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Journal of Health Communication: International Perspectives Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uhcm20
The Tyranny of Marijuana: Legislation, Science, and Evidence? Scott C. Ratzan Published online: 18 Feb 2014.
Click for updates To cite this article: Scott C. Ratzan (2014) The Tyranny of Marijuana: Legislation, Science, and Evidence?, Journal of Health Communication: International Perspectives, 19:2, 133-135, DOI: 10.1080/10810730.2014.882679 To link to this article: http://dx.doi.org/10.1080/10810730.2014.882679
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &
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Journal of Health Communication, 19:133–135, 2014 Copyright © Taylor & Francis Group, LLC ISSN: 1081-0730 print/1087-0415 online DOI: 10.1080/10810730.2014.882679
Editorial The Tyranny of Marijuana: Legislation, Science, and Evidence?
Downloaded by [Michigan State University] at 12:35 18 February 2015
SCOTT C. RATZAN On January 1, 2014, Colorado dispensaries began selling marijuana for recreational use to adults 21 and older, as well as allowed for its commercial cultivation, manufacture, and sale. This followed voter supported initiatives passed less than two years earlier legalizing marijuana for adults 21 and older of Washington State and Colorado. The media flurry and demand from Colorado residents (those allowed to buy 1 ounce) and out of state visitors (allowed to buy ¼ ounce) has sparked media coverage on the law and access. Much of the dialogue is focused on democracy, legal realities of state versus federal law, and the economics of the cost and tax potential with the new legal product. However, the public support of marijuana laws and, more importantly, the normalization of marijuana use challenges informed, evidence-based decision making from a public health perspective. The Obama administration opposes legalization on their web site: “… legalization of marijuana and other illegal drugs … runs counter to the public health approach to drug policy. Evidence shows our drug problem is a major public health and safety threat, and drug addiction is a disease that can be successfully prevented and treated. Legalizing drugs would increase their availability and normalize their use, leading to increased negative health consequences, particularly among young people. Drug legalization also undermines preventative health strategies, a keystone in improving overall public health in the United States” (White House, 2013). Yet, current popular opinion does not align with the government’s views on legalization. According to an October 22, 2013 Gallup poll, 58% of Americans favor marijuana legalization, in contrast to 12% approval in 1969. The question to consider is: should public opinion dictate legislation over science and evidence of public health dangers? Over time, norms, standards, and freedoms have evolved in America. Yet, while evidence for hazards, harms, and risks become clearer, public opinion and policy often follows different criteria in the modern-day democracy. How is one supposed to make an informed decision as a voter, parent, teacher, or pleasure-seeker, when the facts and realities of marijuana are not communicated in a way that promotes understanding? Even though Cannabis has been used for medicinal purposes for about three millennia, it was not popularized in medicine until the middle of the 19th Century. Its
Scott C. Ratzan, MD, is Editor-in-Chief of the Journal of Health Communication: International Perspectives.
