Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

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Sunday, August 3, 2014

Another potent statistical take-down of bad science used to prop up pot prohibition

Mj-erIn this recent post, I highlighted to potent work done by folks at the Washington Post concerning marijuana research and data in this detailed Wonkblog piece  highlighting all the problems with all the science claims by the federal government to justify marijuana prohibition.   I now just saw this notable follow-up piece by Christopher Ingraham at Wonkblog headlined "The federal government’s own statistics show that marijuana is safer than alcohol." Here are excerpts:

Opponents of marijuana legalization return to one particular number over and over in their arguments: the number of emergency room visits involving marijuana. [An] ONDCP fact sheet breathlessly reports that "mentions of marijuana use in emergency room visits have risen 176 percent since 1994, surpassing those of heroin." The Drug Enforcement Administration's "Dangers and Consequences of Marijuana Abuse," a 41-page tour-de-force of decontextualized factoids, reports that marijuana was involved in nearly half a million E.R. visits in 2011, second only to cocaine.

The problem, of course, is that these numbers are meaningless without knowing how many people are using those drugs to start with.  When you consider that there are approximately 70 times more marijuana users than heroin users in the United States, it makes sense that more of the former are going to the hospital than the latter.

Since the government doesn't provide these comparisons in a meaningful way, I've done it myself....

For 2010, the latest year for which complete alcohol data are available, I grabbed the number of regular users from the National Survey on Drug Use and Health.  "Regular," in this case, means people who report using a given substance in the past month.  I then grabbed 2010 E.R. visits involving these substances from the Drug Abuse Warning Network.  This is a hospital reporting system that collects detailed data on all E.R. admissions involving a given drug.  These E.R. visits can involve the use of multiple substances, so the numbers for each drug involve all visits for which that drug was listed as a contributing factor....

The figures clearly show that on a per-user basis, marijuana is considerably less likely to send you to the E.R. than heroin, cocaine or meth.   Marijuana users are also 75 percent less likely to face an E.R. visit than prescription drug abusers.

But most surprisingly, marijuana is significantly safer to use than alcohol.  For every thousand regular alcohol drinkers there are eight more trips to the E.R. than for every thousand marijuana users.  Or in other words, alcohol is about 30 percent more likely to send you to the E.R. than marijuana.

These are all the federal government's own numbers, and they show that marijuana is considerably less harmful to users than alcohol.  At the risk of sounding like a broken record, this comports with just about every other credible study of the drug.

August 3, 2014 in Federal Marijuana Laws, Policies and Practices, Recreational Marijuana Data and Research, Science | Permalink | Comments (0)

Thursday, July 31, 2014

Digging seriously in to "What Science Says About Marijuana"

WonkThe title of this post is drawn in part from the headline of this latest editorial in the New York Times series explaining its editorial judgment that marijuana prohibition should be ended (first noted here).  Here is an excerpt from this editorial:

As with other recreational substances, marijuana’s health effects depend on the frequency of use, the potency and amount of marijuana consumed, and the age of the consumer. Casual use by adults poses little or no risk for healthy people. Its effects are mostly euphoric and mild, whereas alcohol turns some drinkers into barroom brawlers, domestic abusers or maniacs behind the wheel.

An independent scientific committee in Britain compared 20 drugs in 2010 for the harms they caused to individual users and to society as a whole through crime, family breakdown, absenteeism, and other social ills. Adding up all the damage, the panel estimated that alcohol was the most harmful drug, followed by heroin and crack cocaine. Marijuana ranked eighth, having slightly more than one-fourth the harm of alcohol.

Federal scientists say that the damage caused by alcohol and tobacco is higher because they are legally available; if marijuana were legally and easily obtainable, they say, the number of people suffering harm would rise. However, a 1995 study for the World Health Organization concluded that even if usage of marijuana increased to the levels of alcohol and tobacco, it would be unlikely to produce public health effects approaching those of alcohol and tobacco in Western societies.

Most of the risks of marijuana use are “small to moderate in size,” the study said. “In aggregate, they are unlikely to produce public health problems comparable in scale to those currently produced by alcohol and tobacco.”

While tobacco causes cancer, and alcohol abuse can lead to cirrhosis, no clear causal connection between marijuana and a deadly disease has been made. Experts at the National Institute on Drug Abuse, the scientific arm of the federal anti-drug campaign, published a review of the adverse health effects of marijuana in June that pointed to a few disease risks but was remarkably frank in acknowledging widespread uncertainties. Though the authors believed that legalization would expose more people to health hazards, they said the link to lung cancer is “unclear,” and that it is lower than the risk of smoking tobacco....

