Since the 1960s, there have been calls for legalisation and/or at least decriminalisation of cannabis due to its relative harmlessness and the negative impact of users entering the criminal justice system for having it in their possession. In the Caribbean, and partly because of its association with Rastafarianism, these calls have argued that its beneficial effects outweigh any of its potential negative sequelae. A frequently cited model of decriminalisation is the Netherlands, where cannabis use has been decriminalised such that ‘coffee shops’ have been selling small amounts for recreational use since 1976. The use of medicinal marijuana is legal with a prescription in the Netherlands. Over the past 20–25 years, there has been a movement within the Americas to follow this lead and gradually decriminalise the use of recreational cannabis and legalise the use of medicinal cannabis. This chapter presents Caribbean research on negative aspects of cannabis use as well as international research presenting both sides.