Addiction medicine physicians oppose state marijuana initiatives

Yesterday, the American Society for Addiction Medicine, the country's foremost association of physicians who diagnose and treat substance abuse addiction, released a statement opposing all of the state ballots that propose to legalize marijuana. 

From their statement:

ASAM asserts that the significant public health problems and costs related to marijuana legalization are not well-understood by the public or policymakers. ASAM's conclusion that marijuana legalization would threaten public health is based on the following:

·         Marijuana use is neither safe nor harmless. Marijuana contains psychoactive cannabinoids which can produce a sense of discomfort and even paranoid thoughts in some users. Cannabinoids interact with brain circuits in comparable ways to opioids, cocaine and other addictive drugs. Marijuana use is associated with damage to specific organs and tissues and impairments to behavioral and brain functioning.

·         Of greatest concern is marijuana use during adolescence—a time of ongoing brain development and heightened vulnerability to addiction. Research shows that heavy marijuana use decreases neurocognitive performance, with worse neurocognitive effects seen among those who begin marijuana use early.

·         Marijuana is addictive. Repeated marijuana use is reinforcing because the drug increases activation of reward circuitry in the brain. Approximately 9% of people who try marijuana become dependent. For those who begin using the drug in their teens, approximately 17% become dependent. These figures are similar to alcohol dependence.

·        Legalization would promote the public perception that marijuana is harmless at the same time that availability of the drug would grow exponentially. The rate of marijuana use and marijuana-related substance use disorders, including addiction, would increase.

·         Increased marijuana addiction would heighten demand for substance use disorder treatment services, which already are inadequate for current needs.

·         Marijuana use is associated with increased rates, and worsening symptoms, of psychosis. Increased marijuana use caused by legalization and increased access to high-potency marijuana could result in rising rates of psychotic illnesses.

·         Marijuana-related crashes are major traffic safety threats; marijuana use doubles the risk of a crash. Research inWashington State showed that 12% of drivers killed in car crashes were positive for marijuana. Legalization would increase drugged driving. 

      Marijuana legalization will increase its availability to young people, who are the most at risk from this drug. Research shows that marijuana leads to a host of significant health, social, learning and behavioral problems in young users.

Youth access to marijuana would increase if legalized

A pro-marijuana legalization billboard in Colorado shows a boy with his father who is saying, “Please check my son’s ID”.  The message is that if marijuana is sold in stores youth access to it will decrease because stores won’t sell to minors.  While in theory this sounds great, it’s just not true.  If we treat marijuana like alcohol, youth access will increase.  Most kids who drink do not get alcohol by buying it at a store and the same would be true for marijuana.  

Alcohol is easy for teens to get because older friends and siblings can buy it for them legally.  The top three ways teenagers get alcohol is from friends, at a party, or by giving someone money to buy it for them (Washington State Healthy Youth Survey -- HYS). If marijuana is treated like alcohol, teens will just as easily get marijuana as they get alcohol from older friends and siblings.  Though teenagers currently say that marijuana is as easy to get as alcohol, they use legal and regulated alcohol at much higher rates than they use marijuana (HYS).

Like alcohol, youth will get marijuana at home.  Washington tenth graders report that they are more likely to get alcohol from home with or without parents’ permission than from buying it from store (HYS). With the demise of legal sanctions against use, some parents may choose to begin using marijuana, acting as an important new source of exposure for their adolescents.  Parental use of marijuana in the last year is associated with their adolescent’s use during the same period (Legalization of Marijuana: Potential Impact on Youth, American Academy of Pediatrics).

Find out more at WASAVP's Marijuana Education Toolkit.