TABLE.
Known associations between chronic* marijuana use and adverse health outcomes to help guide physicians in counseling adolescent patients.
| System | Known association | Reference(s) |
|---|---|---|
| Respiratory | – Regular users likely to experience wheezing, cough, and mucous production | [27] |
| – No established associations with lung cancer or with long-term changes in lung function | [26–28] | |
| Cardiovascular | – No established association with adverse cardiovascular outcomes among adolescents | [30] |
| – Among adults, elevated mortality among cannabis smokers who have had a prior myocardial infarction | [30, 32] | |
| Endocrine | – Among males, results in dose-related decrease in testosterone levels | [33] |
| – Associations with erectile dysfunction, oligospermia, and inhibition of orgasm in males | [33, 34] | |
| – Association with gynecomastia among males has been reported, but poorly characterized | [33] | |
| Gastrointestinal | – Frequent use may result in cannabis hyperemesis syndrome, marked by nausea, vomiting, epigastric abdominal pain, and occasionally diarrhea, with symptoms characteristically relieved by hot showers or baths | [35] |
| Neurocognitive | – Any use results in short-term decline in attention, executive function and memory, lasting at least one to several days after acute intoxication, with subtle effects at one month | [38] |
| – Use results in near doubling of odds of motor vehicle accident and fatal collision | [39] | |
| – Regular use during adolescence and into adulthood associated with decline in IQ; cessation may not result in restored IQ | [41] | |
| Psychiatric | – Association with psychosis and schizophrenia, with even greater odds among frequent users | [44, 45] |
| – No established association with depression; possible association with anxiety | [44, 46–48] | |
| Psychosocial | – Associations with poor school performance, negative attitudes toward school, and decreased odds of completing high school; however, cause-effect relationship not established | [49] |
| – Association with poor employment outcomes | [50–52] | |
| – Marijuana use itself per se likely does not cause use of other harder drugs, but purchasing marijuana may offer opportunities to purchase of other illicit drugs on the black market, such as heroin, cocaine, amphetamines | [54] |