Psychology Today’s Cannabis Hit Piece Isn’t Rigorous, It’s Recycled Reefer Madness
Samantha Stein, Psy.D., a psychologist in private practice in San Francisco, published a piece on Psychology Today called “The Hazards of Marijuana.” It’s got a respectable outlet’s name on it, a doctorate behind the byline, and a handful of real citations. It also opens with a sentence that has no business appearing under a credentialed clinician’s name:
“When it first became popular, it was seen as the drug of choice for ‘stoners’—people who drop out of school or life. People who lose motivation to do much of anything.”
Let’s sit with that for a second. Who decided that dropping out of “life” is what a stoner does? What’s the diagnostic criteria for dropping out of life, exactly? Is that in the DSM-5, or is that just an opinion Dr. Stein picked up from the same cultural reservoir that gave us Reefer Madness and D.A.R.E. pamphlets? There’s no citation attached to that sentence because there’s no study behind it. It’s a value judgment wearing the costume of a clinical observation, and it tells you everything about the lens this piece was written through before you even get to the parts that are trying to be factual.
Here’s my problem with articles like this one: when you bury real, contested science underneath unsupported moralizing, you make it easy for readers to dismiss the real science too. So let’s separate the two, because Dr. Stein isn’t wrong about everything, and pretending otherwise would make me guilty of the same selective reasoning I’m accusing her of.
The Claims That Have Real Data Behind Them
Stein cites a figure that “roughly 3 in 10 cannabis users develop some degree of cannabis use disorder,” with risk rising for daily use and for people who start before 18 (1 in 6, by her count). That’s not fabricated. It lines up reasonably well with NIDA-adjacent research and with the JAMA Psychiatry study I wrote about elsewhere this week, showing rising CUD rates as today’s products get more potent. I’m not going to pretend cannabis use disorder is a myth invented by narcs. It’s real, it affects a meaningful minority of regular users, and treating it as a non-issue does nobody any favors, least of all the people struggling with it.
Where the article goes wrong isn’t in citing that number. It’s in presenting contested, actively-debated science as settled fact with zero acknowledgment that a debate exists.
The Psychosis Link Is Real, But It’s Not What She Implies
Stein writes there’s “a strong—almost definitive—link” between marijuana and psychosis or schizophrenia, and that “research now shows the risk exists even without any genetic predisposition.” That second clause is doing a lot of quiet work, because it’s nudging readers toward causation without saying the word.
The honest state of the science, per psychiatric researchers actively publishing on this exact question, is that this remains one of psychiatry’s genuine unresolved controversies. A landmark 2021 review in the American Journal of Psychiatry concluded that recent epidemiological findings continue to support both a possible causal effect of cannabis on psychosis and substantial evidence for reverse causation, meaning people in the prodromal stages of schizophrenia may self-medicate with cannabis before their psychosis is diagnosed, and for genetic confounding, meaning some people carry gene variants that raise their risk for both heavy cannabis use and schizophrenia independently. Mendelian randomization studies, which use genetic variants to tease apart cause from correlation, have produced results on both sides of this question. Some find a modest causal contribution from cannabis. Others find the relationship runs the opposite direction, with genetic liability for schizophrenia predicting cannabis use rather than the reverse.
The most defensible summary, the one actual psychosis researchers give, is that cannabis is probably a component cause that interacts with genetic vulnerability, not an independent trigger that creates psychosis out of nothing in a person with no underlying risk. That’s a meaningfully different claim than “a strong, almost definitive link” that exists “even without any genetic predisposition.” One is a hedge grounded in an active scientific controversy. The other is a claim that oversells certainty the field itself doesn’t claim to have.
The IQ Claim Skips the Entire Debate
Stein states plainly that “long-term recreational users show average IQ decline, with the effects especially concentrated in those who start young.” She’s referencing something real, almost certainly the Dunedin cohort study led by Madeline Meier, published in 2012, which did find IQ declines in persistent heavy users who started young.
What she leaves out entirely is that this finding has been seriously challenged. A 2016 study in the Proceedings of the National Academy of Sciences, using two separate longitudinal twin cohorts, found that when you compare cannabis-using twins to their non-using siblings, the twins who used marijuana did not show significantly greater IQ decline than their abstinent siblings. Multiple independent twin studies since have corroborated that finding. The researchers’ conclusion was that the IQ declines observed in cannabis users likely stem from shared familial factors, things like socioeconomic status, that predict both marijuana use and lower intellectual attainment, rather than from a direct neurotoxic effect of the drug itself. Scientific American covered this shift in the science under the headline “Marijuana May Not Lower Your IQ.”
This is precisely the kind of confounding-versus-causation debate that responsible science journalism is supposed to flag. Stein doesn’t flag it. She states the contested finding as though it’s uncontroversial, which misinforms readers just as surely as if she’d invented the statistic outright.
Where I’ll Actually Give Her Credit
I want to be fair here, because objectivity cuts both ways. Stein’s broader point, that “plant medicine” branding oversells cannabis as risk-free, is legitimate. Cannabis absolutely can impair driving, disrupt sleep architecture, provoke anxiety and paranoia in susceptible people, and create real dependence in daily users. Calling it “harmless” is marketing, not medicine, and I’ve made that exact argument myself. A regulated, adult-use product still carries adult-sized risks, and consumers deserve honest labeling instead of wellness-industry spin.
But there’s a difference between “cannabis carries real risks that deserve honest discussion” and opening your article by defining an entire category of users as people who “drop out of school or life.” One is a legitimate clinical point. The other is stigma dressed up in a doctorate, and stigma is exactly what has kept cannabis research underfunded and cannabis users criminalized for the better part of a century.
The Real Hazard
The actual hazard here isn’t marijuana. It’s a licensed clinician publishing on a platform called Psychology Today, presenting contested causal claims as settled science, and opening with an unsourced moral judgment about who “drops out of life.” That’s not psychology. That’s prohibition-era folklore with a byline. If we’re going to have an honest conversation about cannabis risk, and we absolutely should, it has to start with getting the actual state of the evidence right, confounders, reverse causation, competing studies and all, instead of reaching for the stoner stereotype because it’s a familiar, comfortable villain.
MORE ON CANNABIS PSYCHOSIS, READ ON…
