35 thoughts on “Medical Marijuana Debated in Keystone State”

  1. I’m not sure how much we’re actually doing on marijuana enforcement; it’s not a particularly high priority problem relative to meth, for example. And there is a very real social cost to marijuana: roughly a 40% increase in later psychosis among regular users, which has significant costs for disability and health care. If you are one of the large majority who can smoke pot without becoming disabled by it later in life, well so what? But for those who are disabled, and for their friends and family, it’s devastating.

  2. “And there is a very real social cost to marijuana: roughly a 40% increase in later psychosis among regular users.”

    Cites or it didn’t happen. And you also need to tell us what the actual increase is, because going from, say, 10 in 100,000 to 14 in 100,000, for example, is NOT significant in terms of health care and disability, nor is the remainder just a “large majority”.

  3. Whenever people start talking about legalizing drugs I have to qualify my support.

    Legalize it IF, and ONLY IF – I don’t have to pay for the consequences. I don’t want to pay for rehab, or cancer treatment, or whatever else people have done to their bodies.

    I’m all for freedom – especially my own economic freedom.

  4. “Medical Marijuana” is the “Assault Weapons Ban”, it’s a lie just to get a foot in the door.

    There may be some therapeutic values to Marijuana, much like there might be for having one or two drinks a night, having sex, or doing yoga.

    A plant in various stages of process, of varying strains, and varying purity of active ingredients is NOT a pharmaceutical, and not something that can be ethically prescribed as a medication by a doctor.

    Let’s face it, people don’t want “Medical Marijuana” because they want Cancer, AIDS, Glaucoma, ect patients to have a better life, they want it so they can game the system and get high with less legal penalties.

    I have no problem with people recreationally using this drug, I have no problem with this drug being decriminalized.

    I have a HUGE problem with people lying about this to further a political agenda.

    My Doctor may recommend a snort of scotch for my cardiovascular health, as well as my general well-being. My Insurance company will NOT cover me grabbing a fifth of Speyburn Single Malt at the local package store. Nor will they ever.

  5. I never could understand why we are so concerned about what adults put into their own bodes.

  6. How does the risks of MJ compare to that of regular cigs or alcohol? Without those comparisons, it’s impossible to make a genuine cost/benefit comparion.

    Plus, what’s the baseline for the rate of psychosis? a 40% increase over a rate of 1 in 10,000 is way different than a 40% increase in a rate of 1 in 100.

    Finally, even now the set of the population who uses MJ “regularly” is not the same set as the population as a whole, and probably not even close to contiguous with the set of people who use legal recreational drugs (alcohol, tobacco, etc).

    I’m on the side of the cost to society of the War on (some) Drugs isn’t worth it. Simply getting rid of civil asset forfeiture and not putting people in jail for non-violent crimes would be worth it IMHO.

    Spare me from saying that the guys in jail for posession “pled out” from higher charges. I’m sure that’s true in a non-trivial # of cases. I will grant you that, and then point out that much of the violence in the drug trade is because the traders CANNOT resort to the legal system if they have been wronged in the trade. Remove the illegality of the trade, and they can get on with suing each other for breach of contract. And if not, nail them for the actual violence. I really don’t like the “we can’t get him for the big stuff, so we’ll nail him for penny-ante and shovel it on”. There’s just so much penny-ante CRAP now available to charge with; and the remedy is claimed to be “prosecutorial discretion”. We’ve written the .gov end of criminal justice a blank credit contract with an awful big limit; on their word they’ll only use it on “the bad guys”. If nothing else, that’s antithetical to the rule of law vs the rule of man.

    I’m not for universal legalisation – if nothing else, Meth production is a health and safety hazard (but you can nail them for that without the rest of the drug war nonsense). I’ll go for incrementalism – start with MJ, and see what happens. But legalize it fully, don’t just decriminalize it or go the medical route.

