Arguing for Marijuana Legalization? You're Doing it Wrong

All In with Chris Hayes did a segment on the "War on Weed" yesterday that really just drove me crazy.    Let me briefly recap before I tear the whole thing apart.  It started with Lee Fang, an author from The Nation who wrote a piece about the reason Marijuana is still illegal.  He points out that Big Pharma spends a bunch of money advocating against legalization because it would cut into their bottom line, this, it should be noted, is also true for the alcohol and tobacco industries and even for illegal marijuana growers, all of whom would suffer financially from legal marijuana.  That is all simple enough to understand (though certainly newsworthy) so let's move on.  He then brings on former Democratic Congressman Patrick Kennedy who now runs what amounts to a "Drugs are bad" type of a group that opposes legalization.  There is not even one single point he makes that I can accept without comment or refutation so I'll have to come back to that whole bit.  Finally he has the neuroscientist Carl Hart who fills the role of legalization advocate.  He was seemingly dismayed by the lack of opportunity to offer any meaningful response to the former Congressman's laundry list of factual inaccuracies (though I must say that the few precious moment he did have were mostly squandered).  I believe there is an appropriate way to make a marijuana legalization argument yet most proponents choose to make the wrong argument.  I'll come to that but first let me dispel with all the nonsense that Patrick Kennedy was spewing against legalization.

1)  He said that medical marijuana was a "trojan horse for legalization"

To a limited extent that is true. The groups that have pushed for medical marijuana are frequently the same groups that push for recreational marijuana.  It is also true that many of the people that have been prescribed medical marijuana might not be considered "legitimate" patients.  Still, I find this argument completely unpalatable.  I don't know that you could find very many people willing to make that same argument to a patient suffering from Glaucoma, Multiple Sclerosis, AIDS wasting or someone undergoing chemotherapy for cancer.  For many of these people Marijuana is not only the best medication for the ailments they are suffering but the only effective medication for their "legitimate" and serious suffering.  

Let's put this another way.  I hate stairs, for years I have told anyone who would listen that I prefer to walk up an inclined plane than to walk up stairs.  When presented with a choice I will usually avoid stairs even if it means a somewhat longer or more time consuming route.  This means that I will frequently walk up or down a wheelchair accessible ramp rather than take the stairs.  Over time I have noticed that I am far from the only one who makes this similar choice.  In fact, my experience tells me that there are far more able bodied individuals who use wheelchair ramps than those for whom it was built.  The logic of Kennedy's argument seems to suggest that we don't need wheelchair ramps if most of the people that use them could walk up stairs.  This, of course, is not what he was saying but is a natural conclusion to draw from a similar logic.  The point is that even if we grant that most of the people that are medical marijuana patients are "illegitimate" (a conclusion we should be hesitant to make) that is not a good reason to keep those who truly need the medicine from it.

2) He then said that we would be adding on to the burden of addiction by legalizing another drug, evidenced by the claim that Opioid addiction has been fueled by "availability and accessibility."

First, I would like to note that there is an important distinction to make between drug use and drug addiction.  Drug use comes from the potential for intoxication (getting high) and is aided by availability and accessibility.  Drug addiction comes from specific physical reactions to certain drugs through withdrawal, reinforcement, tolerance and dependence.  Having cheap and accessible marijuana certainly wouldn't help with the number of addicts but it has to be coupled with these other factors.  Evidence shows that very few people who ever try marijuana become addicted (were talking low single digits or about 4% depending one which study you consult).  So, when Kennedy says that opioid addiction has been fueled by availability and accessibility he isn't wrong, but the key word there is fueled.  Trying to make the same conclusion for marijuana is quite obviously a false equivalency.  The reason is that, unlike opioids, marijuana is not particularly addictive (see table above).  

