February 5, 2019

With the public hearings on the legalization of recreational marijuana use taking place this week, I thought I would write about my concerns as a pediatrician and why I think our legislators should oppose HB481.

Other states in the US have legalized recreational marijuana use and what have we learned? Unfortunately - not enough. Washington and Colorado legalized recreational use of marijuana in 2012, and in the six years since there are still many questions that need to be addressed – what are the economic costs associated with increased crime, increased health care costs – emergency treatment and substance abuse treatment, increased costs in relation to accidents and injuries on roads or in workplaces? Despite the lack of data other states are continuing to legalize recreational use.

Legalization campaigns give the false impression that marijuana is a benign substance and this presents a significant challenge for educating the public and children about known risks and adverse effects.

It is clear that the potency of marijuana products has skyrocketed. The content of tetrahydrocannabinol (THC or delta-9-THC, the major psychoactive or mind-altering component) in marijuana has increased markedly over the past 50 years from a mean content of 3-5% in the 1970s, now up 500% in potency with current mean concentrations of 18-23% in flowers, and up an average of 1800% in potency to 68-75% through extracted “dabbing” products in Washington State where cannabis is legal.

In regards to effects on children, a few things we do know. In states with recreational marijuana use there are increasing rates of marijuana use by minors, increased arrest rates of minors and more marijuana-related poisonings and hospitalizations. In Colorado, there was a 206% increase in poison control calls regarding children age 0 – 8 from 2012 (pre) to 2015 (post legalization) from extracted and edible marijuana products.

Additionally, I have significant concerns about the lack of provisions in HB481 regarding the commercialization of marijuana. There need to be laws preventing the targeting of children and adolescents. This is even more important in regards to edibles that are packaged like candy and sweets that are attractive to children and often contain 3 – 20 times the THC concentration recommended for intoxication.

There is an increase in vaping in adolescents – 25% of NH high school students (and one-third of seniors) report using vaped products in the past 30 days; and we are seeing an increase in vaped marijuana. Multiple studies have found that youth who try vaping even once have a markedly increased risk of going on to smoke cigarettes and marijuana.  HB481’s loosely-regulated commercialization approach will open the floodgates of vaped, high-dose THC into our schools.

The Medical Society recently developed a policy on marijuana legalization for recreational use that I suggest for your reading. As a pediatrician, I feel there are too many risks and not enough protections in HB481, and that it should be opposed.


Tessa Lafortune-Greenberg, MD
NHMS President