Questions about marijuana usage and legalization have become hot-button political topics, with enthusiastic advocates and opponents. However, with the Virginia state government considering relaxing marijuana laws to allow for greater distribution and purchase opportunities, doctors and patients need to have a clear understanding of the arguments on both sides of the debate and whether science supports them.
Important Facts
In late 2025, President Trump signed an executive order reclassifying marijuana from a Schedule I to a Schedule III drug, substances with potential medical uses and lower risk for abuse.
However, he data around marijuana’s medical benefits and downsides is mixed, due to the lack of time for thorough study and to people’s varied reactions to cannabis, making it difficult to determine the precise cause of their reactions.
Part of the research issue is that products of varying THC concentrations are all labeled as cannabis, thus sometimes not considering the varying concentrations of different cannabis products. Common perceptions of cannabis stems from the products of the 1960s and 70s, where the concentration of THC, the chemical responsible for marijuana’s signature high, was around 1%. Today, vapes and joints have a 30% THC concentration, while dispensaries sell edibles and other products that can have up to 95% concentration, with similar fluctuations appearing in medical marijuana products.
Unfortunately, distinctions between cannabidiol (CBD) and THC are often overlooked. While both are cannabis compounds, THC is associated with recreational use, whereas CBD is available over the counter in Virginia for those seeking non-intoxicating effects. CBD, most often used medicinally, typically induces calm without the psychoactive high of THC-dominant products.
The most recent data indicate that marijuana usage is highest among men ages 18-34, although women are rapidly catching up. General trends suggest that post-legalization usage among this demographic increases, accompanied by slight increases among older and college-educated segments of the population.
The current Virginia bill making its way through the state government would significantly loosen restrictions around recreational marijuana use and transactions. Proponents argue this would ease the process for people who use marijuana medicinally, as well as provide a way to regulate the marijuana being sold and provide competition to the illicit market. However, critics of marijuana legalization have voiced doubts as to whether the possible benefits outweigh the risks.
Marijuana as Medicine?
While most marijuana use is recreational, the biggest supporters of legalization have argued for its medicinal benefits. Some data indicates that cannabis-based medicines are effective at reducing seizures in some forms of epilepsy in children and adults. Others also showed promise for patients dealing with pain from multiple sclerosis and easing the side effects of chemotherapy. Cannabidiol has also shown some potential for easing the effects of depression and substance abuse disorders, but the lack of data blocks widespread use and prescription.
However, the most common arguments for medical marijuana use, such as palliative care, cancer pain, and PTSD, have insufficient data for it to be recommended as a viable care route. Additionally, while some patients who use cannabis to treat sleep disorders have found relief, the overall data is mixed. Some studies indicate cannabis use could disrupt the REM cycle, lowering the overall quality of sleep.
Meanwhile, critics of legalization point to a growing body of data about the damaging effects of cannabis on physical and mental health.
For example, daily or near-daily cannabis use can result in the development of cannabinoid hyperemesis syndrome (CHS), leading to severe nausea and vomiting. CHS actually makes up the majority of cannabis-related ER visits and sometimes leading to complications due to dehydration, kidney injury, and electrolyte imbalance.
Additionally, frequent cannabis use can have devastating mental health impacts, increasing the risk of the development of a psychiatric disorder that develops into a chronic disorder like unipolar depression, bipolar disorder, or even schizophrenia. This risk is especially high with adolescents and young adults, with the demographic with the highest use of marijuana also showing the greatest susceptibility to cannabis-induced adverse psychological reactions. As a meta-analysis noted, “use of cannabis when no psychotic disorder has already occurred increases the risk of its onset, and using cannabis after its onset, worsens clinical outcomes.”
Recent data also indicates that regular consumption of high-concentration THC products can lead to cannabis use disorder, increasing the risk of coronary heart disease, heart attacks, and strokes.
Additionally, other states have reported increases in vehicle fatalities and ER visits for cannabis-related issues, such as acute intoxication and unintentional pediatric exposures.
Critics of marijuana legalization have voiced concerns about whether the possible benefits outweigh the potential physical and psychological detriments, calling it a “huge public health gamble.”
Final Thoughts
Marijuana legalization remains deeply debated, but the key issue is whether current scientific evidence supports or refutes its medical and societal impacts. Until more data is available, doctors and patients must carefully consider the uncertain benefits and risks at the center of the legalization discussion.