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Marijuana: Effects, Medical Uses and Legalization

Botanical name: Cannabis sativa
Other common or street names: weed, pot, herb, bud, dope, spliff, reefer, grass, ganja, 420, chronic, Mary Jane, gangster, boom, skunk. There are over 200 street names for marijuana.

What is Marijuana?

Marijuana (cannabis) is a green, brown or gray mixture of dried, shredded leaves, stems, seeds and flowers of the hemp plant Cannabis sativa. Marijuana is used as a psychoactive (i.e. mind altering) recreational drug, for certain medical ailments and for religious and spiritual purposes. Sinsemilla, hash/hashish (resinous form) and hash oil (sticky black liquid) are stronger forms of marijuana.

According to the National Institute on Drug Abuse (NIDA), marijuana is the most abused drug in the US. Many states in the US have now legalized marijuana for medical and/or recreational use. However, according to federal law, the possession of marijuana (cannabis) is still illegal in the US, except within approved research settings.

How Does Marijuana Work?

The main active chemical in marijuana is THC (delta-9-tetrahydrocannabinol), the psychoactive ingredient. The highest concentrations of THC are found in the dried flowers, or buds. When marijuana smoke is inhaled, THC rapidly passes from the lungs into the bloodstream and is carried to the brain and other organs throughout the body. THC from the marijuana acts on specific receptors in the brain, called cannabinoid receptors, starting off a chain of cellular reactions that finally lead to the euphoria, or “high” that users experience. Feeling of a relaxed state, euphoria, and an enhanced sensory perception may occur. With higher THC levels in those who are not used to the effects, some people may feel anxious, paranoid, or have a panic attack.

Certain areas in the brain, such as the hippocampus, the cerebellum, the basal ganglia and the cerebral cortex, have a higher concentration of cannabinoid receptors. These areas influence memory, concentration, pleasure, coordination, sensory and time perception. 1

Marijuana’s strength is correlated to the amount of THC it contains and the effects on the user depend on the strength or potency of the THC. Different strains will contain different levels of THC. In general, the THC content in marijuana has been increasing since the 1970s, when it contained roughly 10% THC. In 2015, as reported by Live Science, researchers from the American Chemical Society found levels of THC at roughly 30%.

There are many other chemicals found in marijuana, many of which may adversely affect health. Marijuana contains over 60 different cannabinoid compounds, and overall 400 different compounds have been identified in marijuana, including THC, cannabidiol (CBD), cannabinol, and β-caryophyllene, as noted by the National Institute of Drug Abuse (NIDA).

How is Marijuana Used?

Marijuana may be smoked as a cigarette (called a joint or a nail) or in a pipe or bong. It may be smoked in “blunts”, which are cigars that have been emptied of tobacco and refilled with marijuana, often in combination with another drug, such as crack. The “blunts” retain tobacco leaf used to wrap the cigar and therefore it combines marijuana’s active ingredients with nicotine and other harmful chemicals.

Some users also mix marijuana into food or use it to brew tea. In states that have now legalized sale of marijuana for recreational use, the marketing of edible products, such as cookies, brownies, and chocolates, are popular for those who prefer not to smoke the product.

Vaporizers are also popular for those who prefer not to inhale smoke. The devices concentrate the THC from the marijuana into a storage unit and the person then inhales the vapor, not the smoke. Some vaporizers use a liquid marijuana extract that can be extremely high in THC content, and can be dangerous to novice users, resulting in emergency room admissions.

Approved and Investigational Products

In the United States, the Controlled Substances Act (CSA) of 1990 classifies marijuana as a Schedule I substance, which states it has no approved medical use and a high potential for abuse. This Federal definition is highly controversial, and can limit marijuana’s availability for clinical research studies. However, many US states have legalized the use of marijuana for medical and/or recreational use. Prescription medicines containing synthetic cannabinoids (THC) are also available. Dronabinol, a pharmaceutical form of THC, and nabilone, a synthetic cannabinoid, are approved by the FDA to treat certain conditions.

  • Marinol, generics (dronabinol capsules) – Classified as Schedule III
  • Syndros (dronabinol liquid) – Classified as Schedule II
  • Cesamet (nabilone capsules) – Classified as Schedule II

Syndros is a liquid form of dronabinol. Both dronabinol and nabilone are approved to treat patients receiving anti-cancer medicine (chemotherapy) who have nausea and vomiting, particularly patients who do not respond to other treatments.

Dronabinol (Marinol and Syndros) is also approved to treat anorexia (loss of appetite) associated with weight loss in patients with AIDS (Acquired Immune Deficiency Syndrome).

Sativex (nabiximols) is not currently approved for use in the US, but is available in dozens of countries outside the US, including Canada, the UK, Spain, Germany, Denmark, the Czech Republic, Sweden, and New Zealand.

