Recreational cannabinoid use: The hazards behind the “high”

Potential adverse consequences of cannabis use

Although the potential adverse consequences are vast, the literature on this subject is limited for various reasons:

• Many studies are observational with a small sample size.
• Most studies examine smoked cannabis—not other routes of delivery.
• When smoked, the dose, frequency, duration, and smoking technique are variable.
• The quantity of Δ-9-tetrahydrocannabinol (THC), the primary psychoactive component in cannabis, is variable. (For more on the chemical properties of the marijuana plant, see “Cannabinoids: A diverse group of chemicals.”⁷)
• Most studies do not examine medical users, who are expected to use less cannabis or lower doses of THC.
• There are confounding effects of other drugs, notably tobacco, which is used by up to 90% of cannabis users.⁸

Lower quality of life. In general, regular non-medical cannabis use is associated with a lower quality of life and poorer socioeconomic outcomes (TABLE 1).^9-12 Physical and mental health is ranked lower by heavy users as compared to extremely low users.⁹ Some who attempt butane extraction of THC from the plant have experienced explosions and severe burns.¹³

Studies regarding cannabis use and weight are conflicting. Appetite and weight may increase initially, and young adults who increase their use of the drug are more likely to find themselves on an increasing obesity trajectory.¹⁴ However, in an observational study of nearly 11,000 participants ages 20 to 59 years, cannabis users had a lower body mass index, better lipid parameters, and were less likely to have diabetes than non-using counterparts.¹⁵