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Science Should Guide Marijuana Policy

August 18, 2014

In a series of recent articles, The New York Times’ editors presented a case for repealing the federal ban on marijuana, including the disproportionate impact of current marijuana laws on minorities. While there is no question that we should rectify any injustices associated with such policies, we also need to consider and prepare for the escalation in social and health costs that could result from creating a third legal drug in this country.  We should be thoughtfully examining all policy and regulatory options available to minimize harms to society and promote Americans’ safety, well-being, and competitiveness.

Marijuana leaf

We do not yet know how marijuana will affect vulnerable populations like older people or those with physical or mental health problems. We do know that marijuana increases the risk of car accidents (about 2-fold on its own, even more in combination with alcohol). And the science of marijuana’s long-term effects is increasingly clear. Besides being addictive, marijuana is cognitively impairing even beyond the phase of acute intoxication and regular use during adolescence may cause a significant, possibly permanent IQ loss. Brain scans in users who started when they were young show impaired neural development, probably because cannabis interferes with normal brain maturation.

There is no reason to think laws limiting marijuana to adults will be any more successful than comparable laws for cigarettes or alcohol. Legalization will likely increase the already substantial proportion of teens that use marijuana regularly and thus put themselves at a competitive disadvantage in school and life.  As a nation already faltering in educational achievement, we should not hamstring our competitiveness in this area further.

As states consider modifying their marijuana laws, it is crucial they use science to guide their decision making, learn from past mistakes, and act to prevent the establishment of a “big marijuana” industry that will benefit from creating and sustaining a new generation of young people addicted to their product. Furthermore, we have a responsibility to ensure our nation’s healthcare workforce is prepared to respond to both the increased interest in the potential therapeutic uses of marijuana as well as its negative health consequences that policy changes will likely spur.

Approaching drug use as a public health issue should be a critical goal, and these approaches should be informed by science.

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legalizing marijuana

This is very bad legislation! Our younger generation will be an or presently in jeopardy. This plant when smoked affects clarity of mind!!!

Cannabis and psychosis

Could you please comment on the evidence that cannabis may be a causal component of schizophrenia and other psychoses?

Available research suggests

Available research suggests that marijuana may contribute to the development of psychotic disorders in individuals who have a pre-existing genetic or other vulnerability. This review summarizes the science so far.

Stop the lies

Can we please for once get the real science and not your blah blah. I've heard this nonsense since I was a child and had to endure the fried egg campaign to keep kids off drugs. Miss Nora, your own government web sites have numerous articles touting the safety and medicinal use of cannabis. It was this same government that synthesized the plant for it's medical benefits. How can you keep lying to the public? How can you keep claiming it has no benefits when anyone with a computer can track down the government patents and studies done at respected Universities? They can research for themselves how this plant was demonized in the first place by large companies looking to stop the competition. The same sites have stories about hundreds upon thousands of lawsuits and deaths associated with the pharmaceuticals that have been deemed safe. Please stop already. This demonizing of a plant has caused so much more harm in the last 70 years. If you are going to keep posting your chicken little act then at least add to it the full reports. Show us the science such as the chemical makeup of the plant. Tell us just what percentage of THC is used in the so called 'studies' that say it's harmful. Try to study the medicinal aspects of the plant and use it's oil instead of watching people smoke it. Get out of your office and go visit some hospitals. Visit the patients saying their diseases have been cured by this plant. Then, if you dare, go visit any cancer ward and speak with the children who are dying. Talk to their parents about how harmful they think cannabis is compared to the chemo that's being pumped into their little bodies. Frankly at this point, I don't care if making it legal causes more children to try it. When and if they do, they will decide for themselves if it's worth continuing. Whether or not they ever try cannabis, they will some day be given a deadly drug by some doctor. What about that problem now Miss Nora? How many prescriptions are you on? How many die everyday because of these legal 'beneficial' medicines? Enough already! We are sick of the bold face lies.

I can't believe this propaganda

While it's a waste of time to even bother commenting. I have to make one point. You said this should be treated as a public health issue but in the same writing piece you advise that every person that consumes cannabis should be arrested and prosecuted. That's not treating this like a public health issue that's treating this whole mess as a criminal matter. It's a shame if you believe the stuff you've written, we should be advocating for the truth not spreading misinformation.

