro cell studies (lowest evidence) to animal bioassays (in vivo) to human retrospective studies to human prospective studies to meta-analyses and reviews of all direct evidence. It is difficult and expensive to conduct large-scale, long-term human studies, and the ability of researchers to conduct these has often been hampered by marijuana's illegality. Marijuana advocates may make claims based on in vitro studies of single chemicals, but this is never convincing evidence for human health &mdash; it is merely suggestive for further research.
 * 3) "So far, researchers haven't conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its cannabinoid ingredients) outweigh its risks in patients it's meant to treat."

Another problem with research on the medical effects on marijuana is that for the rare cases of US Federal Government-funded research, the marijuana is required to be sourced from the Federal Government. Such marijuana by today's commercial marijuana standards is considered to be low-grade (ditch weed), and is not comparable in terms of chemical content to what most people actually smoke.

Toxicity
Marijuana and THC are generally considered to have low toxicity, particularly compared to other recreational drugs. One method of assessing toxicity is using the Margin of Exposure (MOE) method, where MOE = Human exposure / Animal median lethal dose. For example, for alcohol and nicotine, the MOE is low (<10), meaning the risk is high with the exposure dose close to the lethal dose. For THC, the MOE is high (>10,000), meaning the risk of death is low.

It has often been claimed (including by former-Presidential candidate Gary Johnson) that no one has ever died from a marijuana overdose. The first problem with this claim is that it does not clearly state whether the lack of mortality is from direct causes (toxicity), or from indirect causes (i.e., from judgment or psychomotor impairment). Too often individuals cite that individuals haven’t died from cannabis &mdash; I don't think that's true. It certainly can be argued that cannabis use has contributed to the deaths of individuals, such as due to impairment during driving. Marijuana has been cited as the sole cause of at least some traffic fatalities. After marijuana legalization in Colorado, traffic fatalities in which marijuana was at least partly-responsible increased to 94 in 2014, a not-insignificant number compared to alcohol-related traffic fatalities for that year (170 fatalities). Marijuana does impair judgment, motor coordination, and reaction time, and its effect on impairment is either additive or synergistic with alcohol.

Marijuana has been associated with at least 7 cases of heart attacks in different people (at least 4 of whom had normal coronary vasculature) and possibly some deaths, and marijuana is known to have several vascular effects that may be causative (e.g., tachycardia, hypertension, bradycardia, and hypotension).

Pain and spasticity
A 2015 review of human studies in The Journal of the American Medical Association found that there was high-quality evidence for treatment of chronic pain, neuropathic pain, and spasticity from multiple sclerosis (MS). The author also concluded that "Medical marijuana is used to treat a host of indications, a few of which have evidence to support treatment with marijuana and many that do not."

A large, multi-faceted literature review by the National Academies of Sciences, Engineering, and Medicine (NASEM) also concluded: The review also concluded that the effects were modest. However, separate studies have shown that US states with medical marijuana have reduced opioid prescriptions and 25% fewer opioid-related deaths.
 * In adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.
 * In adults with multiple sclerosis (MS)-related spasticity, short-term use of oral cannabinoids improves patient-reported spasticity symptoms.

Nausea
A 2015 review of randomized controlled trials in humans found that the majority of the studies were at risk of bias due to not being double blind, or from attrition of test subjects. Nonetheless, the authors concluded that marijuana-based medications may be useful for treating nausea. The NASEM report also concluded, "In adults with chemotherapy induced nausea and vomiting, oral cannabinoids are effective antiemetics," and that the effects were modest.

Glaucoma
Marijuana treatment for intraocular pressure from glaucoma is widely cited as effective, particularly because the first authorized usage of medical marijuana since its criminalization was based on a court case by Robert Randall in 1976. There is some supporting scientific evidence that marijuana is efficacious for at least some types of glaucoma, based on small studies on humans. The effect on intraocular pressure is relatively brief, and there are other pharmaceutical treatments available for glaucoma which have been tested for safety and efficacy. The American Glaucoma Society and the Canadian Ophthalmological Society oppose medical marijuana usage due to extensive adverse effects.