133
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Editorial
medicinal properties were recognized in India as it was used at that time for analgesic, sedative, anti-inflammatory, antispasmodic, and anticonvulsant effects. The United States had its first law called the Marihuana Tax Act (1937) that levied a fee of $1 per ounce for medicinal use of Cannabis and $100 per ounce for recreational use. In 1951, Congress passed the Boggs Act, which for the first time included Cannabis with narcotic drugs. In 1970, the Controlled Substances Act classified marijuana as a Schedule I drug; these drugs are distinguished as having no accepted medicinal use. Even so, Cannabis was distributed to patients by the U.S. government on a case-by-case basis under the Compassionate Use Investigational New Drug program established in 1978. In 1982, the “Surgeon General’s Warning on Marijuana” was issued. In short the Surgeon General stated marijuana use “is a major public health problem in the United States” (Centers for Disease Control and Prevention, 1982). The Surgeon General cited health hazards associated with marijuana with an evidence base corroborated by the World Health Organization and Canadian authorities. They concluded “acute intoxication with marijuana interferes with many aspects of mental functioning and has serious, acute effects on perception and skilled performance, such as driving and other complex tasks involving judgment or fine motor skills.” The report stated: “Among the known or suspected chronic effects of marijuana are: 1. short-term memory impairment and slowness of learning. 2. impaired lung function similar to that found in cigarette smokers. Indications are that more serious effects, such as cancer and other lung disease, follow extended use. 3. decreased sperm count and sperm motility. 4. interference with ovulation and pre-natal development. 5. impaired immune response. 6. possible adverse effects on heart function. 7. by-products of marijuana remaining in body fat for several weeks, with unknown consequences. Of special concern are the long-term developmental effects in children and adolescents, who are particularly vulnerable to the drug’s behavioral and psychological effects.” As noted in 1982, according to the National Institutes of Health, the evidence still suggests that marijuana has certain adverse health effects. As it is usually smoked, marijuana can cause or worsen respiratory symptoms (e.g., bronchitis, chronic cough). It also impairs short-term memory and motor coordination; slows reaction time; alters mood, judgment, and decision-making; and in some people can cause severe anxiety (paranoia) or psychosis (loss of touch with reality). Nonetheless, marijuana is legal for medicinal use prescribed by a licensed doctor and dispensary in 20 states and the District of Columbia. Scientists know little about how the active compounds in marijuana affect different users. In line with the Surgeon General’s warning over three decades ago that marijuana can harm adolescent brain development, estimates are that a quarter of marijuana consumers were underage even in the past climate of limited availability. With the increased access with marijuana dispensaries and increased volume, legalization is happening faster than good science and understanding. On quick review by the Editor on the Internet via a number of search engines, it is difficult to find any evidence-based information from reputable public health sources.
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If one searches the Centers for Disease Control, World Health Organization, National Institutes of Health, U.S. Department of Health and Human Services, state public health departments, and professional associations (such as the American Medical Association, American Academy of Family Physicians, and the American Academy of Pediatrics), there are few, if any, public-facing health literate fact sheets, guides, or other tools for informed decision-making. In the early stage of our republic, Madison and others warned of the “tyranny of the majority” in the Federalist papers. Alexis de Tocqueville titled a section of his book Democracy in America (1835) with this idea. John Stuart Mill, Friedrich Nietzsche, and Ayn Rand further opined on what it meant for society. The phrase generally conjures up the idea that the (voting) majority should not restrict the rights of the individual. Today, we are witnessing a new “tyranny of the majority” with marijuana legalization. This movement to legalize a harmful product began in certain states, with limited populations and modest margins of voter victories (it passed with about 56% of registered voters in both states). Both state and federal lawmakers have acknowledged that marijuana is a dangerous drug and that the illegal distribution and sale of marijuana is a serious crime. Yet, in August 2013, the Justice Department announced it would not challenge the legality of the new laws, provided that strict rules were maintained regarding the drug’s sale and distribution. This new trend, when applied to issues of health that have consequences beyond one’s personal physiology, challenges the very essence of our science and evidence based approach to public health. Social values, community empowerment, personal freedoms, and modern communication shape our future. We ought to take a hard look at this case of marijuana legalization—whether in our role(s) as voters, policymakers, and researchers and/or in our private roles as parents, friends, and pleasure seekers, to help advance a world in which we would like our children and future generations to live.
References Centers for Disease Control and Prevention. (1982, August 13). The Surgeon General’s warning on marijuana. MMWR: Morbidity and Mortality Weekly Report. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/00001143.htm Gallup. (2013). Retrieved from http://www.gallup.com/poll/165539/first-time-americans-favorlegalizing-marijuana.aspx White House Office of National Drug Control Policy. (2013). Marijuana resource center. Retrieved from http://www.whitehouse.gov/ondcp/marijuanainfo/ White House Office of National Drug Control Policy. (2013). Marijuana myth and facts, 2013. Retrieved from https://www.ncjrs.gov/ondcppubs/publications/pdf/marijuana_myths_ facts.pdf
Journal of Health Communication: International Perspectives Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uhcm20
The Tyranny of Marijuana: Legislation, Science, and Evidence? Scott C. Ratzan Published online: 18 Feb 2014.