A scientific study on the comparison of harms is needed

Dear Dr. Volkow,

Firstly let me applaud your defense of policy based on science. I agree that our scientific understanding of public health issues should absolutely inform policy. Furthermore, I have examined in depth the many NIDA supported studies of cannabis's potential negative effects, and agree with your assertion that there is ample evidence to suggest that consumption of cannabis, especially by the young, likely invites serious health risks.

Despite my agreement with these points, I feel that there has not been adequate study on the totality of societal harms caused by the use of cannabis (either in it's current illegal context, or in the anticipated expansion of use in a legal context) in contrast to the totality of societal harms caused by it's prohibition. It would seem to me that such study would be a necessary first step to adequately inform public policy.

Based on this paucity of evidence, I would expect that any assertion that the totality of societal harm is reduced by maintaining the current prohibitions on the sale and use of cannabis cannot be supported scientifically.

Based on some studies that I have read, it would seem that by coupling a legalization of cannabis with strong regulation and a strong public health education campaign aimed at informing the public of potential dangers, that the total usage increase could be successfully minimized, while at the same time dramatically reducing the costs and societal harms caused by the current law enforcement approach, resulting in a net reduction in societal harms.

However, I am not yet convinced on the quality of that research, and believe that neither NIDA nor NIH has yet supported any such investigation into this question. I'd therefore presume you don't feel comfortable at present commenting on it's accuracy.

Will NIDA at some point support such research to better inform public policy?

Thank You for your consideration of my comment.

Look at the children

Here are many of the children that have had to be moved from their home states in hopes of finding help. Our current way of treating their illnesses are failing miserably. Something needs to be done now.
http://www.huffingtonpost.com/2014/01/31/cannabis-for-children_n_4697135...

It's too bad the research

It's too bad the research funding has typically funded negative studies. Science is supposed to be an unbiased approach to finding answers, however in this case, marihuana has been subject to very biased funding tactics. If a scientist wants to show positive effects they must seek private funding since the agenda of drug policy has been to eradicate rather illucidate.

NIDA and several other

NIDA and several other Institutes at the NIH do currently support projects looking at the therapeutic effects of cannabis and cannabinoids. For more information, see: http://www.drugabuse.gov/drugs-abuse/marijuana/marijuana-research-nida

Enough is enough - no more double standards.

To whom it may concern: Could you imagine how many people would die if all our pharmacies suddenly decided to sell OTC drugs in 1kg bricks or 1g baggies, with no mention of the ingredients or purity level, nor how much equals a safe dose?

A street drug consumer has to put up with this sort of thing every time they buy another dose of a controlled substance not approved for medical usage - just pointing that out because it greatly contributes to the death rate in our nation, and everywhere else. The War on Drugs has failed miserably. It has not met any of its goals or promises set forth over 40 years ago. It has not reduced the availability of controlled substances , which are now far cheaper, far more potent, and more available than they were 40 years ago. I'm not defending peoples' choices to consume street drugs, but I also would never judge them for it. And I'm not suggesting it's risk free, as no drug use is without risk. Is it reckless, risky, and potentially deadly in the worst case scenario to engage in such behavior? Absolutely - especially when it comes to the "harder" substances. That being said, no matter what the potential risks to their health, human beings WILL ALWAYS continue to consume mind altering substances based on preference, regardless of whether they are legal or not. And the reasons for them choosing to use such substances are numerous. The route or path to eventual compulsive drug seeking behavior can be an extremely complicated issue spanning several decades.

Regardless of the reasons some of us persist in risking our lives because we do not prefer alcoholic beverages and/or tobacco/nicotine products, yelling at them for their actions, calling them names, and judging or treating them like criminal scumbags will NOT solve anything and won't help anyone. It will only make things worse. If anything, it will make them want to escape their sober state of mind even more if they are treated irrationally by complete strangers - all because of a plant, powder, or pill. Therefore, if our intention is to sincerely try to help them, the derogatory remarks and the bloated propaganda needs to completely stop, and a radical shift in laws, policies, and education needs to prevail.

I cannot stress this enough: Everyone should never think that socially accepted, regulated, legal drugs such as alcohol are inherently safe for consumption, because they're absolutely not. Not even close. In large amounts, ethyl alcohol has been shown repeatedly to be neurotoxic, hepatotoxic, and cardiotoxic. And in any amount, it is now a Group 1 Carcinogen according to the World Health Organization, and listed beside Asbestos, Formaldehyde, and various radioactive isotopes (among other things). That's correct - any amount of ethyl alcohol consumed by a human being increases the risk of developing cancer. Therefore, if - for example - I am a drinker, and I partake in stigmatizing and ostracizing the "other drug users" for their decision to risk their health to get "high," I believe it's very hypocritical (and ironic, if I was to end up with cancer due to booze).