Mental health
The 2017 NASEM review concluded: Psychosis is associated with marijuana users who favor high THC/low CBD varieties. There is also evidence that psychosis is associated with highly-concentrated forms of marijuana (e.g., "dabs", "shatter" and "wax"), as well as with substances with synthetic cannabinoids (a.k.a., "spice"). The erroneous idea that dabs are "safe" has been propagated by parts of the marijuana industry without addressing the known risks of consuming high levels of THC.
 * Cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use the greater the risk.
 * In individuals with schizophrenia and other psychoses, a history of cannabis use may be linked to better performance on learning and memory tasks.
 * Cannabis use does not appear to increase the likelihood of developing depression, anxiety, and posttraumatic stress disorder.
 * For individuals diagnosed with bipolar disorders, near daily cannabis use may be linked to greater symptoms of bipolar disorder than non-users.
 * Heavy cannabis users are more likely to report thoughts of suicide than non-users.
 * Regular cannabis use is likely to increase the risk for developing social anxiety disorder.

General
Claim: "The combination of THC and terpenes modulates each strain to have its own effect, flavor, energy and medical uses."

Research findings: This is sufficiently vague that it is basically true, but not very informative.

Cannabinoids
Because of the evidence above from studies on whole marijuana, the focus below on specific chemicals will be on claims other than for treatment of pain, nausea, glaucoma, depression and MS. There is reasonable evidence of marijuana efficacy for these claims, though the efficacy regarding a specific chemical may be another matter. Furthermore, the focus below will be on claims regarding specific diseases (e.g. cancer) or implying the treatment of diseases (e.g., anti-proliferative implies cancer treatment), rather than vague disease-related claims (e.g., antimicrobial).

Cannabichromene (CBC)
Claims: treatment of anxiety and stress, anti-viral, cancer, bone growth

Research findings:
 * Anxiety: see above
 * Stress: no studies in PubMed
 * Anti-viral: no studies in PubMed
 * Cancer: CBC had some effect against breast tumors in vitro. The evidence is suggestive for further research.
 * Bone growth: no studies in PubMed

Cannabidiol (CBD)
Claims: treatment of MS, epilepsy, diabetes (by lowering blood sugar), stress, insomnia

Research findings:
 * Diabetes: CBD was effective in lowering the incidence of diabetes in mice in two studies.  Two studies in humans showed a possible protective effect from  marijuana on diabetes onset (association but not necessarily causation).
 * Epilepsy: A 2015 review found that purified CBD showed promise in uncontrolled studies, but that controlled studies were lacking. Questions remain about safety and efficacy. A 2017 trial study of 120 patients found that children with a type of childhood epilepsy known as Dravet Syndrome had a greater reduction in convulsions when treated with CBD than placebo. In 2018, an FDA panel recommended CBD as the very narrowly defined treatment, specifically for "seizures caused by Lennox-Gastaut syndrome (LGS) and Dravet syndrome in patients aged 2 and older."

There is a lot of interest in potential medical uses of CBD, but as of 2019, treatment of Dravet Syndrome-type epilepsy is the only FDA-approved treatment.

Cannabidiolic Acid (CBD-A)
Claims: treatment of inflammation and cancer

Research findings:
 * Cancer: There are a few in vitro studies, so the evidence is only suggestive that more research is needed.

