More states have legalized marijuana, thereby creating a potentially confusing situation. Local, state and federal laws may differ for medical, recreational and commercial use. Something that is accepted in one location may be criminal behavior in another. A person may be confronted by unexpected problems, especially when traveling.

There is evidence that marijuana and its active ingredient tetrahydrocannabinol (THC) can have beneficial effects for patients with a variety of medical disorders such as glaucoma, cancer and anorexia. Occasional recreational use is associated with relatively benign behavior. Marijuana may be safer than alcohol over time. And if you don’t inhale then you can even become president.

Unfortunately, marijuana can also have negative effects, which may not always be recognized by its users. If it is legal, then it must be safe, right?

Marijuana health risks do exist and can be identified for patients using medical algorithms.

  • Clinical Findings in Marijuana IntoxicationClinical Findings in Marijuana Intoxication


In states where marijuana is still illegal the distribution and sales may be controlled by gangs or drug cartels, causing a significant amount of violent crime in urban areas. In places where marijuana is legal, dispensaries and growing sites may be targets for robbery.

One thing that marijuana shares with alcohol is the ability to impair driving. Throw in a cell phone, sleep deprivation or some other drugs and you can have a dangerous mix for both the driver and others on the road.

Workplace Drug Testing

Navigating the tangled web of workplace drug testing can be a challenge. If marijuana is legal in a locale, then finding it in your urine should be OK. Right? Just because a drug is legal or that you have a prescription does not mean that you will automatically get a pass. If an employer can refuse to employ nicotine users then why not marijuana users?

Various federal agencies such as the Department of Transportation (DOT) regulate workers engaged in safety sensitive positions such as truck driver, pilot, and train engineer. Testing is federally mandated and if the Federal Register says that marijuana is banned for your job then you may be in trouble. Arguing that you have a prescription for marijuana may indicate that you are not fit to perform the job and need to be reassigned.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has worked to create drug-free workplaces. Drug-free workplace status can be intertwined with OSHA, workman’s compensation and health insurance. If you agree to participate in a drug-free workplace, then you may have to comply in order to be eligible for other benefits.

Finally, there is the question of a positive test during a post-accident evaluation. Is the marijuana in your system from last week? Or was it the cause of the accident?

  • False Positive Immunoassay for Tetrahydrocannabinol (THC) in a Patient Being Treated with Pantoprazole or Other Proton Pump InhibitorFalse Positive Immunoassay for Tetrahydrocannabinol (THC) in a Patient Being Treated with Pantoprazole or Other Proton Pump Inhibitor

Marijuana Health Risks

Chronic heavy use of marijuana can bring on negative health issues including lung disease, oral problems, and spread of communicable diseases including STDs. Synthetic marijuana-like compounds can have serious side effects. They can be used to adulterate a low-grade product to increase profit, unknown to the user.

  • Pulmonary Complications of Smoking MarijuanaPulmonary Complications of Smoking Marijuana
  • Risk Factors for Transmission of Tuberculosis in People Who Use Marijuana (Hotboxing, Shotgunning)Risk Factors for Transmission of Tuberculosis in People Who Use Marijuana (Hotboxing, Shotgunning)

One of the unexpected disorders associated with marijuana is hyperemesis, which may be complicated by dehydration and acute renal failure.

  • Cannabis Hyperemesis Syndrome (CHS)Cannabis Hyperemesis Syndrome (CHS)

Some people who use marijuana have psychiatric problems. Since people with psychiatric problems may try to self-medicate, it is sometimes difficult to know which came first. However, high potency marijuana and heavy use can cause problems. If nothing else chronic, heavy use can impact social functioning and coping skills over time. Some heavy users develop dependency and are at risk for withdrawal on discontinuation.

  • Clinical Features for Marijuana WithdrawalClinical Features for Marijuana Withdrawal

Take-Home Message

Marijuana may be here to stay, but so are the problems related to its use. As these problems emerge algorithms can help navigate the legal and social issues that arise.