  • Sativex, an oral sublingual spray, is approved for use in multiple sclerosis (MS) spasticity, and for chronic cancer pain in some countries.
  • Sativex is composed of standardized extracts of THC and cannabidiol and is available as an oral mucosal spray formulation.
  • Studies (Lakhan) report that THC and cannabidiol (CBD) provide therapeutic benefit for Multiple Sclerosis (MS) spasticity (muscle stiffness / spasm) symptoms.

GW Pharmaceuticals and Otsuka Pharmaceuticals announced results of three US Phase 3 trials in 2015 for the use of Sativex for the treatment of pain in patients with advanced cancer who experience inadequate analgesia during optimized chronic opioid therapy. According to the study results, Sativex did not meet the primary endpoint of demonstrating a statistically significant difference from placebo for pain control.

Epidiolex (cannabidiol), also called CBD, is a cannabinoid product approved in June 2018. It is used for the treatment of patients one year and older with seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome or tuberous sclerosis complex. Epidiolex is the first FDA-approved drug that contains CBD, a purified drug substance derived from cannabis. It comes as an oral solution.

Common side effects with Epidiolex included sleepiness, diarrhea, sedation and lethargy, possible liver damage, and decreased appetite, among others.

It was rescheduled from a Schedule I controlled substance to a Schedule V controlled substance in September 2018 by the DEA. However, in April 2020, the DEA fully removed the controlled drug status of Epidiolex in the US.

Extent of Marijuana Use

Marijuana is by far the most commonly abused or used substance in the U.S. Not surprisingly, the numbers are particularly high within younger age groups.

In the 2019 Monitoring the Future Survey from the National Institute on Drug Abuse (NIDA), 35.7% of 12th graders reported marijuana use in the past year. This compares to 28.8% of 10th graders and 11.8% of 8th graders.

  • In 2019, it was found that vaping of marijuana on the rise among teens.
  • However, the survey continues to find declines in prescription opioid misuse, tobacco cigarettes, and alcohol

Marijuana is reported as the most widely used illicit drug in the US, according to the 2018 National Survey on Drug Use and Health.

  • In the past survey year, over 43 million people age 12 and older reported using marijuana.
  • In the same survey, past year marijuana use among adolescents aged 12 to 17 years was over 3 million in 2018.
  • Overall, marijuana use was highest amongst the age group 18 to 25 years of age at 34%.

Marijuana Side Effects

Side effects of marijuana use will be variable from person to person, depending upon strength and amount of marijuana used and if the user is occasionally or chronically exposed to THC. Side effects can be magnified in older people.

The short-term effects of marijuana or cannabinoid use include:

  • increased heart rate
  • low blood pressure, orthostatic hypotension
  • muscle relaxation
  • slowed digestion
  • dizziness
  • distorted perception (sights, sounds, time, touch)
  • difficulty in thinking, memory, and problem solving
  • loss of coordination and motor skills
  • agitation, anxiety, confusion, panic, paranoia
  • increased appetite
  • dry mouth, dry eyes

Reaction time may be impaired while driving. NIDA research shows that drivers have slower reaction times, impaired judgment, and problems responding to signals and sounds if driving while under the influence of THC.

Panic attacks, paranoia and psychosis may occur acutely and be more common in psychiatric patients, a reported by Heller. For chronic users, the impact on memory and learning can last for days or weeks after its acute effects wear off, as noted by the NIDA. Marijuana, if purchased on the street, may be cut (or substituted) with substances that can lead to unknown, dangerous side effects.

THC in marijuana is strongly absorbed by fatty tissues in various organs. Generally, traces of THC can be detected by standard urine testing methods several days or more after a smoking session. In heavy chronic users, traces can sometimes be detected for weeks after they have stopped using marijuana.

Long-term abuse of marijuana may lead to dependence in some people. One study (McKenna) reported on the addicting potential of marijuana, noting that “it is an erroneous belief widely held by the general public, and among many physicians, that marijuana is not addicting.” However, not all people will become addicted to marijuana and the effects can be psychological in some patients.

Withdrawal symptoms can occur upon abrupt cessation of the drug, including:

  • anxiety
  • agitation
  • tremulousness
  • elevation of vital signs
  • insomnia
  • irritability

Marijuana also may affect mental health. Studies show that use may increase the risk of developing psychosis (a severe mental disorder in which there is a loss of contact with reality) including false ideas about what is happening (delusions) and seeing or hearing things that aren’t there (hallucinations), particularly if you carry a genetic vulnerability to the disease. Also, rates of marijuana use are often higher in people with symptoms of depression or anxiety, as reported by the NIDA. There have been no reports of THC overdose leading to death.

Marijuana Effects on the Heart

Shortly after smoking marijuana the heart rate increases drastically and may remain elevated for up to 3 hours. This effect may be enhanced if other drugs are taken with marijuana.

