California’s Cannabis Crisis: A Public Health Time Bomb

The passage of California’s Proposition 64 legalizing recreational marijuana in 2016 was supposed to usher in a safer, more equitable, and regulated future for Californians. Instead, it delivered a heavily taxed and regulated, commercialized industry that co-exists with a bountiful supply of illicit cannabis enterprises. The result — a public health crisis that’s overburdening the healthcare system, endangering children, and quietly punishing the very people state leaders claim to protect.

The Smoke No One Voted For

Walk through many California neighborhoods and you’ll find the pungent scent of cannabis is more common than cigarette smoke ever was. A 2021 study found cannabis use is now more likely to occur inside homes with children than tobacco, a stunning reversal in public acceptance of marijuana consumption.

This isn’t just a cultural shift; it’s a public health hazard, especially for residents with asthma or cardiovascular conditions. Marijuana smoke contains many of the same toxic and carcinogenic chemicals as tobacco, including “acetaldehyde, ammonia arsenic, benzene, cadmium, chromium, formaldehyde, hydrogen cyanide, isoprene, lead, mercury, nickel, and quinoline.” And while California’s Health and Safety Code (§11362.3) prohibits cannabis use in places where tobacco is banned (workplaces, federal property, state parks and beaches), enforcement is lax. Apartment dwellers, tenants in mixed-use buildings, and workers at cannabis-hosted events are now routinely exposed to secondhand marijuana smoke, often without consent or recourse. Meanwhile, the state’s “Right to Farm” laws also offer little relief to rural residents forced to endure the “sewer-like” stench of nearby cannabis farms.

For a state once hailed as a pioneer in clean air and anti-smoking legislation, this is a stunning regression. Incredibly, Assembly Bill 1775 recently signed by Governor Newsom, allows cannabis retailers and microbusinesses to host live indoor events where food and non-alcoholic beverages are served. Note: marijuana yes, alcohol no. Why, you may wonder? Defense attorneys will tell you, marijuana DUIs are easier to fight than alcohol-related ones.

The Healthcare Fallout of California’s Cannabis Policies

CNN Health highlighted a 2025 systematic review published in the journal Heart. This study pooled the data from 24 studies published between 2013-2023. Their results are cause for concern, especially in light of the ongoing legalization of recreational marijuana. Researchers found that cannabis use is associated with significant cardiovascular risks: a 29% increased risk for heart attack, a 20% increased risk for stroke and a whopping 110% increased risk for cardiovascular death, when compared to non-users.

Additionally, CNN Health interviewed researchers at the University of California, San Francisco, who stressed that cannabis’ negative cardiovascular effects are not limited to those who smoke or vape. Dr. Leila Mohammadi, reported that consuming THC-edibles was associated with a 56% reduction in vascular function compared to non-users.

The damaging health impacts of cannabis go far beyond cardiovascular effects to include serious mental health and addiction concerns. Researchers found that consuming high-potency THC products is linked to an increased risk in developing generalized anxiety disorder, psychosis and schizophrenia, along with a “four-fold increased risk of addiction.” Exacerbating the issue, high-potency concentrates — some exceeding 90% THC — are rapidly becoming the norm, not the exception.

As the legalization of marijuana expands, along with the false notion that it is somehow a safer alternative to traditional medications and tobacco smoke, it is becoming ever more apparent that our hospital systems will see a rise in THC-related cardiovascular events and psychosis.

Children Are Paying the Price Too

The healthcare fallout is not limited to adults. Rady Children’s Hospital in San Diego reports treating over 100 children annually for cannabis poisoning (2020-2022). Dr. Natalie Laub, a pediatrician at Rady, sadly noted that toddlers arrive in “very bad shape… with seizures and not breathing… altered mental status; they won’t wake up.” These are not isolated incidents. They’re the logical result of widespread normalization, lax packaging standards, and an explosion of high-potency products designed to look like candy.

