Referenda on the November 2018 ballots of 16 Wisconsin counties and two cities revealed that between 67 and 88% of voters supported legal medicinal marijuana use-not surprising since 33 states have already taken that step. But in Dane, Eau Claire, La Crosse, Milwaukee, Racine, and Rock counties, an average of 65.1% of voters supported legalizing recreational use.

If that many Wisconsinites believe adults should use marijuana for fun, we need to look at the unintended consequences. Especially for the youth who will inevitably tap into adult supplies.

Research shows that:

• Marijuana and certain cannabinoid compounds can be temporarily effective for pain control and relief from some disease symptoms and chemotherapy side effects. But research has not identified the specific properties responsible for the results.

• Today's marijuana is not like that of 20 years ago. Hallucinogenic tetrahydrocannabinol (THC) content has risen from 2% to as high as 28%. Variously named concentrates are popular products with THC levels as high as 68%. Often odorless and smokeless, they can be vaped or smoked.

• Long-term physiological and psychological effects for concentrate users are unknown. Addiction studies show that the more potent the drug, the more likely dependence and continued use will occur.

• A landmark United Kingdom study found that high potency marijuana use resulted in a three times greater risk of psychosis. Daily use raised it to five times the risk. Multiple other studies document a relationship between regular cannabis use and increased suicide intent. More than one study found that marijuana provides no long-term improvement of Post-traumatic Stress Disorder (PTSD), although one compound-cannabidiol (CBD) oil-appears to reduce anxiety. The Veterans Administration has initiated a clinical trial to assess its effectiveness.

• Regular marijuana use negatively affects learning, memory, attention, academic achievement and social relationships. Using in adolescence and young adulthood can be detrimental to normal brain development.

• Increased revenues from taxes, licenses and fees in regulated recreational use can be lucrative for local and state government. But social and public health consequences are affecting states like Colorado, California and Washington. Studies to assess those consequences are cutting into revenues.

• Legalization and regulation don't eliminate black market sales. Colorado's highway seizures of marijuana have increased 39% since 2013 and U.S. mail seizures, 1,042%. Drug cartels ability to undercut prices of legal product have caused dispensary prices to nose dive. Criminals from regulated states are arriving to make legal purchases for black market sales elsewhere.

• According to the Wisconsin Alcohol Policy Institute, alcohol-related injuries kill more people in the state than alcohol-related disease. Evidence shows that in states with legal recreational use, cannabis-related injuries and deaths, on and off road, are increasing.

• Evidence also shows that states with legal recreational use have more unintentional cannabis overdose injuries among children, with ingestion the primary cause. At Children's Hospital Colorado facilities, the number of treatments for cyclic vomiting, paranoia, psychosis and other acute cannabis-related symptoms have increased.

For at least two decades, American teens have had easy access in our communities and schools to mood altering drugs. We adults are shamefully inept at prevention and intervention. Is Wisconsin, like Seattle and Denver, prepared for more marijuana dispensaries than McDonald's or Starbucks near our high schools? Or more drug dealers from neighbor states here to buy legal product?

A 2015 Health Metrics and Evaluation study found that Wisconsin was the heaviest-drinking state in the country. Minimizing the negative effects of marijuana use and making its use socially acceptable are dangerous for children. Those who use marijuana before age 18 are four to seven times more likely to develop a marijuana use disorder. According to results in the nationwide 2018 Monitoring the Future study, 12th grade use of marijuana vaping is rising. Should we ignore this trend?

Until scientific research excludes public health risks for the young, Wisconsinites should vote a resounding no to legalizing recreational use of marijuana. We owe our kids that much, don't we?