In a move hailed as progressive by pot smokers everywhere, Colorado and Washington State have taken the step of legalizing marijuana. Policymakers concerned with the possible public health consequences were perhaps not as enthusiastic. A study published this month by the RAND Drug Policy Research center, in the American Journal of Public Health, offers some direction to policymakers looking at the potential impact of legalizing marijuana on public health. The authors of the RAND study recommend a look at the lessons learned from regulation of tobacco and alcohol. Some of the issues under examination include limiting access to marijuana for young people, minimizing driving under the influence, restricting contaminants in the marketed marijuana, reining in dependence and addiction, and discouraging combined use of marijuana and alcohol. A few of the issues still confronting policymakers are: rules for ensuring the safety of the marijuana product, appropriate venues for distribution of the marijuana, and whether to assess taxes on the product by weight, cost, or quantity of psychoactive ingredients.
Statistical arguments for and against legalizing marijuana vary widely: someone approaching an analysis of these statistics should consider the relative validity of their source, and of numerous factors that complicate the figures. One should also be aware that it is possible for both sides of the question to offer the same statistics, differently interpreted, to support their respective arguments. For example, in February, 2014 the Columbia University’s Mailman School of Public Health published a report indicating that fatal crashes involving the use of marijuana have tripled over the past 10 years. Looking at only this information, the prospect of marijuana legalization looks exceedingly dim. However, one must consider the limitations of the available data. There does not presently exist an accurate test like the breathalyzer for checking marijuana intoxication. There is a way to look at cannabis levels using a driver’s saliva, but this is not widely used by the police. Cannabis can be measured in a driver’s bloodstream as much as a week after use, hence a report of cannabis associated with a fatal crash can only be a statement that marijuana was involved, but can say nothing about whether the driver was impaired at the time of the crash. Furthermore, the study mentions absolutely nothing about confounding factors; involvement of prescription drugs (very much on the increase in incidence), or the lack of a definitive standard for marijuana potency. With this information taken into account, the numbers presented by the Columbia study look much less formidable. One factor the study does take into consideration is the effect of combining alcohol and marijuana: a drunk driver is 13 times more likely to have a fatal crash than a sober person. That number goes up to 24 times more likely to have a fatal crash if the driver is under the influence of both alcohol and marijuana.
There is an open question as to whether the lessons learned from alcohol and tobacco will be useful in legalizing marijuana. To be completely reasonable, many of the questions raised by legalizing marijuana could be answered by examining its already well-documented use. One cannot help but marvel at the irony in looking at the history of the two most dangerous legal substances for lessons in regulation. Despite strict governmental regulations on alcohol and tobacco, addiction remains rampant. Alcoholism continues to destroy families, personal lives, careers, and presidential administrations. Extremely harsh consequences for drunken driving have failed to keep people from doing it. Despite widespread campaigning to raise public awareness about the dangers of smoking, and the enormously inflated cost of cigarettes, people continue to smoke, putting themselves at increased risk of various cancers, emphysema, and heart disease.
All of this is not to say that legalizing marijuana should not happen. However, the fundamental lesson learned from alcohol regulation during Prohibition could be that addiction trumps legislation. That is to say, an individual who is thoroughly addicted to a particular substance will walk through fire to get it, and may not be stopped by adverse consequences, or the pleadings of his loved ones, or any sort of legislation regulating the use of his drug of choice. Also, one can make a strong argument that Prohibition had an encouraging effect on the already prolific use of alcohol: by making it illegal, it became a font of wealth for underground distributers of alcohol. In fact, the ultimate lesson learned from alcohol and tobacco might well be that the business of taxing and regulating legalized marijuana is going to be extremely lucrative for the government.
Opinion by Laura Prendergast