Cannabigerol (CBG)
Claims: stimulates the growth of new brain and bone cells, antibacterial, anti-tumor (cancer), treatment of insomnia

Research findings:
 * Brain growth: Ordinarily, one does not want to stimulate cell growth because it could increase the risk of cancer. The idea that this is a good thing seems to imply that the claimants (Steephill Labs) are referring to Huntington's disease, a progressive disease of the brain that causes degeneration of nerve cells. A CBG derivative &mdash; not CBG itself &mdash; was tested in mice with a Huntington's-like disease &mdash; not Huntington's itself, and the results showed promise. A different study of CBG itself in mice that did not have any disease also showed some neuroprotection. No studies have been conducted on humans, the evidence of CBG being effective on Huntington's is weak.
 * Bone growth: no publications on CBG and bone in PubMed between 1966 and 2016
 * Cancer: a study of CBG on a mouse model of colon cancer (in vivo) showed that CBG hampered tumor progression. No studies have been conducted on humans.
 * Insomnia: No studies in PubMed

Cannabinol (CBN)
Claims: treatment of insomnia, nausea and convulsions

Research findings:
 * Insomnia: A 2014 review of cannabinoid administration on sleep found that there were "various effects of cannabinoid administration on several aspects of sleep", and that because of methodological issues, it was not possible to make a conclusion.
 * Convulsions: Only 1 reference was found in the US National Library of Medicine PubMed database (between 1966 and 2016) on CBN and convulsions in humans: a single page in an obscure journal. A study on CBD on induced seizures in rats showed that it was an effective anticonvulsant. One would have to conclude that the evidence is weak.
 * Nausea: see above

Tetrahydrocannabinol (THC)
Claims: "THC has been shown to be effective in the treatment of a variety of ailments and disorders including pain, tumors (cancer), nausea and ADHD." Kelly Hauf claimed to have cured herself of oligodendroglioma brain cancer by treating herself with cannabis oil. She now runs a website that reports testimonials, a single case study, and in vivo studies. The website is also anti-chemotherapy.

Research findings:
 * Cancer: The best evidence of treatment of cancer with marijuana chemicals is suggestive but not convincing, because it relies on in vitro studies. A phase 1 clinical trial on a THC-CBD mixture for treatment of brain (and spinal cord) tumours is currently underway.
 * ADHD: In humans, marijuana exposure to the developing embryo and fetus "is associated "with a plethora of neurobehavioural deficiencies…" There is evidence that the deficiencies are due to THC. The deficiencies include anencephaly, ADHD, memory impairment, and learning disability.
 * Pain: see above

α-Bisabolol
Claims: anti-inflammatory, anti-irritant, antioxidant, anti-microbial, analgesic

β-Caryophyllene
Claims: treatment of sepsis and inflammation, infections (bacterial and fungal), alcoholism, and cancer

Guaiol
Claims: antimicrobial, anti-inflammatory

Humulene
Claims: treatment of cancer, infections (bacterial), inflammation, and appetite suppression

Research findings:
 * Cancer: A small, short study of injected tumor cells in mice found some inhibitory effects of α-humulene. Given the shortcomings of this study (injected tumors, small number of animals), the relevance to humans is minimal. In vitro studies on humulene have also been conducted.

d-Limonene
Claims: treatment of gastric reflux, antibacterial, antifungal, depression, anxiety, and cancer

Research findings:
 * Gastric reflux: a single, small unpublished study reported positive results in humans. This is not convincing evidence because the study was not peer-reviewed (e.g., the study methods could have been defective, or there could have been bias in the study).
 * Cancer: d-limonene was tested in a small phase I trial and a limited phase II for treatment of cancer patients; effectiveness of the treatment was not reported as only tolerance of d-limonene was tested. d-limonene inhibited a liver carcinogenesis mechanism in vitro,  but this is only suggestive of further research. Furthermore, d-limonene caused kidney tumors in male rats at high doses.
 * Depression and anxiety: see above

Linalool
Claims: treatment of insomnia, psychosis, anxiety, epilepsy, depression, and pain

Research findings:
 * Psychosis: A 2015 review found that marijuana containing high levels of THC was associated with psychosis in users. Linalool may or may not counteract the psychotic effects of THC, but it would seem to be wise to avoid marijuana (and THC) as a psychosis treatment.
 * Depression and anxiety: see above
 * Pain: see above

β-Myrcene
Claims: treatment of cancer, inflammation, pain, insomnia, infection and spasms

Research findings:
 * Cancer: β-Myrcene inhibited a liver carcinogenesis mechanism in vitro, but this is only suggestive of further research.
 * Pain: see above

trans-Nerolidol
Claims: inhibits growth of leishmaniasis, antiparasitic, antifungal, antimicrobial

Research findings:
 * Leishmaniasis: A mixture of cis- and trans-nerolidol was effective at inhibiting the growth of Leishmania spp. in vitro. The results would only warrant further research.

