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Medical vs recreational marijuana: What’s legal, what’s not

Contemporary PEDS Journal, Vol 36 No 7, Volume 36 , Issue 5

As of 2019, medical marijuana is legal in 33 states and Washington, DC; recreational marijuana in 10. At the federal level, marijuana remains a Schedule 1 drug, meaning that it currently has no accepted medical use and has a high potential for abuse.

This is the current legal landscape of marijuana in the United States. Dig a little deeper and it gets more complex. Laws governing the sale and dispensing of products for medicinal or recreational use vary from state to state, and what goes into products also varies. There are more than 100 cannabinoids (class of chemical compounds) in the marijuana (cannabis) plant, of which the most studied are tetrahydrocannabinol (THC, the main psychoactive constituent of cannabis) and cannabidiol (CBD). Products for medicinal or recreational use can have different combinations of these cannabinoids as well as different doses.1

Products for pediatric medicinal use typically have higher concentrations of CBD and lower THC and recreational products have higher concentrations of THC, which is the psychoactive component of marijuana. All products for medicinal use are offered through state dispensaries, whereas those for recreational use are offered through retail recreational dispensaries.


A further complexity is the availability of over-the-counter, hemp-based products. Hemp is marijuana but with a low THC dose (<0.3%). No certification is needed to obtain these products.



1. Committee on Substance Abuse; Committee on Adolescence. Policy statement. The impact of marijuana policies on youth: clinical, research, and legal update. Pediatrics. 2015;135(3):584-587.