The popularity of marijuana has increased substantially over the past few decades. In 1992, fewer than 1 million people used it daily or almost daily, a record low in data from the National Survey on Drug Use and Health, which began in the 1970s. At the same time, about ten times as many people reported daily alcohol use.
In the 1990s, marijuana was illegal at the federal level and in every state. However, it has changed dramatically in three decades: today, marijuana is legal for recreational use by adults in nearly half of U.S. states, putting it on par with alcohol in its status as Americans' favorite intoxicant.
According to a study by Jonathan Caulkins, a professor at Carnegie Mellon University, in 2022, the number of Americans who use marijuana daily or almost daily will surpass those who do the same with alcohol for the first time. The number of daily marijuana users has increased from less than 1 million in 1992 to 17.7 million in 2022, a 15-fold increase.
In the 1990s, marijuana was illegal at the federal level and in every state. However, it has changed dramatically in three decades: today, marijuana is legal for recreational use by adults in nearly half of U.S. states, putting it on par with alcohol in its status as Americans' favorite intoxicant.
According to a study by Jonathan Caulkins, a professor at Carnegie Mellon University, in 2022, the number of Americans who use marijuana daily or almost daily will surpass those who do the same with alcohol for the first time. The number of daily marijuana users has increased from less than 1 million in 1992 to 17.7 million in 2022, a 15-fold increase.
Marijuana is at the center of a changing perception of alcohol in society. With growing awareness of the negative effects of even moderate alcohol consumption, many are turning to THC-based products as a more natural alternative. The THC industry is actively promoting its products, emphasizing their potential health benefits, including reduced nausea, pain, and insomnia.
Note that the increase in daily smokers — whether vape or edible enthusiasts — is linked to the booming marijuana industry. More and more Americans are living in neighborhoods with access to stores offering a variety of products, from cartridges and edibles to oils and waxes with high THC concentrations. This has become available to those who previously avoided use for fear of smoking or breaking the law.
The rapid changes in the policy of marijuana legalization and its widespread availability have been a real challenge for researchers who have not had time to adapt to the rapidly changing situation. This means that millions of daily users are in practice becoming participants in an experiment that investigates the health effects of marijuana.
Note that the increase in daily smokers — whether vape or edible enthusiasts — is linked to the booming marijuana industry. More and more Americans are living in neighborhoods with access to stores offering a variety of products, from cartridges and edibles to oils and waxes with high THC concentrations. This has become available to those who previously avoided use for fear of smoking or breaking the law.
The rapid changes in the policy of marijuana legalization and its widespread availability have been a real challenge for researchers who have not had time to adapt to the rapidly changing situation. This means that millions of daily users are in practice becoming participants in an experiment that investigates the health effects of marijuana.
However, marijuana is not without risks. Some side effects are becoming apparent to users and health professionals alike. Dr. Nora Volkow, director of the National Institute on Drug Abuse, stresses that despite hopes for positive effects, there are no free solutions in biology.
For example, cannabinoid hyperemesis syndrome, which is manifested by intense bouts of nausea and vomiting due to long-term marijuana use, is becoming more common. Doctors are increasingly encountering patients with these symptoms and attribute it to the use of high-THC marijuana. Evidence has also been documented that regular use is associated with an increased risk of stroke and cardiovascular disease.
The most troubling studies are those involving adolescents and young adults. While marijuana may be less dangerous for middle-aged people, the effects on youth require further study. Studies show that regular marijuana use at a young age may increase the risk of schizophrenia and psychotic disorders, as well as lead to depression and brain changes. In addition, marijuana can be addictive and increase the risk of addiction to other substances. According to a recent Columbia University study for the New York Times, about 18 million Americans may suffer from a cannabis use disorder or addiction.
For example, cannabinoid hyperemesis syndrome, which is manifested by intense bouts of nausea and vomiting due to long-term marijuana use, is becoming more common. Doctors are increasingly encountering patients with these symptoms and attribute it to the use of high-THC marijuana. Evidence has also been documented that regular use is associated with an increased risk of stroke and cardiovascular disease.