Ocimene
Claims: antiviral, antifungal, antiseptic, decongestant, antibacterial

α-Pinene
Claims: treatment of asthma and inflammation

Terpinolene
Claims: anticancer, antioxidant, sedative, antibacterial, antifungal

Psychoactive claims
Claim: God gave us cannabinoid receptors so we could smoke pot all day.

Reality: Cannibinoid receptors are activated by i.e., cannibinoid chemicals that are naturally produced by the human body (e.g. arachidonoylethanolamine). Activation of cannibinoid receptors causes several physiological functions including gastrointestinal activity, cardiovascular activity and bone growth.



So, why then are there cannabinoids in marijuana; did God put them there because he liked stoners? No. The most likely answer is that wild Cannabis species with higher levels of THC deter grazing by herbivores. Yes, cannabinoids are one of many  natural pesticides produced by plants, just like others—such as caffeine and capsaicin (the active ingredient in spicy foods)—that we clever apes have found useful and/or enjoyable.

Ecological claims
Marijuana has sometimes been greenwashed as being particularly ecologically sound, either explicitly or implicitly (e.g., just by associating it with the word "green"). While this may be true of ditch weed (e.g. uncultivated marijuana with low THC/CBD content) or commercial hemp, it is not very likely for what you're buying for psychoactive and/or medical purposes. Commercial marijuana is either farmed outdoors (often requiring synthetic pesticides), or indoors (requiring large amounts of electricity for lighting). In California, outdoor marijuana is often grown illegally on public land, which both deprives the public of access (since it's heavily guarded) and degrades ecosystems with clearing and pollution.

Risks
For many people, knowing the actual risks of cannabis is difficult. On the one hand, there are those who say it is extremely addictive and causes cancer and mental illness; on the other hand, there are those who say it is not addictive and can remedy cancer and mental illness. To add to the confusion, both camps can quote a large amount of scientific literature supporting their claims. There are two main reasons the scientific evidence behind the risks of cannabis can seem so contradictory: first, prohibition makes studying cannabis's effects tricky for researchers, and second, media often reports studies that have major implications, but not the many subsequent studies that undermine them. For instance, a recent study that reported cannabis use causes an irreversible and large IQ drop was heavily reported, but the many subsequent studies that failed to replicate its findings were not. This is not just a problem when it comes to cannabis, but all media reporting on science.

It is believed that cannabis is nowhere near as dangerous as heroin or cocaine, and is also much safer than legal drugs alcohol and tobacco. However, there are other illegal drugs, such as psilocybin and LSD, which are considered safer than cannabis.

Adverse effects
As previously mentioned, cannabis impairs awareness and thus it is very dangerous to drive or operate machinery while under its influence. And while subjective, the smell can be extremely off-putting.

Dependence
Cannabis dependence occurs in about half of long-term daily users. Cessation by a dependent user causes withdrawal, usually characterized by anxiety, cravings, low mood, and disturbed sleep. These symptoms usually last a couple of days to a week. . Symptoms tend to be mild, comparable to withdrawal symptoms experienced when quitting caffeine. (While this is clearly not a good thing, anyone tempted to cite it as a reason to ban cannabis should compare it to the effects of quitting or .)

Effect on the young
Cannabis use during pregnancy "is associated with decreased attention span and behavioral problems." Additionally, children exposed to cannabis in utero also are reported to have "lower scores on tests of visual problem solving, visual-motor coordination, and visual analysis" than children who were not exposed.