  7. Personally, I’ve seen friends and acquaintances destroy their lives with various drugs, including but not limited to, alcohol. That said, I don’t blame drugs for these issues … they are the decisions of free-thinking people. I also don’t blame guns for crime …

    That said, it has long been my personal opinion that drugs should be legalized … and yes, I mean all of them. Just look at what prohibition has cost us.

  8. I’d just like to jump in and point out that judging whether or not any kind of illegal drug causes mental illness is extremely difficult, because many people with undiagnosed mental illnesses seek out drugs to try to self medicate. it’s sort of like that brady study, do people who are in danger of being killed carry guns for protection, or does carrying a gun increase people’s danger of being killed?

  9. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review,
    THM Moore, S Zammit, A Lingford-Hughes, … – The Lancet, 2007

    Schizophrenia affects about 1% of all Americans. There are other psychoses, somewhat less common that collectively get us to about 2%.

    Lancet. 1982 Dec 18;2(8312):1364-6.
    Cannabis-associated psychosis with hypomanic features.

    Rottanburg D, Robins AH, Ben-Arie O, Teggin A, Elk R.

    Is cannabis use psychotogenic?

    W Hall – The Lancet, 2006

    The 2007 study is the reason that the Lancet reversed a longstanding editorial position in support of decriminalization of marijuana.

    Pot isn’t the only drug that increases these risks, of course. Alcohol does also.

  10. “I’d just like to jump in and point out that judging whether or not any kind of illegal drug causes mental illness is extremely difficult, because many people with undiagnosed mental illnesses seek out drugs to try to self medicate.”

    A true statement, but the longitudinal study of Swedish conscripts suggests what the direction of causality is.

    Look, I know that almost every American of my generation smoked pot, and many still do. For many of you, it hasn’t done you any harm. The same is true for alcohol: most people who drink manage to do so without becoming alcoholics, or developing mental illness. But the minority that do end up becoming enormous costs the society.

  11. Here’s a 2004 British Journal of Psychiatry paper about marijuana and psychosis. http://bjp.rcpsych.org/cgi/content/abstract/184/2/110

    Results On an individual level, cannabis use confers an overall twofold increase in the relative risk for later schizophrenia. At the population level, elimination of cannabis use would reduce the incidence of schizophrenia by approximately 8%, assuming a causal relationship. Cannabis use appears to be neither a sufficient nor a necessary cause for psychosis. It is a component cause, part of a complex constellation of factors leading to psychosis.

    Now, it is entirely possible that people who are predisposed to later psychosis start using marijuana because of that predisposition–that something in the pre-psychotic brain causes them to seek marijuana. But it is also entirely possible that marijuana causes mental illness in some. I have three relatives for whom marijuana use preceded by a year or two significant mental illness problems. One became schizophrenic in 1973, and remains so today. He will never recover, and the taxpayers have spent an incredible amount of money supporting him and caring for him ever since. (LSD may also have been a contributing factor.) Another relative went from mild bipolar disorder to extreme bipolar disorder (including hallucinations) within a year or so of starting to smoke pot. A third relative within a few months of starting to smoke pot had an extreme bipolar disorder breakdown which leaves him disabled (and dependent on government support) today, more than 20 years later.

  12. I’m not a denier of the risks. I don’t think smoking pot is a wise thing and I wouldn’t do it even if it were legal and accepted. I do drink, but I figure one drug is enough for one brain.

  13. Spare me from saying that the guys in jail for posession “pled out” from higher charges.

    Show me some statistics on the number of guys in jail for possession of marijuana. I would be startled if this is anything but a tiny fraction of 1%. The vast majority of people in jail for marijuana-related charges are there for trafficking.

  14. I do drink, but I figure one drug is enough for one brain.

    It’s wise to look at your family risk with alcohol. If you have blood relatives with addiction or severe mental illness problems, you are probably taking a high risk messing with any of the addictive drugs. If you have no blood relatives with addiction or mental illness problems, your risks are probably lower.

