The Risks and Benefits of Cannabis Use: A Balanced Perspective

Legal marijuana use was first introduced to the US when California legalized it for medical use in 1996. Since then, many other states have followed suit and as of 2025, medical marijuana is legal in 38 states and recreational marijuana use is legal in 24. With changing laws and growing public acceptance over the last few decades, cannabis use has become more common across the country. Medical research has largely focused on cannabidiol, CBD, which has anti-inflammatory, pain-relieving, anti-nausea, and other properties that can be beneficial for treating chronic pain, epilepsy, managing nausea and vomiting for cancer patients, and some neurodegenerative diseases such as Parkinson’s disease. Additionally, THC (tetrahydrocannabinol), the psychoactive component of cannabis, produces a euphoric effect, and has been explored for use in end-of-life care. While research has shown benefits with marijuana use, it is not without risks.

Benefits of Cannabis Use:

1. An Alternative for NSAIDS in treating chronic pain: 

Chronic pain is the most common condition for which patients seek medical marijuana. It is also the most studied use, with research showing that cannabis can provide significant relief compared to a placebo. Cannabis may serve as an alternative to NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen, which can cause stomach and kidney problems, and to prescription opioids, which carry a high risk of addiction.

2. Treating Epilepsy:There is strong evidence that cannabis can help treat certain types of epilepsy that don’t respond to standard medications. This is especially true for children with severe forms of epilepsy. When conventional treatments fail to control seizures, cannabis is increasingly being explored as an option—and often, it’s the parents who advocate for trying it after watching their children continue to suffer ⁴. For many families, cannabis has offered hope where other methods have not.

3. Cannabis and Cancer: 

One of the most well-known medical uses of cannabis is helping cancer patients who experience nausea and vomiting from chemotherapy. Studies have shown that when cannabinoids (the active compounds in cannabis) are used alongside standard anti-nausea medications like ondansetron, patients often report a reduction in their symptoms ³. Many patients in these studies also said they preferred using cannabis to manage their symptoms—even when it didn’t work significantly better than the standard medications ³. This may be due to a sense of personal control, or fewer side effects for some individuals.

Risks of Marijuana use:

1. Cannabis and Brain HealthOne of the risks of chronic marijuana use is on brain health, particularly in those who start use before 18. Marijuana use has immediate effects on attention, memory, cognitive function, decision making and coordination ⁵. Chronic use for those whose onset of use was in adolescents has shown to lead to a permanent decline in IQ, memory, and other cognitive functions ⁶.

2. Cardiovascular Risks: Recent studies have shown a link between chronic cannabis use and a higher risk of cardiovascular problems, including heart attacks, strokes, and arrhythmias-irregular heart rhythms. This may be due to the way THC—the main chemical in cannabis that causes the “high”—interacts with cannabinoid receptors in our heart and blood vessels that help regulate the heart and circulatory system ¹. While researchers are still studying exactly how cannabis affects heart health, the evidence suggests a cause for concern.

3. Cannabis Hyperemesis SyndromeAmong long-term users of recreational marijuana, there have been increased cases of those who suffer from Cannabis Hyperemesis Syndrome (CHS), as a symptom from chronic use of the drug ⁷. CHS is a form of cyclical vomiting syndrome, where one experiences episodes of nausea, vomiting, and abdominal pain, caused by chronic marijuana use. It may take anywhere from 4 months to several years of avoiding marijuana to get relief from CHS ⁷. 

In summary, research has shown that cannabis can offer several therapeutic benefits, especially for those who experience adverse side effects or don’t respond to conventional treatments. In these cases, medical cannabis may be a helpful alternative. However, it’s important to weigh these benefits against the potential risks—especially with chronic cannabis use. Chronic use has been linked to concerns with impacts on heart health, mental health, and memory. As with any substance, understanding both the risks and benefits is key to making informed choices.

References:

1. Chandy M, Jimenez-Tellez N, Wu JC. The relationship between cannabis and cardiovascular disease: clearing the haze. Nat Rev Cardiol. 2025;22:467–81. https://doi.org/10.1038/s41569-025-01121-6

2. Wei TT, et al. Cannabinoid modulation of immune cell reprogramming. Cell. 2022;185(10):1676–93.e23. https://doi.org/10.1016/j.cell.2022.04.005

3. National Academies of Sciences, Engineering, and Medicine. Therapeutic effects of cannabis and cannabinoids. Washington (DC): National Academies Press; 2017. Available from: https://www.ncbi.nlm.nih.gov/books/NBK425767/

4. Rak G. Canadian Pediatric Society issues guidance on cannabis. Medscape. 2024 Apr 23.

5. Centers for Disease Control and Prevention. Cannabis and brain health. 2024 Feb 15 [cited 2025 Jul 11]. Available from: https://www.cdc.gov/cannabis/risk-factors/brain-health.html

6. Meier MH, Caspi A, Ambler A, et al. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci U S A. 2012;109(40):E2657–64. doi:10.1073/pnas.1206820109

7. Perisetti A, Gajendran M, Dasari CS, Bansal P, Aziz M, Inamdar S, Goyal H. Cannabis hyperemesis syndrome: an update on the pathophysiology and management. Ann Gastroenterol. 2020;33(6):571. doi:10.20524/aog.2020.0528

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