Trump’s FDA Pick Thinks Marijuana Is A ‘Gateway Drug’ That Causes Heart And Mental Health Problems

President-elect Donald Trump’s pick to run the Food and Drug Administration (FDA) is a medical marijuana skeptic, promoting claims that cannabis use is linked to cardiovascular issues and mental health problems for youth. He has also suggested that marijuana is a gateway drug.

Marty Makary, a surgeon and medical commentator, has been selected to serve as FDA commissioner in the incoming Trump administration—a critical role as far as federal cannabis policy is concerned.

While the Robert F. Kennedy Jr., the president-elect’s choice for secretary of the U.S. Department of Health and Human Services (HHS) that oversees FDA supports ending marijuana prohibition and legalizing certain psychedelics for therapeutic purposes, Makary has been critical of cannabis use.

In September, he said that “people think marijuana today is the marijuana of hippies and that it’s entirely safe—but marijuana today is roughly 20 times more potent.”

“Even though it may have lower health complications in adults, that may not be true for adolescents where their mind is still developing,” he said on the mindbodygreen podcast. “The drug may have a different impact on young, healthy teenagers.”

“Some studies have found that among teenagers who use marijuana the risk of a psychosis diagnosis later in life goes way up—as many as 25 percent of people who consume it,” Makary said in the comments, which were first flagged by Cultivated Media, adding that he’s “not making a statement about the legalization or non-legalization,” but “to suggest that it is entirely safe is not consistent with the real scientific literature.”

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He made similar points in his book, Blind Spots, that was published in September, while peddling the gateway theory that cannabis leads to use of other more dangerous drugs.

“If we are going to be objective, we need to stop saying that marijuana is harmless and not a gateway drug,” he said. “The truth is that the available evidence does not support those opinions.”

Makary also disputed the “economic argument” that legalizing marijuana “kneecaps” illicit drug trafficking organizations, contending that “cartels and Chinese organized crime groups” dominate marijuana sales in states such as California, Oklahoma and Kentucky—and that they engage in a “modern form of slavery on U.S. soil today” by trafficking “their own workers.”

“The prevailing (popular) view on how to tackle America’s drug crisis is to increase law enforcement and/or legalize drugs. Another approach, that does not exclude other tactics, is to lower demand,” he said.

“The belief that marijuana is safe and definitely not a gateway drug looms large in society today, even among some doctors. Two dozen states have legalized recreational use of marijuana, as of 2023, and its use has become mainstream. But could it be that we are convincing ourselves what we want to be true?”

He additionally claimed that cannabis “may also affect intelligence,” citing a study tying marijuana use to “declines in verbal IQ and executive function tasks, such as trial and error learning and conditional association learning.”

However, he conceded that “there are underappreciated health benefits to THC, the active ingredient in marijuana,” describing “patients with Crohn’s disease and terminal cancer benefit from ‘medical marijuana.’”

“But that doesn’t mean it’s safe for young developing minds,” he said. “Another big question is: Is marijuana a gateway drug? What blows me away is how many people have strong opinions that it’s not, without any robust data to support their position.”

In February, Makary shared a social media post about a study linking daily cannabis use to increased risk of cardiovascular issues, commenting that it’s “one of many” such studies reaching the same conclusion and that “weed is not as safe as many people think.”

One of many studies showing the strong link between chronic marijuana use and cardiovascular disease. Weed is not as safe as many people think. https://t.co/s2JWDSCnrX

— Marty Makary MD, MPH (@MartyMakary) February 29, 2024

If confirmed as FDA commissioner, Makary would wield significant authority over cannabis-related policy issues. For example, a current top official at the agency recently said FDA retains authority to remove cannabis-infused foods and drinks from the market, though that level of enforcement action is rare.

FDA also plays a central role in any drug rescheduling decision, leading a scientific review that is then provided to HHS and submitted to the Drug Enforcement Administration (DEA) for consideration. That’s the process that’s actively unfolding after FDA determined that marijuana should be moved from Schedule I to Schedule III of the Controlled Substances Act (CSA).

While certain stakeholders have been encouraged that Trump’s HHS pick, Kennedy, is in favor of cannabis reform and could theoretically push for complete descheduling with another review, the FDA commissioner’s perspective would likely factor into the rulemaking process.

With Makary signaling opposition to marijuana—and pro-legalization former Rep. Matt Gaetz (R-FL) being replaced by former Florida Attorney General Pam Bondi (R), who opposed medical cannabis legalization in the state, as Trump’s choice to lead DOJ—the prospects of a revolutionary approach to marijuana under a Trump administration have become all the more uncertain.

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Photo courtesy of Mike Latimer.