    Nature had an article several months ago about the genetic nature of schizophrenia and bipolar disorder. They found about 10,000-15,000 individual mutations responsible for schizophrenia–and oddly enough, the same set involved with bipolar disorder. Whether these genes actually cause either illness in an individual seems to be related to some environmental factor, perhaps a virus. (The mutations are heavily grouped in an area known to be associated with certain categories of virus sensitivity.) Alcohol is known to be a risk factor for severe bipolar disorder, and I have seen some anecdotal evidence suggesting that marijuana may also be a risk factor. (I stayed away from both as a child–perhaps why I didn’t end up in serious trouble.)

  15. From Schizophrenia Bulletin (2008) http://schizophreniabulletin.oxfordjournals.org/cgi/content/abstract/34/6/1111

    The abstract:

    Cannabis use is considered a contributory cause of schizophrenia and psychotic illness. However, only a small proportion of cannabis users develop psychosis. This can partly be explained by the amount and duration of the consumption of cannabis and by its strength but also by the age at which individuals are first exposed to cannabis. Genetic factors, in particular, are likely to play a role in the short- and the long-term effects cannabis may have on psychosis outcome. This review will therefore consider the interplay between genes and exposure to cannabis in the development of psychotic symptoms and schizophrenia. Studies using genetic, epidemiological, experimental, and observational techniques will be discussed to investigate gene-environment correlation gene-environment interaction, and higher order interactions within the cannabis-psychosis association. Evidence suggests that mechanisms of gene-environment interaction are likely to underlie the association between cannabis and psychosis. In this respect, multiple variations within multiple genes—rather than single genetic polymorphisms—together with other environmental factors (eg, stress) may interact with cannabis to increase the risk of psychosis. Further research on these higher order interactions is needed to better understand the biological pathway by which cannabis use, in some individuals, may cause psychosis in the short- and long term.

  16. I’m Irish… there’s problems with alcohol on both sides of the family. Not much of history of mental illness. My grandfather had problems, but he was such a severe alcoholic it would be hard to say what problems were organic and what problems were caused by the fact that he was a raging alcoholic.

  17. I’m fairly convinced you inherit your drinking habits from your father. Neither of my parents had problems with alcohol, but my grandfather on one side did, and my great grandfather on the other side did. I’ve had no aunts or uncles that have had problems with drinking.

    I drink about the same as my father, which is to say more than is probably healthy at times, but not so much that it interferes with our jobs or personal lives. My maternal grandfather spent most of his time not at work stewed, and missed work a lot because of drinking.

  18. I’m Irish… there’s problems with alcohol on both sides of the family. Not much of history of mental illness.

    You seem to be quite fortunate then. You are doubtless aware of the saying that “Alcohol is the curse of the Irish.” So is mental illness, apparently. The Invisible Plague documents the quite astonishing increase in mental illness rates in Western Europe since the 1600s–something that had grown so fast by the late 1600s that it was a subject of considerable discussion. While Irish mental illness grew at about the same rate, it started from a higher base. Irish immigration to America and Canada was recognized at the time as contributing to increased mental hospital admissions.

    It is certainly true that some people suffering from depression start to drink like fish. It makes them feel better…for a while. But alcohol is a depressant, and the problem comes back. Sometimes the things people do while drunk fill them with held-in rage–leading to depression.

  19. Opponents of marijuana legalization, I presume, assume that legalization would necessarily increase usage among the general population.

    Is that a safe assumption?

    Would a legalized, free-choice solution, coupled with educational programs on the risks, etc. of use be a better solution than a prohibitory scheme?

    What are the trade-offs in social costs between the “costs” associated with current usage and the current prohibitory scheme, and the “costs” associated with legal usage and the presumptive regulatory scheme? Include revenue from taxation … currently, there is no legitimate revenue tied from the prohibitory scheme.