  • One study (Mittleman) has suggested that the risk of heart attack may increase by up to 4.8-fold in the first hour after smoking marijuana. The effect may be due to the increased heart rate and altered heart rhythms.
  • The risk of heart attack may be greater in those with specific risk factors such as patients with high blood pressure, heart arrhythmia, or other cardiac disease.

Harvard Health also reports that the risk of a heart attack is several times higher in the hour after smoking marijuana, and this should be a red flag for anyone with a history of heart disease. The risk of stroke may be increased, as well.

Marijuana Effects on the Lungs

Studies have shown that marijuana smoke contains cancer-causing hydrocarbons and is an irritant to the lungs. Marijuana users tend to inhale more deeply and hold their breath longer than tobacco smokers do, which further increases lung exposure to carcinogenic smoke.

  • After smoking marijuana, the bronchial passage relaxes and becomes enlarged. Marijuana smoke contains many of the same cancer-causing chemicals found in cigarette smoke, often in greater quantities (Mehmedic).
  • Both types of smoke contain cancer-causing nitrosamines, polycyclic aromatic hydrocarbons, vinyl chlorides, and phenol (Martinasek).

People who smoke marijuana often have the same respiratory problems as cigarette smokers. These individuals may have daily cough and phlegm, symptoms of chronic bronchitis, shortness of breath, chest tightness, wheezing and more frequent chest colds. They are also at greater risk of getting lung infections like pneumonia, as reported by the NIDA.

A systematic review (Martinasek) of the respiratory effects of marijuana indicates that there is a risk of lung cancer from inhalational marijuana as well as an association between inhalational marijuana and spontaneous pneumothorax, emphysema, or COPD. In the review, eight of the 12 studies indicated an increased risk of lung cancer from cannabis use or cases indicating lung cancer occurrence.

Drug Interactions With Marijuana

  • Combining marijuana with other CNS depressant drugs that also cause drowsiness or sedation (such as alcohol, barbiturates, sedating antihistamines, anti-anxiety medications, opiate pain killers, etc) can magnify the drowsiness.
  • A study (Hartman) shows that low doses of alcohol can significantly elevate the concentrations of THC in the blood.
  • Marijuana use can raise the heart rate (tachycardia) and may be dangerous if used with other drugs that may also increase the heart rate. People with cardiovascular disease should avoid marijuana use.
  • The cannabinoids in marijuana (THC, cannabidiol) can affect liver enzymes and may alter the blood levels and effects of medications.
  • Drug interactions are often unpredictable or undocumented with marijuana and extreme caution should be exercised.
  • DO NOT drive if you are under the influence of marijuana, alcohol or any sedating drug. This is illegal in all U.S. states, even where recreational marijuana use is legal.

Effects During Pregnancy and Breastfeeding

Marijuana is also the most common illicit drug used during pregnancy, in roughly 2% to 5% of women.

According to a report published by the American College of Obstetricians and Gynecologists (ACOG) entitled Marijuana Use During Pregnancy and Lactation, 34% to 60% of marijuana users continue use during pregnancy, with many women believing that use is relatively safe. These numbers could rise as more states continue to legalize marijuana for medicinal or recreational purposes. Due to possible side effects of marijuana on the fetus, ACOG recommends that marijuana should be avoided during pregnancy.

  • Any drug of abuse can affect a mother’s health.
  • It can be difficult to determine the effects of marijuana on a baby’s health because women who use marijuana often use other substances, such as alcohol, nicotine, or drugs of abuse.
  • THC appears to cross the placenta (Davies).

Human fetuses exhibit the cannabinoid receptor type 1 in the nervous system as early as 14 weeks of gestation, and animal studies suggest cannabinoid exposure may lead to abnormal brain development. As reported by de Moraes Barro and colleagues, babies born to adolescents who used marijuana during pregnancy have shown adverse neurological behavior effects of the newborns in the first 24 to 78 hours after delivery.

Most reports do not show an association between marijuana use and preterm birth. However, as noted by ACOG, studies have suggested the use of marijuana with tobacco may increase the risk for preterm delivery. In addition, research demonstrates that babies born to mothers who used marijuana during pregnancy at least once per week (or more) were smaller than those born to mothers who used the drug less frequently.

Studies on school performance have shown differing results: in middle class children age 5 to 12 years, no specific cognitive effects were seen; however, in lower socioeconomic, primarily urban groups, poorer reading and spelling scores and lower teacher-perceived school performance was observed, per ACOG.

THC is excreted in breast milk (Davies). ACOG recommends that marijuana use be discontinued during breastfeeding. The scientific data are not strong enough to determine the risk to the nursing infant.

Addictive Potential of Marijuana

A drug is addicting if it causes compulsive, uncontrollable drug craving, seeking, and use, even in the face of negative health and social consequences.

