Experts Build Case Against Marijuana Legalization


The President’s Symposium, “Marijuana: Patient to Policy,” was a popular discussion about the legalization of marijuana.

The drive to legalize or decriminalize marijuana is gathering momentum despite growing evidence it is not a “safe intoxicant.” Fueling the drive is the money of those hoping to become “Big Tobacco 2.0,” according to speakers during Friday’s President’s Symposium, “Marijuana: Patient to Policy.”

Moderated by ASAM President Stuart Gitlow, MD, MPH, MBA, the session featured four speakers and a spirited dialog as speakers discussed questions from the audience. The interest was so great that the session was presented two times Friday.

“We are in an interesting setting where marijuana as medicine has paved the way for people to feel they have a safe intoxicant,” Dr. Gitlow said. “They see this new drug as being a safe intoxicant…without any repercussions.

“This is the work of two groups—those who want to make money off it and those who want to get stoned.”

Wilson M. Compton, MD, MPE, Deputy Director of the National Institute on Drug Abuse, reviewed research showing the growing use of marijuana, how it affects IQ, and how it may lead to addiction.

In 2013, 19.8 million people used marijuana, and 40 percent used it daily or almost daily. It also is not your father’s marijuana, he said, because today’s marijuana is three to four times more potent than it was in past decades.

While according to DSM-IV 9 percent of marijuana users become dependent, those who start using it in their teenage years or are heavy users are more likely to later be found dependent. Studies also show that an increasing number of teens are getting marijuana from other people’s prescriptions where medical marijuana is legal and through nonsmoking routes, such as edibles.

“Does it matter? This is where we begin to link public health issues with neuroscience,” Dr. Compton said. A study in New Zealand showed a drop in IQ in people followed from birth to their late 30s when they began smoking marijuana as teens and continued to smoke.

Other studies around the world have shown links between marijuana use and schizophrenia and an increase in suicide attempts in teen years. The U.S. is now developing a large-scale study of 10,000 children to understand brain growth and development in connection with marijuana, he said.

Kevin Sabet, PhD, Assistant Professor of Psychiatry and Director of the Drug Policy Institute at the University of Florida, and President of Smart Approaches to Marijuana, said that money is driving efforts to legalize marijuana. “We are on the way to creating Big Tobacco 2.0,” he said.

Today, there is a generational divide, where older people do not understand that teens are not smoking joints in the basement. They are getting marijuana in new forms, such as oils and food, Dr. Sabet said.

“The marijuana industry does not make money if some of you relive your glory days at Woodstock,” he said. “It is about people younger than me hooking new customers. That is the only way to stay in business in the addictive industry.”

The number of young people smoking marijuana daily has increased by a factor of seven since 1992, he said, adding, “It is incumbent upon you to stand for a sensible policy that niether demonizes nor legalizes marijuana.

Kevin M. Gray, MD, Associate Professor at the Medical University of South Carolina, Charleston, discussed the challenges of treating cannabis use disorder in youths.

“I noticed anecdotally that some patients were not doing as well as other patients (in mental health treatment clinics) and, lo and behold, most of those were marijuana users,” he said.

That led Dr. Gray to become more involved in marijuana-use studies, and today there is a growing understanding of the endocannabinoid system. Research has shown the effectiveness of N-acetylcysteine (NAC) to reduce drug-seeking in adolescents, but more study is needed, he said. Other studies have used cessation counseling and cash reinforcement for marijuana-negative urine samples from participants, which has been criticized, but effective.

The final speaker was Patrick J. Kennedy, Former U.S. Representative and Founder of the Kennedy Forum, who made brief remarks, adding that he was interested in having an interactive discussion with the audience. He was critical of drives to legalize marijuana, adding, “no one in Congress or in the White House is fighting this.”