  20. Opponents of marijuana legalization, I presume, assume that legalization would necessarily increase usage among the general population.

    Is that a safe assumption?

    Yes, simply because legalization would reduce costs, simplify acquisition of marijuana (since it would be legal to advertise), mainstream distribution. I rather doubt that anywhere except California is marijuana at free market prices, and as a general rule, reducing the price of a commodity increases demand, until the market is glutted. In my experience, there are a significant number of people for whom the market could not be glutted until they were smoking pot 24/7.

    My daughter tells me that passage of California’s medical marijuana initiative (which I regret to say that I voted for) was widely perceived by her fellow middle schoolers as an adult endorsement of marijuana not being a problem.

    Would a legalized, free-choice solution, coupled with educational programs on the risks, etc. of use be a better solution than a prohibitory scheme?

    Educational programs are definitely the best solution. The problem is that education alone seems to be insufficient, or we wouldn’t have vast numbers of smokers. Is there anyone, anywhere, that doesn’t know that smoking cigarettes stands a good chance of causing an excruciating and miserable death?

  21. This may not be the most linerarly organized posting, but here goes. . . .
    I’m in favor of legalizing MJ, to see where it goes from there.

    We have quite the historical background to learn from, if we would. It was called Prohibition, and it outlawed alcohol. And see what it got us. Bootlegging, poisonous bathtub gin, speakeasys where otherwise ordinary citizens broke an immoral law, Al Capone and all the other gangs and gang activities that go along with any desirable but formerly-legal-but-now-illegal substance.

    Not to mention the extravagant gov’t spending and growth of power while attempting to control what had previously been a legal drink.

    I think that one of the reasons that MJ has been kept illegal is that the gov’t cannot control it to tax or otherwise regulate it. This is, after all is said, a common weed that can be grown by anyone, anywhere, at almost anytime. It may not be the highest quality stuff when homegrown, but for many, who cares?

    And, like alcohol, if you don’t wish to imbibe, for work, religious, or personal reasons, you don’t have to. Yet alcohol is legal and freely available (if somewhat expensive, due to taxes).

  22. Thank you, Clayton. In response:

    http://norml.org/pdf_files/NORML_Cannabis_Mental_Health_Context.pdf

    http://medicalmarijuana.procon.org/viewanswers.asp?questionID=000220

    And most specifically to your original claim:

    http://www.wellsphere.com/drug-addiction-article/media-suffers-attack-of-cannabis-psychosis/305225

    and

    http://scienceblogs.com/denialism/2007/07/does_smoking_cannabis_cause_sc.php

    I’d also like to reiterate Ian Argents query of “How does the risks of MJ compare to that of regular cigs or alcohol? Without those comparisons, it’s impossible to make a genuine cost/benefit comparion,”, and, well, ALL of Carl from Chicago’s preceding post, plus consideration of the “costs” of the further encroachment of State force on individual autonomy and the right to self-determination.

  23. After thinking about the entire “gun control” debate for many years, I feel strongly that what flat-out motivates a great many of gun control supporters (and some of them in powerful positions) is simply a gut-level dislike for guns, and the “gun culture” that those people associate with guns. When you cut to the chase, and cut away all the politics and “correctness”, for many who wish to eliminate or diminish the second amendment … it is simply because they don’t like guns and consider themselves superior to those who do.

    Likewise, I strongly feel that what flat-out motivates a great many supporters of drug prohibition is simply a gut-level dislike for drugs and the “drug-culture” (or “hippie” culture or “counter-culture”) that those people associate with drugs. Similarly … who was it that pushed the hardest for alcohol prohibition? Members of the “temperance movement”, quite literally, flat-opt hated drink … they associated it with pretty much ALL the evils they saw ailing the United States during that period. That movement, culminating in the 18th amendment, was also called the “Noble Experiment.” That vernacular implies that the experiment (prohibition) was viewed not only as having “excellent properties” but also associated with “superiority” of some sense, be it of mind, character, ideals, or morals. Simply put … prohibitionists were better people than those supporting the freedom of choice. A rigorous superiority complex can be powerful motivator!