Research suggests that roughly 9% of users become addicted to marijuana, with higher rates if the user starts at a young age (17%) and in those who use marijuana daily (25-50%). While not everyone who uses marijuana becomes addicted, when a user begins to seek out and take the drug compulsively, that person is said to be dependent or addicted to the drug. Some heavy users develop a tolerance to marijuana, meaning that the user needs larger amounts to get the same desired results that he or she used to get from smaller amounts, as noted by the NIDA.

Long-term users who try to quit could experience withdrawal symptoms such as sleeplessness, irritability, anxiety, decreased appetite and drug craving. Withdrawal symptoms usually begin about a day after the person stops using marijuana, peaks in 2 to 3 days and may take about 1 to 2 weeks to subside. McKenna reports that marijuana addiction is difficult to treat in the clinic. Patients can have a lengthy withdrawal and symptoms that can continue for months after stopping marijuana use.

Which states allow Medical Marijuana?

As of November 3, 2020, 35 U.S. states, the District of Columbia, Puerto Rico and Guam now legally allow marijuana for personal medical use. Rules surrounding the use of medical marijuana vary by state.

The first state in the union to legalize the medical use of marijuana was California in 1996 with Proposition 215. States that allow medical marijuana include: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Washington, and West Virginia, plus the District of Columbia, Puerto Rico and Guam.

Marijuana has been used as a therapeutic and medicinal agent for centuries, dating back to the 27th century BC. Today, it is still used for medicinal purposes, although restrictive laws surrounding its use now exist. Medical marijuana is available in many different forms from dispensaries: as an oil, pill, vaporized liquid, nasal spray, and as the dried plant product.

Legal Status of Medical Marijuana

Medical marijuana in the U.S. is controlled at the state level. It is important to recognize that state medical and recreational marijuana laws do not change the fact that using marijuana continues to be an offense under U.S. federal law. Per federal law, cannabis, is a schedule I drug.

Use of medical marijuana outside of the state laws for illegal use or trafficking would not be tolerated by state or federal government.

In general, in order to qualify for legal medical marijuana, patients must: have a diagnosed condition that is on their state’s list of qualifying medical marijuana conditions and receive a medical recommendation from their doctor. The patient can then obtain a medical marijuana card, or qualification, to purchase medical marijuana and associated products from dispensaries.

Although the conditions vary from state-to-state, top medical conditions for which patients might use medical marijuana include:

Recreational Use of Marijuana

As of Nov. 3, 2020, the states or districts where recreational use of marijuana is legal are:

  • Alaska
  • Arizona
  • California
  • Colorado
  • Illinois
  • Maine
  • Massachusetts
  • Michigan
  • Montana
  • Nevada
  • New Jersey
  • Oregon
  • South Dakota
  • Vermont (allows marijuana possession, growing and consumption; retail sales approved but not yet active pending subsequent legislation)
  • Washington State
  • Washington, D.C. (allowing marijuana possession, growing and consumption; the sale of marijuana for recreational purposes remains illegal; there are seven medical dispensaries)

It is important to note that the federal government still considers marijuana a dangerous drug and that the illegal distribution and sale of marijuana is a federal crime. Under the Controlled Substances Act (CSA), marijuana is still considered a Schedule 1 drug.

Cities, municipalities, employers, landlords, and universities may have special policies about the use of marijuana. Use within any federal land, national park or monument is still illegal. Be sure to check all rules before use, especially in areas that may be under federal law.

Recreational and medical marijuana are lucrative.

  • According to Statista, medical marijuana retail sales reached $5.2 billion in 2019, with sales projected to reach $8.4 billion in 2023.
  • In 2019, retail sales of recreational marijuana exceeded $8 billion, and are expected to exceed $34 billion by 2023.

Marijuana Dangers: Driving, Use in Children

Smoking marijuana can make driving dangerous; do not mix the two. The cerebellum is the section of the brain that controls balance and coordination. When THC affects the cerebellum’s function, drivers may have slower reaction times, impaired judgment, and problems responding to signals and sounds if driving while under the influence (DUI) of THC.

In all states, including states that allow recreational marijuana, driving under the influence of marijuana is illegal.

  • However, because THC metabolites can remain in the blood for up to one month (or possibly longer), the DUI charge is usually based subjective measures.
  • The evaluation will take into account driving patterns, one’s physical symptoms and appearance, a field sobriety test, and possibly a blood test for THC.
  • States differ on the penalties, although an arrest and court date will most likely be involved if the officer deems the person impaired.
  • First offenses rarely involve long jail time, but may involve probation, community service, a suspended license, fines and fees, and DUI school.

The American Academy of Pediatrics (AAP) released a report urging doctors to protect children from the harms of marijuana as the U.S. becomes increasingly tolerant to the drug. The brain is not fully developed until around 25 years of age. Experts note that marijuana use in the young can lead to abnormal brain development.

