Marijuana Today: A Familiar Playbook With New Risks
- Michael R. Delman, MD, FACP, FACG, DFASAM
- 5 days ago
- 2 min read
“It’s déjà vu all over again.”— Yogi Berra
It was 1954. Big tobacco companies — despite denials — were marketing to young people. The Surgeon General had not yet issued any warnings about the risks of smoking. Negative studies were actively refuted by the tobacco industry. I was 12 years old and already addicted to nicotine.
Fast forward to today.
Once again, big business is involved. According to Whitney Economics, U.S. adult cannabis sales reached $32.6 billion in 2024 and are projected to grow to $35.2 billion — a 12.1% increase. Cannabis is the most commonly used federally illegal drug in the U.S. An estimated 52.5 million Americans (19% of the population) used it at least once in 2021, a number that has likely increased with legalization in many states.
In 2022, 31% of U.S. high school 12th graders reported using cannabis in the past year, with 6.3% reporting daily use in the past 30 days. Cannabis vaping remains popular among 6% of 8th graders, 15% of 10th graders, and 21% of 12th graders.
Make no mistake — this is not the marijuana used by the "flower children" of the 1960s and '70s. Back then, the active component tetrahydrocannabinol (THC) was present at about 3%. Today, THC concentrations can exceed 95%.
Cannabis is not harmless and is addictive. Approximately 4 million Americans meet the diagnostic criteria for marijuana use disorder, including abuse, dependence, or addiction. Researchers estimate that about 3 out of 10 cannabis users have a cannabis use disorder (CUD). The risk of developing CUD is even greater for those who begin using cannabis before age 18.
CUD directly affects the parts of the brain responsible for memory, learning, attention, decision-making, coordination, emotion, and reaction time. Marijuana use also increases the risk of psychosis, including schizophrenia, in some individuals. It may elevate the risk of pregnancy complications, and breastfeeding women should not use cannabis.
The global cannabis market is expected to grow to $63.7 billion by 2025, with the cannabis cultivation market projected to reach $447.9 billion by 2029. This is big business — and like the tobacco companies of the past, today’s cannabis industry relies on attracting younger users to sustain growth.
How can you educate yourself?
Learn the facts. Share the information. Never attempt hazardous activities after using marijuana. The following resources can help:
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