Wednesday, August 15, 2012

Praising Marijuana Prohibition


The view from the White House.

As regular readers of Addiction Inbox will know, I am on record as favoring some form of decriminalization for marijuana. But I also write regularly about the difficulties of marijuana addiction and withdrawal. And I have been critical of the operational strategies employed by the medical marijuana movement in the several states in which it now operates. What I have not done, to date, is offer up the official view of a drug policy analyst from the Obama administration who straightforwardly favors a continuation of the legal prohibition against marijuana. 


One of the architects of the current federal resistance to marijuana legalization is Kevin Sabet, an assistant professor and the director of the Drug Policy Institute at the University of Florida College of Medicine. Sabet served from 2009 to 2011 in the Obama Administration as Senior Advisor for the White House Office of National Drug Control Policy (ONDCP) under Drug Czar Gil Kerlikowske, and was influential in shaping federal marijuana policy. Sabet consults with governments and NGOs on a wide range of drug policy prevention issues, and recently debated legalization advocate Ethan Nadelmann on CNN. He is also a regular columnist for thefix.com  and Huffington Post. He agreed to participate in a frank and lengthy 5-question interview with Addiction Inbox. (Be sure to check out the comments below).

1. In his new book, Too High to Fail, journalist Doug Fine argues that "the Drug War is as unconscionably wrong for America as segregation or DDT." Would you comment on this sweeping condemnation?

First, I think it is interesting to note that only people who want to condemn all of our current drug policies use the term "drug war." No one in serious policy circles uses that term anymore, and that is because it is woefully inadequate and vague as a way to describe a whole slew of policies designed to both reduce drug prevalence and drug consequences. I think his comparison is clumsy and unfair. Do some drug policies hurt disadvantaged groups? Of course they do. Is it a moral imperative to fix those policies, learn from our past mistakes and make our policies better? Of course it is. There's no reason to think that those policies can't be changed—in the White House in 2009, for example, we drastically reduced the penalty for crack cocaine. But what makes Mr. Fine's comparison even more wrong-headed and backwards is that we know that if we scale-up—not eliminate, as he would—the policies we know do work in reducing drug use and its consequences, all communities in America would benefit. A handful include:

(a) community-based prevention that not only focuses on stopping drug use among school kids, but in changing bad local laws and ordinances that promote underage drinking, smoking, and marijuana use (so-called "environmental policies");

(b) early intervention and detection of drug use in health settings;

(c) evidence-based treatment, including methadone and buprenorphine, as well as 12-step programs;

(d) recovery-based policies that don't penalize people for past drug use and instead facilitate recovery;

(e) law enforcement based on credible threats and modest sanctions.

2. The Drug War is an industry—the DEA alone has a budget of 2 1/2 billion and employs almost 10,000 people. If we add in profits from the private prison industry, and the money-laundering banks, the money is staggering. Wouldn't it make sense to recoup those historical costs by legalizing and taxing marijuana?

That phrase assumes two things: (a) criminal justice and regulation costs would be drastically reduced, or eliminated, with marijuana legalization; and (b) the underground market would be eliminated with marijuana legalization. Both of those assumptions are huge leaps that don't stand up to our experience with our already two legal drugs—alcohol and tobacco.

First, we know that legalization means more consumption. More consumption means more regulation. Today we have liquor laws, laws against drinking and driving, laws against public drunkenness, etc. With regards to legal alcohol, we make 2.6 million arrests every year for the violation of those laws. Meanwhile, we arrest a million fewer times for illegal drugs (1.6 million/year). Legal alcohol costs us money with regards to crime and regulation. I think that is a big consideration in this whole debate that we rarely hear about. So that means we'd have to have more prisons, more police, and more regulation costs under legalization—especially since few people are in prison or jail solely for marijuana use.

And I'm not so sure the underground market would be eliminated with marijuana legalization. Especially if it is taxed heavily, the incentive for the underground market—having been painstakingly established for decades by multinational corporate structures (cartels)—is very little. We'll still need a black market for underage marijuana, for marijuana to be sold to repeat offenders, etc. I just don't see the cartels throwing up their hands and saying "OK, it's legalized. We're out of the game now. Let's get into the ice cream business."

3. A "Pax Cannabis" would require rescheduling marijuana at the federal level, with an overt recognition that marijuana has some redeeming medical value. What's the argument for maintaining cannabis as a Schedule 1 drug along with heroin, a drug with which it has almost nothing in common? Could you comment on the upcoming U.S. Appeals Court consideration of medical marijuana?

