Further ponderings: legalisation of recreational marijuana in Colorado and Washington

One of my posts from a few days ago was in relation to the recent passing of two key amendments in Colorado and Washington, in relation to recreational marijuana use. At the time, I noted that I was curious to see the implications of the passing of these amendments, and the potential problem this may pose to Federal authorities in the United States. 

The reason that this may be problematic for Federal authorities is that since marijuana is classified as a Schedule 1 drug in the Comprehensive Drug Abuse Prevention and Control Act of 1970, it is illegal to possess, use, buy, sell, and/or cultivate marijuana. This stance, combined with failed attempts at rescheduling marijuana, does put Washington and Colorado at odds with the Federal government, and puts lawmakers in these two states into a tricky situation until the ramifications of these votes develop.

Map of current United States cannabis laws
Light Green: State with legal medical cannabis
Olive Green: State with decriminalized cannabis possession laws
Dark Green: State with both medical and decriminalization laws
Purple: State with legalized cannabis
(Map courtesy of Wikipedia)

It was brought to my attention that in March of 2009, Eric H. Holder Jr, current Attorney General of the United States, indicated that the Justice Department has no intentions to prosecute medical marijuana dispensaries in California and other states. In this regard, use of medical marijuana may seem to be on a sure footing in Colorado, Washington, and in any other states that have passed laws pertaining to this matter. What is not sure sure is whether this "tolerance" of the Justice Department and U.S. Government will extent to recent attempts to legalise the recreational use of cannabis. 

Indeed, this concept was the focus of an article by professor and former Federal prosecutor Mark Olser, published on the CNN website. Professor Olser expresses his view in a rather succinct, and perhaps even poetic, manner: 

"The residents of Colorado and Washington state have voted to legalize the recreational use of marijuana, and all hell is about to break loose -- at least ideologically"

Without delving into the conflict between State's rights and appeals from ethics and morality within an ideologically diverse nation such as the United States, it will be curious to see the broader implications of this vote. Already, four leaders from Latin American countries (Mexico, Belize, Honduras and Costa Rica) have claimed that the votes in Washington and Colorado state will have significant implications for current attempts to halt drug smuggling. Indeed, these votes may also even affect the stance of these nations with regards to the current War on Drugs.

Perhaps one of the more concerning news stories to come out in the days following the Colorado and Washington votes, and in relation to the Federal stance on possession and cultivation of marijuana, is the case against Chris Williams. Following the move by the state of Montana to legalise medical marijuana, Williams opened a marijuana grow-house. Due to Federal laws surrounding the cultivation of marijuana, as set out by the Controlled Substances Act of 1970, Williams faces a mandatory minimum jail sentence of 80 years. 

Though I would generally not desire to second-guess the Justice Department of the United States, this seems to be outrageously draconian. Though it is true that Williams turned down various plea bargains offered by the Justice Department, to me it seems that the application of the Controlled Substances Act of 1970 seems outdated, doubly so when contrasted with two states explicitly legalising cannabis for recreational purposes. Perhaps it is time the Drug Enforcement Agency (DEA) and other parties consider whether this act represents a legal anachronism in light of recent events and the comments of Attorney General Holder back in 2009.

As an aside, the issues of medical and recreational marijuana use in relation to the United States reminds me of one of my lecturers from undergraduate days. During our discussion of drug law in relation to the seeming aversion some countries and jurisdictions have towards harm minimisation, he vehemently declared that the current stance is "schizophrenic". No doubt that these are strong words, though perhaps not surprising when one reads of draconian sentences for actions that are ostensibly legal from an individual's position within a State's legislature. 

Until next time,
Nathan

The War on Drugs - Press Release by Australia21

In recent days there has been a really fascinating media release from a think tank known as Australia 21. Described on their website as "... an independent, non-profit organisation whose core purpose is multidisciplinary research and inquiry on issues of strategic importance to Australia in the 21st century", Australia 21 has released their much-anticipated report on discussing the costs and benefits of any potential changes to Australia's policy on illicit drugs.

The report itself is rather controversial. Not only does it broach a subject that many people still find taboo in this day and age, it also has quite a controversial title: "The Prohibition of Illicit Drugs is Killing and Criminalising Our Children and We Are All Letting It Happen". Title notwithstanding, the report makes for fascinating reading, though I must admit that at the time of writing, I am only part way through reading it. What has been clear so far is that the release of this report has already lead to debate within the wider community over current legislation regarding illicit/recreational drugs. As mentioned in a previous post, this is a contentious issue that, unfortunately, tends to be political suicide for those willing to bring it up for discussion and debate.

At any rate, the fact that drug legalisation and drug policy is once again being discussed does give one hope that a more reasonable and evidence-based approach to recreational drugs, harm minimisation and harm reduction will be reached.

Until next time,

Nathan

The War on Drugs - Medicinal Marijuana

Though I tend to only enter into political debates with my closest friends, I cannot help but comment on a clip that I found on YouTube. In short, Republican presidential candidate Mitt Romney is answering a question from an audience member regarding medicinal marijauna.

