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Friday, November 9, 2012

Legalization of Marijuana To Help Prevention, Schools, and Health?





For the first time, two American states have legalized the recreational use and sale of marijuana.
Colorado, Washington State and Oregon voted on  initiatives that would legalize the recreational use and sale of marijuana in their respective states. Only residents of Oregon rejected the move.

What would legalized recreational use mean?

(1)  Colorado and Washington don’t simply lessen the penalties for users from criminal charges to fines. The states do legalize and tax sales — a step that not even countries like the Netherlands, where wholesale selling and growing is illegal but small retail sales are tolerated in licensed “coffee shops,” have taken.

(2) Washington’s law involves a licensing regime, to be handled by the state’s liquor control board, for growers and sellers. Initiative 502 bans sales to people under 21 and sets a 25% tax on both wholesale and retail sales, which will be used to fund drug prevention, schools and health insurance.


It sets a legal limit on THC blood levels for driving (THC is the active ingredient in cannabis). It also bans growing for personal, non-medical use.

(3) Colorado’s new law is somewhat different: Amendment 64 allows personal possession and growing for one’s own use or to give away. Sales, however, will require a license from the state department of revenue and will be taxed to fund school construction, at a rate of up to 15%. The Colorado Legislative Council estimates that this could bring in between $4 million and $21 million annually, after accounting for initial costs of $1.3 million and $700,000 to fund the regulatory apparatus.

 (Maia Szalavitz, "Two U.S. States Become First to Legalize Marijuana," Time, November 7 2012)

Pros and cons of the controversial legalization aside, I find it most interesting that marijuana would be taxed to fund drug prevention, schools, and health insurance. Does anyone else see the irony here?

To me, using the funds in the manner proves these states are contradicting themselves in terms of philosophy. I mean, in my mind, this could be seen as an invitation to the populace: "Smoke dope to help kids keep off of drugs, provide them with better schools, and pay for any medical and psychological damage getting high might do."



Let's looks at the potential for legalization and trouble in these areas:

Drug Prevention

A. Dependency and Addiction

According to the National Institute on Drug Abuse (NIDA) Long-term marijuana abuse can lead to addiction; that is, compulsive drug seeking and abuse despite the known harmful effects upon functioning in the context of family, school, work, and recreational activities. Abuse of marijuana can especially lead to addiction in people who are genetically vulnerable.

Estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent) and among daily users (25-50 percent).

Of the estimated 6.9 million Americans classified with dependence on or abuse of illicit drugs, 4.2 million were dependent on or abused marijuana. In 2002, 15 percent of people entering drug abuse treatment programs reported that marijuana was their primary drug of abuse.

(Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS): 1992-2002, National Admissions to Substance Abuse Treatment Services. DASIS Series: S-23, DHHS Pub. No. (SMA) 04-3965. DHHS, 2004)

Hall et al. conclude that around one in ten people who ever try cannabis will become dependent at some point. For those who use cannabis several times the chance is increased from one in five to one in three and daily users are considered at the greatest risk of dependence with about a one in two chance.

(W. Hall W., L. Degenhardt, and M. Lynskey, M. The Health and Psychological Effects of Cannabis Use. National Drug Strategy Monograph Series, no. 44. 2001)


According to Copeland, Gerber and Swift, the main factors related to a heightened risk for developing problems with cannabis use include frequent use at a young age; personal maladjustment; emotional distress; poor parenting; school drop-out; affiliation with drug-using peers; moving away from home at an early age; daily cigarette smoking; and ready access to cannabis. The researchers conclude there is emerging evidence that positive experiences to early cannabis use are a significant predictor of late dependence and that genetic predisposition plays a role in the development of problematic use.

(J. Copeland, J. S. Gerber, W. Swift. Evidence-based Answers to Cannabis Questions a Review of the Literature. National Drug and Alcohol Research Centre University of New South Wales A report prepared for the Australian National Council on Drugs, December 2004)

B. Withdrawal

Evidence suggests that cannabis users can develop tolerance to the effects of THC and experience withdrawal symptoms. Long-term marijuana abusers trying to quit report withdrawal symptoms including: irritability, sleeplessness, decreased appetite, anxiety, and drug craving, all of which can make it difficult to remain abstinent. These symptoms begin within about 1 day following abstinence, peak at 2-3 days, and subside within 1 or 2 weeks following drug cessation.