The most troubling studies are those involving adolescents and young adults. While marijuana may be less dangerous for middle-aged people, the effects on youth require further study. Studies show that regular marijuana use at a young age may increase the risk of schizophrenia and psychotic disorders, as well as lead to depression and brain changes. In addition, marijuana can be addictive and increase the risk of addiction to other substances. According to a recent Columbia University study for the New York Times, about 18 million Americans may suffer from a cannabis use disorder or addiction.
Determining potential health harms is more difficult given the growing number of daily users. Even if statistics show that there are more of them, many questions remain regarding how often they use, how they use, whether they smoke or eat, and how high the THC concentration is.
According to Caulkins, there are different types of daily users. Some use marijuana like someone taking melatonin before bed to ease pain or improve sleep, while others may smoke it multiple times a day. At the same time, the study shows that daily users make up a small portion of all users, yet are responsible for three-quarters of all marijuana purchases. Exactly how many of the 17.7 million daily users use marijuana in large quantities also remains unclear, as the research does not record how often or how much use occurs.
Researchers also face challenges in understanding exactly what users are consuming, as commercially available products often differ in concentration from those encountered by previous generations. According to government data, the THC content of marijuana seized by the Drug Enforcement Administration has more than tripled over the past 25 years, from 5% to 16%. What's more, many dispensary products can contain even higher amounts of THC, up to 90% or even 100%.
According to Caulkins, there are different types of daily users. Some use marijuana like someone taking melatonin before bed to ease pain or improve sleep, while others may smoke it multiple times a day. At the same time, the study shows that daily users make up a small portion of all users, yet are responsible for three-quarters of all marijuana purchases. Exactly how many of the 17.7 million daily users use marijuana in large quantities also remains unclear, as the research does not record how often or how much use occurs.
Researchers also face challenges in understanding exactly what users are consuming, as commercially available products often differ in concentration from those encountered by previous generations. According to government data, the THC content of marijuana seized by the Drug Enforcement Administration has more than tripled over the past 25 years, from 5% to 16%. What's more, many dispensary products can contain even higher amounts of THC, up to 90% or even 100%.
Ziva Cooper, a researcher at the University of California, Los Angeles, notes that she often has to educate patients about what exactly they're consuming. «As researchers, we're trying to catch up with what's going on in the cannabis world. And we're woefully behind» — she states. Although cannabis has been used by humans for at least 10,000 years (it had widespread medical use in the United States in the late 19th century), its demonization began in the 1970s under the Nixon presidency, leading to its criminalization.
Secret records indicate that Nixon was aware that marijuana «posed no particular threat». However, his «war on drugs», which was supported by the subsequent administrations of Ronald Reagan, George Bush Sr. and Bill Clinton, caused both users and suppliers to discourage the use of cannabis for fear of arrest. Public perception of the drug remained less threatening, with marijuana smoking often portrayed in comedies. However, the reality of criminalization was significantly different: hundreds of thousands of people were arrested and sent to prison each year for selling and distributing marijuana, and this harm did not proportionately affect black communities.
Secret records indicate that Nixon was aware that marijuana «posed no particular threat». However, his «war on drugs», which was supported by the subsequent administrations of Ronald Reagan, George Bush Sr. and Bill Clinton, caused both users and suppliers to discourage the use of cannabis for fear of arrest. Public perception of the drug remained less threatening, with marijuana smoking often portrayed in comedies. However, the reality of criminalization was significantly different: hundreds of thousands of people were arrested and sent to prison each year for selling and distributing marijuana, and this harm did not proportionately affect black communities.
Over time, there was growing awareness of the negative effects of criminalizing marijuana, as well as a growing movement to recognize its medical benefits. This was especially true for parents undergoing chemotherapy and cancer, for whom marijuana use became a way to combat nausea. Activists aimed at reducing mass arrests and addressing racial disparities in the court system urged states to decriminalize marijuana and review sentences for those already serving time. With the approval of marijuana's medical use came a wave of demands to legalize it for adults.
Today, marijuana is legal for medical use in 38 states and for adult recreational use in about half of the states, including the District of Columbia. However, it remains illegal at the federal level and is classified as a Schedule I drug, which precludes its recognition for medical use. This situation makes it difficult to obtain the necessary permits and government funds for scientific research. Scientists emphasize that such restrictions hinder research into both the potential risks and benefits of long-term marijuana use. This year, the Biden administration proposed moving marijuana to Schedule III, which could lead to its reevaluation.
