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“Legalized pot would mean more addiction” … but maybe to a safer product?

The title of this post is drawn from the headline of this new commentary published by CNN and authored by Kevin Sabet, and includes what is, for me, a key follow-up question to any discussion of marijuana use and abuse.  My interest in a follow-up question is driven largely by the fact that this commentary, somewhat surprisingly, does not actually really discuss marijuana use or abuse or provide any sophisticated discussion of marijuana addiction rates.  Here are a few excerpts from the commentary:

“The war on drugs has failed” is a mantra often heard in policy and media circles these days. But not only is the phrase outdated (the 1980s called — they want their slogan back), it is far too simplistic to describe both current drug policy and its outcomes.

The latest incarnation of this ill-advised saying can be found in a report arguing that since cannabis and heroin prices have fallen while their purity has increased, efforts to curb drug use and its supply are doomed to failure.  This leads some to highlight the possibility of alternatives in the form of “regulation” (e.g., legalization) of drugs.

But a closer look at the data — and the implications for a policy change to legalization — should give us pause if we care about the dire consequences drug addiction has on society.

Globally, drug use has been stable over the past decade, though it is difficult to paint such a broad brush across countries and substances.  But in the U.S. alone, there has been a 40% drop in cocaine use since 2006 and a 68% decrease in workplace positive cocaine tests.  Overall in the U.S., all drug use has fallen by about 30% since 1979.

There are likely numerous reasons for this drop, but we can’t ignore the fact that the world’s top supplier of the drug — Colombia — has greatly improved its security situation over the same period.  With help from the United States, Colombia has managed to reduce the amount of land dedicated to coca growing by nearly two-thirds from 2000 to 2010.

Potential production of cocaine has also fallen more than 60%, though in places without such security enhancements — namely Bolivia and Peru — cocaine production has picked up.  Still, this shows that progress is not only possible, it is happening….

Some have offered legalization as a possible alternative.  But we know from our experience with currently legal drugs — prescription drugs (which are now the leading cause of accidental deaths in the U.S.), alcohol and tobacco — that legality means commercialization, normalization and wider access and availability that lead to more use and addiction.

Legalization in the United States is likely to accompany a bombardment of promotion, similar to our other three classes of legal drugs.  These industries will stop at nothing to increase addiction since their bottom line relies on it.  In fact, we know that 80% of the profit from addictive industries comes from the 20% of users who consume most of the volume of the substance.

According to internal documents that the government forced Big Tobacco to release during its historic court settlement, those companies are ready to pounce on the golden opportunity of drug legalization.  It is no wonder that the parent company of Phillip Morris, Altria, recently bought the domain names “AltriaCannabis.com” and “AltriaMarijuana.com.” If this sounds frightening, it should be.

Big Tobacco tried for decades to conceal the harms of their drug, and millions of lives were lost as a result.  We are naive to think that this wouldn’t happen with any other drug that is legalized….

On the other hand, legalization — especially in ad-obsessed America — would not only sweep the causes of drug use under the rug, it would open the floodgates to more addiction, suffering and costs than we could ever bargain for.

I share Sabet’s claimed interest in taking a “closer look at the data,” but the very data he references in this commentary strikes me as the basis for encouraging marijuana reform efforts because doing might very well lead to more addictions to a drug which arguably is much less dangerous not only than other illegal drugs, but also even less dangerous than “our other three classes of legal drugs”!

For starters, Sabet highlights in this commentary that “there has been a 40% drop in cocaine use since 2006” and he concedes that there “are likely numerous reasons for this drop.”  What he fails to discuss, however, is the possibility that wider availability of legalized medical marijuana in many states since 2006 might be playing a significant role in the big drop in cocaine use.  Here I am just speculating, but the broader point is that if legalization of marijuana moves some folks to use marijuana a lot more, but harder and more harmful drug like cocaine and heroin and meth a lot less, we end up with a quite significant overall public health benefit.

Similarly, while Sabet laments that legal and regulated “prescription drugs … are now the leading cause of accidental deaths in the U.S.,” he fails to discuss or acknowledge the oft-stressed point made by marijuana reformers that it is impossible to die from an overdose of marijuana.  So again, even if legalized marijuana leads to more abuse of this drug, that reality could be a good outcome if more pot abuse means less prescription drug abuse and less accident deaths from the more lethal drugs.

The mention of Big Tobacco and the scare tactic used here by Sabet is another variation of this story.  Based on discussions with various public health folks, smoking marijuana may prove to be significantly less addictive and harmful than smoking tobacco, and thus a move by tobacco companies to focus more on the marijuana market and less on the tobacco market might actually result in a positive public health result. (And, of course, many marijuana users are interested in edibles or other ways to consume marijuana that does not have the same direct or indirect harmful effects of smoking.)

As students in my on-going Marijuana Law, Policy & Reform seminar know, I keep trying to identify and fully understand the very strongest arguments against modern marijuana reform efforts.  As suggested above, I do not think this latest commentary from Kevin Sabet is among them.

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