(A.J. Budney R.G. Vandrey, J.R. Hughes JR, J.D.Thostenson, Z. Bursac. "Comparison of Cannabis and Tobacco Withdrawal: Severity and Contribution to Relapse." J Subst Abuse Treat. March 12, 2008.)

Schools

A. Lower Grades and Absence

Students who smoke marijuana get lower grades and are less likely to graduate from high school, compared with their nonsmoking peers. Workers who smoke marijuana are more likely than their coworkers to have problems on the job. Several studies have associated workers' marijuana smoking with increased absences, tardiness, accidents, workers' compensation claims, and job turnover.

(M. Lynskey, M. and W. Hall. "The Effects of Adolescent Cannabis Use on Educational Attainment: A Review." Addiction 95(11):1621-1630. 2000.)

B. Problems Remembering Information

Because marijuana compromises the ability to learn and remember information, the more a person uses marijuana the more he or she is likely to fall behind in accumulating intellectual, job, or social skills.

(J.S. Brook, P. Cohen, and D.W. Brook. "Longitudinal Study of Co-occurring Psychiatric Disorders and Substance Use." J Acad Child and Adolescent Psych 37(3):322-330. 1998)

Moreover, research has shown that marijuana's adverse impact on memory and learning can last for days or weeks after the acute effects of the drug wear off. The heavy marijuana users in the study had more trouble sustaining and shifting their attention and in registering, organizing, and using information than did the study participants who had used marijuana no more than 3 of the previous 30 days. As a result, someone who smokes marijuana once daily may be functioning at a reduced intellectual level all of the time.

(H.G. Pope and D. Yurgelun-Todd, D. "The Residual Cognitive Effects of Heavy Marijuana Use in College Students." JAMA 275(7):521-527. 1996.)

C. Problems With Cognitive Skills: Math and Verbal Expression

In one study of cognition, adults were matched on the basis of their performance in the 4th grade on the Iowa Test of Basic Skills. They were evaluated on a number of cognitive measures including the 12th-grade version of the Iowa Test. Those who were heavy marijuana smokers scored significantly lower on mathematical skills and verbal expression than nonsmokers.

(R.I. Block, and M.M. Ghoneim. "Effects of Chronic Marijuana Use on Human Cognition." Psychopharmacology 100(1-2): 219-228. 1993)

D. Poor Outcomes On Measures of Life Satisfaction

Marijuana users themselves report poor outcomes on a variety of measures of life satisfaction and achievement. A recent study compared current and former long-term heavy users of marijuana with a control group who reported smoking cannabis at least once in their lives, but not more than 50 times.  Despite similar education and incomes in their families of origin, significant differences were found on educational attainment and income between heavy users and the control group: fewer of the cannabis users completed college and more had household incomes of less than $30,000. 

When asked how marijuana affected their cognitive abilities, career achievements, social lives, and physical and mental health, the overwhelming majority of heavy cannabis users reported the drug's deleterious effect on all of these measures.

(A.J. Gruber, H.G. Pope, J.I. Hudson, J.I.; and D. Yurgelun-Todd. "Attributes of Long-term Heavy Cannabis Users: a Case-control Study. Psychological Medicine 33:1415-1422. 2003)

Health Insurance Concerns

A. Decrease in Immunity to Fight Fungi, Bacteria, Tumors

Smoking marijuana regularly (a joint a day) can damage the cells in the bronchial passages which protect the body against inhaled microorganisms and decrease the ability of the immune cells in the lungs to fight off fungi, bacteria, and tumor cells. For patients with already weakened immune systems, this means an increase in the possibility of dangerous pulmonary infections, including pneumonia, which often proves fatal in AIDS patients.

B. Pulmonary Infections

The main respiratory consequences of smoking marijuana regularly (one joint a day) are pulmonary infections. The effects also include chronic bronchitis, impairment in the function of the smaller air passages, inflammation of the lung, the development of potentially pre-cancerous abnormalities in the bronchial lining and lungs, and, as discussed, a reduction in the capabilities of many defensive mechanisms within the lungs.

(Donald P. Tashkin, M.D., "Effects of Marijuana on the Lung and Its Immune Defenses," Secretary's Youth Substance Abuse Prevention Intiative: Resource Papers, March 1997, Center for Substance Abuse Prevention.)