Rescheduling marijuana is one of the biggest red herrings I can think of in this debate. If rescheduled tomorrow, it would do nothing to allow marijuana to be sold legally. Rather, it would be a huge symbolic victory for marijuana advocates -- but it would be wholly wrong on the science. Placing a drug in schedule 1 simply means the drug has no medical use and a high potential for abuse. It has nothing to do with the other drugs in that category (e.g. heroin). If it were a drug, a telephone would also need to be in Schedule 1 - I'm addicted to my cell phone and I know it has no medical use. That doesn't mean a phone is as dangerous as a syringe of heroin.  Today, cocaine is Schedule 2 because it has some very limited hospital use. Can a 21-year-old kid with no medical knowledge sell cocaine from a "dispensary" called "Happy Clinic" legally? Of course not, though that is what is happening [with marijuana] in California.

In order to be used for medical use, a specific product needs to be approved by FDA. Marijuana's specific product, so far, is Marinol, a Schedule 3 drug which has been approved by FDA and is used by people throughout the world. Crude, raw marijuana is not a specific product. The best way I can put it is this: We don't smoke opium to get the effects of morphine, so why do we think we need to smoke marijuana to get its potential medical effects? We have non-inhaled medications that are approved and we have others on the way. For a lot more on this, you can check out an article I wrote for Join Together. I think the District court opinion will rest on the science and agree with the Department of Health and Human Services that raw, crude marijuana is not medicine.

4. Alaska decriminalized marijuana in 1975, and only recriminalized after lengthy pressure from the Reagan administration. Isn't cultivation of this flowering weed for personal use the most obvious and straightforward solution?

The Reagan Administration could have cared less about Alaska, frankly. Alaska recriminalized because voters there wanted that to happen. They didn't like the effect of decriminalization on their state. That said, I don't think many people are in favor—and I am not—of locking up people smoking small amounts of marijuana. That isn't happening anywhere. One notable exception is New York City where they impose 24-hour detentions for public use and selling as part of their broken windows approach to crime control.

Indeed, in the 1970s, twelve states formally decriminalized marijuana. This meant that persons found to have a small amount of marijuana were not subject to jail time, but rather they would receive a civil penalty, such as a fine. The discussion in the United States is highly complex because even in jurisdictions without a formal decriminalization law, persons are rarely jailed for possessing small amounts of cannabis. A rigorous government analyses of who is in jail or prison for marijuana found that less than 0.7% of all state inmates were behind bars for marijuana possession only (with many of them pleading down from more serious crimes).[1] Other independent research has shown that the risk of arrest for each “joint,” or cannabis cigarette, smoked is about 1 arrest for every 12,000 joints.[2] This probably explains the fact that the literature on early decriminalization effects on use has been mixed. Some studies found no increase in use in the so-called “depenalization” states, whereas others found a positive relationship between greater use and formal changes in the law.[3]

The more recent discussion about state-level legalization may provide more insights. Two RAND Corporation reports concluded that legalization would result in lower cannabis prices, and thus increases in use (though by how much is highly uncertain), and that “legalizing cannabis in California would not dramatically reduce the drug revenues collected by Mexican drug trafficking organizations from sales to the United States.”[4]

5. Marijuana advocates don't like to hear it, but pot is addictive for some users. Where do you stand on this controversial issue?

Science tells us that marijuana is addictive—about 1 in 11 people who ever smoke marijuana are addicted; but if you start in adolescence that number climbs to 1 in 6. That's not anyone's opinion but rather the result of rigorous scientific research done by the National Institutes of Health and confirmed by other international scientific bodies. Is marijuana as addictive as tobacco cigarettes? No. The addiction rate for tobacco is about 1 in 3; for heroin it is lower, about 1 in 4. Users who try to quit experience withdrawal symptoms that include irritability, anxiety, insomnia, appetite disturbance, and depression.

A United States study that dissected the National Longitudinal Alcohol Epidemiologic Survey (conducted from 1991 to 1992 with 42,862 participants) and the National Epidemiologic Survey on Alcohol and Related Conditions (conducted from 2001 through 2002 with more than 43,000 participants) found that the number of cannabis users stayed the same while the number dependent on the drug rose 20 percent ­ from 2.2 million to 3 million.[5]Authors speculated that higher potency marijuana may have been to blame for this increase. As I've heard said many times by experienced tokers, "this isn't your Grandfather's Woodstock Weed."


[1] “Substance Abuse and Treatment, State and Federal Prisoners, 1997.” BJS Special Report, January 1999, NCJ 172871. http://www.ojp.usdoj.gov/bjs/pub/pdf/satsfp97.pdf

[2] Beau Kilmer, Jonathan P. Caulkins, Rosalie Liccardo Pacula, Robert J. MacCoun, Peter H. Reuter, Altered State? Assessing How Cannabis Legalization in California Could Influence Cannabis Consumption and Public Budgets, RAND, 2010.