Click for updates To cite this article: Scott C. Ratzan (2014) The Tyranny of Marijuana: Legislation, Science, and Evidence?, Journal of Health Communication: International Perspectives, 19:2, 133-135, DOI: 10.1080/10810730.2014.882679 To link to this article: http://dx.doi.org/10.1080/10810730.2014.882679
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &
Downloaded by [Michigan State University] at 12:35 18 February 2015
Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
Journal of Health Communication, 19:133–135, 2014 Copyright © Taylor & Francis Group, LLC ISSN: 1081-0730 print/1087-0415 online DOI: 10.1080/10810730.2014.882679
Editorial The Tyranny of Marijuana: Legislation, Science, and Evidence?
Downloaded by [Michigan State University] at 12:35 18 February 2015
SCOTT C. RATZAN On January 1, 2014, Colorado dispensaries began selling marijuana for recreational use to adults 21 and older, as well as allowed for its commercial cultivation, manufacture, and sale. This followed voter supported initiatives passed less than two years earlier legalizing marijuana for adults 21 and older of Washington State and Colorado. The media flurry and demand from Colorado residents (those allowed to buy 1 ounce) and out of state visitors (allowed to buy ¼ ounce) has sparked media coverage on the law and access. Much of the dialogue is focused on democracy, legal realities of state versus federal law, and the economics of the cost and tax potential with the new legal product. However, the public support of marijuana laws and, more importantly, the normalization of marijuana use challenges informed, evidence-based decision making from a public health perspective. The Obama administration opposes legalization on their web site: “… legalization of marijuana and other illegal drugs … runs counter to the public health approach to drug policy. Evidence shows our drug problem is a major public health and safety threat, and drug addiction is a disease that can be successfully prevented and treated. Legalizing drugs would increase their availability and normalize their use, leading to increased negative health consequences, particularly among young people. Drug legalization also undermines preventative health strategies, a keystone in improving overall public health in the United States” (White House, 2013). Yet, current popular opinion does not align with the government’s views on legalization. According to an October 22, 2013 Gallup poll, 58% of Americans favor marijuana legalization, in contrast to 12% approval in 1969. The question to consider is: should public opinion dictate legislation over science and evidence of public health dangers? Over time, norms, standards, and freedoms have evolved in America. Yet, while evidence for hazards, harms, and risks become clearer, public opinion and policy often follows different criteria in the modern-day democracy. How is one supposed to make an informed decision as a voter, parent, teacher, or pleasure-seeker, when the facts and realities of marijuana are not communicated in a way that promotes understanding? Even though Cannabis has been used for medicinal purposes for about three millennia, it was not popularized in medicine until the middle of the 19th Century. Its
Scott C. Ratzan, MD, is Editor-in-Chief of the Journal of Health Communication: International Perspectives.
