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In some, it can cause or exacerbate anxiety and depression. And those with a genetic predisposition might be at risk of developing schizophrenia if they use pot, a 2012 study in Biological Psychiatry concluded. Longtime users may experience withdrawal symptoms like unease, restless- ness, and irritability if they quit. Scary, yes, but such effects aren't that different from what drinkers experience. A few drinks can impair memory, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) states.

And withdrawal symptoms from heavy, long-term alcohol use are much more alarm- ing: hallucinations or delusions. There's some evidence pot may have negative effects on your heart, including case reports of heart attacks and strokes among recent or heavy users. But little is known about the link, says David Goff, Jr., MD, PhD, dean of the Colorado School of Public Health at the University of Colorado at Aurora. One study from 2013 shows that pot may decrease fertility, because it can lower levels of the luteinizing hormone, needed for ovulation. It can't compare to the health effects of tobacco, partly because, as Dr. Goff notes, "people don't smoke a pack of joints a day." Still, he says, "voluntarily putting smoke into your lungs is dumb." Dr. Grant adds, "When you smoke marijuana, you bring in tars that can cause lung cancer." Using a vaporizer may reduce your tar exposure. Tori C., a student at a large southern university, skips alcohol and smokes pot usually. In the fall of 2014, she was sexually assaulted after a party where she and her attacker had been drinking.

It happens way too often: More than 690,000 college students are assaulted each year by someone who has been drinking, NIAAA statistics estimate. The annual number of victims of alcohol- related sexual assaults, specifically, is 97,000. Pot, meanwhile, tends to lessen aggressive behavior. Moderate and high doses may even suppress violence and reduce irritability and hostility in group settings, according to a review of research in Addictive Behaviors. Compared with the first six months of 2013, the murder rate in Denver, Colorado, dropped by 38 percent in 2014, the first year you could lawfully buy pot. The rate of forcible sex offenses dropped by almost 19 percent. Critics caution, however, that it may be a case of correlation, not causation. Tori knows the only person to blame for her rape is her rapist. Drinking inhibits my ability to function more than pot. When I smoke, I stay in control." She feels the same way about driving high. She tries not to drive under the influence of anything, she says, "but if I had to, I could drive stoned. There's no way I could operate a vehicle drunk." She's not way off base. A 2010 study published in the American Journal on Addictions found that drivers under the influence of alcohol underestimate how impaired they are, while participants who smoke pot drive cautiously to compensate. Drunk drivers also have more trouble keeping a car in its lane than marijuana users do. Pot-related road fatalities appear to be rising: About 12 percent of U.S. drivers in fatal accidents in 2010 had cannabinoids in their system, up from 4.2 percent in 1999. "If you're high, you shouldn't be driving," says Dr. "One could argue that drunk driving is worse, but that doesn't mean pot is safe." Pot & the Bottom Line. This debate is far from over, so maybe take it slow. Legalization opponents worry there isn't enough education and regulation to keep users safe. Denver has seen a rise in ER visits after people ingested large amounts of pot- laced goodies, which can cause anxiousness and hallucinations. In one tragic case, a visiting college student jumped off a balcony and died.

"When I bought weed from a dispensary, I asked, 'What are the side effects? What's the correct dose?'" says Carla Lowe, founder of Citizens Against Legalizing Marijuana. Most states have agencies intended to provide some level of oversight on how dispensaries operate, but Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, notes that there are no agreed-upon safety regulations of any kind: no supervision of testing facilities, and tests for contaminants aren't standardized. "People are used to buying weed on the black market with no idea about quality," he says. "As consumers get more sophisticated, they'll demand higher quality and better testing." So in an ideal world, with rigorously regulated dispensaries and organic pot at shoppers' disposal, would a healthy person be healthier if she used marijuana? Studies show the most support for marijuana's ability to relieve pain and muscle spasms, per a review published in the Journal of the American Medical Association in 2015. And if weed has protective qualities that might help healthy women, it remains to be seen. It's still illegal for recreational use in nearly every state, of course. In those places where it is legal, it's up to individuals to decide if pot is lifting them up or holding them back. For Tori C., marijuana became a crutch instead of a cure.

After the trauma of her sexual assault, she admits she abused pot for months, getting high several times a day to "be numb." Her best friend set her straight: "She told me to stop smoking all the time and do my homework. Smoking so much just put a Band-Aid on what was really bothering me." This article was originally published as "Should Everybody Just Get Stoned?" in the January 2016 issue of Cosmopolitan . A service of the National Library of Medicine, National Institutes of Health.


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