Marijuana smoke is blanketing the country. Clearly, Americans are big fans of marijuana. In fact, a record high 60% of Americans favor its legalization, according to a 2016 Gallup poll. This compares with only 12% in 1969.
New laws about marijuana have dramatically changed our country’s landscape. As the new federal-government administration steps in, additional changes and possible reversals of existing policies are likely. So where do we stand today? What should we consider in the future?
More than 111 million Americans have used marijuana at least once in their lifetime; 22 million are current (past month) users and 8 million are daily users, according to the National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration. An estimated 4.2 million people aged 12 or older had a marijuana-use disorder in the past year in 2014.
A growing number of crashes and fatalities are related to driving under the influence of drugs, says the National Highway Traffic Safety Administration, which conducts the National Roadside Survey, an anonymous, voluntary, random sample of drivers, asked to provide breath, oral fluid and/or blood samples. The prevalence of tetrahydrocannabinol (THC) in the systems of weekend nighttime drivers was 8.6% in 2007, and 12.6% in the 2013-2014 survey.
According to a scientific review article written by the director and other leading scientists at the National Institute on Drug Abuse published in the New England Journal of Medicine in 2014, the short-term effects of marijuana use include: impaired short-term memory (making it difficult to learn and retain information), impaired motor coordination (heightening the risk of injury and accidents), altered judgment and, in high doses, psychosis and paranoia.
The effects of long-term marijuana use include: addiction, altered brain development, poor educational outcome (increasing the risk of drop-out), cognitive impairment (lower IQ function among frequent adolescent users), and diminished life satisfaction and achievement. These effects are strongly associated with initial marijuana use in early adolescence. Additional effects include symptoms of chronic bronchitis and increased risk of chronic psychotic disorders (including schizophrenia) in predisposed individuals.
The same New England Journal of Medicine article states that the clinical conditions with symptoms that may be relieved by marijuana and its constituents include: epilepsy, glaucoma, nausea, Multiple Sclerosis, AIDS-associated wasting syndrome, inflammation and chronic pain.
Numerous longitudinal, epidemiological research studies have repeatedly demonstrated that the earlier the onset of drug and alcohol use, the more likely the development of addiction. The National Comorbidity Survey in 1994 estimated that 17% of adolescent marijuana users can become addicted.
Twenty-eight states and Washington, D.C., Guam and Puerto Rico currently have comprehensive medical marijuana programs, according to the National Conference of State Legislatures. This began with voters in California more than 20 years ago in 1996. This was not subject to voter approval in Minnesota.
Twenty-one states and Washington, D.C., have decriminalized marijuana. Small, personal-consumption amounts have minimal criminal penalties and are considered a civil or local infraction, or the lowest state misdemeanor with no possibility of jail time.
Eight states and Washington, D.C., have legalized adult recreational use of marijuana. This started in 2012 with voters in Colorado and Washington and in 2014 in Oregon, Alaska and Washington, D.C. In November 2016, California, Maine, Massachusetts and Nevada were added to the list. Voter initiatives alone have legalized recreational marijuana use to date.
In spite of these largely voter-initiated, state-level changes, marijuana maintains a federal designation as a Schedule I drug under the Controlled Substance Act of 1970. This was reaffirmed with input from three federal agencies in 2016, the U.S. Department of Justice, the U.S. Food and Drug Administration and the U.S. Department of Health and Human Services.
States limit use of medical or recreational marijuana to people age 21 and older, as is the case with alcohol-use laws. Yet already, 30% of students try marijuana before leaving high school, according to the national 2015 Monitoring the Future Study. Eighty percent of 12th graders said they could “fairly easily” or “very easily” get marijuana. The proportions of eighth-, 10th- and 12th-graders who are current (past month) marijuana users are 6.5%, 14.8% and 21.3% respectively.
As for alcohol, 45.2% of students say they have tried alcohol at least once, and the proportions of eighth-, 10th- and 12th-graders who are current (past month) alcohol users were 10%, 22% and 35% respectively in 2015. Alcohol age limits have limited effects.
A great deal has happened on the marijuana front over the course of my 30-year career as a drug-abuse policymaker and epidemiologist. Voters, not medical practitioners or scientists, have been able to determine medical practice. Local, state and federal policies remain at odds with each other. Differences of opinion have intensified and the pro-marijuana advocates are as organized as ever. The marijuana industry has expanded by leaps and bounds.
Beneath it all, however, we must pause to seriously consider the known, detrimental effects of repeated marijuana use on the developing adolescent brain. We must act accordingly and responsibly in ways that promote the public health and safety, help delay initiation of use, and reduce, not increase, the accessibility of marijuana to this particularly vulnerable population.
Carol Falkowski is CEO of Drug Abuse Dialogues, former director of the Minnesota state drug and alcohol abuse agency and former director of research communications at Hazelden. Since 1986, she has been part of a 20-member, nationwide drug-abuse epidemiology network of the National Institute on Drug Abuse and is author of the reference book, “Dangerous Drugs: An Easy-to-Use Reference for Parents and Professionals.”