As of 2019, 33 states have legalized different types of marijuana (Governing, 2019). Eleven of those states, and the District of Columbia, now allow marijuana to be used recreationally (Governing,2019), and the remaining 22 states allow for medicinal marijuana use; each state has differing laws related to the use of legalized marijuana. For instance, Vermont legalized recreational marijuana, and even allows adults aged 21 and over to grow the plant for personal use only(Governing, 2019). A few of the states permit medicinal use only, in order to provide for cannabis-infused products like oil or pills, but does not allow the product to be smoked (Governing, 2019).
Medicinal marijuana has been legal longer than recreational marijuana. Recreational use was first allowed in 2012 after laws were passed in Colorado and Washington (ABC News, 2012). Research has been emerging that notes the increase of marijuana-related emergency department and urgent care visits since the legalization of recreational marijuana. Mechcatie (2018) published an article in The American Journal of Nursing, where she evaluated a study completed in Colorado. The result of the study showed a significant increase at a hospital in Colorado after the laws were passed. There were nearly five times as many marijuana-related visits when comparing the year 2005 with 2015 (Mechcatie, 2018). Also worth noting, is that the number of behavioral health consultation and psychiatric diagnoses tripled between 2005 and 2015 (Mechcatie, 2018).
Another consistent change in the data related to emergency department visits, is the large increase of children, adolescents, and geriatric populations being seen for accidental ingestion of edible marijuana products. Wolf (2019) argues that the workload in emergency departments has increased in states with legalized recreational use. In addition to the accidental ingestion, there has been a marked increase in psychiatric problems and cyclic vomiting syndrome (Wolf, 2019). Wolf (2019) concludes that more needs to be done to standardize the dosing and labeling of marijuana products, and states that there are benefits to legal cannabis consumption in non-harmful amounts.
Some people rely on the benefits of proper use of marijuana products. Kohn (2018) published an article in The Journal of Nursing about the positive aspects of marijuana. The article focuses on a little boy named Jackson. At the age of eight he began having seizures several times a day, which resulted in over 50 hospitalizations and caused him to miss much of his fourth and fifth grades. After visiting more than 20 doctors all over the country, Jackson had no diagnosis and no successful treatment plan. In 2014, Jackson started using medicinal marijuana. He went from having over 200 seizures a month, to a single seizure every one to two weeks. He was able to discontinue much of his seizure medication.
Jackson ingested his medicinal marijuana in the form of droplets, which allows for a more precise dosing and does not create damage in the lungs such as you would see after smoking. His droplets are made up of mainly cannabidiol (CBD); marijuana consists of two main molecules: Tetrahydrocannabinol (THC) and CBD. While THC is mind-altering, CBD is not. Researchers have found that CBD can treat epilepsy, anxiety, PTSD, insomnia, autoimmune disorders, depression, schizophrenia, heart disease, cancer, and more (Kohn, 2018). CBD has been found to block cancer cells from metastasizing, decrease hallucinations in certain psychiatric disorders, increase serotonin, and can be used as a powerful anti-inflammatory (Kohn, 2018).
CBD products for medicinal use can range from $100 to $1000, and they are not covered by insurance. Researchers are also having a problem developing CBD medications because marijuana is a Schedule 1 drug. This requires government approval. Although being petitioned to separate CBD from THC in drug classification, the Drug Enforcement Administration continues to keep marijuana a Schedule 1 drug without differentiation. A British pharmaceutical company has had much success with their pure CBD drug Epidiolex, and it is sold and used in 29 other countries, while still not allowed in the United States.
There are pros and cons regarding the research being done on recreational and medicinal marijuana use, since states control their own laws and do not allow for the necessary standardization of dosing and packaging. For this reason, it seems as if there is a danger related to accidental ingestion and improper dosing. When these CBD and THC products are sold, consumers need to regulate their own dosages. With further research and pharmaceutical product development, there is potential for medications to be produced and used for many serious medical issues.
ABC News. (2012). Colorado, Washington Become First States to Legalize Recreational Marijuana. Retrieved from https://abcnews.go.com/Politics/OTUS/colorado-washington-states-legalize-recreational-marijuana/story?id=17652774
Governing. (2019). “State Marijuana Laws in 2019 Map.” Governing, 2019, https://www.governing.com/gov-data/safety-justice/state-marijuana-laws-map-medical-recreational.html.
Kohn. (2018). “A powerful new form of medical marijuana without the high.” The Journal of Nursing, 2018, https://www.asrn.org/journal-nursing/1641-a-powerful-new-form-of-medical-marijuana-without-the-high.html.
Mechcatie. (2018). “The Impact of Legalization of Medical and Recreational Marijuana.” American Journal of Nursing, vol. 118, no. 7, 2018, p. 16., doi:10.1097/01.naj.0000541420.13348.d8.
Wolf, et al. (2019). “The Perceived Impact of Legalized Cannabis on Nursing Workload in Adult and Pediatric Emergency Department Visits: A Qualitative Exploratory Study.” Public Health Nursing, 2019, doi:10.1111/phn.12653.