With respect to tobacco/nicotine products, I won't go any further than to state that every 8 seconds, there is a death somewhere in the world due to this very costly habit which has been shown to be more addictive, more habit-forming than heroin, cocaine, and everything else that's considered a scourge.

I am very concerned for the future of our nation, because if the current drug laws continue to be left as they are, the situation will continue to get progressively worse, as it has for the past 4 decades - ever since Nixon (who happened to be crooked all along) declared War on Drugs for reasons which more and more of us strongly believe had little to do with health concerns, and much more to do with votes, approval ratings, and party donations. After officially declaring war on drugs, Nixon made a promise that America would be free of street drugs by the turn of the decade (1980), and obviously it didn't happen. And if that wasn't bad enough already, In 1998, the United Nations foolishly declared that we would have a drug-free planet within a decade, committing member states to eliminate or significantly reduce use of opiates, cannabis and cocaine as they had all been hoodwinked into ratifying the UN Single Convention on Narcotic Drugs treaties. Instead, global opiate use rose by more than one-third, with big rises also for cocaine and cannabis. Last year (2013), the British Medical Journal found that street prices had declined over the past two decades, while potency and general availability increased.

So when - and more importantly, how - will this madness end (before one of your loved ones ends up dead too)? Well, Uncle Sam can continue to stubbornly arrest, execute, or even torture every drug dealer his bureaucratic lackeys catch, and it won't make an ounce of a difference, as there's always someone desperate enough to take his/her place. You can also throw all the users in prison, but beware that their drugs of choice are available in there as well - smuggled in by guards looking to make some extra money. Corruption is rampant in law enforcement when it comes to narcotics. Not one prison in America is drug free.

Whatever your opinion on the matter, we must all understand and accept the fact that drug dealers accept a career in drug trafficking knowing full well that it may end in their death or life in prison. So regardless of what is done to them once they are caught and apprehended, the dealing will continue as if nothing happened. As such, if our government truly wants to see a reduction in drug use, things need to change, and radically.

First thing's first - The only way we can hope to cripple a $350 - 400 billion USD illegal industry (and growing very fast) is to either stop the demand, or, take over the supply. It's really not rocket science. Since demand for these drugs will NEVER cease, unfortunately, that means plan B: take over the supply, strictly regulate it, tax the hell out of it, and educate everyone about the dangers of using, as is done with smoking, but don't turn them into criminals, as it won't help them stop in the long term. This decision - while extremely controversial due to decades of propaganda - will help stop the spread of HIV and other diseases, as well as help stop addicts spending whatever money they have on their drug of choice (black market prices are still quite expensive). Not everyone likes alcohol and tobacco, just like not all of us enjoy sushi or chicken. Accept it, and get over it, because some people would rather smoke weed instead of drinking beer - it's what makes us human (unique tastes and preferences).

Secondly, the abstinence-based approach carries with it some very unrealistic expectations and it needs to be dropped in favor of something a little more reasonable, such as harm reduction, which has been proven to be far more effective when properly implemented.

Third - Non-violent drug users should never be considered criminals for the simple act of possessing and consuming a substance. If anything, they need some proper medical attention, and not a stint in prison where they can continue to access their drug of choice. They are suffering enough already, and yet we want to jail the non-violent ones further? Where's the logic in this? Our tax dollars are better spent elsewhere than keeping an otherwise law-abiding individual locked up because he happened to be in possession of some pills, powder, or parts of a plant for personal use. Criminalizing such victimless behavior is far more harmful than the crime of drug possession. Prison is not a place where you go and come out a changed man for the better.

Lastly - the biased propaganda, and the stigma surrounding the street drug using minority must end. Again, no one is suggesting that recreational drug consumption is a good idea. No drug is without risk. But enough with the name-calling and discrimination. They are human beings, not animals. We must have some patience with them. They didn't become addicts overnight, and they certainly cannot stop their addiction overnight either. It's a prolonged process which they will need to stop. It's very sad to think that these individuals would be accepted by society if only they picked another poison to consume - a legal one such as alcohol.

All in all, enough is enough. 4+ decades and no tangible results, but only failures. Over $1,000,000,000,000 USD in tax payer money spent over the past 4 decades in the US alone on efforts to eradicate street drugs for good, with no empirical data to suggest any of it has been a success in the long term. It either stops now, or, it'll stop when too many of the so-called elites are affected and caught, but by then I'm afraid our urban areas will have been turned into war zones due to the unnecessary militarization of our police.

