By Teresa Alasio MD
Over the past decade, marijuana has undergone a remarkable transformation in American society. Once relegated to the shadows of counterculture, it now occupies prominent storefronts in cities and towns across the country. As of 2025, more than half of U.S. states have legalized recreational marijuana, and nearly all permit its use for medical purposes. This shift has brought undeniable benefits—economic growth, criminal justice reform, and expanded medical research—but it has also introduced complex public health challenges that demand our attention.
The New Perception: Safe and Mainstream?
Legalization has sent a powerful message: marijuana is safe. Dispensaries today resemble boutique retailers, and cannabis products are marketed as wellness aids, sleep enhancers, and even productivity boosters. Edibles are packaged in pastel colors, and CBD can be found in everything from lotions to lattes.
But this glossy rebranding comes at a cost. Research from the National Institutes of Health (NIH) and the Monitoring the Future survey indicate that as marijuana becomes more accessible and socially accepted, perceived risk among teens and young adults declines—and use increases. In 2023, nearly 30% of U.S. high school seniors reported using marijuana in the past year, a rate that has held steady or increased in legal states despite age restrictions.
Today’s Marijuana: More Potent, More Powerful
A crucial but often overlooked fact: marijuana is not what it used to be. According to the Drug Enforcement Administration (DEA), the average THC content in marijuana has tripled since the 1990s, rising from about 4% to more than 15%. Concentrated products like wax and oils can contain THC levels as high as 90%. This dramatic increase in potency has real consequences, especially for young people.
Numerous studies, including those published in JAMA Psychiatry and The Lancet Psychiatry, have found that regular marijuana use during adolescence is associated with impaired memory, reduced academic achievement, and a higher risk of developing anxiety, depression, and, in vulnerable individuals, psychosis. The developing brain is particularly sensitive to THC, and early, frequent use can have lasting effects.
Impaired Driving: A Growing, Underestimated Risk
Legalization has also complicated efforts to keep roads safe. While the dangers of drunk driving are widely understood, the risks of driving under the influence of marijuana are less well known—and harder to measure. THC impairs motor coordination, reaction time, and judgment, but unlike alcohol, its effects are not reliably detected by blood tests or breathalyzers.
Data from the Insurance Institute for Highway Safety and the Governors Highway Safety Association show that states with legal marijuana have experienced increases in traffic accidents and fatalities where THC was detected. For example, a 2022 study in JAMA Network Open reported a 16% increase in injury crashes following legalization in several states. The risk is clear: impaired driving endangers not only the user but everyone on the road.
Youth Access: Persistent Challenges
Despite strict regulations, underage access to marijuana remains a significant concern. Child-resistant packaging is not foolproof, and edibles—often resembling candy or baked goods—are particularly attractive to children and teens. The American Association of Poison Control Centers reports that calls related to unintentional marijuana ingestion by children have risen sharply in states with legal access, with thousands of incidents annually.
Parents should be aware: legalization does not equate to harmlessness. Open, informed conversations about cannabis use are as vital as discussions about alcohol and tobacco.
One Size Does Not Fit All
Cannabis is not inherently good or bad; its effects depend on the individual, context, and dosage. For some, especially those with chronic pain or undergoing chemotherapy, medical marijuana offers real relief under a doctor’s supervision. For others, particularly those with a family history of mental illness, marijuana can trigger panic attacks, paranoia, or long-term dependence. The distinction between medical and recreational use is often blurred in public discourse, but it matters.
The Path Forward: Education and Regulation
Legalization is not the end of the conversation—it’s the beginning. Like alcohol and tobacco, marijuana requires ongoing, evidence-based public health education and regulation. This includes:
• Clearer labeling of THC content and health risks.
• Stronger protections to prevent youth access.
• Training for healthcare providers to recognize and address cannabis-related issues.
• Accessible resources for those struggling with cannabis dependence.
Public health campaigns must keep pace with the rapidly evolving cannabis landscape. Scare tactics and glorification are equally unhelpful; honest, nuanced education is essential.
Conclusion: Embracing Nuance
The legalization of marijuana has corrected many past injustices and opened doors for research and medical progress. But it has also brought new risks that we cannot ignore. Marijuana is neither the villain of the “Just Say No” era nor a harmless herbal remedy. As a society, we owe it to ourselves—and especially to our youth—to approach cannabis with the nuance it deserves, weighing both its benefits and its risks.
In this new era, being informed isn’t just wise—it’s essential.
The information presented is for educational purposes only and not meant as a substitute for medical advice. If you have a specific medical concern, please consult your medical provider.
Dr. Teresa Alasio is the Medical Director and Owner of Intentional Self Aesthetics, located in Downtown New Canaan. She lives in New Canaan with her family.
