The issue of recreational marijuana is a broader social policy consideration that includes the implications of legalization for international drug cartels, national criminal justice policies, and federal and state tax revenues in addition to public health. However, physicians responsible for public health are experts with a personal interest in the subject. Recent legislation reflecting changes in public attitudes toward marijuana has allowed recreational marijuana use in Colorado and Washington. Unfortunately, the negative health consequences of the drug are not significant in the debate over the legalization of recreational marijuana. In many cases, these negative effects are more pronounced in adolescents. A compelling argument, based on these negative health effects in adolescents and adults, can be advanced to break the direction society is taking in terms of legalizing recreational marijuana. There is evidence that the compounds naturally found in marijuana have therapeutic benefits for symptoms of diseases such as HIV/AIDS, multiple sclerosis, and cancer. If these compounds are to be used under the auspices of “medical marijuana,” they would have to go through the same rigorous approval process as other drugs prescribed by doctors, including randomized, placebo, and active controlled trials to evaluate safety and efficacy, not through referendum or state legislation. However, decriminalization and legalization lead to different outcomes – good criminal justice policies may not be synonymous with good health policies. Observers in our state wonder if legalization could come to North Carolina. That seems unlikely given conservative tendencies in the General Assembly, and a voting initiative is equally unlikely, as lawmakers would have to agree to put it on the ballot in North Carolina. The percentage of 12- to 17-year-olds who use marijuana is higher than the national average in all states where marijuana is legal. For example, 16.21% of Colorado teens and 18.86% of Alaskan teens reported using marijuana in the past year, compared to an average of 12.29% for the U.S.
as a whole in 2015/2016.  Marijuana use by Colorado teens increased by an average of 20% over two years after adult-use marijuana was legalized.  Early studies have suggested cognitive declines associated with marijuana (particularly early and heavy use); these declines persisted long after the acute cannabis intoxication phase.44–46 Recently, Meier and colleagues analyzed data from a prospective study that followed subjects from birth to age 38; Their findings provided supporting evidence that cannabis use, when it began during adolescence, was associated with cognitive impairment in several areas, including executive function, processing speed, memory, perceptual reasoning, and verbal comprehension.47 Rogeberg48 criticized the study`s methodology, saying the results were confused by differences in socioeconomic status; However, this assertion was based on partial analyses using very small numbers. Other sub-analyses49 of the original study cohort showed that marijuana was equally common in populations with higher socioeconomic status, suggesting that socioeconomic status was not a confounding variable. Every epidemiological study is subject to confusing bias and future research will be needed to clarify and quantify the link between cognitive decline and marijuana use in adolescents. However, the results of the original study by Meier et al. show that there is indeed an independent association between intelligence loss and marijuana use in adolescents. Incidentally, this finding is consistent with previous studies.44 There is clear public support for the failed change in our anti-marijuana policy.  More than half of U.S. states legalized marijuana for medical purposes, and 40 states took steps between 2009 and 2013 to relax their drug laws (e.g., decriminalize or reduce penalties for possession).  Marijuana has consistently been shown to be a risk factor for schizophrenia and other psychotic disorders.30–32 The association between marijuana and schizophrenia meets many, but not all, standard criteria for epidemiological determination of causality, including experimental evidence,33,34 temporal relationship,35–38, biological gradient,30,31,39 and biological plausibility.40 Genetic variation may explain why marijuana use Other criteria are not strongly met.
such as strength of association and specificity.41,42 When these genetic variants are researched and characterized, marijuana use can be shown to cause or trigger schizophrenia in a genetically vulnerable population. The risk of psychotic disorder is more pronounced when marijuana is used at an earlier age.32, 43 Medical marijuana remains controversial, but it is gaining traction as a legitimate recommendation for various symptoms. Although many states have legalized cannabis for medical and recreational purposes, more research is needed. The National Sheriffs` Associations, the National Association of District Attorneys, the National Coalition of Drug Enforcement Associations (NNOAC) found that states that legalized marijuana were unable to control the drug black market. Oregon State Police reported that 70% of marijuana transactions remain illegal despite legalization laws. Marijuana is sold on the street in legalized states and exported in bulk to other non-legalized jurisdictions. There are even reports of foreign drug cartels, including Mexican cartels, moving their operations to Colorado to take advantage of lax marijuana laws. According to the California Police Chiefs` Association, in addition to violations of federal law, there is abundant documentation on the many harmful effects of marijuana legalization.6 Recreational marijuana will have many negative health effects. The drug is addictive, with growing evidence of a withdrawal syndrome. In addition, it has been shown to have negative effects on mental health, intelligence (including irreversible decreases in cognition) and the respiratory system.
Acutely drunk driving with marijuana significantly increases the risk of a fatal car collision. Recreational legalization may have theoretical (but as yet unproven) positive social implications on issues such as national criminal justice policies, but these effects will not be without significant public health and societal costs. Currently, there is a lack of resources to educate doctors about this most commonly used illegal substance. The potential benefits and significant risks associated with marijuana use should be taught in medical schools and residency programs across the country. Legalization also serves racial justice, as drug-related arrests disproportionately affect minorities. Colorado and Washington were the first two states to legalize recreational marijuana in 2012. Since then, the District of Columbia and 11 other states have also fully legalized marijuana, including for recreational use. New Jersey, Arizona, Montana and South Dakota just voted on voting initiatives to legalize recreational marijuana. South Dakota also voted for a medical cannabis program, as did Mississippi. Law enforcement in states that have legalized marijuana know better than anyone what awaits them every day. Several national law enforcement groups oppose the legalization of marijuana and have written to Congress about it.
5 The National Fraternal Order of Police stated that a joint study by the University of Colorado, Johns Hopkins University, and Harvard Medical School on the effects of legalization in Colorado found that: Researchers at the University of Washington School of Medicine found that “rates of marijuana use by youth are declining as more U.S. states legalize or decriminalize use. of marijuana. and the number of adults who use the drug. increased.  Marijuana use among Grade 8 students in Washington state increased from 9.8% to 7.3% in 2014-2016 after legalization in 2012, according to a December 2018 RAND report.  A Centers for Disease Control (CDC) study found that marijuana use among U.S. children ages 12 to 17 decreased 17 percent last year, from 15.8 percent in 2002 to 13.1 percent in 2014.