Legal Weed Isn’t the Disaster—Lazy Thinking Is
An Op Ed response to Charles Fain Lehman’s recent WSJ essay, “Legal Marijuana’s Disastrous Legacy"
Charles Fain Lehman’s article, “Legal Marijuana’s Disastrous Legacy,” reads like a frantic eulogy for American reason. His framing—grim anecdotes, cherry-picked stats, a fog of causation errors—presents cannabis legalization as a social unraveling. But as a physician who’s guided tens of thousands of patients through cannabis care, I see a different reality: legalization isn’t the problem. Poor guidance is.
The public health question isn’t whether cannabis use exists. It’s how it exists. Haphazard consumption by uninformed users—without structure, education, or clinical insight—can absolutely lead to confusion, misuse, or overexposure. But that’s not a condemnation of cannabis. It’s a reflection of the vacuum left by healthcare systems, policymakers, and medical gatekeepers who have yet to meaningfully engage with the science.
The Teen Use Scare—Missing the Data
Lehman invokes teen use as proof of policy failure. But multiple national surveys show adolescent cannabis use is flat or falling. The Youth Risk Behavior Surveillance System, Monitoring the Future, and CDC-backed reviews all paint a consistent picture: no statistically significant increase in teen use after legalization. A recent 2024 meta-analysis of 30+ studies concluded recreational laws may nudge older adolescent use modestly—but medical laws don’t budge it at all.
What Lehman misses is what every good clinician knows: Data snapshots without trendlines or controls mislead. And cherry-picked stats divorced from clinical context aren’t analysis—they’re alarmism.
ER Visits & Edibles—Learning Curves, Not Catastrophes
Yes, ER visits from edibles have ticked upward in some states. But the pattern is consistent with first-generation exposure curves—temporary spikes in misuse that taper once labeling improves and public education takes hold. Unlike alcohol or opioids, cannabis intoxication isn’t lethal, and most episodes resolve with reassurance and rest.
As a physician, I’ve treated patients confused by edibles. I’ve also treated far more harmed by medications they were prescribed. The answer isn’t vilification. It’s guidance.
Crime Isn’t Surging—But Enforcement Patterns Are
Lehman points to increased crime near dispensaries. But large-sample studies suggest otherwise. A 2021 study in Justice Quarterly found no increase in violent or property crime after retail legalization. In fact, cities with regulated storefronts often see reduced police calls, likely because illicit market activity declines.
Legalization hasn’t unleashed lawlessness—it’s shifted law enforcement priorities. That’s a systems-level discussion, not a cannabis one.
On “Addiction” and What CUD Actually Means
Lehman leans heavily on Cannabis Use Disorder (CUD) statistics. But here’s the catch: CUD doesn’t mean ‘uses cannabis regularly’—it means use causes measurable dysfunction. DSM-5 criteria require persistent impairment—not occasional forgetfulness or feeling “too high.” While CUD exists, its prevalence remains far lower than for alcohol, tobacco, or prescription anxiolytics. And unlike those substances, cannabis rarely carries the same risk for physical dependence or withdrawal morbidity.
When used under proper guidance, the risk profile of cannabis is more favorable than most other agents in its therapeutic class.
The Author Misses the Real Story
Lehman treats cannabis as a flat object: used or not, legal or not, good or bad. But cannabis is not monolithic—it’s a chemical family interacting with the endocannabinoid system, a regulatory network in all humans involved in pain, mood, memory, appetite, immune balance, and more.
Discovered just 35 years ago, the ECS is still barely taught in medical school, yet it is foundational to human physiology. Any substance that interfaces with it—especially one as chemically diverse as cannabis—requires clinical discernment, not culture-war sloganeering.
Here’s the nuance Lehman misses entirely: There’s a difference between people using cannabis randomly, and patients using it under trained guidance. That difference is as wide as self-medicating with leftover antibiotics versus completing a tailored treatment plan from a physician.
Our culture’s cannabis use today is largely unguided—yes. But that’s a failure of our system, not of the plant.
When Bozo Filters Fail
Science is about pattern recognition, discernment, and humility. When someone with no public health training offers sweeping conclusions from loosely interpreted stats, they’ve confused confidence with competence.
Lehman’s argument is a textbook example of what happens when the “bozo filter” breaks down—when selective reading and ideological bias pass for insight. That’s not just frustrating. In a national conversation about medicine, safety, and autonomy, it’s dangerous.
What We Need Instead
If we’re serious about public health, we need better regulation, better education, and better access to evidence-based cannabis care. We need physicians trained in ECS physiology and empowered to guide patients through this therapeutic landscape—not left reacting to stigma, fear, or prohibition-era logic.
Lehman’s fears are not unfounded—but they are misdirected. The answer to confusion isn’t criminalization. It’s clinical leadership.
Read how cherry-picking studies and inflated confidence mislead the public—and what real science actually looks like. (CEDclinic.com)
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