In 2022, President Joe Biden signed legislation aimed at expanding medical marijuana and cannabidiol research to help overcome some of the federal barriers. The new law requires the DEA to increase the number of registered researchers and manufacturers capable of supplying cannabis and its derivatives. It also calls for a needs assessment for researchers and allows doctors to discuss the possible benefits and risks of marijuana use with patients.
Today, marijuana is legal for medical use in 38 states and for adult recreational use in about half of the states, including the District of Columbia. However, it remains illegal at the federal level and is classified as a Schedule I drug, which precludes its recognition for medical use. This situation makes it difficult to obtain the necessary permits and government funds for scientific research. Scientists emphasize that such restrictions hinder research into both the potential risks and benefits of long-term marijuana use. This year, the Biden administration proposed moving marijuana to Schedule III, which could lead to its reevaluation.
In 2022, President Joe Biden signed legislation aimed at expanding medical marijuana and cannabidiol research to help overcome some of the federal barriers. The new law requires the DEA to increase the number of registered researchers and manufacturers capable of supplying cannabis and its derivatives. It also calls for a needs assessment for researchers and allows doctors to discuss the possible benefits and risks of marijuana use with patients.
The federal government's approach results in each state developing its own regulations, without a uniform set of national safety standards. The partial legalization and lack of federal regulation creates confusion around marijuana use and its long-term effects. In addition, the market is changing rapidly. For example, the 2018 Farm Bill legalized hemp, which has unexpectedly contributed to the rise in popularity of delta-8 THC. This delta-9 THC analog is less potent in its natural form, but manufacturers have been able to extract and synthesize it, creating more potent concentrates. This has resulted in products that the FDA warns may pose health risks.
Nevertheless, the government must take additional steps. In September, the National Academies of Sciences, Engineering, and Medicine released a report suggesting steps that can be implemented at the state and federal levels to create better public policy on marijuana and minimize potential public health harms over the next five years.
The document includes specific recommendations, such as eliminating loopholes in the 2018 Farm Bill and clarifying that all forms of THC should be regulated under the Controlled Substances Act. More broadly, the report calls on states that have legalized marijuana, public health professionals, and state agencies like the CDC to come together to establish unified guidelines on marijuana and create a set of rules for its production and sale. The authors emphasize that marijuana should be regulated in the same way as alcohol and tobacco.
It is also recommended that the federal government support additional research on marijuana use and initiate a public awareness campaign about the risks to various populations, including teens and the elderly.
Nevertheless, the government must take additional steps. In September, the National Academies of Sciences, Engineering, and Medicine released a report suggesting steps that can be implemented at the state and federal levels to create better public policy on marijuana and minimize potential public health harms over the next five years.
The document includes specific recommendations, such as eliminating loopholes in the 2018 Farm Bill and clarifying that all forms of THC should be regulated under the Controlled Substances Act. More broadly, the report calls on states that have legalized marijuana, public health professionals, and state agencies like the CDC to come together to establish unified guidelines on marijuana and create a set of rules for its production and sale. The authors emphasize that marijuana should be regulated in the same way as alcohol and tobacco.
It is also recommended that the federal government support additional research on marijuana use and initiate a public awareness campaign about the risks to various populations, including teens and the elderly.
This task is complex, but it does not cover all the questions that have arisen for researchers. For example, Caulkins raises other important aspects.
Cannabis poisoning impairs short-term memory. When marijuana was considered a social drug, this didn't bother many people. But now about half of cannabis is consumed by people who use it regularly, and perhaps spending 50% of their time under the effects, whether they are at work or studying. How does that affect their performance and their learning capacity? We are underinvested in understanding the effects of the billions of hours spent under the influence of cannabis.
This is a difficult question to answer. But it is critical, especially for the millions of people involved in this real-time marijuana experiment. «It may not be a problem. But perhaps it affects people's abilities to achieve life goals in various subtle ways» — Caulkins notes.
In July, New York City Mayor Eric Adams announced significant progress against illegal marijuana stores. After the legalization of marijuana in 2021, unlicensed outlets began proliferating. Despite the closure of more than 700 such stores and the seizure of vast quantities of product as part of Operation Protective Castle, thousands of stores continue to operate.