To his credit, Kennedy does acknowledge that marijuana is already widely available in spite of decades of prohibition.  The problem with legalization, as he argues, is that there would then be for profit companies who would be marketing marijuana to young adults and teens (though i'm sure that would be regulated) targeting vulnerable populations and turning them into addicts.  Again, we need to realize that this isn't a terribly addictive product.  To make a regular marijuana consumer you don't just have to get them to try it, you need them to like it.  To summarize, the only gains that have been made in reducing marijuana use through prohibition is the small subset of the population that is unwilling to try it simply because of its illegality AND who otherwise would have liked it and continued to use beyond a brief experimental phase.  The same could not be said for tobacco or opioids which are actually addictive and need only be tried briefly to hook and individual for life.

3)  Tied into this last point is an argument that we would be sending the wrong message to our kids.  He said that kids would think it's no big deal, like grabbing a bottle of booze from the cupboard.

I have to say, this is one of my favorite arguments to destroy.  Any rational adult knows that it is actually better (were it not for legal consequences) for their kids to experiment with marijuana over alcohol.  Even our sitting president acknowledged this fact.  But, as a marijuana legalization advocate I don't like to play the "look at legal things worse than pot" game.  The fact is trying to have prohibition for popular drugs is always foolish public policy.  Alcohol prohibition was bad, marijuana prohibition is bad, and tobacco prohibition would be bad.  My hope is that even people who are against all these vices will see that the best solution lies with education rather than prohibition.  

Starting about 5 years ago we had a major shift in high school drug use patterns.  For the first time ever recorded there were more graduating seniors who had tried marijuana over cigarettes.  The fact that this happened mostly because of decreased tobacco use rather than increased marijuana use is a major public health victory.  Looking at the chart above we can draw 2 conclusions: 1- Tobacco use has gone down even though it is still legal, and 2- Marijuana use has stayed steady.  The truth is that I don't believe we can replicate the success of tobacco reductions with marijuana.  The problem is that there is no major scare factor, an education campaign will be hard to mount around relatively minor long term risks associated with marijuana use.  Still this would be better than obvious lies we present with abstinence only drug education.  When adults are hyperbolic about the dangers of marijuana use they lose all credibility.  Teenagers are capable of seeing straight through the lies and turn, instead, to the internet to find out the "truth" about marijuana.  This is potentially dangerous because of the potential for misinformation about the actual risks of use.  For example, there is a legitimate concern about high concentrate edibles with marijuana; people have been known to take to much which can lead to problems.  But if we are dishonest with our drug education, why would they believe us when we try to explain the actual dangers?  

Kids are bright enough to get that just because something is legal does not mean that it is safe, especially when taken to extremes.  They appear to be getting this message with tobacco.  They are starting to realize (I hope) that it is legal to eat fast food all three meals everyday, but you'll end up dying of cardiac arrest in your 40's (if you're lucky).  If we want our kids to believe us when we tell them about the danger and warning signs of tolerance and withdrawal, we have to cut out the "reefer madness."

4) Tobacco, alcohol and marijuana are "gateway drugs."

I almost can't believe we are still talking about this.  If I was Carl Hart I would have used my precious few moments on air to debunk this tired myth once and for all.  PLEASE can't we finally put this to rest.  Kennedy said that the "real" gateway drugs are tobacco and alcohol (i.e legal drugs) which leads kids to marijuana before they get tired of this and move on to harder drugs.  I would like to state this as clearly as possible, there is NO SUCH THING AS A GATEWAY DRUG!  It simply does not exist, not tobacco, not alcohol, and not marijuana.  

Here is essentially how the gateway theory developed.  If you filled a stadium with people who were heroin addicts (Kennedy chose Heroin so I'll stick with that) and polled them on whether they had tried marijuana before heroin you would find that virtually everyone would honestly say that they had.  Presto! Gateway theory is proven, right? Wrong!  My favorite rebuttal to this (though not sure who deserves proper attribution) is to ask the same stadium of people how many of them had tried milk before heroin.  Again you would find that it was pretty much everyone (or actually everyone if you count breast milk), does that make milk a gateway drug?  Of course it doesn't, that would be ridiculous. The appropriate way to test for the gateway theory would be to fill the stadium with marijuana users and to ask them how many had moved on to try heroin.  If you did that you would find that almost none did, in fact, it would be about the same percentage as those who used heroin from the regular population.  Marijuana doesn't cause heroine addiction, it doesn't lead to it, there is no gateway.  But, if you were going to become a heroine addict, you are most likely going to have gone through a plethora of other drugs before you tried shooting up, including tobacco, alcohol and marijuana.  

