AAP maintains its opposition to legal marijuana

Marijuana use risks harm to children and adolescents and should not be legal, the American Academy of Pediatrics (AAP) reiterates in an updated policy statement.

The policy statement updates the 2004 statement, “Legalization of Marijuana: Potential Impact on Youth.” An accompanying technical report reviews what is known about marijuana’s effects on health and the developing brain and about the relationship between adolescent marijuana use and its legal status.

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Citing data supporting harm to the health and brain development of children and adolescents, the AAP opposes marijuana use in persons aged 0 to 21 years and legalization of the drug. It also opposes medical use of marijuana outside the US Food and Drug Administration’s usual approval process for pharmaceuticals while recognizing the need for exceptions for children with “life-limiting or severely debilitating conditions and for whom current therapies are inadequate.”

The AAP strongly supports research and development of pharmaceutical cannabinoids and advocates reclassifying marijuana from Drug Enforcement Administration Schedule I (“no currently accepted medical use and a high potential for abuse”) to Schedule II (high abuse potential but less than Schedule I drugs) for this purpose.

The policy statement also strongly supports decriminalizing marijuana use by minors and young adults in favor of treating young persons with marijuana use problems. It urges pediatricians to advocate for laws that prevent harsh criminal penalties for possession and use.

To protect children in states where recreational marijuana is legal, the AAP strongly recommends strictly enforcing rules that limit access and marketing to children and adolescents. Marijuana sold legally for either recreational or medicinal use should be packaged in childproof containers to prevent accidental ingestion.

The AAP urges pediatricians in states where marijuana is legal to advocate for regulations similar to those governing alcohol and tobacco, including a minimum age for purchase of 21 years. Any revenue arising from regulation should support research on marijuana’s health risks and benefits. Federal and state governments should monitor the health impact of marijuana, especially on the young.

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The policy statement strongly opposes smoking marijuana because of lung damage and potential risks of secondhand smoke. It discourages marijuana use by adults in the presence of minors because of the influence of adult role models on child and adolescent behavior.

Risks of marijuana use for adolescents include impairment of memory, concentration, and learning; lower chances of finishing high school or earning a college degree; interference with motor control, coordination, and judgment; and, for regular users, psychological problems, impaired respiratory health, and higher risk of drug dependence in adulthood.