The clip:

And the quote:

"...And you know you know you hear that story, people who are sick needing medicinal marijuana, but marijuana is the entry drug for people trying to get kids hooked on drugs. I don't want medicinal marijuana, there are... synthetic forms of marijuana that are available for people that need it on prescription. Don't open the doorway to medicinal marijuana"

To begin with, marijuana has been used for medicinal purposes for a number of reasons. Primarily, marijuana (and select cannabinoids present in marijuana) have been shown to decrease the incidence and strength of nausea, and to stimulate hunger. These effects benefit those on chemotherapy or who are afflicted with AIDS, and has also been shown to have positive effects on patients with glaucoma. 

That marijuana has been used for medical purposes is of no surprise. Records from as far back as 4000 BCE have shown that marijuana has been used for medicinal purposes by the Chinese, during the Neolithic period. Even in relatively modern times, tinctures and extracts of marijuana have been used to treat pain and headaches, to aid in sleep, and so on.

Perhaps what irritates me most with Romney's comment on medicinal marijuana is that he refers to the spurious notion that marijuana is a gateway drug. For those unfamiliar, the Gateway Drug Theory proposes that the use of "softer" recreational drugs, like marijuana, alcohol and tobacco, leads to a dramatically increased risk of a user moving on to "harder" drugs like heroin, cocaine and so on. It is also posited that as a user moves on to "harder" drugs, that they will also move on to a life of crime in order to fund their drug habit. There are variations of the Gateway Drug Theory, but for now we will deal with Romney's concern, that marijuana (and other "soft" drugs) are used to hook children on "harder" drugs.

I won't deny that research into the Gateway Drug Theory is still ongoing, and that for every article criticising this theory, another article comes out shortly thereafter criticising the criticism, and so on. That being said, there are some fairly big holes in this theory. Namely, the theory itself relies on the post hoc ergo propter hoc logical fallacy. In the context of the Gateway Drug Theory: 

An individual tried a "soft" drug like marijuana. They then moved on to use a "hard" drug. Therefore, use of the "soft" drug caused them to use a "hard" drug at a later date. 

To put it another way, in this case correlation does not explicitly imply causation.

The main criticisms of the Gateway Drug Theory are detailed on the wikipedia page linked above. In summary, the more salient criticisms are:

• Due to curiosity and/or the pleasure-seeking behaviour of humans, some people will actively seek out and experiment with drugs. So-called "gateway" drugs are simply those that are more readily available;
• In the event that an individual seeks out recreational drugs that are illegal, they will be exposed to the black market for drugs. In this case, they will be exposed to readily available "harder" drugs. Therefore, the availability of different recreational substances on the black market is a possible cause for moving on to harder drugs, rather than use of a "soft" drug leading directly to the use of a "hard" drug, regardless of circumstance;
• Hyperbole and misinformation surrounding the nature of gateway recreational drugs causes teenagers and adults alike to distrust all anti-drug messages, thereby resulting in the individuals trying other, "harder" drugs at a later point;
• Drug dealers that have access to "harder" drugs will, due to the nature of their wares, be unwilling to engage in sales with those unfamiliar with gateway drugs. Therefore, those that buy from these dealers will already be acquainted with the "harder" drugs.

Another aspect of Romney's argument is that marijuana is addictive. Now, this is a tricky thing to deal with, as two separate forms of addiction exist. One is physical addiction/dependence, whereby continued use of a drug results in a physical need to continue usage, and has neurobiologic underpinnings. The other is psychological addiction/dependence, in which there is a strong behavioural aspect to the addiction.

The dependence potential of marijuana is interesting, in that it is reported as being less addictive than alcohol, tobacco, heroin, cocaine and select other recreational drugs. Nutt et. al (2007) provide an interesting comparison between various licit and illicit recreational drugs, with the following graph a concise summary of their findings:

In addition, a fascinating study by Coffey et. al.(2002) reveals that the symptomatology of marijuana dependence is poorly defined. Overall, marijuana dependence is a known phenomenon (recognised in the DSM-IV, section 304.30), and involves both physical and psychological dependence on the drug in question. 

In short, the argument that Romney uses is poorly constructed. It relies on the fact that marijuana is a gateway drug, which is still under debate. In addition, it posits that marijuana is addictive (which it is). What is not recognised is that a large number of recreational drugs (including legal drugs like tobacco and alcohol) have a higher dependence potential than marijuana.

I will cede, however, that the development of synthetic preparations of cannabinoids is a good thing. This allows dosage to be controlled, thereby ensuring that an adequate dose is provided to the patient. Furthermore, in patients that may require medicinal marijuana but do not want to experience the psychoactive effects of marijuana, well, the synthetic preparations of the cannabinoids present in marijuana provides a good middle ground.

In the end, contentious issues like the War On Drugs and medical marijuana will continue to be debated. Indeed, this is an area that I will come back to in the future. And as for Mr. Romney, well, he personifies my gripe with the aversion that many politicians have towards evidence-based policies, and those politicians that happily invoke populism and puritanism in order to win votes. Unfortunately, this is a phenomenon that is not limited to the United States of America, and seems to creep into politics, whether in Australia or abroad.

Thanks for reading,

Nathan