Regulation of Marijuana
Although federal law that considers marijuana an illegal drug remains unchanged, as of July 2014, thirty-five states and the District of Columbia permit some form of marijuana consumption for medical reasons, eighteen of these states and DC have also decriminalized possession of small amounts of marijuana and Colorado and Washington have legalized it for recreational use--a step that other states are considering. In fact, about 74% of the U.S. population now lives in a state with relaxed marijuana laws.
This liberalization trend has gained momentum for several reasons, including the argument that the illegal drug trade that fosters criminal behavior, violence, and destruction of public lands could be decreased, the need to regulate a drug that’s availability and use is widespread, the possibility of tax income from sales, the unfairness of marijuana arrests (8.2 million between 2001 and 2010) and 20,000 to 30,000 incarcerated for selling or possession, the cost of drug enforcement estimated at $3.6 billion annually, and the lifelong harm of an arrest record to education, employment and eligibility for a loan or mortgage.
Because it can take up to 12 days for marijuana to leave the body, even with sporadic use and without a drug arrest, marijuana use can keep a person from getting a job because some employers test for drug use as part of the hiring process. And some companies do routine drug tests on employees, so people who use marijuana can lose their jobs.
The legal trends on regulation of marijuana use and possession are also fostered by the argument that marijuana is relatively harmless, especially compared to tobacco and alcohol, and that legal bans on use are futile, in that 30 million Americans use marijuana every year and 44% of teens have tried it at least once.
However, regular use among teens is much lower than ever use. According to the National Institute on Drug Abuse (NIDA)'s 2012 Monitoring the Future study, about 6.5% of 8th graders, 17.0% of 10th graders, and 22.9% of 12th graders had used marijuana in the month before the survey, and 6.5% of 12th graders reported using marijuana daily.
Short-Term and Long-Term Effects of Marijuana
Loss of coordination, and distorted judgment and perception can make driving unsafe. According to the NIDA, studies in various locations found that approximately 4 to 14 percent of drivers who sustained injury or death in traffic accidents tested positive for THC. The NIDA also noted several studies that found that marijuana use more than doubles a driver’s risk of being in an accident. This can be compared to the overall risk of a vehicular accident that increases by a factor of 5 with a blood alcohol level of 0.08%, the legal limit in most countries.
In another study reported by the NIDA, researchers followed people from age 13 to 38. They found that heavy users of marijuana in their teens who continued frequent use into adulthood had a significant drop in IQ, even if they quit. Effects can also be unpredictable when marijuana is used in combination with other drugs but it is known that marijuana and alcohol potentiate the harmful effects of each of the drugs.
* The effect is strongly associated with initial marijuana use early in adolescence.
People who use marijuana may also experience a withdrawal syndrome when they stop using the drug. It is similar to what happens to tobacco smokers when they quit—people report being irritable, having sleep problems, and weight loss—effects which can last for several days to a few weeks after drug use is stopped. Relapse is common during this period, as users also crave the drug to relieve these symptoms.
While most people who smoke marijuana do not go on to use other drugs, long-term studies of high school students show that few young people use other illegal drugs without first trying marijuana. For example, the risk of using cocaine is much greater for those who have tried marijuana than for those who have never tried it. Using marijuana puts children and teens in contact with people who use and sell other drugs. So, a person who uses marijuana is more likely to be exposed to and urged to try other drugs. The effects of marijuana on the developing brain of adolescents may also affect their likelihood of using other drugs as they get older.
What About Medical Marijuana?
However, a recent comprehensive evaluation of the potential benefits of marijuana carried out by the institute of Medicine considered medications containing synthetic THC to be of value in treating severe pain, spasticity, nausea in cancer patients undergoing chemotherapy, and to stimulate appetite in patients with wasting syndrome—severe, involuntary weight loss—due to AIDS.
What if a Person Wants To Quit Using Marijuana?
Do Liberalized State Medical Marijuana Laws Increase Use?
As noted by Volkow and colleagues in the New England Journal of Medicine, “…the effects of a drug (legal or illegal) on individual health are determined not only by its pharmacologic properties but also by its availability and social acceptability. In this respect, legal drugs (alcohol and tobacco) offer a sobering perspective, accounting for the greatest burden of disease associated with drugs, not because they are more dangerous than illegal drugs but because their legal status allows for more widespread exposure. As policy shifts toward legalization of marijuana, it is reasonable and probably prudent to hypothesize that its use will increase and that, by extension, so will the number of persons for whom there will be negative health consequences.”
There is a reasonable concern that the trajectory of a burgeoning marijuana industry could mimic that of tobacco, with industrial production of easily available low-cost products, false claims of benefits and risk, and marketing to youth. There is also concern that under an onslaught of lobbying to protect corporate interests, regulation will lag, as it did with tobacco. The marijuana industry already has an advocacy organization—the National Cannabis Industry Association—to protect and advance its corporate interests.
The challenge to society is to avoid the widely recognized detrimental consequences of criminalizing marijuana possession and use, but to also recognize and minimize the negative consequences of marijuana for both individuals and society and recognize that these consequences are especially serious for young people. To this end, better research to allow sound policies, better education of the public, especially teens, and avoidance of the commercialized free-market approach that has failed to protect the public from tobacco are indicated.
Here is Dr. Gupta’s advice: “Young, developing brains are likely more susceptible to harm from marijuana than adult brains. Some recent studies suggest that regular use in teenage years leads to a permanent decrease in IQ. Other research hints at a possible heightened risk of developing psychosis. Much in the same way I wouldn't let my own children drink alcohol, I wouldn't permit marijuana until they are adults. If they are adamant about trying marijuana, I will urge them to wait until they're in their mid-20s when their brains are fully developed.”