How legalized marijuana is affecting our
society has no clear answers, scientists and public health experts
say — mainly because we don't have enough information yet.
In
Colorado, state-sanctioned sales to any adult have been legal only
since Jan. 1, 2014.
Massachusetts, where voters approved a ballot
initiative last year, won't see retail sales until July 2018.
Studies
have shown both increases and decreases in youth and adult use,
unreliable law-enforcement data about crashes and uncertainty about
whether medical marijuana does what its backers claim.
While
marijuana evangelists often deny that the drug could hurt anyone, some
drug treatment experts say that when highly concentrated, it can cause
psychosis.
Medical benefits
Marijuana
appears to be an effective treatment for chronic pain, nausea and
symptoms of multiple sclerosis, according to a January 2017 report from
some of the nation’s top doctors and public health experts.
Commissioned
by the National Academies of Sciences, Engineering and Medicine, the
report said “conclusive or substantial” research backs the effectiveness
of cannabis for those three conditions.
But
the report also warns of dangers: Increased risk of car crashes, lower
birth weights and problems with memory and attention. It found strong
connections between heavy cannabis use and the development of
schizophrenia and other psychoses.
A variety of
state and federal government agencies helped pay for the report, which
included research from medical doctors, mental health practitioners and
addiction specialists. Authors repeatedly noted that data on marijuana
use is limited and scientists need more information as more and more
states legalize medical marijuana.
"Conclusive
evidence regarding the short- and long-term health effects (harms and
benefits) of cannabis use remains elusive. A lack of scientific research
has resulted in a lack of information on the health implications of
cannabis use, which is a significant public health concern for
vulnerable populations such as adolescents and pregnant women,” the
report said.
Deborah Hasin, an epidemiology
professor at Columbia University’s Mailman School of Public Health, has
performed studies that found the prevalence of marijuana use disorders
doubled between 2001 and 2013.
“If you increase
the prevalence of users, you are going to increase the prevalence of
people who have adverse consequences,” she said.
Youth use
But
the data on which Hasin based her most recent study also showed slight
drops in youth marijuana use in Colorado in the years following
legalization. Voters legalized the drug in 2012, but sales didn't start
until about 14 months later.
In Colorado, the
percentage of teens 12 to 17 who had used marijuana in the previous
month dropped from 12.6% in 2012-13 to 11.1% in 2014-15. In the same
period, teens' past-year use dropped twice as fast, from 20.8% to 18.8%.
In
Washington, which legalized recreational marijuana in 2012, 17% of high
school sophomores surveyed in 2016 reported having used marijuana in
the previous month, down from 20% in 2010, according to the annual
Washington State Healthy Youth Survey.
Nationally, 7.2%
of teens reported using marijuana the previous month in 2014-15,
according to the National Survey on Drug Use and Health from that year.
The survey is the most recent one available from the federal Substance
Abuse and Mental Health Services Administration.
Crime and public safety
Colorado Attorney General Cynthia Coffman said she believes data collection is lagging everywhere in the marijuana industry.
As
the top law enforcement officer for the first state to legalize pot,
Coffman worries about small towns struggling with the effects of major
growing operations and marijuana users moving to big cities without jobs
or housing.
“Has
the sky fallen? No it hasn’t, but there has been a cultural change,"
she said. "We’ve seen it in small towns and big cities. ...
"I
would be pleased if it didn’t have a significant effect on crime, on
DUI, on kids. It would make me happy to be wrong," she said. "I live in
the world that sees the consequences.”
Dale
Mondary, a police chief in Desert Hot Springs, Calif. — a former Drug
Abuse Resistance Education officer now policing California's first
city to allow commercial marijuana growing operations — remains deeply
concerned about what will happen when people drive high.
First,
he fears they will cause crashes. And second, because marijuana
intoxication has no standard like blood-alcohol content for booze, he
fears that his officers will be spending more and more time in
courtrooms.
National Highway Traffic Safety
Administration officials have said they believe drugs are increasingly a
factor in fatal crashes though more research is needed. In 2015, about 1
in 5 of more than 31,000 fatal crashes in the U.S. involved at least
one driver who tested positive for drugs — up from 12% in 2005.
A
separate federal study of 11,000 weekend, nighttime drivers found 15.1%
tested positive for illegal drugs in 2013 and 2014, up from 12.4% in
2007. Marijuana represented the largest increase: 12.6% tested positive
in 2013 and 2014, up from 8.6% in 2007.
Mondary also is worried about security at dispensaries and the persistence of the black market.
"I’m still very, very concerned about the recreational use. And frankly I’m opposed to the recreational use," he said.
But part of his job now is to protect the industry and its customers.
"If
the city is going to allow it, I need to make sure we keep that product
and our community just as absolutely safe as we can get it," he said.
Learning from other states
Mason Tvert,
a spokesman for the pro-legalization Marijuana Policy Project who
helped pass the Colorado law, believes concerns about marijuana are
overblown and said the vast majority of users consume it responsibly.
The
increasing acceptance of marijuana legalization reflects the reality
that marijuana is far safer than many other widely accepted drugs, from
prescription opiates like OxyContin to alcohol, he said.
“There’s
more use overall because people are recognizing that marijuana use is
not as harmful as they were led to believe,” Tvert said. Many police
officers have struggled to accept that voters have chosen to legalize
marijuana, and many skeptics' claims have proven false.
And
the war on drugs has brought innumerable negative consequences across
the country, particularly for minority communities, he said.
State
lawmakers are watching early adopters Colorado, Oregon and Washington,
John Hudak of the Brookings Institution said. Some states have sought to
preempt disconcerting trends, especially involving kids.
In
the months after legalization, Colorado saw a jump in the number of
children hospitalized for marijuana poisoning. The state later put new
packaging and labeling regulations in place.
Now
states such as Massachusetts, where lawmakers are crafting their own
recreational pot rules, are writing those kinds of regulations into the
laws before the first marijuana products get sold.
The
debate is no longer about whether marijuana legalization will
expand but what steps state legislators take to manage the risks that
can accompany the industry, Hudak said.
"The march toward reform is an obvious one,” he said.
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