Lebanon has recently become the first Arab country to legalize the plantation of cannabis for medical use.Penalties for illegal recreational use ranges from confiscation or small fines to jail time and even death. In some countries citizens can be punished if they have used the drug in another country, including Singapore and South Korea. Usage
In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65). Cannabis is by far the most widely used illicit substance. United States
Between 1973 and 1978, eleven states decriminalized marijuana. In 2001, Nevada reduced marijuana possession to a misdemeanor and since 2012, several other states have decriminalized and even legalized marijuana.In 2018, almost half of the people in the United States had tried marijuana, 16% had used it in the past year, and 11% had used it in the past month. In 2014, daily marijuana use amongst US college students had reached its highest level since records began in 1980, rising from 3.5% in 2007 to 5.9% in 2014 and had surpassed daily cigarette use.In the US, men are over twice as likely to use marijuana as women, and 18–29-year-olds are six times more likely to use as over-65-year-olds. In 2015, a record 44% of the US population has tried marijuana in their lifetime, an increase from 38% in 2013 and 33% in 1985.Marijuana use in the United States is three times above the global average, but in line with other Western democracies.
Peripheral cyanosis may be due to the following causes:
All common causes of central cyanosis
Reduced cardiac output (e.g. heart failure or hypovolemia)
Cold exposure
Chronic obstructive pulmonary disease (COPD)
Arterial obstruction (e.g. peripheral vascular disease, Raynaud phenomenon)
Venous obstruction (e.g. deep vein thrombosis)

Differential cyanosis
Differential cyanosis is the bluish coloration of the lower but not the upper extremity and the head. This is seen in patients with a patent ductus arteriosus. Patients with a large ductus develop progressive pulmonary vascular disease, and pressure overload of the right ventricle occurs. As soon as pulmonary pressure exceeds aortic pressure, shunt reversal (right-to-left shunt) occurs. The upper extremity remains pink because deoxygenated blood flows through the patent duct and directly into the descending aorta while sparing the brachiocephalic trunk, left common carotid, and left subclavian arteries. Evaluation
A detailed history and physical examination (particularly focusing on the cardiopulmonary system) can guide further management and help determine the choice of testing to be performed. Tests that can be performed include pulse oximetry, arterial blood gas, complete blood count, methemoglobin level,  electrocardiogram, echocardiogram, X-Ray, CT scan, cardiac catheterization, and hemoglobin electrophoresis. In newborns, peripheral cyanosis typically presents in the distal extremities, circumoral, and periorbital areas. Of note, mucous membranes remain pink in peripheral cyanosis as compared to central cyanosis where the mucous membranes are cyanotic. It is important to note that skin pigmentation and hemoglobin concentration can affect the evaluation of cyanosis. Cyanosis may be more difficult to detect on people with darker skin pigmentation.