As California continues to lead the way in pro-cannabis cultivation, production, and policy-making, while virtue-signaling on its healthcare concerns for both its legal and illegal citizens, take note: science bends to politics in the once Golden State.

A Healthcare System Buckling Under Its Own Weight

One might hope California’s public health system could absorb the fallout from its cannabis policies. But that hope is naïve — and dangerous.

In 2024, California expanded Medi-Cal to include the last remaining group of illegal immigrants not already covered: those aged 26 to 49. That added over 700,000 new recipients to a system already strained by low reimbursement rates and long wait times.

Critically, this expansion was not matched by a corresponding increase in the number of providers willing to accept Medi-Cal. In fact, only 64% of California physicians currently do. Therefore, it would not be prognostication to surmise that legal low-income Californians now face even longer delays, fewer specialists, and deteriorating access to care. And heartbreakingly, more will join those who have already died waiting for appointments, procedures, or treatment.

Rather than prioritize better service or provider recruitment, California chose to expand coverage even further — largely for political reasons — and now everyone is paying the price. The cannabis-related rise in ER visits is just one more weight on a system already teetering.

Follow the Money — If You Can

Rather than confront the consequences of these policies, California’s bureaucracy has opted for a financial sleight of hand. A 2025 report from the Paragon Health Institute exposed a maneuver in which the state taxes Medicaid insurers at triple the rate of private ones, then recycles those funds to draw down higher federal matching dollars, a scheme likened to “legalized money laundering.” Between 2023 and 2026, it’s projected to generate nearly $19 billion in federal reimbursements.

But the money isn’t going toward stabilizing Medi-Cal. Instead of aiming to recruit doctors, shorten wait times, or invest in addiction treatment, the money is being redirected to pay for the expansion of Medi-Cal eligibility for illegal immigrants and wealthier seniors, through the elimination of asset tests. The result? California’s public healthcare system is now a slow-moving train wreck — and cannabis is one of the conductors.

The Cost of Going “Legal”

Meanwhile, California’s cannabis tax policy may backfire. The state recently raised its excise tax from 15% to 19%, a move that will almost certainly push more California consumers into its prolific black market. According to ERA Economics, Californians consume a higher percentage of cannabis from unlicensed operators than licensed ones (60% to 40%). Moreover, 91% of all cannabis produced in California in 2024 came from unlicensed growers (11.4 of the 12.5 million pounds of cannabis produced), many of whom may bypass testing for pesticides, mold, heavy metals or solvent residues. As illicit growers remain largely unhindered by the excise tax increase, licensed cultivators, already burdened by regulation and mandatory safety and contaminant testing, have warned that the hike will likely force many of them to shut down.

Lack of Legal Deterrents

California’s illegal growers face minimal penalties. As CNN’s Kyung Lah recently reported, illegal cannabis cultivation in California is often charged as a misdemeanor—regardless of whether it’s one plant or a truckload. This allows unregulated farms to operate without oversight, sidestepping the costs of compliance while posing environmental and chemical hazards to the public. The result: unregulated growers flooding both the California and national market with potentially toxic, unlabeled products.

California’s regulatory model punishes compliance and rewards evasion. It’s the inverse of public safety.

A Moral Reckoning Is Due

Marijuana legalization was sold to Californians as a moral cause: safer streets, social justice, tax revenue for schools and youth programs. But nearly a decade later, those promises have gone up in smoke. Equity has been replaced by cronyism. Public health has taken a back seat to profit and virtue signaling. And the state’s neediest residents — including legal citizens who depend on Medi-Cal — are being quietly sacrificed on the altar of progressive optics.

It’s time for Sacramento to stop chasing tax revenue for progressive ideological causes and start focusing on outcomes: policies aimed at improving public health, accessible healthcare, and meaningful regulation and enforcement. Because right now, California’s cannabis experiment is not just failing, it’s harming the very people it promised to help.