[3] For a discussion see MacCoun, R., Pacula, R. L., Reuter, P., Chriqui, J., Harris, K. (2009). Do citizens know whether they live in a decriminalization state? State cannabis laws and perceptions. Review of Law & Economics, 5(1), 347-371.

[4] Beau Kilmer, Jonathan P. Caulkins, Rosalie Liccardo Pacula, Robert J. MacCoun, Peter H. Reuter, Altered State? Assessing How Cannabis Legalization in California Could Influence Cannabis Consumption and Public Budgets, RAND, 2010. And see Kilmer, Beau , Jonathan P. Caulkins, Brittany M. Bond and Peter H. Reuter. Reducing Drug Trafficking Revenues and Violence in Mexico: Would Legalizing Cannabis in California Help?.Santa Monica, CA: RAND Corporation, 2010. http://www.rand.org/pubs/occasional_papers/OP325. Also available in print form.

[5] ]Compton, W., Grant, B., Colliver, J., Glantz, M., Stinson, F. Prevalence of Cannabis Use Disorders in the United States: 1991-1992 and 2001-2002Journal of the American Medical Association.. 291:2114-2121.



29 comments:

Adam said...

I know it's a bit cliché but, given some of this comments, I would have asked whether he thinks alcohol and tobacco should - pragmatism aside - be legal. Is there any question of personal liberty and enjoyment or would he happily prohibit alcohol if it were only used by a minority or was only discovered today? Huge respect for any official who'd give that an honest answer!

Steve Rolles said...

Some reasonable points here from Sabet, but also many errors and straw man misrepresentations of the reform position:

Sabet says: "only people who want to condemn all of our current drug policies use the term "drug war." No one in serious policy circles uses that term anymore" . That is simply not the case. Not only is the phrase a piece of populist rhetoric devised by the US architects of the modern punitive enforcement model, but it is one that is still widely used in the media by many of the positions advocates, as well as politicians, including heads of state, across the world. the ONDCPs recent attempts to distance themselves from the phrase are welcome, but would carry more weight of they were attached to a significant contraction in punitive police and military supply side enforcement. This has not happened - the proportions of spending on enforcement against treatment/prevention remain unchanged. In this context talk of 'Ending the war on drugs', 'more balanced approaches' or a 'third way' is just empty rhetoric. For many caught up on the front line the 'war on drugs' remains very real.

Sabet then seems to imply that those who advocate law reform are opposed to evidence based treatment and prevention programs. This is not the case and is actually somewhat offensive. There may be debate around which interventions are most effective but no one is opposed to treatment and prevention in principle where it can be shown to be effective. Indeed a key thread of the reform argument focuses on transferring resources from failed or counterproductive enforcement initiatives to proven public health ones (including preventions treatment, harm reduction and so on. The argument is also made that a punitive enforcement approach does not protect vulnerable groups but directly and indirectly harms them - (see www.countthecosts.org for more on this point).

Sabet claims the mantle of 'evidence based' policy but it is striking to contrast the welcome acceptance of some evidence based harm reduction programs - such as buprenorphine and methadone - with the administrations rejection of the extensive evidence base for diamorphine (heroin) prescribing, and safe injecting facilities. These are rejected not because of inadequate evidence but because they are seen as politically challenging. The same can be said for the growing evidence for decriminalisation of drug users - something that has not only been well established in countries all across the world, but has been supported by the heads of The Global Fund and UNAIDS, the Red Cross/Crescent, and recent reports from the UNDP's global commission on HIV and the law. Nowhere has Sabet addressed the fundamental question of why it is appropriate to crimiminalise a consenting adult activity - when, as is usually the case, it does not harm others. ONDCP rhetoric that we should not punish addiction does not add up to much when most users are not addicts and are not in need of any social or medical intervention.

Steve Rolles said...

cont...

Sabet states that 'First, we know that legalization means more consumption' from whcih he goes on to make a a number of secondary points. These are only reasonable if the initial assumption is - and that is what it remains; an unevidenced assumption. The use of legal drugs goes up and down, the same with illegal drugs - there is little evidence to suggest that legal status or punitiveness of enforcement is a significant variable regarding prevalence - particularly of problematic use. More significant appears to social cultural and economic factors that are largely beyond the realms of drug policy, specifically enforcement policy. Price, availability and marketing/promotions have all been shown to be variables in prevalence of alcohol and tobacco use - but Sabet misrepresents the legal regulation argument by pushing this comparison too far. There is no reason why prices, availability, and marketing cannot be controlled, as indeed they are for alcohol and tobacco products in many countries. Where this has been done we often witness falls in consumption and prevalence - as has most obviously happened in the Western world with tobacco - still very much legal; - just more effectively regulated - prices, packaging, availability, consumption in public places, advertising bans and so on - controls that are obviously impossible in an unregulated market subject only to the laws of supply and demand, and controlled not by responsible authorities, but criminal entrepreneurs.

he then says 'I'm not so sure the underground market would be eliminated with marijuana legalization'. this is a Straw Man - no one is claiming it would be eliminated, only that it would be substantially reduced. That is still obviously progress in terms of reduced opportunities for crime.