Cannabis poisoning impairs short-term memory. When marijuana was considered a social drug, this didn't bother many people. But now about half of cannabis is consumed by people who use it regularly, and perhaps spending 50% of their time under the effects, whether they are at work or studying. How does that affect their performance and their learning capacity? We are underinvested in understanding the effects of the billions of hours spent under the influence of cannabis.
This is a difficult question to answer. But it is critical, especially for the millions of people involved in this real-time marijuana experiment. «It may not be a problem. But perhaps it affects people's abilities to achieve life goals in various subtle ways» — Caulkins notes.
In July, New York City Mayor Eric Adams announced significant progress against illegal marijuana stores. After the legalization of marijuana in 2021, unlicensed outlets began proliferating. Despite the closure of more than 700 such stores and the seizure of vast quantities of product as part of Operation Protective Castle, thousands of stores continue to operate.
This situation reflects the general problem of cannabis legalization in the US, where the black market is only growing. For example, California has seen an increase in illegal operations since legalization in 2016, and Washington, D.C. has over 100 illegal stores ten times the number of licensed stores.
The growth of the black market has caught states off guard in many ways. States that were hoping to get tax dollars from legalizing marijuana are instead seeing their legal markets weaken. Take Colorado, once a national model for how a state can legalize pot and also reap huge profits from it. It received roughly $1 billion in tax revenue in the first five years after legalizing retail in 2014, money it promised to put toward education. Now those revenues are shrinking, down 11% in the last year alone, according to a state forecast.
Truth be told, most shoppers don't care if the store selling their THC-infused sharp cheese snacks has a license, but they're well aware of when they'll have to pay an extra $20 in tax. Public acceptance and interest in the plant is growing, so of course illegal situations will continue to flourish — especially if the regulated market is inherently over-regulated and there's a price difference. However, because the laws of supply and demand apply to marijuana, the price of even licensed quality drugs has also plummeted in every state, partly at the expense of black market products.
The growth of the black market has caught states off guard in many ways. States that were hoping to get tax dollars from legalizing marijuana are instead seeing their legal markets weaken. Take Colorado, once a national model for how a state can legalize pot and also reap huge profits from it. It received roughly $1 billion in tax revenue in the first five years after legalizing retail in 2014, money it promised to put toward education. Now those revenues are shrinking, down 11% in the last year alone, according to a state forecast.
Truth be told, most shoppers don't care if the store selling their THC-infused sharp cheese snacks has a license, but they're well aware of when they'll have to pay an extra $20 in tax. Public acceptance and interest in the plant is growing, so of course illegal situations will continue to flourish — especially if the regulated market is inherently over-regulated and there's a price difference. However, because the laws of supply and demand apply to marijuana, the price of even licensed quality drugs has also plummeted in every state, partly at the expense of black market products.
This has infuriated licensed stores and growers and robbed them of potential revenue, so that in California, for example, the number of legal marijuana growers and brands has dropped by 70% — and many shuttered companies owe the state millions in taxes, according to the SFGate report. And if the black market has crushed the dreams of many pot entrepreneurs, it has also caused another surprising turn of events.
The rise in illegal vendors is likely due to an inefficient licensing system. In New York, for example, licenses are issued very late, which directs shoppers to illegal sources. Experts say that the only solution may be full federal legalization and simplification of the licensing procedure.
While the authorities are trying to regulate the market with raids, the consequences of a growing black market may have a negative impact on legalization. Illegal products, as the recent spike in illnesses has shown, can be dangerous and contain substances that are not allowed in legal stores. The black market has remained resilient even in the face of legalization, making it difficult for legitimate trade. Now that the legal market has been in existence for less than 15 years, it faces a shattered reputation for the illegal trade, which has been active for almost a century.
The rise in illegal vendors is likely due to an inefficient licensing system. In New York, for example, licenses are issued very late, which directs shoppers to illegal sources. Experts say that the only solution may be full federal legalization and simplification of the licensing procedure.
While the authorities are trying to regulate the market with raids, the consequences of a growing black market may have a negative impact on legalization. Illegal products, as the recent spike in illnesses has shown, can be dangerous and contain substances that are not allowed in legal stores. The black market has remained resilient even in the face of legalization, making it difficult for legitimate trade. Now that the legal market has been in existence for less than 15 years, it faces a shattered reputation for the illegal trade, which has been active for almost a century.