Let's recap.  1) There are at least some medical marijuana patients who are unquestionably "legitimate" and for whom safe and legal access is a necessity, regardless of abuses of the system. 2) Legalization of marijuana will lead to a modest rise in marijuana users in the short term before once again plateauing.  Marijuana is not particularly addictive and there is no rational grounds to assume that "big marijuana" could turn a whole generation into deadbeat stoners. 3) It is better to be honest with our children about the actual  dangers of marijuana use than it is to send hyperbolic scare messages.  Tobacco education has been more effective than marijuana prohibition. and finally 4) THERE IS NO SUCH THING AS A GATEWAY DRUG!  Instead of lying to kids our politicians and other leaders have been lying to adults, the only difference is that it is actually working.  It appears that we are more gullible than our children.

Okay, with that now out of the way I want to spend a little time talking about the correct and incorrect way to advocate for marijuana legalization.  There are two main approaches to advocating for sensible drug policy, neither of which I am a fan of.  

1) Talking about money

It is true that we spend insane amounts of money maintaining marijuana prohibition and have very little to show for it.  It is also true that we are foregoing insane amounts of money by not taxing marijuana sales in a well regulated market.  The problem with money is that you completely miss the moral argument.  For some reason, money is no concern when it comes to saving even just one child (that is unless we're talking about a latino child from some Central American country fleeing the most horrific violence imaginable).  I have written about how legalization advocates can't just flash dollar signs but have to win the morality argument before.  This still holds true today.  What seems strange to me is that we can win the morality argument.  Whenever someone asks you to think about the message we are sending to the kids ask them about the kids of the non-violent drug users who have been sent to jail for decades, had their assets confiscated, had their student loans rescinded, can no longer support their families, and have been marked forever as felons.  Ask them about entire communities that have been devastated, about whole demographics who have been systematically biased and who were born with dramatically fewer options and opportunities.  How's that for morality?

2) Comparing marijuana to tobacco, alcohol and pharmaceuticals

This one is tempting as seen by the failed effort on Chris Hayes' show last night.  Advocates like to point out that marijuana is safer than any of these legal substances but by making this connection you are inviting all of the problems associated with tobacco, alcohol and pharmaceuticals into the marijuana legalization debate.  Frequent responses include noting that the revenue generated from alcohol taxes doesn't come close to matching the costs associated with alcohol use. That legal drugs are more popular than marijuana and we would essentially be doubling down.  That there would then be corporate incentives to encourage marijuana addiction.  That legal drugs are actually more gateway drugs, etc.  Each of these arguments can easily be refuted, but before you know it you are now talking about other drugs and not marijuana.

So, what is the correct approach to advocating marijuana legalization?  We need to argue that marijuana is actually good.  Not just that it is better than the alternative nor that it isn't worth the cost we have spent but that it is actually good.  We need to argue that all those medical marijuana patients that appear illegitimate are actually legitimate.  We need to argue that marijuana isn't only better than alcohol but better than aspirin.  We need to show that moderate consumption can go a long way to calming the anxious and stressed American population with relatively modest side effects.  We need to show that marijuana is better than sleeping pills, pain pills, and recreational drug use.  We need to argue that the Federal coffers and not the foreign cartels should be profiting of it's distribution.  We need to eradicate non-violent addicts from our prisons and we need to invest in our inner cities.  We need to win the moral argument.  Marijuana is not just "not that bad" rather, "marijuana is good."

*I should note that I don't believe marijuana is for everyone, but I believe that most people are capable of making that decision for themselves (at least with the aid of a doctor).  Certainly we can agree that there is no logical purpose in incarcerating non-violent offenders.