Abstract

The paper by DeFilippis et al. (1) in this issue of the Journal is a timely reminder of how little we know about cannabis consumption, cardiovascular disease (CVD), and cannabis’ health effects in general. It is also a firm confirmation of the negative effects of any cocaine use, a much better understood risk factor for acute myocardial infarction, stroke, and diminished survival. Cannabis has long been the most widely used “illicit substance” in the United States; recent data (from 2014) for past month marijuana use in persons age ≥12 years was 8.4% (2). However, the status of cannabis in the United States is increasingly licit. Evolving public opinion (61% of U.S. adults sampled in 2018 think marijuana should be legal) (3), an exhaustion with a “war” on a drug that about one-half of U.S. adults have used at some point in their life, and perhaps the very real appeal of new streams of tax revenue have led to the approval of medical cannabis in 30 states plus the District of Columbia, 9 of which (plus the District of Columbia) legalized recreational use. This includes Massachusetts, the site of the DeFilippis et al. (1) study, which is expected to have tax-stamped recreational cannabis products for sale to any adult age >21 years by July 2018. Federally, cannabis remains illegal and is a schedule-I controlled substance (no accepted medical use, high abuse potential).