The New Weed Whackers
The New Weed Whackers
A meeting last week between Attorney General Eric Holder and Washington state governor Jay Inslee was “confidence building” for Inslee and left him ready to move forward with the state’s new rule legalizing the recreational use of marijuana, he told the Seattle Times. Although Holder didn’t say anything explicit about whether the Obama administration will take legal action against the first two states that have legalized the drug—Washington and Colorado—so far the president seems to be signaling that he will allow the states to experiment.
But opposition forces are also scaling up. Last week, Patrick Kennedy, former Democratic representative from Rhode Island, announced that he is organizing a group to fight marijuana legalization. The organization, Project SAM—for Smart Approaches to Marijuana—announced its formation at a press conference in Denver. Its board includes former Bush and Obama drug policy advisor Kevin Sabet, conservative columnist David Frum and Harvard assistant professor of pediatrics Sharon Levy, MD.
Of course, the involvement of a politician like Kennedy in such a group, whether Democrat or Republican, isn’t exactly newsworthy. Both parties tend to be reactionary on drug policy and neither has distinguished itself in terms of fighting addiction. But I had higher hopes for Kennedy as an advocate, given the long history of addiction in his famous family and his own ongoing recovery.
In fact, I can’t really get my head around why people who have suffered addiction would support criminalization—especially people like Kennedy whose top talking point is that addiction is a disease. For one, isn't the very fact that they themselves got addicted evidence of the failure of current drug policy? If prohibition worked as prevention, illegal drug addicts wouldn’t have a story of their own to tell.
How many people are directly killed by marijuana? Officially, zero.
Second, if arresting and incarcerating users is essential to effective treatment, why argue that addiction is a disease? No one says we should arrest diabetics for failing to take their insulin or heart patients who don’t exercise. Nor is anyone calling for jailing obese people caught within 500 feet of a McDonald’s or criminalizing the possession of non-diet soda, despite New Yorkers' complaints about Mayor Bloomberg's "nanny state."
There is no drive to lock up people caught drinking suspiciously heavily at bars or to incarcerate shady-looking cigarette smokers: We only arrest alcoholics who put others at risk with their driving or other dangerous behavior, and we merely socially isolate smokers—we don’t imprison them for their vice. So why should illegal drug addicts be singled out as criminals?
A reasonable argument could be made to keep marijuana use a crime if the drug was particularly dangerous. But proving it more harmful than alcohol or tobacco is a fool’s errand. Cigarettes, for example, kill about half of their regular users via cardiovascular disease or lung cancer, producing an annual death toll of some 400,000 smokers and nearly 50,000 nonsmokers exposed to secondhand smoke. Since about 30% of those who try smoking become regular smokers, the many costs of this death rate are extremely burdensome. This is one of the world's most important public health problems.
Alcohol is also a major killer: 26,000 Americans die annually from liver cirrhosis and other medical diseases linked to excessive drinking. Some 10,000 die in car accidents, including innocent victims. Alcohol overdose kills several hundred people annually and contributes to thousands of overdose deaths from heroin, prescription pain relievers and other depressant drugs. Drinking is also estimated to be an important factor in between 19% and 37% of all violent crime, including murders.
And how many are directly killed by marijuana? Officially, zero. The drug is not linked to lung disease, liver disease or overdose; its association with violent crime is via its prohibition. It’s probable that stoned driving causes some deaths, but during the period when marijuana use in the US rose from single-digit percentages to half of the adult population at least having tried it, traffic deaths overall dramatically declined. And some studies even show that stoned drivers become more cautious and drive more slowly, making them less dangerous than drunk ones.
While a review of the research suggests that there may be some increased risk of death among marijuana users, virtually all of the studies are confounded by concurrent tobacco smoking and other types of illegal drug use, leaving little data indicating significant harm. Lung cancer did not rise as marijuana use did, and given all the research attention devoted to finding marijuana dangerous, the fact that no major risks have turned up so far is reassuring. Even claims of cognitive damage to long-term smokers are contested, with conflicting literature that looks nothing at all like the clear research on smoking and cancer or alcohol and cirrhosis. Moreover, a lower proportion of its users get addicted to marijuana than those who use tobacco or alcohol.
So, what’s the argument for treating marijuana users worse than smokers or drinkers? The idea that it is a “gateway” to other addictions has been debunked by the Institute of Medicine, a branch of the National Academy of Sciences that advises Congress on policy. Indeed, research in countries like the Netherlands that have decriminalized use shows that any “gateway” effect that does occur is likely associated with the drug’s illegal status. In fact, fewer Dutch marijuana users go on to use “harder” drugs—probably because allowing quasi-legal sales of cannabis in “coffee shops” reduces contact with criminal dealers who also sell drugs like heroin.
But Kennedy and Project SAM insist on reefer madness. They argue that marijuana “directly contributes to mental illness,” and this is why it should remain illegal. But while research does suggest that marijuana use may be linked with earlier onset of schizophrenia in those who are already predisposed to develop it, like many of the other problems supposedly linked to pot use, schizophrenia rates remained stable or even decreased as marijuana use rates have skyrocketed.
Project SAM claims not to support incarceration of users: They say that those who are arrested for possession should instead be “subject to a mandatory health screening and a marijuana-education program,” which would refer people to treatment only “if needed.” However, they also argue that “the individual could even be monitored for six to twelve months in a probation program designed to prevent further drug use,” although they allow that those who successfully complete treatment or probation should not be left with a criminal record.
SAM argues that marijuana should remain illegal because it “contributes to mental illness.”
But what they don’t mention is that such systems typically subject those who don’t comply to increasing periods of incarceration and a criminal record—otherwise, how do you ensure compliance? And what is the point of criminalization? In many states, first-time marijuana possession cases are now typically dismissed or result in a fine. If instead we recriminalize in these states and require screening, compulsory treatment “if needed” and probation to monitor compliance, new expenses will likely add up fast.
While such a program might be better than the current system for some people in states that have not decriminalized, for others, especially the young and the mentally ill who are at greatest risk of noncompliance, it would likely result in greater harm.
Ironically, people susceptible to mental illness, even one as general as depression, are the very group Kennedy says he seeks to protect. Since those who use drugs to self-medicate due to emotional problems are more likely to relapse and to fail to meet the requirements of treatment—particularly if they do not receive adequate care—a system that puts marijuana users under strict supervision and punishes relapsers severely will simply pull more of the mentally ill into the prison system. And prisons are already the biggest provider of mental health care—if it can be called that—in the country.
Instead of hanging on to tools that are too, dare I say, blunt for the job, we need to take marijuana use out of the justice system entirely and treat addiction as the public health problem that it is. Kennedy, above all, should know that taking the same action and expecting different results is not the way to get better, in either addiction or drug policy.
Maia Szalavitz is a columnist at The Fix. She is also a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).