133
Downloaded by [Michigan State University] at 12:35 18 February 2015
134
Editorial
medicinal properties were recognized in India as it was used at that time for analgesic, sedative, anti-inflammatory, antispasmodic, and anticonvulsant effects. The United States had its first law called the Marihuana Tax Act (1937) that levied a fee of $1 per ounce for medicinal use of Cannabis and $100 per ounce for recreational use. In 1951, Congress passed the Boggs Act, which for the first time included Cannabis with narcotic drugs. In 1970, the Controlled Substances Act classified marijuana as a Schedule I drug; these drugs are distinguished as having no accepted medicinal use. Even so, Cannabis was distributed to patients by the U.S. government on a case-by-case basis under the Compassionate Use Investigational New Drug program established in 1978. In 1982, the “Surgeon General’s Warning on Marijuana” was issued. In short the Surgeon General stated marijuana use “is a major public health problem in the United States” (Centers for Disease Control and Prevention, 1982). The Surgeon General cited health hazards associated with marijuana with an evidence base corroborated by the World Health Organization and Canadian authorities. They concluded “acute intoxication with marijuana interferes with many aspects of mental functioning and has serious, acute effects on perception and skilled performance, such as driving and other complex tasks involving judgment or fine motor skills.” The report stated: “Among the known or suspected chronic effects of marijuana are: 1. short-term memory impairment and slowness of learning. 2. impaired lung function similar to that found in cigarette smokers. Indications are that more serious effects, such as cancer and other lung disease, follow extended use. 3. decreased sperm count and sperm motility. 4. interference with ovulation and pre-natal development. 5. impaired immune response. 6. possible adverse effects on heart function. 7. by-products of marijuana remaining in body fat for several weeks, with unknown consequences. Of special concern are the long-term developmental effects in children and adolescents, who are particularly vulnerable to the drug’s behavioral and psychological effects.” As noted in 1982, according to the National Institutes of Health, the evidence still suggests that marijuana has certain adverse health effects. As it is usually smoked, marijuana can cause or worsen respiratory symptoms (e.g., bronchitis, chronic cough). It also impairs short-term memory and motor coordination; slows reaction time; alters mood, judgment, and decision-making; and in some people can cause severe anxiety (paranoia) or psychosis (loss of touch with reality). Nonetheless, marijuana is legal for medicinal use prescribed by a licensed doctor and dispensary in 20 states and the District of Columbia. Scientists know little about how the active compounds in marijuana affect different users. In line with the Surgeon General’s warning over three decades ago that marijuana can harm adolescent brain development, estimates are that a quarter of marijuana consumers were underage even in the past climate of limited availability. With the increased access with marijuana dispensaries and increased volume, legalization is happening faster than good science and understanding. On quick review by the Editor on the Internet via a number of search engines, it is difficult to find any evidence-based information from reputable public health sources.
Downloaded by [Michigan State University] at 12:35 18 February 2015
Editorial
135
If one searches the Centers for Disease Control, World Health Organization, National Institutes of Health, U.S. Department of Health and Human Services, state public health departments, and professional associations (such as the American Medical Association, American Academy of Family Physicians, and the American Academy of Pediatrics), there are few, if any, public-facing health literate fact sheets, guides, or other tools for informed decision-making. In the early stage of our republic, Madison and others warned of the “tyranny of the majority” in the Federalist papers. Alexis de Tocqueville titled a section of his book Democracy in America (1835) with this idea. John Stuart Mill, Friedrich Nietzsche, and Ayn Rand further opined on what it meant for society. The phrase generally conjures up the idea that the (voting) majority should not restrict the rights of the individual. Today, we are witnessing a new “tyranny of the majority” with marijuana legalization. This movement to legalize a harmful product began in certain states, with limited populations and modest margins of voter victories (it passed with about 56% of registered voters in both states). Both state and federal lawmakers have acknowledged that marijuana is a dangerous drug and that the illegal distribution and sale of marijuana is a serious crime. Yet, in August 2013, the Justice Department announced it would not challenge the legality of the new laws, provided that strict rules were maintained regarding the drug’s sale and distribution. This new trend, when applied to issues of health that have consequences beyond one’s personal physiology, challenges the very essence of our science and evidence based approach to public health. Social values, community empowerment, personal freedoms, and modern communication shape our future. We ought to take a hard look at this case of marijuana legalization—whether in our role(s) as voters, policymakers, and researchers and/or in our private roles as parents, friends, and pleasure seekers, to help advance a world in which we would like our children and future generations to live.
References Centers for Disease Control and Prevention. (1982, August 13). The Surgeon General’s warning on marijuana. MMWR: Morbidity and Mortality Weekly Report. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/00001143.htm Gallup. (2013). Retrieved from http://www.gallup.com/poll/165539/first-time-americans-favorlegalizing-marijuana.aspx White House Office of National Drug Control Policy. (2013). Marijuana resource center. Retrieved from http://www.whitehouse.gov/ondcp/marijuanainfo/ White House Office of National Drug Control Policy. (2013). Marijuana myth and facts, 2013. Retrieved from https://www.ncjrs.gov/ondcppubs/publications/pdf/marijuana_myths_ facts.pdf