Although a 2012 study purported to find that cannabis use in adolescents leads to a drop in IQ, subsequent studies have found no such effect. But a UK study did find a 3% drop in school exams taken at age 16."

Relationship with mental illness
The link between cannabis use and mental illness is controversial and hotly debated. Cannabis use is associated with anxiety disorders, but not depressive disorders. Correlation does not imply causation, however, especially when cannabis is so heavily associated with relieving stress. Many sufferers of depression and anxiety who self-medicate with cannabis believe it helps them more than many other remedies.

The relationship between cannabis and psychotic illnesses is more controversial and intricate. It is thought that cannabis with a high concentration of THC (i.e. cannabis that is smoked to get high) worsens pre-existing psychotic illnesses, but cannabis with a lower concentration of THC and higher concentration of CBD (i.e. most medicinal cannabis) can help remedy psychosis. It is thought that, for people with a genetic predisposition towards psychotic illness, heavy use of cannabis with a high concentration of THC can "nudge" them into psychosis. However, something as seemingly harmless as living in a city carries the same risk of "nudging" someone into psychosis.

Lung damage
Smoking cannabis can cause bronchitis episodes. Sharing water pipes and smoking with multiple people in a confined area ("hotboxing") can contribute to the spread of respiratory disease.

If medical marijuana is taken by smoking it, this presents the usual problems from a scientific perspective, that is the harm done to the lungs pot smoke actually contains more "tar" (i.e. aromatic carcinogens like pyrenes) than cigarettes; while usually less smoke is inhaled, whatever smoke is inhaled is inhaled more deeply than cigarette smoke. Marijuana has not been proven to cause lung cancer, but bronchitis among other irritations is quite possible.This particular problem can be reduced or avoided by using a vaporizer or putting the marijuana in food or using consumables such as chocolate containing THC. Also, researchers are working on isolating specific active compounds in order to make them deliverable via pill.

Relationship with cancer
Perhaps the most hotly debated risk of cannabis use is its effect on cancer. Like many plants, cannabis contains chemicals that are tumorigenic and anti-tumorigenic in vitro (in the lab dish): this is not convincing evidence with regard to human health. For example, both aristolochia and coffee contain tumorigenic and anti-tumorigenic chemicals, yet aristolochia is a very potent human carcinogen but coffee improves human health and reduces the risk of some cancers.

Due at least in part to the illegality of cannabis, there has been a dearth of large-scale, high quality epidemiology studies on cannabis and cancer. A 2015 review of 34 epidemiologic studies found no clear evidence for head and neck cancers, an association with testicular cancer in three relatively small case-control, and insufficient evidence for other cancers. It was noted that the majority of the studies were case-control (retrospective) with inherent study weaknesses, and the authors recommended that a large-scale prospective study be conducted. A 2015 large-scale case-control study of cannabis use and bladder cancer that was not reported in the 2015 review found that cannabis was associated with a reduced incidence of bladder cancer, but no cause-and-effect relationship could be established.

Harm reduction experts have recommended eating or vaporizing cannabis as a way to avoid or minimize possible carcinogenic chemicals in the smoke.

Gateway drug hypothesis

 * Main article: Gateway drug theory

Flammability
Regardless of all else, anyone foolish enough to light up in places known to contain large amounts of flammable substances (such as gas stations or in front of racks of propane tanks) is quite literally playing with fire.

Medical marijuana
Medical marijuana is the use of marijuana for medicinal purposes, largely to relieve conditions such as glaucoma, nausea associated with chemotherapy, and appetite loss in AIDS patients. It is well established to relieve chronic pain without the intense physical dependency that comes with opiates or other CNS depressants. Marijuana has also been shown to assist in management of many gastrointestinal disorders, including Crohn's disease, irritable bowel disorder, and more.

The issue is a hotly contested one (in the United States) because many states have specifically legalized this use of marijuana, while the federal government continues to insist on classifying marijuana as a dangerous "narcotic" with no medical value, and criminally prosecuting those who grow, sell, and use the plant.