Sabet then rather misrepresents the Rand reports - they also model a rise in use following a dramatic drop in price - which is not in any way a certainty as they acknowledge. His summary in no way reflects the ambiguities and uncertainty they factor into their analysis. He has done something similar with the Mexican criminal profits analysis - I recommend those interested read the reports and their critiques for themselves - as they are not well represented here.
Finally on addiction - very few advocates of reform deny cannabis can be harmful and addictive for some users - although there may be a tendency for some on both sides of the debate to filter the science to suit their own agendas. From my view - however harmful cannabis may be, a regulated market with strict government control of products (quality, potency, THC/CBD rations etc), packaging (health info), licensed vendors and sales outlets can only serve to reduce those potential risks - all evidently increased by the current unregulated criminal free for all. Such a model would additionally facilitate getting honest accurate information about cannabis risks to target populations - and could of course generate tax revenue to support public health education, treatment and so on.

Dirk Hanson said...

One of the major arguments, as Steve notes, centers on whether legalization means more consumption of cannabis, less consumption, or about the same. While the Dutch experience isn’t a perfect fit—they didn’t legalize—it suggests that lawful but limited access to cannabis does not NECESSARILY create a dramatic rise in underage use.

Steve Rolles said...

As the opponents of regulation like to point out, use in the Netherlands did rise after the (defacto) legalisation in 1976. The important observation that they rarely make however, is that it also rose (often faster) in the surrounding coutries that did not adopt the coffeeshop model. This again points to the observation that legal availabilty on its own is probably a marginal driver of prevalance - wider socio-economic and cultural trends are much more important. It has been observed by Reuters/McCoun that there was a noted increase in use when the coffeeshops started marketing themselves more agressively. This does not mean that legal regulation is a failed model - rather it should help inform what kind of regulation model we adopt (ie one in which legal availability exists, but with strict controls on marketing that seeks to increase consumption - perhaps by removing or controlling profit motivation).

Dirk Hanson said...

Thanks for the clarification. Should have appended "compared to other countries" to my remark.

Dirk Hanson said...

One of Sabet's interesting points for me concerns his notion that legalizers don't factor in the actual cost of that legalization, comparing it to the enormous costs of alcohol enforcement. It's not all just tax money in the public hopper.

Steve Rolles said...

Its something Transform have considered - there is some discussion and tentsative estimates in our 2009 cost benefit analysis paper for example, and more discussion ion teh Alternative world drugs report - economics chapter. There are ofcourse costs in regulating drugs - but they are likely to be dramatically lower than current enforcement spending, quite aside from all the other costs of prohibition.

If you look at the costs for the UK health and safety executive or the MRHA, regulation does not appear to be too onerous. The comparison with alcohol is instructive but including the enforcemetn costs of dealing with alcohol intoxication is a seperate issue from regulating a market and is also uniquely costly for alcohol, because of its unique disinhibitory effects. Cannabis intoxication does not tend to lead to violence or disorder on anything like the same scale.

Kevin Sabet said...

Thanks for the comments, Steve. It was good seeing you recently in the Bay Area.

I wish I had time to comment on all of what you said (you and I have spoken at length about these issues of course in person) but I will just say this:

--The Obama Admin has made a significant shift in terms of emphasis (and funding) between supply and demand. As you know, ONDCP's main muscle to flex is its ability to get the message out about drugs and its ability to get states -- which is where most of the demand money is spent -- to focus on this issue. I'd give this Administration an A-/B+ in that regard. Witness the major focus by states on the biggest drug problem of our time now in the US - prescription drugs (which, by the way, are legal and yet cost society billions!)

-- Wholly disagree about prevalence levels for legal vs illegal drugs. The past 100+ years have shown that when drugs are legal, more people use them.

-- You should never assume anything that was not said explicitly by the writer. I never said that those who advocate "reform" (by the way, I advocate reform too -- but I do not slide to the extreme of that spectrum where legalization sits) are anti-prevention/treatment.

Steve, you have more faith than I do that as a society we could responsibly regulate these substances. Given the heavy advertising of alcohol (all voluntary ad bans have gone out the window) and the ruthless promotion of cigarettes still (mainly now in the developing world), and the current Rx drug epidemic, I do not believe the risks would outweigh the benefits.

