The legalization of recreational marijuana remains unapproved in Pennsylvania even as various leaders up to the Governor circulate proposals to change that. But make no mistake. De facto legalization has already begun, and we need a better mental health system to treat the health problems that are already here and will only be growing.
The impact on kids and adults
Products with high amounts of THC, marijuana’s active ingredient, circulate widely — with some products diverted from medical dispensaries and others sold in vape shops. In 2024, Children Hospital of Philadelphia’s Poison Control Center reported receiving a call every day about a child under six being harmed by a THC-laden product in PA and Delaware. Some of these children must be put into ICUs or placed on ventilators. Others suffer from psychosis, anxiety and depression.
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Children consume edibles containing marijuana thinking they are treats or simply the means to get high. But with their developing brains, kids face higher risks, especially if they regularly use the potent strains now for sale. Cannabis may also trigger serious conditions like schizophrenia or bipolar disorder if children are predisposed to them.
Adult use is not risk-free either. Heavy users can experience cycles of intense nausea and vomiting. Actor David Krumholtz lost 100 pounds when his heavy marijuana use triggered extended bouts of vomiting, leading him to spend 10 hours a day in the bath of his New Jersey home in a desperate bid to relieve his symptoms.
Recent studies find that heavy marijuana use creates a sixfold higher risk of heart attack and a fourfold higher risk of stroke after three years.
Today’s weed is far more potent than the drug that baby boomers remember. While THC levels were 4 to 8 percent back in the 1960s, it’s common to find marijuana with more than 25 percent THC now.
As we learn all this, the market overseeing cannabis-related products is poorly regulated. Hemp products regularly exceed legal potency levels and are laced with fungus, pesticides and mold, according to an Inquirer analysis of 10 products.
We need a better system to reduce harm
As a researcher and ethicist working in mental health, and as a medical cannabis cardholder, I am familiar with the long effort to demonize cannabis and its users, and do not wish to add to it. If PA opts for full legalization amid the current budget crisis, we need to be smart about marijuana’s harms and benefits, adopting the recommendations of experts from the National Academy of Medicine which warned of the adverse effects of THC in the developing brain.
Today’s weed is far more potent than the drug that baby boomers remember. While THC levels were 4 to 8 percent back in the 1960s, it’s common to find marijuana with more than 25 percent THC now. Vaping products can be even more potent, exceeding 95 percent THC purity. Virtually all drugs become harmful if the dose is too high.
It is encouraging that the bipartisan Senate Bill 120 now before the legislature contains many important provisions for easing health risks and addressing questions of equity. Key to this is to create a dedicated fund for mental health services to deal with these looming problems. We shouldn’t bundle the money with anything else because mental health services inevitably get shorted. We can’t let that happen here. The risks are too great.
PA should release all individuals who are among the roughly 40,000 people still being held in U.S. jails for cannabis charges. This is an ethically critical point, and we must ensure it happens.
We also need money targeted for education. Parents need to know how to store these drugs, and people should know what heavy use can do and how to get help. This material shouldn’t be sensational and must treat people like adults. Moderate use just like everything is critical.
THC levels should be closely regulated along with edibles, because children consume them too easily. And no company should be allowed to market to young people.
Most people want legalization, but it needs to be rational or it will add to our problems. I urge our legislators not just to approve marijuana but to create a better health system to manage its effects.
Dominic Sisti, PhD, is a Senior Fellow at the Leonard Davis Institute of Health Economics and Associate Professor in the Department of Medical Ethics & Health Policy at the University of Pennsylvania. He directs the Scattergood Program for the Applied Ethics of Behavioral Health Care at Penn.
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