Not the best report card, it has to be said. Although I’d suggest a lot of the findings suggests that a mass market free market economy based on the processed food model of cannabis may well play a part in the issues they highlight.
Purpose
Since the Oregon Health Authority Public Health Division (PHD) last published public health statements on cannabis in 2017, the science on cannabis and health has advanced considerably. Over the same period, regulatory changes have expanded the availability of cannabis in the United States and abroad. The need for updated public health statements was noted by the Oregon Cannabis Commission, an advisory body established by the state Legislature. PHD conducted a review of scientific literature and key reports to produce public health statements about the potential health effects of cannabis use.
Evidence was assessed about both harms and benefits of cannabis use. These statements are intended for everyone, including members of the public, clinicians, public health agencies, cannabis producers and retailers, legislators, policymakers, and the media.
The statements are for educational purposes and are not a substitute for medical care or consultation with a health care professional.
Important context
The following information is intended to help readers understand the current state of research about cannabis-related harms and benefits, and factors to consider when reviewing available research.
Terminology
Cannabis is the preferred term for products derived from cannabis plants. Cannabis contains tetrahydrocannabinol (THC), cannabidiol (CBD), and numerous other cannabinoids. The terms marijuana and hemp are also used and are more specific: marijuana refers to products that contain ≥0.3% total THC concentration and hemp refers to products that contain <0.3% total THC concentration by dry weight.
This distinction is important because there are major differences in effects; THC and related cannabinoids cause intoxication, whereas CBD and related cannabinoids do not. Intoxication refers to impairment of cognition, perception, or control.
When it comes to safely operating a motor vehicle, THC-containing cannabis is the main concern.
Most of the cannabis used in the US today contains THC. Cannabis products that do not contain THC (i.e., hemp) have been less studied. CBD is the most commonly used and studied cannabinoid besides THC. Many of the health effects associated with cannabis are primarily due to THC and related psychoactive cannabinoids; Health Effects of Cannabis 5 of 20 products that contain CBD or related non-intoxicating cannabinoids appear to lack many of the same effects, including harms, but have not been comprehensively studied, with the exception of FDA-approved drugs such as Epidiolex® (pharmaceutical CBD).
Non-intoxicating cannabinoid products are not necessarily safe to use; CBD, for example, can have adverse effects and interactions with pharmaceuticals. Synthetic cannabinoids not found in the cannabis plant are also available and are less studied than the major natural cannabinoids.
Cannabis products and potency
The range of cannabis and cannabis-derived products today is larger than ever. It includes FDA-approved prescription medicines such as Epidiolex® and Marinol® (dronabinol), regulated adult-use and medical marijuana, regulated hemp products, as well as a variety of illicit, intoxicating marijuana and hemp products. Cannabis products come in many forms, including cannabis flower, edibles, oils, tinctures, concentrates, topicals, and more. Regulated cannabis products— marijuana and hemp—must meet testing, labeling, recordkeeping, total THC limits, and other requirements that are designed to promote safety and reduce risks. Illicit products, whether sold online or in-person, generally do not meet these safety standards.
The potency of cannabis products has greatly increased over the decades, and today a wide range of high-potency and high-dose cannabis products are readily available. Many studies that have looked at potential therapeutic effects of cannabis have used pharmaceutical-grade cannabinoids and may not apply to over-the-counter products, which have less reliable dosing and purity. Some CBD-only products have been found to contain THC.
Depending on how they are grown, produced, or processed, some cannabis products may be contaminated by pesticides, mold, or bacteria. This review mainly focuses on the types of cannabis available in regulated retail stores. Unless otherwise specified, this report summarizes evidence about cannabis and cannabinoid products that are sold in retail cannabis stores in Oregon, most of which are products containing delta-9-THC, the predominant natural form of THC.
Sometimes evidence is related specifically to CBD (for example, evidence supporting CBD pharmaceuticals for treating certain seizure disorders). This report does not attempt to assess evidence from hemp-derived synthetic cannabinoids (such as delta-8-THC), which can be sold outside the legal retail marketplace.
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Summary of major findings
Below are the specific health outcomes with the strongest evidence supporting links to cannabis use. These, as well as findings with weaker evidence, are compiled in the revised public health statements on pages 10–18. We found moderate or strong evidence for links between cannabis use and many health harms:
Read the full report