The American Society of Addiction Medicine, the largest association of physicians specializing in addiction, issued a white paper in 2012 opposing legalization because “marijuana is not a safe and harmless substance” and marijuana addiction “is a significant health problem.”

Nonetheless, that health problem is far less significant than for other substances, legal and illegal. The Institute of Medicine, the health arm of the National Academy of Sciences, said in a 1999 study that 32 percent of tobacco users become dependent, as do 23 percent of heroin users, 17 percent of cocaine users, and 15 percent of alcohol drinkers. But only 9 percent of marijuana users develop a dependence. “Although few marijuana users develop dependence, some do,” according to the study. “But they appear to be less likely to do so than users of other drugs (including alcohol and nicotine), and marijuana dependence appears to be less severe than dependence on other drugs.”

There’s no need to ban a substance that has less than a third of the addictive potential of cigarettes, but state governments can discourage heavy use through taxes and education campaigns and help provide treatment for those who wish to quit.

One of the favorite arguments of legalization opponents is that marijuana is the pathway to more dangerous drugs. But a wide variety of researchers have found no causal factor pushing users up the ladder of harm. While 111 million Americans have tried marijuana, only a third of that number have tried cocaine, and only 4 percent heroin. People who try marijuana are more likely than the general population to try other drugs, but that doesn’t mean marijuana prompted them to do so.

Marijuana “does not appear to be a gateway drug to the extent that it is the cause or even that it is the most significant predictor of serious drug abuse,” the Institute of Medicine study said. The real gateway drugs are tobacco and alcohol, which young people turn to first before trying marijuana.

This NY Times piece is a potent and effective review about what we really know about marijuana's health and societal impact.  Even more powerful on the same front, though, is this remarkable new Wonkblog piece from the Washington Post that highlights all the problems with all the science claims by the federal government to justify marijuana prohibition.  The title of this piece, with is a must-read for anyone who really care about both the science and advocacy realities surrounding marijuana reform, is "The federal government’s incredibly poor, misleading argument for marijuana prohibition." Here is how it gets started:

The New York Times editorial board is making news with a week-long series advocating for the full legalization of marijuana in the United States. In response, the White House's Office of National Drug Control Policy (ONDCP) published a blog post Monday purporting to lay out the federal government's case against marijuana reform.

That case, as it turns out, it surprisingly weak. It's built on half-truths and radically decontextualized facts, curated from social science research that is otherwise quite solid. I've gone through the ONDCP's arguments, and the research behind them, below.

The irony here is that with the coming wave of deregulation and legalization, we really do need a sane national discussion of the costs and benefits of widespread marijuana use. But the ONDCP's ideological insistence on prohibition prevents them from taking part in that conversation.

July 31, 2014 in Assembled readings on specific topics, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Science | Permalink | Comments (0)

Wednesday, June 11, 2014

"The DEA: Four Decades of Impeding And Rejecting Science"

Logo_headerThe title of this post is the title of this notable new report from the Drug Policy Alliance.  Here is an excerpt from the report's executive summary:

The Drug Enforcement Administration (DEA) is charged with enforcing federal drug laws. Under the Controlled Substances Act of 1970, its powers include the authority to schedule drugs (alongside other federal agencies) and to license facilities for the production and use of scheduled drugs in federally-approved research. Those powers are circumscribed by a statute that requires the agency to make its determinations based on scientific data.

The case studies compiled in this report illustrate a decades-long pattern of behavior that demonstrates the agency's inability to exercise its responsibilities in a fair and impartial manner or to act in accord with the scientific evidence – often as determined by its Administrative Law Judges.

The following case studies are included in this report:

  • DEA Obstructs Marijuana Rescheduling: Part One, 1973-1994
  • DEA Overrules Administrative Law Judge to Classify MDMA as Schedule I, 1985
  • DEA Obstructs Marijuana Rescheduling: Part Two, 1995-2001
  • DEA Overrules Administrative Law Judge to Protect Federal Monopoly on Marijuana for Research, 2001-2013
  • DEA Obstructs Marijuana Rescheduling: Part Three, 2002-2013

These case studies reveal a number of DEA practices that work to maintain the existing, scientifically unsupported drug scheduling system and to obstruct research that might alter current drug schedules.

June 11, 2014 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Science | Permalink | Comments (0)

Tuesday, April 29, 2014

This is your brain on drugs: what a recent fMRI study can and can’t tell us about the effects of marijuana use

Two weeks ago (okay, I'm late to the party), news broke of a new study showing that the brains of casual marijuana users are different than those of non-users. The study was just published in the Journal of Neuroscience and can be found here.