I could do this all day but maybe we should have an online live debate sometime to discuss further. I am always open to an honest discussion and I really do appreciate you spending time reviewing my work. It helps me think better.

Adam, as for your alcohol comment -- no I do not believe alcohol should be illegal but that is based purely on cultural reasons (alcohol has been used by the masses for thousands of years in a very widespread fashion as opposed to any of the current illegal drugs), but I do support more restrictions on the drug. It is a crime that our alcohol taxes are 1/5 of what they were during the Korean War (in the US) because of industry pressure.

This is precisely what I fear under legalization -- a massive industry pushing heavy use and low taxation.

All the best, Kevin Sabet

Anonymous said...

this man is so misguided. i find myself having problems understanding how he has managed to arrive at his arguments as they are so weak and clearly fallable. it's not even worth delving into because only a fool argues with an idiot and i think everyone should just move on and get on with real things.

steve castleman said...

Addiction is a chronic, progressive disease. But only for a minority of users. SO we should concentrate on getting help to those who become addicted, attacking the demand side of the drug problem.

Education and treatment are key. For a not-for-profit website that discusses the science of substance use and abuse in accessible English (how alcohol and drugs work in the brain; how addiction develops; why addiction is a chronic, progressive brain disease; what parts of the brain malfunction as a result of substance abuse; how that malfunction skews decision-making and motivation, resulting in addict behaviors; why some get addicted while others don't; how treatment works; how well treatment works; why relpase is common; what family and friends can do; etc.) please click on www.AddictScience.com.

Steve Castleman
AddictScience.com

Jason Reed said...

Kevin,

One issue I would like to address is that of prescription drugs and the epidemic the U.S faces. You draw comparisons that they are 'legal' and this affirms your position.

I disagree. The prescription drug problem you face is once more down to legal drug pushing if you'll grant me the crude term. The pharmaceutical industry is less that affable as I'm sure you'll agree. The lack of governmental control in this sector is negligible and exactly an area where perspective policies need to learn from. The latest scandal from GSK is a perfect case in point. http://www.bbc.co.uk/news/world-us-canada-18673220

Prevalence tends to come from parties who have are financially incentivised for increased use.

Dirk Hanson said...

In today's news, a good example of the yin and the yang:

"Pot-smoking moms crusade for decriminalization"
http://www.thestar.com/news/gta/article/1242478--pot-smoking-moms-crusade-for-decriminalization
AND

"Legalization of Marijuana and the Impact on Children"
http://www.drugfree.org/join-together/drugs/legalization-of-marijuana-and-the-impact-on-children

Steve Rolles said...

thanks for your response Kevin. Yes there ios much we have discussed in the past and can again, and I like the idea of debate at some point.

On the 'legal drugs used more' point - I dont think this claim is sutainable. Legal drugs that are aggressively marketed perhaps - but as i have made clear this is a risk we can reasonable anticipate and design regulatory models to prevent. We have learnt lessons from the mistakes with tobacco and have changed regulatory frameworks - cigarette use has been falling for decades without the need to resort to punitive blanket prohibitions. The use of many prohibited drugs is rising - in the UK the use of many recently prohibted drugs - such as ketamine - has risen post-ban. The evidence base for a major role of legal status is suprisingly thin; the evidence base for a deterrent effect is shockingly thin given its cetrality in tyhe prohibtionist paradigm.

There are ofcourse many legal drugs that are not widely used - mainly because people do not like them. Solvents and inhalents are legal and universally available but not very popular. People make a personal cost benefit analysis and decide against use.

It is right that we help people make these decisions based on the best possible information (but not scaremongering or misinformation which can easilyy backfire as some of the more extreme reefer madness material seems to have).

This was not the case earlier in the last century regards tobacco, but that has changed - as has patterns of use in a positive direction.

Perhaps the US, with its free market leanings, isnt willing or able to develop the kind of heavily regulated markets transform and others want to see - That IS a major problem, both for the US reform movement and the wider world. We will continue to make the case for appropriate regulation and try to establish functional and apporpriate models elsewhere. We are and continue to be heavily criticial of much tobacco and alcohol policy and are active in c alling for improved regulation of both (as is clear from our literature, including Blueprint). The goal is the same as for curremtly illegal drugs - the optimal level of market regulation that deloivers the best outcomes on the goals we all share for a healthier safer society.