    Moreover … it is difficult for me to see an outcome of prohibition (be it alcohol or drugs) that is not also coupled, at least to some extent, with prohibition of arms. They simply feed off each other. It is a short and pretty convincing chain-of-events from alcohol prohibition and the “gangster crime” it spawned, to the National Firearms Act of 1934. It is also a pretty short chain-of-logic for some (including powerful folks like our President, Attorney General, and Secretary of State) to argue that in order to control drug-associated violence (gangster crime) in Mexico an America’s cities, we really need to prohibit the sale/possession of various (you name it) firearms here in the United States.

    In the same manner that the diminishment of certain individual rights are stepping-stones to the diminishment of other rights, so too is the prohibition of certain things the stepping-stone to the prohibition of other things.

    In summary … it just seems to me (strongly seems to me) that these things come as packages … prohibition, crime, and the government’s exertion and extension of power to both enforce the prohibitory schemes and minimize crime that is, ironically, a consequence of those same prohibitory schemes. Prohibition necessarily comes at a cost of the loss of individual rights, and often, the loss is far more reaching than folks might envision.

    Dyed-in-the-wool social conservatives would be wise to reconsider these issues, and where they stand on many of the current prohibitory schemes.

  24. And, like alcohol, if you don’t wish to imbibe, for work, religious, or personal reasons, you don’t have to. Yet alcohol is legal and freely available (if somewhat expensive, due to taxes).

    It depends where you live. A lot of Alaskan communities (overwhelmingly native) have banned alcohol because of the enormously destructive effects. While Prohibition produced enormous problems (which you mention), it had some positive effects as well, such as the cutting of cirrhosis of the liver deaths by roughly half–which came back up again, somewhat gradually, after Prohibition’s repeal. In many parts of the U.S., Prohibition did effectively end the availability of alcohol–reducing domestic violence, rape, murder, child sexual abuse, and other such consequences of drunkenness. Of course, in many big cities, alcohol remained available, and whatever gain there might have been on alcohol-related violence was overwhelmed with gangsterism.

    Some of you may find it an attractive analogy: gun prohibition, alcohol prohibition, marijuana prohibition. But these are actually rather different categories. If the only reason to own guns was for entertainment, it would be very hard to justify the legality of something that has a significant misuse problem. It is because guns have two utterly essential functions (self-defense, and tyranny control) that we accept the negative consequences of widespread gun ownership.

    It is the case that the decline of Prohibition led to the National Firearms Act of 1934. The progressive forces that had pushed for Prohibition (alongside traditional morality sorts) were redirected by FDR to pursue handguns. In both cases, there was a very understandable desire to find a simple, easy solution to very ugly and complex social problems. Prohibition by itself was unlikely to fix those problems, and guess what? It moved the problems around instead. And the same is true for marijuana bans. A law by itself is not very effective, and produces new and different problems.

  25. After thinking about the entire “gun control” debate for many years, I feel strongly that what flat-out motivates a great many of gun control supporters (and some of them in powerful positions) is simply a gut-level dislike for guns, and the “gun culture” that those people associate with guns.

    That’s certainly true for some of the gun haters. But over the years, I’ve talked to, and tried to reason with, a lot of gun control activists. As a general rule, what drives them isn’t an abstract disapproval of guns, but that they have lost a loved one to a gun murder, gun suicide, or far more rarely, a gun accident. (Survivors of gun crimes, on the other hand, tend to buy a gun.)

  26. Thanks Clayton, and I do comprehend many of your points. They are surely not without merit. This is good discussion.

    I suppose at some level, however, “we” (the majority, the elected government, etc.) could compile an infinite list of items, behaviors, thoughts, etc. that have “social cost”, and that the effective prohibition thereof could arguably reduce social cost and “make the world a better place.” And we could argue all day long that “this freedom is worth the cost, while that freedom is not.”