Sick and Tired Already

Malarky. Let's just control everybody. Let's surrender our individual rights as adults and let some "Big Brother" government enforce its will on me as a sentient being. Let's make it illegal for me to harvest honey because I might get stung. Forbid me to swim without a license because I might drown if not properly taught. Is it illegal to drink turpentine? Common sense says we shouldn't do it. Whose life is it, anyway? We are about to surpass George Orwell's 1984 with a vengeance. Take away our guns first, and then you can take anything you want whenever you want. I am 55 years old, and this is not the America I grew up in. If I choose to drink alcohol or smoke a herb, I do not need or respect your permission.

Marijuana and violence

One widespread myth that should be dispelled pronto is this notion that marijuana induces users to be peaceful and non-violent. Popularized by the pro-legalization lobby, many seem to believe strongly that greater world-wide use of marijuana would necessarily make the world more peaceful and that there would be fewer wars. Let me suggest why this is a falsehood.
True, cannabis under the influence is a sedative, but the real harms come later from mental illness after months or years of use.(that's another area of vast confusion for the public)
To wit: Has anybody noticed that many, if not all of the notorious mass murderers on US soil and many abroad over that the last few decades were pot users? Bundy, Manson, Breveik, Holmes, Klebold, Harris, Dahmer, etc. And, has anybody noticed the assassination attempts on US policitians since Sirhan, Sirhan, were all also users of pot? Fromme, Moore, Hinkley, Loughner and now Ortega-Hernandez. In fact, Ortega-Hernandez's express purpose for attempting to assassinate the President was frustration over pot legalization. (there may be some connection between Sirhan and hashish, still unknown), Also, of interest, Chapman who assassinated John Lennon, was a pot user too. And then, many of the major bombers on US soil were pot users as well- the Weather Underground, McVeigh, Nichols, Fortier, the Tsarnaevs, and many other attempts, ALL pot users.
Then we have the innumerable homicides across the land, in just about every newspaper every day, so so many connected to narcotics, every which way you turn, of which the common denominator in every single one of them, is marijuana, And then we have the gangs and their myriads of murders. Yep, they too use marijuana and test postive for it druing arrests. Well, what about the gangs and drug cartels in Mexico who are committin these horrendous atrocities? Yep, them too it appears, though evidence is sketchy and hard to come by. But just like all dealers of narcotics, they must be well familiar with their merchandise. Well what about the terrorists in the Middle East? Apparently them too, where hashish and high potentcy marijuana abound in their culture, Google and you can even see kids smoking hashish, travelers and soldiers will also attest to widespread narcotics use all across the Middle East. Hashish is given to the suicide bombers, the terrorists are heavy users of cannabis, plus narcotics are fundamental to their militant training. It appears this process has been going on in the Middle East for a longtime, whereas in the West, in our 'drugs are beautiful' idiocy, we are merely seeing the tip of the iceberg was cannabis use escalates both in potency and frequency. Likely why so may users attest to the so-called harmlessness of pot, ie the children of the sixties, is because most use was of milder, less potent pot. Once in a while, a predisposed user over indulges over the months or years, devolops a mental derangement, and then for whatever reason, seeks revenge on society through mass murder.
Now, it's impossible to establish causal relationships merely from anecdotal data, ie correlation is not causation. Yet, at least in my opinion, there does appear to be a mental derangement that can develop in some susceptible cannabis users that may deprive them of inhibitions for unleashing the most horrible and unspeakable forms of violence. The exact process at the neuro-biological level is unknown, yet with so, so many cases, it appears something is going on that alters the mind to that end.
Whether science can ever prove this connection, let alone show interest, is one thing. But I think we can all veritably lay to rest this notion that widespread marijuana use (including hashish) will necessarily bring about more world peace. It's a myth.

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The following website can help you find substance abuse or other mental health services in your area: www.samhsa.gov/Treatment. If you are in an emergency situation, people at this toll-free, 24-hour hotline can help you get through this difficult time: 1-800-273-TALK. Or click on: www.suicidepreventionlifeline.orgExternal link, please review our disclaimer.. We also have step by step guides on what to do to help yourself, a friend or a family member on our Treatment page.

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    National Institute of Drug Abuse (2014). Science Should Guide Marijuana Policy Retrieved from http://www.drugabuse.gov/about-nida/noras-blog/2014/08/science-should-guide-marijuana-policy

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