Originally posted 12/8/2012
I’ve been hearing more calls these days to change US marijuana laws (note- Colorado and Washington legalized recreational use of marijuana shortly after this article was originally posted).  Legalizing marijuana has been a cause for some citizens for decades, and efforts to change marijuana laws have waxed and waned since I was a teenager in the 1970’s.  Some people believe that this time around, attitudes are truly changing.  A recentQuinnipiac University poll  showed that as of November 2012, a majority of US voters favor legalization of the drug for recreational use.
The current status of marijuana laws are confusing, to say the least. Marijuana is regulated at multiple jurisdictional levels, so a person in any one location is subject to state, federal, and sometimes local laws.  These laws are often at odds with each other, so the legality of marijuana depends largely on the employer of the agent or officer making the arrest.
There are also multiple forms of legality. In November, Colorado and Washington State legalized possessing up to one ounce of marijuana.  Another dozen-or-so states decriminalized marijuana over the past 20 years, so that possession of the drug is punishable by citation, not prison time.  Another 20 or so states have laws allowing for the medical use of marijuana, including in some cases provisions to grow marijuana for personal use or for a small number of patients.
By Federal law, marijuana use remains illegal in virtually all settings.  The DEA classifies marijuana as ‘Schedule I’, the same status as heavy-hitters like LSD or Heroin.  Smoking marijuana can be reason enough for most employers to terminate employment.  And violation of marijuana laws, even possessing small amounts of marijuana, can result in permanent banishment from federal financial aid programs for higher education.
I have no pressing opinion on this issue.  I don’t have a ‘marijuana problem’, and I never really had a problem with the drug.  I smoked it as a teen, and note that the year of my high school graduation, 1978, was the peak year for marijuana use in this country.  But I never enjoyed smoking pot as much as some people appear to.  I always had things that I wanted to do or accomplish, and smoking marijuana, as I grew older, got in the way of those things.
Marijuana was a much less potent drug in the 1970’s than it is today.  In my teens, people talked about ‘smoking a joint or two.’  Now that the THC content is much greater, people have ‘hits.’  I just realized, by the way, how ‘square’ I sound right now.
It is difficult to know whether perceptions surrounding marijuana are accurate or based in fantasy.   Last night I saw a Facebook post from one of my HS classmates that included a picture of my geography teacher in 1976, wearing extra-long, extra-wide, plaid bell-bottom slacks.  It is hard to remember 1970’s marijuana without remembering all the other silly things that we did in the 1970s, that seem so harmless in retrospect.  On the other hand, I remember the fallout shelters and nuke drills back then, which on paper seem every bit as serious as any ‘fiscal cliff.’   Clearly, dangerous things in the past seem less frightening than dangerous things now.
Is marijuana a ‘gateway drug’ that leads to use of more dangerous substances? Marijuana smokers are more likely to use heavier drugs than are non-marijuana-users, but correlation is not causation.  I’m reluctant to conclude that marijuana use ‘causes’ people to use pain pills or heroin. At the same time, I don’t buy the arguments by some pot smokers that marijuana keeps them sober from alcohol or illicit substances.
My Klout score isn’t so high as to impact the likelihood of legalization of marijuana, but I will share a few thoughts anyway about my clinical experiences and observations:

    • Many of my patients can smoke marijuana without apparent negative impact on their lives.
    • Many patients have shared with me their desire to stop smoking, but are unable to leave the drug behind.
    • The biggest downside of marijuana use from my perspective is the complacency that some users develop.  Some marijuana smokers seem to accept miserable circumstances that they would be more likely to change if forced to endure them without smoking pot.
    • Medical marijuana, at least in some cases, is a system rife for abuse.  I meet patients from neighboring Michigan who are prescribed marijuana to treat pain from cancer and side effects from chemotherapy.  I see other patients prescribed marijuana for headaches, fibromyalgia, anxiety, depression, irritable bowel, Crohn’s disease, and a host of other symptoms and disorders.  For all other medications, the FDA provides guidelines on the proper indications for the drug.  Medical marijuana, however, has been embraced as a panacea for so many symptoms and conditions that it is difficult to accept any specific treatment as ‘clinically indicated.’  The illegal status of marijuana, of course, prevents the FDA from considering the drug as medically indicated for any condition.  So we have the worst of both worlds;  a drug without proper vetting by the FDA, only-legal-enough to allow for use without good clinical study.
    • Proponents of marijuana legalization compare marijuana to alcohol from the perspective of fairness, but when doing so often neglect to consider the huge societal costs from use of alcohol.  Or as your grandma used to say, ‘two wrongs don’t make a right.’

    Many young people have been led to believe that the Obama administration is on ‘their side’ in regard to legalizing marijuana.  I wonder, though, if legalization of marijuana will require the lead of a traditional antagonist—as Clinton participated in welfare reform, and Nixon opened relations with China.  In other words, I’m not expecting big changes on the federal level anytime soon.
    (Addendum: We have a good experiment underway in two states— let’s follow the data….)


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