June 2004, VOLUME113 /ISSUE 6

Legalization of Marijuana: Potential Impact on Youth

  1. Committee on Substance Abuse and Committee on Adolescence


As experts in the health care of children and adolescents, pediatricians may be called on to advise legislators concerning the potential impact of changes in the legal status of marijuana on adolescents. Parents, too, may look to pediatricians for advice as they consider whether to support state-level initiatives that propose to legalize the use of marijuana for medical purposes or to decriminalize possession of small amounts of marijuana. This policy statement provides the position of the American Academy of Pediatrics on the issue of marijuana legalization, and the accompanying technical report (available online) reviews what is currently known about the relationship between adolescents’ use of marijuana and its legal status to better understand how change might influence the degree of marijuana use by adolescents in the future.

  • marijuana
  • legalization
  • substance abuse
  • decriminalization


Substance abuse by adolescents is an ongoing concern of pediatricians. Marijuana is the illicit substance most commonly abused by adolescents.1 Any change in the legal status of marijuana, even if limited to adults, could affect the prevalence of use among adolescents.2 For example, tobacco and alcohol products, both legal for adults 18 and 21 years of age, respectively, are the psychoactive substances most widely abused by adolescents.

Marijuana currently is classified by the US Drug Enforcement Agency as a schedule I drug, which means that it has a high potential for abuse, has no currently accepted medical use in the United States, and lacks accepted safety for use under supervision by a physician. Rigorous scientific research to determine whether marijuana, especially cannabinoids, has any potential therapeutic effect is just beginning. In contrast, the significant neuropharmacologic, cognitive, behavioral, and somatic consequences of acute and long-term marijuana use are well known and include negative effects on short-term memory, concentration, attention span, motivation, and problem solving, which clearly interfere with learning; adverse effects on coordination, judgment, reaction time, and tracking ability, which contribute substantially to unintentional deaths and injuries among adolescents (especially those associated with motor vehicles); and negative health effects with repeated use similar to effects seen with smoking tobacco.3

More information, including historical perspectives on the legal status of marijuana as well as concerns surrounding medicinal use of marijuana, is available in the accompanying technical report (available online).2


  1. The American Academy of Pediatrics opposes the legalization of marijuana.

  2. The American Academy of Pediatrics supports rigorous scientific research regarding the use of cannabinoids for the relief of symptoms not currently ameliorated by existing legal drug formulations.

Committee on Substance Abuse, 2001–2002

Edward A. Jacobs, MD, Chairperson

*Alain Joffe, MD, MPH

John R. Knight, MD

John Kulig, MD, MPH

Peter D. Rogers, MD, MPH

Janet F. Williams, MD


Deborah Simkin, MD

American Academy of Child and Adolescent Psychiatry


Karen S. Smith

Committee on Adolescence, 2001–2002

David W. Kaplan, MD, MPH, Chairperson

Angela Diaz, MD

Ronald A. Feinstein, MD

Martin M. Fisher, MD

Jonathan D. Klein, MD, MPH

Ellen S. Rome, MD, MPH

*W. Samuel Yancy, MD


Ann J. Davis, MD

American College of Obstetricians and Gynecologists

Glen Pearson, MD

American Academy of Child and Adolescent Psychiatry

Jean-Yves Frappier, MD

Canadian Paediatric Society


Karen S. Smith


  • * Lead authors