Frequent use of high-potency THC over extended periods of time suggests that there can be negative effects on learning, memory, attention and problem-solving ability, as reported in Pediatrics. The AAP suggests that doctors urge parents not to use marijuana around children. Other concerns with children include the potential of exposing them to secondhand smoke and accidental poisoning with edibles such as brownies or candy.

Related:

See Also

  • Bath Salts
  • Cannabis
  • Cocaine
  • Devil’s Breath
  • Ecstasy
  • Fentanyl (Abuse)
  • GHB
  • Gray Death
  • Hashish (Hash)
  • Heroin
  • Ketamine
  • Kratom
  • Krokodil
  • LSD
  • MDMA (Ecstasy, Molly)
  • Mescaline (Peyote)
  • Opium
  • PCP (Phencyclidine)
  • Psilocybin (Magic Mushrooms)
  • Quaaludes
  • Rohypnol
  • Speed (methamphetamine)
  • Synthetic Cannabinoids (Synthetic Marijuana, Spice, K2)
  • TCP (Tenocyclidine)
  • U-47700 (Pink)

Sources

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  • Illinois just legalized marijuana. Vox. June 25, 2019. Accessed Aug. 27, 2020.
  • FDA Approves Epidiolex (cannabidiol) to Treat Lennox-Gastaut Syndrome and Dravet Syndrome. June 25, 2018. Drugs.com. Accessed Aug. 27, 2020 at https://www.drugs.com/newdrugs/fda-approves-epidiolex-cannabidiol-lennox-gastaut-syndrome-dravet-syndrome-4769.html
  • Justice Department Issues Memo on Marijuana Enforcement. The US Department of Justice. Jan 4, 2018. Accessed Aug. 27, 2020 at https://www.justice.gov/opa/pr/justice-department-issues-memo-marijuana-enforcement
  • National Institute on Drug Abuse (NIDA). NIH. NIDA Info Facts. Accessed Aug. 27, 2020. https://www.drugabuse.gov/publications/drugfacts/marijuana
  • National Institute on Drug Abuse (NIDA) for Teens. NIH. Marijuana. Accessed Aug. 27, 2020. https://teens.drugabuse.gov/drug-facts/marijuana
  • Lakhan SE, Rowland M. Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review. BMC Neurology 2009:9;59. Accessed Aug. 27, 2020.
  • American Academy of Ophthalmology Reiterates Position that Marijuana is Not Proven Treatment for Glaucoma. June 27, 2014. Accessed Aug. 27, 2020 at https://www.aao.org/newsroom/news-releases/detail/american-academy-of-ophthalmology-reiterates-posit
  • UNODC. World Drug Report 2010. United Nations Publication, 2.4 Cannabis. p. 194. Accessed Aug. 27, 2020 at http://www.unodc.org/documents/wdr/WDR_2010/2.4_Cannabis.pdf
  • U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Office of Applied Studies. Results from the 2016 National Survey on Drug Use and Health: Key Substance Use and Mental Health Indicators in the United States.
  • Monitoring the Future 2016 Survey Results. National Institute of Drug Abuse (NIDA). Accessed Aug. 27, 2020. http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2012.pdf
  • de Moraes Barros MC, Guinsburg R, de Araújo Peres C, et al. Exposure to marijuana during pregnancy alters neurobehavior in the early neonatal period. J Pediatr. 2006;149:781-7.
  • Jacob L Heller, MD, MHA. Marijuana Intoxication. Medline Plus. NLM/NIH. 1/5/2011. Accessed November 9, 2016 at https://medlineplus.gov/ency/article/000952.htm
  • Mittleman MA, Lewis RA, Maclure M, et al. Triggering myocardial infarction by marijuana. Circulation 2001;103(23):2805-9.
  • Hashibe M, Morgenstern H, Cui Y, et al. Marijuana use and the risk of lung and upper aerodigestive tract cancers: Results of a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2006;15(10):1829-34.
  • American Medical Association. Report 3 of the Council on Science and Public Health (I-09) Use of Cannabis for Medicinal Purposes (Resolutions 910, I-08; 921, I-08; and 229, A-09). 2009.
  • Parents Move to Colorado for Miracle Pot for Children. USA Today. February 18, 2014. Accessed Aug. 27, 2020. usatoday.com/story/news/nation/2014/02/17/moving-medical-marijuana-epilepsy-children/5255323/
  • ProCon.org. Medical Marijuana. Accessed November 9, 2016. medicalmarijuana.procon.org
  • The Brookings Institute. Brookings. Q&A: Legal Marijuana in Colorado and Washington. May 21, 2013. Accessed Aug. 27, 2020. https://www.brookings.edu/research/qa-legal-marijuana-in-colorado-and-washington/
  • Forbes. It’s No Toke: Colorado Pulls in Millions in Marijuana Tax Revenue. March 11, 2014. Accessed Aug. 27, 2020. https://www.forbes.com/sites/kellyphillipserb/2014/03/11/its-no-toke-colorado-pulls-in-millions-in-marijuana-tax-revenue
  • The Washington Post. Gov Beat. Minnesota’s Legislature Approves Medical Marijuana. Could New York Be Next? May 19, 2014. Accessed Aug. 27, 2020. https://www.washingtonpost.com/blogs/govbeat/wp/2014/05/19/minnesotas-legislature-approves-medical-marijuana-could-new-york-be-next/
  • McKenna G. The Current Status of Medical Marijuana in the United States. Hawaii J Med Public Health. 2014 Apr; 73(4): 105–108.
  • American College of Obstetrics and Gynecology (ACOG). Marijuana Use During Pregnancy and Lactation. No. 722. October 2017.
  • Davies J, Bledsoe J. Prenatal Alcohol and Drug Exposures
    in Adoption. Pediatr Clin N Am 52 (2005) 1369 – 1393.
  • Marijuana and heart health: What you need to know. Harvard Health Publishing. August 2017. https://www.health.harvard.edu/heart-health/marijuana-and-heart-health-what-you-need-to-know
  • Quinnipiac University National Poll. Release Details. August 3, 2017. Accessed Nov. 25, 2017.
  • Blaszczak-Boxe A. Potent Pot: Marijuana Is Stronger Now Than It Was 20 Years Ago. Live Science.
  • Turbert D, et al. Does Marijuana Help Treat Glaucoma? The American Academy of Ophthalmology (AOO). June 27, 2014. https://www.aao.org/eye-health/tips-prevention/medical-marijuana-glaucoma-treament
  • Cannabis and Cannabinoids (PDQ)–Patient Version published by the National Cancer Institute. April 13, 2017. Accessed Nov. 27, 2017 at https://www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq
  • Hartman RL, Brown TL, Milavetz G, et al. Controlled cannabis vaporizer administration: blood and plasma cannabinoids with and without alcohol. Clin Chem. 2015:61:85-69. Accessed Nov. 27, 2017.
  • Hill KP. Medical marijuana for the treatment of chronic pain and other medical and psychiatric problems: a clinical review. JAMA. 2015. 313:2474-83. Accessed Nov. 27, 2017 at https://jamanetwork.com/abusenotice
  • Yadav V, Bever C, Bowen J, et al. Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2014:82:1083-92.
  • CNN Money. 10 things to know about legal pot. May 26, 2017. Accessed Nov. 28, 2017 at https://money.cnn.com/2017/04/19/news/legal-marijuana-420/index.html
  • Mehmedic Z, Chandra S, Slade D, et al. Potency trends of Δ9-THC and other cannabinoids in confiscated cannabis preparations from 1993 to 2008. J Forensic Sci. 2010 Sep;55(5):1209-17. Accessed Nov. 28, 2017.
  • Martinasek MP, McGrogan JB, Maysonet A. A Systematic Review of the Respiratory Effects of Inhalational Marijuana. Respir Care. 2016 Nov;61(11):1543-1551. Accessed Nov. 28, 2017 at http://rc.rcjournal.com/content/61/11/1543.full

