Global health. The current scenario and future perspectives

215 in 2013 and Canada in 2018, but several states within the United States had already advanced with local legislation and others have approved them subsequently. So, by the end of 2021, a total of 17 states plus the District of Columbia have legalized recreational marijuana use (in more recent cases, the law has not yet been implemented). At a federal level, it remains an illicit substance. The new regulatory frameworks in these territories share a fundamental aspect, namely, the legalization, but each one has particularities that can make them very different. For example, in Uruguay there is strong state regulation that controls the type of substance produced (two varieties with a maximum THC content of 9% and a minimum CBD content of 3%) and controls the sale price. In addition, users must be registered in one of the three available options (self-cultivation, club registration or pharmacy registration), the minimum age to access is 18 and a maximum of 40 grams per month can be acquired (10 grams per week). This does not occur in US states, where a much freer market generally operates – retail prices are set by the market – and people aged 21 or older can access marijuana without requiring registration. The 2021 UNODC report (UNODC, 2021b) (Booklet 3, pages 32 and onwards) provides a detailed comparative description of different aspects of laws in each territorial space. It can be observed that there is no single regulatory model, but rather a diversity of them. These new regulations have not been exempt from controversy; they have supporters and detractors with varied arguments in each case. But the current regulatory model has also been under discussion for quite some time. While many arguments are rooted in ideological issues, below we will review some aspects observed as a result of implementing new approaches to recreational marijuana use. One argument against changes in current policy has focused on the fact that marijuana is harmful to health and that its legalization would create an opposite perception among the population, which would result in further decreased risk perception and therefore greater consumption. First, it is important to reiterate that drugs, all drugs, are harmful to health, not because they are legal or illegal, but because they are drugs according to the definition provided by the World Health Organization. For this reason, this argument is irrelevant when discussing drug legalization. Second, marijuana use has not necessarily gone up and even changes could be similar to those shown by countries where it has not been legalized. What do the results show about marijuana consumption in territories where it has been legalized? In Canada, the law was implemented in October 2018 and to evaluate the impact of cannabis legalization and regulation, the Department of Health (Health Canada) implemented a cannabis survey system among individuals aged 16 and older (Canadian Cannabis Survey).