The researchers used magnetic resonance imaging (MRI) to scan the brains of 40 young adults aged 18-25. 20 of those subjects were casual marijuana users and 20 were non-users. Controlling for other behaviors such as alcohol and tobacco use, the researchers found that marijuana use was correlated with changes to the shape, size, and density of particular areas of the brain. From the study:

“The results of this study indicate that in young, recreational marijuana users, structural abnormalities in gray matter density, volume, and shape of the nucleus accumbens and amygdala can be observed. Pending confirmation in other cohorts of marijuana users, the present findings suggest that further study of marijuana effects are needed to help inform discussion about the legalization of marijuana.”

The study generated a lot of media coverage, and, unfortunately, over-statements of the study’s actual implications for ongoing policy debates. For example, the Society for Neuroscience issued a press release for the study. The release, while titled with appropriate caution (“Brain Changes are Associated with Casual Marijuana Use in Young Adults”), relays unsupported claims from scientists regarding the ramifications of the study. One of the authors, Hans Breiter, is quoted as saying ““This study raises a strong challenge to the idea that casual marijuana use isn’t associated with bad consequences.” And Carl Lupica, a researcher from the National Institute on Drug Abuse who was not involved with the study, similarly suggests that “This study suggests that even light to moderate recreational marijuana use can cause changes in brain anatomy.”  

The problem is that the study doesn’t necessarily support such conclusions. The study’s findings, while intriguing and valuable, are still quite limited. For one thing, the study will need to be replicated. The subject pool of 40 is rather small. That’s not reason enough to dismiss the study -- much brain science research relies on small n studies, because MRIs are cumbersome and expensive, and one can find statistically significant results with small pools – but it is reason to be particularly cautious about the results pre-replication.

Second, correlation doesn’t equal causation. Law policymakers commonly ignore this important scientific concept, but even scientists sometimes get ahead of themselves and jump to conclusions not warranted by a study’s design. In this study, for example, it is quite possible that people who use marijuana have differently sized and shaped brains to begin with; for example, maybe their brains are simply wired to seek out more risky behaviors and that’s why they’ve decided to use an illicit substance. Since we don’t know the size and shapes of these brains before they started using marijuana, we can’t say which came first: the marijuana usage or “the structural abnormalities in gray matter density, volume, and shape of the nucleus accumbens and amygdala.”

Third, even if the study’s results could be replicated and even if they could (somehow) demonstrate a causal connection between marijuana use and brain structure, it’s not clear from this study anyway why we should care. To be sure, different areas of the brain are associated with different functions and I wouldn't want to tinker with the size, shape, or density of my brain. But the study’s author’s can’t yet say that the changes they observe in brain structure necessarily cause negative changes in behavior.  For example, some studies suggest that the nucleus accumbens might play a role in drug addiction. But it’s not clear whether that changes observed in this study are associated with (let alone cause) marijuana addiction or any other bad behavioral outcomes; indeed, the authors made a point of excluding “dependent” marijuana users from the subject pool.

Law and neuroscience is a very promising field. It is generating intriguing findings concerning important issues like culpability. But as the best in this nascent field know, there is still much to be learned about the brain. This study is an intriguing development and clearly worthy of more follow ups. I think research on the brain cold help us understand marijuana’s effects and put them in perspective with those of alcohol, tobacco, cocaine, etc. But for now, bold statements about the import of brain science for policy debates over marijuana seem premature.

April 29, 2014 in Criminal justice developments and reforms, Current Affairs, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research, Recreational Marijuana State Laws and Reforms, Science | Permalink | Comments (2)

Thursday, March 6, 2014

Florida conservatives now talking up nuanced positions on marijuana reform

FloridaAs reported in this lengthy local article, headlined "Conservative committee opens door to medical marijuana for Florida," a notable swing/southern state now has a number of notable legislators talking in notable ways about marijuana reform.  Here are excerpts:

One conservative Republican who has suffered from brain cancer talked about the deceit of the federal government in hiding the health benefits of marijuana for his cancer.  Another legislator reluctantly met with a South Florida family, only to be persuaded to support legalizing the drug.

Then there was Rep. Charles Van Zant, the surly Republican from Palatka who is considered the most conservative in the House. He not only voted with his colleagues Wednesday to pass out the bill to legalize a strain of marijuana for medical purposes, he filed the amendment to raise the amount of psychoactive ingredients allowed by law — to make it more likely the drug will be effective.