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Marijuana and Cannabis information from Drugs.com, Including marijuana uses, side effects, and legal status.

Don’t Drive High

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Drug-impaired driving is dangerous

There’s a lot going on around you when you drive. You need to be totally focussed so that if a split-second – and potentially life-saving – decision needs to be made, you’re ready for it.

Drugs affect your ability to react and increase the chance of a crash. Don’t get behind the wheel or get in a car with an impaired driver — it’s just not worth the risk.

In an instant.

Video length: 30 seconds.

(Music)

(A woman livestreams herself smiling and waving on her cell phone)

(TEXT ON PHONE: Your’re live We’re inviting your followers to your live video now!)

(TEXT ON PHONE: Olivier joined your live video.)

(A phone records three young adults standing together smoking marijuana. The video is captioned with smoke, tree and eye rolling emojis.)

(The phone records one of the men getting into the driver’s seat, visibly impaired.)

(Sound of car starting)

(The phone films two passengers in the back seat, laughing and dancing.)

(TEXT ON SCREEN: Almost there! Chloe’s party)

(The woman in the passenger seat takes selfies using different filters on her face.)

(The phone records the man in the driver’s seat. He appears to be tired. The video is captioned with smoke and face palm emojis.)

(The passenger looks at the driver, concerned, then continues taking selfies.)

(Horn honks)

(Headlights shine into the car. The woman in the passenger seat looks surprised)

(The passenger’s eye is shown close up. Her pupil contracts.)

(Crashing sound)

(The window explodes beside the two backseat passengers and driver. The car spins out of control.)

Your life can change in an instant.

Don’t drive high.

(A phone with a selfie of the passenger onscreen is on the pavement, covered in glass.)

A message from the government of Canada.

(Canada wordmark)

(TEXT ON SCREEN: #dontdrivehigh)

Eye-opener

Video length: 30 seconds.

