Cannabis carries both real risks and real therapeutic potential, but causal evidence is still largely missing

A balanced review found cannabis use is associated with respiratory, cardiovascular, cognitive, and psychiatric harms, but causal relationships are mostly unestablished, while therapeutic potential for cannabinoid-based drugs spans a wide range of conditions.

Cohen, Koby et al.·Clinical pharmacology and therapeutics·2019·Moderate EvidenceReview
RTHC-01988ReviewModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Repeated cannabis use is associated with respiratory and cardiovascular disorders, cognitive alterations, psychosis, schizophrenia, and mood disorders. However, causal relationships are largely missing. Simultaneously, cannabinoid-based drugs show promising therapeutic potential for neurological and psychiatric disorders. Both the popularity and the evidence gaps are growing.

Key Numbers

Cannabis is the most popular illicit drug in the Western world. Associated harms include respiratory, cardiovascular, cognitive, and psychiatric effects. Causal relationships are not established for most. Therapeutic potential spans neurological and psychiatric conditions.

How They Did This

Contemporary narrative review covering adverse effects, safety, and therapeutic potential of cannabis and cannabinoid-based drugs.

Why This Research Matters

Cannabis policy often operates in the space between demonstrated associations and unproven causation. This review honestly addresses both sides, providing a framework for conversations about cannabis that acknowledge uncertainty rather than treating the science as settled.

The Bigger Picture

The cannabis debate is often polarized between those who emphasize harms and those who emphasize benefits. This review makes the case that both perspectives have evidence behind them, and the key unanswered question is causation.

What This Study Doesn't Tell Us

Narrative review without systematic methodology. The balance between harms and benefits varies by condition, dose, and population. "Causal relations missing" does not mean no causation exists.

Questions This Raises

  • ?Will longitudinal studies establish causation for the observed associations?
  • ?How should clinical and policy decisions be made in the face of this uncertainty?
  • ?Can therapeutic benefits be separated from recreational risks?

Trust & Context

Key Stat:
Causal evidence still missing
Evidence Grade:
Rated moderate because the review provides a fair synthesis of the field, though narrative format limits systematic rigor.
Study Age:
Published in 2019.
Original Title:
Positive and Negative Effects of Cannabis and Cannabinoids on Health.
Published In:
Clinical pharmacology and therapeutics, 105(5), 1139-1147 (2019)
Database ID:
RTHC-01988

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Is cannabis harmful?

It is associated with respiratory, cardiovascular, cognitive, and psychiatric effects, but causal relationships have not been definitively established for most of these.

Does cannabis have legitimate medical uses?

Yes. Cannabinoid-based drugs show promising therapeutic potential for multiple conditions. The challenge is maximizing benefits while minimizing risks, which requires better evidence than currently exists.

Read More on RethinkTHC

Cite This Study

RTHC-01988·https://rethinkthc.com/research/RTHC-01988

APA

Cohen, Koby; Weizman, Abraham; Weinstein, Aviv. (2019). Positive and Negative Effects of Cannabis and Cannabinoids on Health.. Clinical pharmacology and therapeutics, 105(5), 1139-1147. https://doi.org/10.1002/cpt.1381

MLA

Cohen, Koby, et al. "Positive and Negative Effects of Cannabis and Cannabinoids on Health.." Clinical pharmacology and therapeutics, 2019. https://doi.org/10.1002/cpt.1381

RethinkTHC

RethinkTHC Research Database. "Positive and Negative Effects of Cannabis and Cannabinoids o..." RTHC-01988. Retrieved from https://rethinkthc.com/research/cohen-2019-positive-and-negative-effects

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.