Finally, please dont suggest that regulated markets for risky products are an extreme policy position. Libertarian free market legalisation models perhaps - but not regulation as we have envisaged it. Regualtion is the norm for almost every other risky product of personal behaviour, and such regulation is a primary fucntion of governments ocross the world. If anything, blanket punitive prohibitions are the extreme position - especially when they remain dogmatically entrenched despite half a century of disasterous outcomes, and actively seek to prevent any form of experimentation with alternative apporaches. That is both extreme and profoundly anti-science.

4surf said...

In this drug policy world of crazies on all side, thankfully we have Kevin Sabet to give us honest, sensible and helpful counsel. I'm a fan Dr. Sabet.

ndnjones said...

"precisely what I fear under legalization -- a massive industry pushing heavy use and low taxation." Also the goals of the pharmaceutical industry.
You really think cannabis will become a monolithic "massive industry"? Look--there are hundreds of makers of alcoholic beverages, and they compete on the free market. This suggests prohibiting for-profit lobbyists, not intoxicants!
I predict that the legalization of cannabis will produce thousands of small companies, all competing in cannabis NICHES, as there are different niches for alcohol (red wine, white wine, bourbon, pilsner beer, dark beer, ales, bourbon, Scotch, ad nauseum). And, although I could be making my own beer legally, it is many times easier to grow a little marijuana; and many, many, many users will do just that. Because growing is illegal now, the "massive industry" aka drug cartels, exerts deadly pressure for heavy use and NO taxation on THE WHOLE WORLD. Your attitude is simply "not in my back yard"--let the producing countries' economies and people suffer. They are just collateral damage in this war. The deaths of 100,000 innocent people in Mexico alone, much less hundreds of thousands more across the globe, are on the hands of prohibition, and nothing else.

carrotstick said...

ndnjones: you think the 100K people dead in Mexico are INNOCENT?! 50% at most. The rest are violent cartel workers.

As for taxes, I thought MJ Leglaization was supposed to bring in tons of $$ for us -- how would this happen if people grew it on their own??

Sabet is right. Our legal drugs (including Rx, ndnjones) are headaches enough.

Dan Riffle said...

The real crux of the issue, and the difference between Sabet and those who favor legalization like myself, is whether you're objective is to reduce use or to reduce the harms associated with use.

The architects of US drug policy - and I'm talking about Kevin here, former ONDCP - are singularly focused on reducing use. That's why his overarching concern is that legalization will lead to a price drop, and subsequent rise in use. And let's not kid ourselves - he's right. His claims are exaggerated, as are his worries about our inability to regulate advertising and throttle industry growth/power. Still, price will drop and use will go up, despite our disagreement about the extent to which that happens.

However, think about the context in which that use happens. Right now, if a 19 year old kid decides he wants to use marijuana, he buys it from a drug dealer. That means he's risking arrest, which means spending a night or two locked in a room with other criminals and addicts - far more harmful than the drug itself. It also means he's getting a clear plastic bag with some green stuff in it. Who knows how much of that is even marijuana, or what's in it. And he's buying it from a person who doesn't care about him, and likely has an inventory of harder drugs s/he is motivated to sell.

Under legalization, that kid probably buys it the same way a 19yo would buy alcohol now - from an older sibling who got it legally. First and foremost, that means his chances of going to jail are dramatically reduced (and really, sending anyone, let alone young impressionable people, to jail for marijuana should be out of the question). But moreover, he'd be getting a product that's been labeled for potency and purity. It's been cultivated and distributed through a regulated system that will include testing for contaminants and banned pesticides and fertilizers. He may even get it in the form of a brownie or cookie, which will certainly be more prevalent under legalization, or use it via vaporizer which will also be more prevalent. Evidence shows (http://www.jstor.org/discover/10.2307/40325781?uid=3739936&uid=2&uid=4&uid=3739256&sid=21100988716163 and http://www.ncbi.nlm.nih.gov/pubmed/22381404 among others) he'd probably use marijuana instead of alcohol, and even if he used both, would certainly be less likely to binge drink, which is a harm reduction for him and everyone around him. There won't be any ecstasy, meth, or other harder drugs available from that source. But perhaps most importantly he's getting it from someone who cares about him. That means he'd be advised to administer via something other than smoking, and if he was showing signs of dependence or abuse, it could be addressed. Drug dealers don't care if you're an addict (most would prefer it that way).

There's obviously a host of other harms associated with marijuana (and I could argue for hours about the harms associated with prohibition) that could be ameliorated under legalization, but not under our current system of unregulated, uncontrolled prohibition. Whether or not use goes up is not the be all, end all.

Treatmentforall said...

Anonymous, do you have to resort to name calling to make your point? Actually you never did make a point.

Sabet is right on and we in the treatment sector need to wake up and support him and these policies. It's not about criminalizing people, though, and Sabet never said that.

@onlyforlulz said...