Pros
A common argument in favour of medical marijuana is a moral one: that the government should not be dictating what an informed person can and cannot put into their own body, and should not be treating those who choose to use one substance or another as criminals. However, see health freedom; depending on who is making the argument, this argument is sometimes the edge of a slippery slope.

While marijuana has any alternative medicine's fair share of anecdotal evidence for symptomatic relief (just ask any pothead about the munchies, regarding use as an appetite stimulant), its effectiveness has also been proven in numerous controlled studies. This even includes the aforementioned munchies.

While cannabis use is not without risk, it is far less dangerous as a medical painkiller than opioids.

In terms of the substances' abilities to cause dependence, the numbers seem superficially similar - about 9% of all marijuana users, medical or recreational, become addicted and about 10% of those prescribed medical opioids become addicted to them. However, the marijuana data is heavily weighted towards recreational users, who are self-selected for substance dependence by the fact that they are using the substance without a legitimate medical need, and also by the fact that in recreational use, cannabis is often mixed with highly addictive drugs like tobacco or alcohol. In comparison, about 80% of heroin addicts have previously been prescribed opioid painkillers, with most of the remaining 20% being the family members of those prescribed medical opioids, showing the potential for opioid addictions to escalate.

In terms of potential lethality to the patient, the effective dose for an opioid to kill your pain is only about a tenth of the dose that would kill your pain permanently; with marijuana, painkilling effects are experienced at less than a 10000th of the lethal overdose (though smaller overdoses can definitely make you think you are dying). Doctors in US states with medical marijuana write fewer prescriptions for opioid painkillers. In a later separate study, it was found that states with medical marijuana had a 25% lower rate of opioid overdose mortality, and that states with recently implemented medical marijuana laws had decreased opioid mortality over time.

Policing of marijuana offences results in disproportionate abuse and incarceration of Black and other minority communities - even the initial illegality of the drug was driven by racism, rather than by any objective medical harms. Unfortunately, it does not necessarily follow that allowing medical use of marijuana will do anything to stop the War on Drugs - while states where marijuana is legal have varying policies on it, marijuana arrests often still continue, and those profiting from medical marijuana are disproportionately wealthy and white. Some Black activists are sceptical of legalisation for this reason, viewing it as a means to take money out of the pockets of largely poor, Black drug dealers and into the pockets of 27-year-old Harvard grads named Colby. However, many others support it, as a means to end mass incarceration and racism, often along with other policies such as forgiveness of those imprisoned for marijuana offences and social equity programs in the medical marijuana industry. Some of the more recent states to legalize, such as New York and Connecticut, have tried to address these issues with their legalization bills by including measures that assist minority communities that were the most affected by the War on Drugs as well as expunging prior marijuana convictions.

Cons
Medical marijuana is sometimes also associated with alternative medicine and the use of herbs for medicinal purposes. In this case, there is the lack of a controlled, carefully measured dose of the plant's active compounds, which can vary widely from individual herb to herb. However, while it is possible to overdose on marijuana, there are no known cases of overdose by smoking/vaporizing/ingestion leading to permanent health effects or death, and as explained above, the problem of overdosing (as in using more than therapeutically beneficial) could possibly be alleviated by extracting or artificially producing the psychoactive compounds and submitting them for approval by the FDA.

The issue has implications for those of us who believe much (not necessarily all) of alternative medicine is quackery and woo. Believing that, for example, laetrile is ineffective bullshit does not necessarily mean believing that it should be illegal or that people should be prosecuted for using or selling it in the United States as they currently are. The same goes even more so for medical marijuana, which unlike Laetrile does have some scientific studies showing it is effective for treating some specific conditions.

Who should take cannabis?
Cannabis lacks any large-scale studies, thus why it hasn't been legalized federally in the United States. So far, all of cannabis's health benefits are detailed in small studies that suggest that it may be helpful. However, if you're willing to be a guinea pig for a drug with debated and want to get high, go for it.