The 11-1 vote by the House Subcommittee on Criminal Justice, was a historic moment for the conservatives in the GOP-dominated House. It was the first time in modern history that the Florida Legislature voted to approve any marijuana-related product. “That’s because people here in Tallahassee have realized that we can’t just have a bumper-sticker approach to marijuana where you’re either for it or against it,” said Rep. Matt Gaetz, R-Shalimar, the committee chairman and sponsor of the bill after the emotional hearing. “Not all marijuana is created equally.”

The committee embraced the proposal, HB 843, by Gaetz and Rep. Katie Edwards, D-Plantation, after hearing heart-wrenching testimony from families whose children suffer from chronic epilepsy. A similar bill is awaiting a hearing in the Senate, where Senate president Don Gaetz, a Niceville Republican and Matt’s father, has said he has heard the testimony from the families and he wants the bill to pass as a first step. “Here I am, a conservative Republican but I have to try to be humble about my dogma,” Senate President Don Gaetz told the Herald/Times....

For a committee known for its dense, often tedious scrutiny of legal text, the debate was remarkable. Rep. Dave Hood, a Republican trial lawyer from Daytona Beach who has been diagnosed with brain cancer, talked about how the federal government knew in 1975 of the health benefits of cannabis in stopping the growth of “brain cancer, of lung cancer, glaucoma and 17 diseases including Lou Gehrig’s disease” but continued to ban the substance. “Frankly, we need to be a state where guys like me, who are cancer victims, aren’t criminals in seeking treatment I’m entitled too,” Hood said.

Rep. Dane Eagle, R-Cape Coral, said he had his mind made up in opposition to the bill, then changed his mind after meeting the Hyman family of Weston. Their daughter, Rebecca, suffers from Dravet’s Syndrome. “We’ve got a plant here on God’s green earth that’s got a stigma to it — but it’s got a medical value,” Eagle said, “I don’t want to look into their eyes and say I’m sorry we can’t help you,” he said. “We need to put the politics aside today and help these families in need.”

The Florida Sheriff’s Association, which adamantly opposes a constitutional amendment to legalize marijuana for medical use in Florida, surprised many when it chose not to speak up. Its lobbyist simply announced the group was “in support.” The bi-partisan support for the bill was summed up by Rep. Dave Kerner, a Democrat and lawyer from Lake Worth. “We sit here, we put words on a piece of paper and they become law,” he said. “It’s very rare as a legislator that we have an opportunity with our words to save a life.”

The only opposing vote came from Rep. Gayle Harrell, R-Stuart, an advocate for the Florida Medical Association. Her husband is a doctor. She looked at the families in the audience and, as tears welled in her eyes, she told them: “I can’t imagine how desperate you must be and I want to solve this problem for you.” But, she said the bill had “serious problems.” It allowed for a drug to be dispensed without clinical trials and absent the kind of research that is needed to protect patients from harm. “I really think we need to address this using science,” Harrell said, suggesting legislators should launch a pilot program to study and test the effectiveness of the marijuana strain. “This bill takes a step in the right direction … but it’s not quite there.”

Cross-posted at Marijuana Law, Policy and Reform

March 6, 2014 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Science | Permalink | Comments (0)

Tuesday, February 11, 2014

Does marijuana make you hungry?

I've always thought one of the strangest things about the DEA's insistence that marijuana has no currently accepted medical use is that one of the claimed medical uses is as an appetite stimulant.  When I cover CSA scheduling of marijuana in my Controlled Substances class, I sometimes joke about whether we really need scientific studies to know that marijuana can make people hungry.  

The DEA's position, of course, is that there isn't enough evidence to say that marijuana can stimulate the appetites of cancer and AIDS patients.  (The synthetic-THC drug Marinol, on the other hand, has been officially determined to make people hungry.)

Though I don't think it will be enough to satisfy the DEA, today brings some new scientific evidence of (and explanation for) marijuana's effect as an appetite stimulant.  The blog Toke of the Town reports:

In a new study published this week in Nature Neuroscience, European researchers claim to have proven that smoking weed does, in fact, give you the munchies. Beyond that, they appear to have isolated the specific region of the brain that is affected by THC consumption, and identified the process through which that desire to eat an entire box of Lucky Charms at 2am comes from. 

February 11, 2014 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Science | Permalink | Comments (0)

Thursday, November 14, 2013

"Medical marijuana advocates in Colorado give pot to pets"

KlibbenThe title of this post is the headline of this notable story via UPI.  Here are excerpts:

Some medical marijuana enthusiasts in Colorado are taking the "holistic approach" by giving their pets pot to deal with pain.

As animals age, it’s harder for them to do things like fetch, run and play, prompting some owners to prescribe marijuana to help fix the problem. "Arthritis is the really big thing for our pets as they get older, for being able to move about and get their exercise,” pet owner Barbara Novey told local Fox affiliate KXRM.