There needs to be serious discussion about the 'using' and 'selling'. In legal terms, the possession of anything more than 1 joint can legally be classified as 'intent to distribute' and consider a felony. This arbitrary standard is applied arbitrarly, yea I said that. 'Intent to distribute' is a felony and this charge is disproportionally attached to poor whites and minorities. There is an inherit racial and socioeconomic bias to marijuana prosecution and incarcerration. This is not taken into consideration when discussion 'possession' arrests.

Malcolm said...

Scientific fact: Marijuana is less addictive than a cup of tea.

http://druglibrary.org/schaffer/library/basicfax5.htm

Dr. Jack E. Henningfield of the National Institute on Drug Abuse and Dr. Neal L. Benowitz of the University of California at San Francisco ranked six psychoactive substances on five criteria.

Withdrawal -- The severity of withdrawal symptoms produced by stopping the use of the drug.

Reinforcement -- The drug's tendency to induce users to take it again and again.

Tolerance -- The user's need to have ever-increasing doses to get the same effect.

Dependence -- The difficulty in quitting, or staying off the drug, the number of users who eventually become dependent

Intoxication -- The degree of intoxication produced by the drug in typical use.

The tables listed below show the rankings given for each of the drugs. Overall, their evaluations for the drugs are very consistent. It is notable that marijuana ranks below caffeine in most addictive criteria, while alcohol and tobacco are near the top of the scale in many areas.

The rating scale is from 1 to 6 --- 1 denotes the drug with the strongest addictive tendencies, while 6 denotes the drug with the least addictive tendencies.


HENNINGFIELD RATINGS

Substance Withdrawal Reinforcement Tolerance Dependence Intoxication

Nicotine 3 4 2 1 5

Heroin 2 2 1 2 2

Cocaine 4 1 4 3 3

Alcohol 1 3 3 4 1

Caffeine 5 6 5 5 6

Marijuana 6 5 6 6 4


BENOWITZ RATINGS

Substance Withdrawal Reinforcement Tolerance Dependence Intoxication

Nicotine 3 4 4 1 6

Heroin 2 2 2 2 2

Cocaine 3 1 1 3 3

Alcohol 1 3 4 4 1

Caffeine 4 5 3 5 5

Marijuana 5 6 5 6 4

UKscholar said...

FOR DAN RIFFLE OF MPP: Sorry, Dan, you're wrong and being unfair on a number of points.

Sabet was an architect of US drug policy, yes, but mainly in the Obama Administration, which aims to reduce drug use *AND* its consequences.It's not fair to mischaracterize his position.

I have worked with him and know he is a fair minded man who seeks facts and in fact has been attacked by drug warriors as someone who supports naloxone and limited needle exchanges.

Oh, and most kids get pot FROM OTHER PEOPLE FOR FREE, usually their friends. Not drug dealers. And the majority of the science says that alcohol and pot are COMPLIMENTS, not substitutes.

I don't think unfettered prohibition is good either, but what MPP advocates for is irresponsible, dangerous, and wrong headed.

ndnjones said...

OK, carrotstick, and the numbers of total deaths just in Mexico are, per the most recent reports I could find, only 40-60K. So, first, if only one tenth are innocent, I still find that unacceptable as collateral damage. Second, with legalization comes the ability to truly control the substances via regulation; addicts could get treatment instead of jail time, reducing both the amount of drug use and the seriousness of its consequences (certainly not tens of thousands of deaths). Third, if illegal drugs were legal, and no matter the degree of regulation, I bet that most of those people-innocent or not--would still be alive, and most of them engaged in legal occupations, and certainly nothing as deadly as the drug black market. What other illegal activity can match the violence of the drug trade? Sex slavery? Illegal arms? What could we compare to the drug war in terms of violent disruption and corruption of society? Well, there was one time in the USA--in the 1930s. The bootleggers were the cartels of that prohibition era, and as soon as alcohol became legal, they had to find other work, some illegal no doubt; but the profits in bootlegging were no longer worth the risk of violent death and the cost of buying off law enforcement and other officials.

Freeman said...

UK Scholar said: "Oh, and most kids get pot FROM OTHER PEOPLE FOR FREE, usually their friends. Not drug dealers."

Oh really? And where do their friends get it? And aren't they kids too? And why are the drug warriors fearmongering with predictions of massive drop in price and massive uptake in usage under legalization if our kids are already getting it for free?

This is misguided on so many levels I don't have time to list them all, but it's obvious you've been studying under the likes of Sabet, have zero real-world experience on the topic, yet think you know it all.

MkkDdd said...

"...we in the treatment sector need to wake up and..." look at career change options, realising that no gravy trail rolls on forever.