    I am skeptical, however, and we surely all draw those lines in different places. On this issue, to me, there is a valuable liberty interest in maintaining the freedom which I might have to enjoy a few bong hits after work, or have a few drink with friends, or to enjoy a nice cigar … or whatever … long as I remain responsible, somehow, for the consequences and costs of those decisions.

    I think, as a general rule, it’s better to default to the situation that enhances individual freedom and responsibility. And what is discouraging to us all is that folks … on the left, in the middle, or on the right … like to pick and choose among the various freedoms and choices we are so graciously willing to “allow” of everyone else.

  27. On this issue, to me, there is a valuable liberty interest in maintaining the freedom which I might have to enjoy a few bong hits after work, or have a few drink with friends, or to enjoy a nice cigar … or whatever … long as I remain responsible, somehow, for the consequences and costs of those decisions.

    Let me give you an example that recently came very close to us here in Idaho. A firefighter from Virginia came out to Idaho on vacation, and decided to do some BASE jumping. There is a bridge over a canyon on the Snake River. Something went wrong with his chute, and there being only 300 feet from bridge to ground, the collision was severe. He ended up in a coma. His insurance would not pay to send him back to Virginia, because it was not medically necessary, and being in a coma meant a Medevac cross-country. My wife’s band (along with many other groups here) raised the money.

    That was in April. He just died in Virginia. Any guesses what seven months in a coma cost in medical care? I’m sure that he went through the lifetime maximum of his insurance policy, and somehow or another, the rest of us got stuck with an incredible bill. I think you can see where his freedom to engage in highly risky behavior put not just him, but the rest of us as well.

    I could come up with dozens of similar examples: people that gorge themselves to obesity; people who engage in unsafe sex with hundreds of complete strangers a month; people who use recreational chemicals that stand a significant chance of causing mental disability.

    None of us is an island. While I cringe at the inevitable danger of loss of personal freedoms that comes with looking at high risk behaviors, I also cringe at the enormous costs that your freedom–decoupled from any possible way for you to pay for the consequences–have on the rest of us.

  28. “I also cringe at the enormous costs that your freedom–decoupled from any possible way for you to pay for the consequences–have on the rest of us.”

    Except, of course, for how that’s not a problem with our freedom, Clayton.

    It’s instead a problem with some of your socialist regulations, which require public payment for private expenses, but are no more inherently valid than the regulations on consciousness-altering substances, and are therefore just as valid targets for repeal.

  29. Clayton, that’s an argument for bubblewrapping the world. And a very long step down a very slipperly slope.

    Holy cow.

  30. Clayton, that’s an argument for bubblewrapping the world. And a very long step down a very slipperly slope.

    Well, really it’s an argument for insurance. Real insurance. It’s ridiculous that we have “health plans” rather than just insure for those things which are catastrophic. In a freer in insurance market, perhaps they wouldn’t cover high risk lifestyles in exchange for a lower premium. But people should be able to make those decisions. The problem in our society is we don’t believe in allowing people to bear the consequences of poor decision making.

  31. Sebastian Said:
    The problem in our society is we don’t believe in allowing people to bear the consequences of poor decision making.

    + 1000

  32. BTW – why *does* the ATF Form 4473 break out Marijuana from “any depressant, stimulant, narcotic drug, or any other controlled substance”? (And for that matter, does that mean that if I was prescribed Ritalin or Dexedrine for attention deficit disorder I would be a prohibited person? Wording of question 11e strictly taken would say so).

  33. It’s instead a problem with some of your socialist regulations, which require public payment for private expenses, but are no more inherently valid than the regulations on consciousness-altering substances, and are therefore just as valid targets for repeal.

    A beautiful libertarian argument. You let me know when you get 10% of Americans to agree with you that we should let stupid people die in the streets because of their actions.

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