Cannabis and its adverse effects: advocating for a nuanced debate
While many American states recently changed the legal status of cannabis and the Canadian federal government instituted a national program to regulate its therapeutic use, the debate surrounding cannabis use and its adverse effects continues to spark interest, both among the experts and among the public at large. In order to properly assess the risks and benefits associated with cannabis use, we suggest not to focus on the question of whether cannabis is deleterious or not, but to focus instead on the factors modulating the relationship between cannabinoid use and its adverse effects on cognition, psychosis and addiction. We discuss here how the content of cannabis, patterns of use, characteristics of the user and exposure to environmental stressors all modify the risks associated with cannabis use. We also underline that growing evidence support both beneficial and deleterious properties of this substance, and the fact that only a portion of users will experience its negative effects. We thus suggest that a better usage and understanding of the literature on those modulating factors seems warranted in order to properly inform the population. This approach will also be critical to take evidence-based decisions regarding its legal status and how to implement the potential changes to current regulations pertaining to the legal status of cannabis.