All of this 'war-on-drugs' nonsense is just a smokescreen for the Abrahamic religions' ongoing repression of gnosis.

Anonymous said...

I fact-checked Kevin Sabet's statement that "A rigorous government analyses of who is in jail or prison for marijuana found that less than 0.7% of all state inmates were behind bars for marijuana possession only (with many of them pleading down from more serious crimes)." He cites a 1997 Dept of Justice report.

That 0.7% is 7774 people in state prisons. Combine that with people in federal prisons, gives 8000.

So 8000 people in state and federal prison for marijuana possession in 1997. Out of 63000 people in prison for drug possession. That is a substantial number of people.

Details:

1) Here is the correct web-address for the Dept of Justice report, “Substance Abuse and Treatment, State and Federal Prisoners, 1997.” BJS Special Report, January 1999, NCJ 172871: http://bjs.ojp.usdoj.gov/content/pub/pdf/satsfp97.pdf

2) Sabet's statement is a quote from an Oct 2010 ONDCP fact sheet on marijuana legalization.

http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/marijuana_legalization_fact_sheet_3-3-11.pdf

3) The Dept of Justice report is from 1997, that's 15 year ago. Aren't there more recent statistics for Sabet to cite?

4) Sabet suggest that some people may have plead down from more serious crimes. That is not mentioned in the Dept of Justice report. The report does mention that most drug charges are for "trafficking" and that included "possession with the intent to distribute".

5) The 0.7% figure is not in the report. But if you multiply 21% of state prisoners on drug charges * 27.1% of state drug charges for possession * 12.9% of total state drug charges for marijuana that gives 0.7% of state prisoners are in for marijuana possession. So the 0.7% is just an estimate which assumes that 12.9% of both drug possession and drug trafficking charges are for marijuana.

6) Calculating the estimated number of people:

state prisoners: 222,100 drug prisoners * 27.1% for drug possession * 12.9% for marijuana = 7774 for marijuana possession.

federal prisoners:
55,759 drug prisoners * 5.3% for drug possession * 18.9% for marijuana = 222 for marijuana possession.

7774 state + 222 federal = 7996 or approx 8000 prisoners for marijuana possession.

7) This does not include people held in local jails, nor people on probation, nor forced unnecessarily into "treatment". Depending where you live in the US, a conviction for drug crimes, including marijuana possession, can mean 1) permanent criminal record, 2) forced to say you are a criminal when applying for a job, 3) difficulties getting travel visas, 4) possibly losing child custody, 5) losing your right to vote, 6) possibly losing professional licenses, 7) name published in newspaper and available in internet search, 8) not able to get student loans, 9) humiliation, inconvenience, and costs of being arrested and paying fines, 10) etc, etc. Most of the above also apply in states where marijuana is "decriminalized".

Matt Elrod said...

Dr. Sabet asked: Crude, raw marijuana is not a specific product. The best way I can put it is this: We don't smoke opium to get the effects of morphine, so why do we think we need to smoke marijuana to get its potential medical effects?

Because we seem fine with people drinking coffee to get their caffeine fix, despite the availability of pharmaceutical alternatives. Some people prefer an expresso to a no-dose pill.

Whole cannabis (which may also be vaporized) is a natural health product, or "dietary supplement" as such therapeutic herbs are classified by the FDA. Under the DSHEA, traditional, therapeutic herbs, and products made from them, are considered safe until proven exceptionally dangerous, not criminal until proven unrealistically safe.

According to the Institute of Medicine, the benefit-risk profile of cannabis is well within that of many commonly used pharmaceutical drugs. Contrary to what many believe, a far greater number of studies have already demonstrated the health benefits and safety of cannabis than exist for such medical standbys as aspirin, penicillin and codeine.

Indeed, these latter drugs (and many more) were approved for sale without any controlled clinical trials whatsoever being done to prove their effectiveness. Instead, these drugs were "grandfathered" into the approved formulary back in the 1930s by virtue of long-time experience showing them to be safe (the so-called Generally Recognized As Safe, or GRAS process). As a similarly long-used medicine (much longer if you count over 3,000 years of experience in Asia and India), cannabis should also have received grandfathered status but, for purely political reasons, it did not.

Anonymous said...

I have also fact checked Sabet's stats and found them to be right.

The Dept of Justice study is done every 10 yrs or so, so the 1997 are actually very recent in that regard (a 2004 report was very similar in terms of numbers).

And I think Sabet would agree with you that past criminal records etc shouldn't count against someone for jobs, etc.

Family Alcoholism said...

I never enjoyed smoking the stuff. Also, I never had the type of craving for it like I have had for alcohol.

Pot just always gave me the munchies.

Related Posts Plugin for WordPress, Blogger...