As marijuana legalization becomes entrenched across America, what is known about the plant’s health benefits and adverse effects is rapidly gaining urgency.

In the first comprehensive review by American researchers in decades, their assessment of 10,000 studies since 1999 quantified the weight of research evidence and found cannabis has legitimate medicinal benefits for a variety of ailments, but also has been shown as a contributor to certain mental health issues and, to some degree, has a role as a gateway drug, according to the report from the National Academies of Sciences, Engineering, and Medicine.

Those are among nearly 100 conclusions reached by the U.S. scientific academy and released Thursday in a massive report on marijuana research to-date that includes directives for future study — notably that more robust exploration is needed across a wide array of public health-focused areas.

“We know very little about the high-potency cannabis that people are smoking; we know very little about the different ways people are using (cannabis),” said Ziva Cooper, a committee member and assistant professor of clinical neurobiology at Columbia University Medical Center.

The review of more than 10,000 scientific abstracts is documented in a 400-page report: “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research.” In cataloging and assessing research as a whole, the report provides clarity on the current knowledge base and also shines a spotlight on what’s lacking, particularly how cannabis is used in treating epilepsy and other conditions such as post-traumatic stress disorder.

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