When I was growing up, we all laughed at Reefer Madness. And why not? All the warnings seemed overblown.
We all knew people who smoked weed, or did it ourselves, and there seemed to be little harm in it.
So when decriminalization came along, a lot of reasonable people shrugged, both because we classified weed as harmless enough, and because we all rightly admitted that the war on drugs wasn’t going so well.
Our paper was just published in the Canadian Medical Association Journal.
People with cannabis-induced psychosis are at a 241.6-fold higher risk of developing schizophrenia.
Cannabis from the 2000s is not the same as today. pic.twitter.com/mwuSRlNuG6
— Nicholas Fabiano, MD (@NTFabiano) August 11, 2025
As legal weed became common, many of us complained about the smell or the fact that stoned servers were a drag, so to speak, but as the data rolled in we noticed a lot more troubling side effects of the widespread availability of THC: schizophrenia rates soared among youth, and actual psychotic episodes were driving people to hospitals.
Since legalization new schizophrenia cases linked to heavy cannabis use have nearly tripled. pic.twitter.com/zomeu1lE69
— Nicholas Fabiano, MD (@NTFabiano) September 3, 2025
And now this: new data shows that over 40% of fatal traffic accidents in Ohio are weed-related.
My colleague once-removed, Stephen Green, who got to witness the legalization trend get going in Colorado, pointed this out:
It’s been six years since legal weed went on sale in Ohio — and now it seems nearly half the stoners in fatal crashes forgot to just stay home and eat their Cheetos. A new Wright State University study showed that more than four out of 10 deadly car crashes included a driver with high levels of THC in their bloodstream.
The study, just published in the Journal of the American College of Surgeons, reviewed data for 246 deceased Ohio drivers, and found an average THC blood level of 30.7 ng/ML — 15 times the state’s legal limit — in 41.9% of dead drivers. Ohio is a fairly typical state in most regards, so I’d take that 42% as a good-enough approximation of trends in states with legal weed.
Almost a dozen years have passed since legal weed first went on sale in Colorado and Oregon, so the numbers, high as they are (heh), don’t surprise me. But the report is also frustrating in the context that it lacks. What percentage of fatal crashes involved weed before 24 states legalized recreational sales?
The closest we get to that side of the issue is this item from the ACS writeup: “The rate of drivers who tested positive for THC did not change significantly before or after legalization (42.1% vs. 45.2%), indicating that legal status did not influence the behavior of those who chose to drive after use.”
The study only reaches back six years — by which time medical marijuana, often a fig leaf for recreational use, had already been legal for four years. Prior to medical (and then recreational marijuana) becoming more widely available, there wasn’t nearly as much testing — making the data frustratingly incomplete.
The best I could come up with was setting Grok loose on the problem. Even Grok sounded a bit frustrated with the lack of data, but what it could find for THC-impaired dead drivers varied wildly from 1.1% in a single 1994 study, all the way up to 9% in 2000.
But both are a far cry from the 42% found much more recently in Ohio.
The American College of Surgeons does not attribute the shocking numbers to the legalization of THC, but I have to admit that I am skeptical that there is no correlation between making THC products easily available and the high number of fatal accidents related to driving high.
No doubt there are lots of people who can get high every once in a while and suffer no ill effects, and I certainly don’t support classifying marijuana or THC products in the same category as meth or fentanyl.
But still, the drive toward legalization was clearly based on horrible data and a misplaced belief that marijuana is pretty harmless. It isn’t.
All things considered, it should be much, much harder to get it.
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