C. Cancer of the Head and Neck

Although one study found that marijuana smokers were three times more likely to develop cancer of the head or neck than non-smokers, that study could not be confirmed by further analysis.

Because marijuana smoke contains three times the amount of tar found in tobacco smoke and 50 percent more carcinogens, it would seem logical to deduce that there is an increased risk of lung cancer for marijuana smokers. However, researchers have not been able to definitively prove such a link because their studies have not been able to adjust for tobacco smoking and other factors that might also increase the risk.

(R. Mehra, et al. "The Association Between Marijuana Smoking and Lung Cancer: A Systematic Review." Archives of Internal Medicine. July 2006)

D. Heart Problems

Within a few minutes after smoking marijuana, the heart begins beating more rapidly and the blood pressure drops. Marijuana can cause the heart beat to increase by 20 to 50 beats per minute, and can increase even more if other drugs are used at the same time.

Because of the lower blood pressure and higher heart rate, researchers found that users' risk for a heart attack is four times higher within the first hour after smoking marijuana, compared to their general risk of heart attack when not smoking.

(J.M. Tetrault' et al. "Effects of Marijuana Smoking on Pulmonary Function and Respiratory Complications: A Systematic Review." Archives of Intern Medicine. February 2007)

E. Risk of Increased Auto Accidents

Driving after smoking marijuana increases the risk of a motor vehicle accident by two to three times, research suggests.
 
Driving after smoking even a small amount of marijuana almost doubles the risk of a fatal highway accident, according to an extensive study of 10,748 drivers involved in fatal crashes between 2001 and 2003.

The study by the French National Institute for Transport and Safety Research published in the British Medical Journal found that seven percent of drivers involved in a fatal highway crash used marijuana. The researchers estimated that at least 2.5 percent of the 10,748 fatal crashes studied were directly caused by the use of marijuana.
(French National Institute for Transport and Safety Research, British Medical Journal, December 3 2005)

F. Increased Psychiatric Disorders

The psychiatric disorders related to cannabis use are anxiety disorders, depressive disorders and psychotic disorders. Cannabis use could be closely linked with the neurobiology of schizophrenia. As the other psychoactive substances, cannabis use worsens the psychiatric outcomes and is associated with poorer treatment compliance.

(X. Laqueille. "Related, Induced and Associated Psychiatric Disorders to Cannabis. La Revue Du Praticien, 55(1), 30-34. 2005)

G. Psychosis

Marijuana exacerbates psychotic symptoms and worsens outcomes in patients already diagnosed with schizophrenia or other psychotic disorders. Several large observational studies also strongly suggest that using marijuana — particularly in the early teenage years — can increase risk of developing psychosis.

An often-cited study of more than 50,000 young Swedish soldiers, for example, found that those who had smoked marijuana at least once were more than twice as likely to develop schizophrenia as those who had not smoked marijuana. The heaviest users (who said they had used the drug more than 50 times) were six times as likely to develop schizophrenia as the nonsmokers.

(S Andreasson, Pl Allebeck, A. Engstrom, U. Rydberg, "Cannabis and Schizophrenia. A Longitudinal
Study of Swedish Conscripts. Lancet 26;2(8574):1483-6. 1987 December)



My Take

Research tells us that legalizing marijuana causes many problems in the areas of drug prevention, education, and health, yet two states have decided to legalize the drug and use profits from the sales and consumption of marijuana to somehow improve the same problems it will surely increase? Isn't this using profits from a vice to escalate the same vice?

I must be missing something here. I thought prevention in the form of "don't do drugs" was the best possible solution to addiction and all of the related misery produced by associated addictive behavior. Now, I understand some people will claim marijuana, used in moderation, is non-addictive and relatively safe, but what kind of person condones its legalization and its profits to "help" the things he/she knows its legalization will make worse? 

A analogy to this "wisdom" seems to me like someone who would look at a detrimental hole in the wall and attempt to repair it with a hammer. The tool of choice is best suited to making the hole larger, not to fixing it. Perhaps he/she should consider another tool of repair altogether. Or, perhaps he/she really doesn't really understand that a "tool" can be an instrument of destruction if used in the wrong manner.

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