(Music)

(Close-up of hands flicking on a lighter and lighting a joint.)

(Sound of coughing)

(Hands fumble to get keys into a car’s ignition.)

(Sound of car starting)

(A woman takes a selfie of her and her boyfriend, who is driving the car.)

(The man’s eyes blink tiredly in the rear-view mirror.)

(A flash of light, then the car crashes and the window shatters.)

(Ringing sound)

(Heartbeat sound)

(A bright light shines into the car. It is a police officer holding a flashlight, looking into the vehicle.)

(The woman in the passenger seat is slouched over.)

(Video flickers and blurs.)

(Quick shots of the man being put into the back of an ambulance.)

(The man is wheeled into a hospital. His mother runs to the gurney, crying.)

(The man is in a hospital room. He sees the police officer in the doorway and a doctor reviewing a medical chart beside his bed. He turns his head and looks over to his girlfriend.)

(A nurse and paramedic are attempting to resuscitate the woman.)

(Sound of girlfriend flatlining)

Your life can change in an instant.

(TEXT ON SCREEN: #DontDriveHigh)

Don’t drive high.

(Close-up of the woman. Her face is bruised. The paramedic is performing CPR.)

A message from the government of Canada.

(Canada wordmark)

It is illegal to drive impaired

Drug-impaired driving can put you, your passengers and anyone sharing the road with you in danger — and for that reason, it’s a serious criminal offense that can result in heavy fines and jail time. Don’t risk a criminal record. Understand the legal consequences of driving high and do your part to plan ahead so you can get home safely.

Driving impaired is illegal. Learn about the types, risks, laws and enforcement.

Driving high has serious consequences

1. “Canada has 1,200+ Drug Recognition Experts trained to spot impaired drivers”

2. “Law enforcement is trained to spot impaired drivers – SFST (Standard Field Sobriety Testing) – 14,400+ trained SFST officers”

3. “Driving high has consequences. Having prohibited levels of impairing drugs in your blood within two hours of driving is a criminal offence”

4. “The law isn’t hazy – 2-5 ng THC per ml of blood – up to $1000 fine”

5. “Drug-impaired driving laws apply to cars, trucks, boats, aircrafts and every other motor vehicle”

6. “The law isn’t hazy – 5 ng or more THC per ml of blood – up to 10 years imprisonment”

6 reasons not to drive high

  1. You could hurt or kill someone you care about
  2. You could get in a crash, hurt yourself or die
  3. You could hurt or kill an innocent stranger
  4. You could get arrested and face trial
  5. You could get your license suspended
  6. You could get a criminal record

Impaired driving is 100% preventable!

Drug-impaired driving is not a game

It’s a dangerous decision that can have serious consequences. Drugs impair your ability to drive by making it harder to focus on the road and make quick, potentially life-saving decisions. Do your part to get home safe — watch these videos to see why you should never drive after consuming drugs.

Perceptions

Video length: 49 seconds.

(Music)

(We open on a Mario Cart style title screen.)

(TEXT ON SCREEN: Your life can change in an instant)

(TEXT ON SCREEN: Start)

(Start is clicked and we transition to a character selection screen. The 3rd character is visibly high and stands swaying.)

(TEXT ON SCREEN: Player 1 Player 2 Player 3 Player 4)

(The third character is selected.)

(TEXT ON SCREEN: Marijuana makes your reaction time slower)

(We transition to the races starting positions and a clock counts down from 3.)

(Crowd cheering)

(TEXT ON SCREEN: 3 2 1 Go!)

(Engines sound)

(Player 1, 2 and 4 pull ahead of Player 3)

(Player 3 swerves on the road, hits a banana, and crashes into a wall.)

(Crash sound)

(TEXT ON SCREEN: 1 in 2 cannabis users don’t think that it affects their driving much. 1 in 5 don’t think it has any negative effect at all.)

(TEXT ON SCREEN: Driving high is not a game.)

(TEXT ON SCREEN: Canada.ca/dont-drive-high)

(Canada wordmark)

Symptoms

Video length: 47 seconds.

(We open on a Borderlands style RPG game title screen.)

(TEXT ON SCREEN: Your life can change in an instant)

(TEXT ON SCREEN: Press start)

(Start is clicked and we transition to a game menu with player inventory and statistics. )

(Music)

(TEXT ON SCREEN: Inventory
Keys – You’re not going anywhere without these.
Health Kit – Restores 100 health.
Joint – Don’t drive high.
Chips – No real health benefits here.
Lighter – Hey man, can I borrow a light real quick?
Cash – $32.65, exactly.)

(The joint is selected and the characters stats drop.)

(TEXT ON SCREEN: Drugs impair your:
• Balance and coordination
• Motor skills
• Judgement
• Reaction time
• Attention
• Decision-making skills)

(TEXT ON SCREEN: )

(Start is clicked and we transition to gameplay where a vehicle is driving.)