"So medication of any type that will help someone that is natural will help their pet as well, and I think that maybe our pets can help us purge this reefer madness mentality and realize that it's not the dangerous drug that you think it is."

Novey thinks pot is therapeutic for her pooch, but NorthWest Animal Hospital veterinarian Dr. John Sudduth asserts that giving a dog medical marijuana can be deadly. "There just hasn't been enough research that has been presented to the medical community that would inform us to how to safely use medication such as marijuana. You're really playing with fire. You don't really know what you're giving and what kind of side effects it could have. It could result in serious illness and it could result in death in some cases."

"Pets are not necessarily people in fur coats," Sudduth added. "And how they metabolize medications and utilize medications those are all separate issues that have to be determined."

It is still illegal for veterinarians to prescribe medical marijuana pills. "We need to know about the indications, the usage, the side effects the toxicities and all of those things would have to be worked out before any of these medications, like marijuana might be used," Sudduth said.

November 14, 2013 in Medical Marijuana Commentary and Debate, Science | Permalink | Comments (0)

Thursday, August 22, 2013

What are the best statistics and strongest research/arguments to support marijuana prohibition and strict criminal enforcement? (Now updated with some...)

I posed the question in the title of this post toward the end of my first class session of the exciting new seminar I am teaching this Fall 2013 semester at OSU's Moritz College of Law.  Indeed, I challenged the terrific (and seemingly very insightful and knowledgeable) students taking the seminar to spend the next week looking for (and sending to me for posting here) the very best statistics and the strongest research and arguments they could find to support marijuana prohibition.

Helpfully, and to provide a running start on a question that I hope will generate some dialogue in the comments, there are more than a few anti-drug advocacy groups which have already marshalled materials in support of prohibition.  A research assistant helped me assemble links to these notable advocacy groups:

I am hoping that seminar students and other readers might help me cull through the materials on these sites and elsewhere to help provide a sophisticated and detailed answer to the question in the title of this post. 

UPDATE:  So far, three students from my seminar have sent me a bunch of materials and links concerning what they perceive to be the "best" ideas and arguments to support marijuana prohibition.  Here are a few highlights from these efforts:

The DEA in 2010 produced this impressive 81-page booket, titled Speaking Out Against Drug Legalization, which says it is "designed to cut through the current fog of misinformation with hard facts [by] present[ing] an accurate picture of America’s experience with drug use, the nature of the drug problem, and the potential for damage if the United States adopts a more permissive policy on drug abuse." Here are a few (of dozens) of the bullet points from this document discussing the health risks posed by marijuana:

  • Harvard University researchers report that the risk of heart attack is five times higher than usual in the hour after smoking marijuana.
  • The National Institute of Health found that a person who smokes five joints per week may be taking in as much tar and cancer-causing chemicals into their lungs as someone who smokes a pack of cigarettes every day.
  • Smoking marijuana weakens the immune system, and raises the risk of lung infections. Other studies indicate that smoked marijuana causes cancer, respiratory problems, increased heart rate, loss of motor skills, and damage to the immune system.
  • According to several recent studies, marijuana use has been linked with depression and suicidal thoughts, in addition to schizophrenia. These studies report that weekly marijuana use among teens doubles the risk of developing depression and triples the incidence of suicidal thoughts.

I have not sought to check or question the references cited for these statements, but I am inclined to take the claims at face value.  In addition, building largely on these sorts of medical claims while making a few other arguments, here are links to a couple notable and prominent commentaries making the case in favor of marijuana prohibition:

Last but certainly not least, the Director of the Office of National Drug Control Policy, R. Gil Kerlikowske, gave this notable public statement to California Police Chiefs Association Conference in March 2010 titled "Why Marijuana Legalization Would Compromise Public Health and Public Safety." Here is how he summed up his main arguments against marijuana legalization at the start and tail end of this speech:

The concern with marijuana is not born out of any culture-war mentality, but out of what the science tells us about the drug’s effects. And the science, though still evolving, is clear: marijuana use is harmful. It is associated with dependence, respiratory and mental illness, poor motor performance, and cognitive impairment, among other negative effects....

Legalizing marijuana would also saddle government with the dual burden of regulating a new legal market while continuing to pay for the negative side effects associated with an underground market whose providers have little economic incentive to disappear....

Legalization means the price comes down, the number of users goes up, the underground market adapts, and the revenue gained through a regulated market will never keep pace with the financial and social cost of making this drug more accessible.

August 22, 2013 in Current Affairs, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Science | Permalink | Comments (1)