(The vehicle crashes)

(Crash sound)

(TEXT ON SCREEN: Cannabis increases your risk of a crash.)

(TEXT ON SCREEN: Driving high is not a game.)

(TEXT ON SCREEN: Canada.ca/dont-drive-high)

(Canada wordmark)

Consequences

Video length: 42 seconds.

(We open on a SIMS style game title screen.)

(Music)

(TEXT ON SCREEN: Your life can change in an instant)

(TEXT ON SCREEN: Start)

(Start is clicked and we transition to a scene of a crash.)

(TEXT ON SCREEN: Coordination Memory Driving ability)

(The character has low stats and is crying.)

(Police Sirens)

(TEXT ON SCREEN: Police reported 3,098 drug-impaired driving violations in 2016.)

(A policeman arrives.)

(TEXT ON SCREEN: $1000 + 1-year driving prohibition
Minimum penalty for a first impaired driving offense.)

(The character is handcuffed and taken to a police holding cell.)

(TEXT ON SCREEN: Driving high is not a game.)

(TEXT ON SCREEN: Canada.ca/dont-drive-high)

(Canada wordmark)

Alternatives

Video length: 49 seconds.

(We open a Virtual Reality style title screen)

(TEXT ON SCREEN: Your life can change in an instant)

(TEXT ON SCREEN: Start)

(Music)

(Start is clicked and we transition to a gameplay. We see floating hands.)

(We move around a room, look out of a window and see a driver smoking cannabis.)

(TEXT ON SCREEN: 2 in 5. Approximate number of people who were passengers in a vehicle driven by someone who had recently used cannabis.)

(The hands interact with virtual buttons.)

(TEXT ON SCREEN: Alternative: designated driver.)

(TEXT ON SCREEN: Alternative: public transit.)

(TEXT ON SCREEN: Alternative: call someone.)

(TEXT ON SCREEN: Alternative: cab or rideshare.)

(TEXT ON SCREEN: Alternative: stay over.)

(The scene distorts.)

(Loud electronic noise.)

(TEXT ON SCREEN: Driving high is not a game.)

(TEXT ON SCREEN: Canada.ca/dont-drive-high)

(Canada wordmark)

Fast facts

If you drive high, you could hurt or kill any passenger in your vehicle — including yourself. You could also hurt or kill an innocent stranger, and even face a criminal record. Driving while impaired is entirely preventable. Learn the facts to understand how your actions could be a danger to others, and the legal consequences you could face.

Drugs impair your ability to drive by affecting:

  • balance and coordination
  • motor skills
  • attention
  • judgment
  • reaction time
  • decision-making skills

Every 3 hours

How often a drug-impaired driving incident is recorded in Canada Footnote 1

It’s illegal

You could face consequences like a fine, criminal charges, even jail time Footnote 4

Over 1 in 4

Number of cannabis users who reported having driven under the influence Footnote 2

Increases Likelihood

Marijuana increases your chances of being in a crash Footnote 3

What you can do

Plan to get home safely

You have options:

Have a designated driver

Call a friend or loved one

Call a cab or ride-share

Take public transit

Get help with drug abuse

Are you or someone you care about struggling with problematic substance use?

Here are some resources to help you find the assistance you need in your area.

Parents: What can you do?

Parents play a vital role in teaching their kids to drive responsibly.

Here are some tips on talking to your child about drug-impaired driving.

In their own words:
Stories from Canadians impacted by drug-impaired driving

Gregg Thomson woke up on a Sunday morning to find out that his 18 year old son Stanley had not come home after a night out with friends. The panic set in immediately and Thomson had a gut feeling that something was wrong, so he decided to call the Ontario Provincial Police (OPP). “When I walked up to the OPP officers and they told me, I fell over… I just fell. The way it hits you, it’s… when you lose a child, it brings a whole different set of emotions that before you’ve had this type of experience, you don’t even understand.” The night before, Stanley decided to get into a car with an individual who was under the influence of marijuana. Not only did Stanley lose his life that night, but the lives of those closest to him were changed forever. Feeling tremendous guilt and devastation, Thomson asked his daughter: “Where did your mum and I fail? Like why did Stanley get in the car that night?” His daughter explained that her parents had not failed, since they had “taught [them] well about alcohol and driving.” The trouble was that these conversations did not include the dangers of driving under the influence of marijuana.

Gregg Thomson
Ottawa, ON

“Drinking and driving is something that we as a society have been talking about for a long time. People know it’s dangerous and illegal. But drugged driving isn’t on everyone’s radar yet. There are a lot of people who don’t think driving while under the influence of a drug is as serious as driving while drunk. People don’t realize the seriousness of it or the devastating consequences. But drugged driving is impaired driving. My family knows just how deadly drugged driving can be. We deal with the impact of it every single day.”

Nancy Stewart
Oakville, ON

Don’t Drive High Campaign