Wednesday, November 2, 2016

Is It Time to Legalize Pot?

David:
With the election taking turns and twists every day, and many Americans feeling great anxiety about the candidates, I thought we might talk about something that may bring a little calm to the country. (Gary Johnson approves of this discussion.)

A new poll shows the support for legalization of the marijuana market has reached an all-time high (pun intended). Is this a good thing, or just driven by money?

Doug:
It is a good thing, and driven by money.

David:
Why do you say it's a good thing? It's true that there is a great deal of money trading hands, now that some state  government has joined the drug-dealing business.

Most of what you know, or think you know, about marijuana is anecdotal. A large portion of the public's opinions on the effects of marijuana is based on stereotypes and Cheech and Chong movies.

Doug:
Of course that is not true. A large portion of the public has used marijuana. That is how they have formed their opinion on the effects of marijuana. But I think you are right that there is a certain segment of society that gets a few stereotypes from Cheech and Chong movies.

David:
They may have some experience with the drug, but many of the "facts" people know are just not true. But scientists also do not know enough about this drug. Why is that?  Because there has been very little scientific study done on the drug in the past 50 years, due to it's clarification as an illegal drug. That may soon change, now that several states have decriminalized it. However, President Obama's FDA has just recently reinforced its position that is it still illegal in all 50 states. This puts the distributers in states like Colorado on very shaky legal ground.



The dangers of marijuana are well documented, and the newer, more potent forms of marijuana that are available today accentuate the downsides. While the numbers of users has risen in the past few years, the number of people who believe its use is risky, or who understand the side effects, is decreasing.

Doug:
I believe both of those points.

David:
It's a little ironic that most of the side effects of tobacco use, including lung cancer, are also found in marijuana use, and yet the same people who are often vocal about limiting or banning tobacco products are the same ones pushing for legalization of marijuana. From a health perspective, smoking marijuana is not safer than cigarette smoking.

Doug:
That isn't ironic. I think that the people that are vocal about limiting second-hand smoke don't care that much about what you do in your own home. What is ironic is that people who are for small government want to keep marijuana illegal.

David:
I don't think that generalization is true at all. There are a great many people who favor both smaller government and the legalization of marijuana. Just take a look at the chart above.

Doug:
I'm not sure how you can read that out of the above chart. But my point was that believing in legalizing pot would be consistent with believing in a small government. But often those two ideas are not held by the same people.

David:
I'm simply pointing out the general support for marijuana while at the same time, there is general condemnation for cigarettes. Big-tobacco cannot advertise on television, for example, while the growing Big-pot industry can.

Many, including many physicians I know, like to compare marijuana use with alcohol. This is an apples and oranges comparison, for the most part. You can have a beer or two with dinner, and not be impaired. You can have a glass of wine or two with dinner and not be impaired. However, smoking a single joint will cause impairment. There is not a certain limit that can be used or consumed that provides a "safe" amount for driving or operating dangerous equipment.

Doug:
There are many factors that can effect what effect drugs will have on your body. But let's be very clear that alcoholism is a serious problem in our country. And people are bad drivers in the best of shape, and even worse when they are impaired in any way. That is the main reason I am very interested in driverless cars. Perhaps driving-while-impaired won't be as large a concern in the not-so-distant future. Marijuana and alcohol may be apples and oranges, but they both can impair judgement.

David:
True. But because many people feel marijuana is benign, they use it with alcohol at times, which could make for a lethal combination while driving. Now that people are using marijuana in Colorado, Washington, Oregon, and Alaska, we'll need to accumulate some data to see to what extent this trend will be. Initial studies have already indicated pot-related traffic deaths in Washington has doubled and has increased by a third in Colorado since legalization.

The short-term effects of marijuana use also include impaired processing of information, which makes problem solving and memory development more difficult. It alters your sense of vision, time, touch, and your mood.

Doug:
You sound like advertising for a pro-pot initiative. Seriously though, this is why people want to use pot. 

David:
Sure, if you want to be stupid, have trouble succeeding in school, and be moody all of the time. And these effects can linger, because the long-term effects are also well-documented. Marijuana affects brain development. When marijuana users begin using as teenagers, the drug may reduce thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions. Marijuana’s effects on these abilities may last a long time or even be permanent. For example, a study showed that people who started smoking marijuana heavily in their teens and had an ongoing cannabis use disorder lost an average of eight IQ points between ages 13 and 38. The lost mental abilities did not fully return in those who quit marijuana as adults.

There are also studies showing the connections between pot use and mental health disorders.

Doug:
I am sure that there are connections, but don't get the causality backwards.




David:
Those can be difficult causality connections to make. Is that person schizophrenic because of their heavy marijuana use, or something else, or just genetics? But studies indicate there is a link.

Despite the myth, marijuana is addictive. 30% of users develop dependency, just like any other addictive drug. It also causes users to get more pleasure from other illegal, addictive drugs, so the argument it is a gateway drug is a reasonable argument. From my own experience, every patient with a heroin overdose I see in the ER, also tests positive for marijuana.

Doug:
The gateway argument is reasonable for what? To keep it illegal? If we are concerned about addictive drugs, you should be much more worried about many other drugs, like oxycontin, or any of those drugs in the opioid family. These are the drugs we need to be talking about government oversight.

David:
It's reasonable to say that using marijuana leads to using other drugs. I didn't say anything more than that. Keep your pants on.

By the way, when I was a resident, we didn't prescribe nearly the amount of opiates that we do today. But then the federal government stepped in in the 1990's and proposed a Patient Bill of Rights through the Center for Medicare and Medicaid Services (CMS). CMS was very critical of doctors' stinginess with pain medication, and physicians felt they would face penalties for not treating pain more liberally. And here we are. And now you'd like to have more government oversight, when it was government oversight that caused this mess.

Doug:
Government makes doctors prescribe too many addictive, expensive drugs?! If the government came into my classroom and told me I had to do something that would harm my students, I would laugh and tell them to get the hell out of my school. Then I would organize the teachers, and dismantle whatever fake Center that advocated harm. But that is just me. Others would wring their hands, and claim "the government made me do it!" Wow.

David:
When the government says you must do such and such, or your college looses its credentials, and you will have no more students, you'd be inclined to follow their "advice".  Glad to hear that you'd mount some resistance while you are unemployed during the years it would take to dismantle the Department of Education (The fake Center you are discussing). I'm at least glad to hear that you consider CMS to be a fake government agency. CMS requires a great many things that are not supported by science.

Doug:
No scientist would say that "X% of users develop a dependency". Like any data, there are many studies showing differing levels of "addiction," depending on how you define addiction. I think most scientists would put the percentage of some type of "addiction" at about 9%.

David:
If a drug causes dependence, then scientists certainly would say that it causes dependency. You're mixing your terms. Dependency is a physical need for a substance, while addiction could be described as a psychological need for a substance. In the case of marijuana, studies show that both are true.

There is much more to learn about this drug, but it is not a benign substance. Before legalizing it nationwide, we should be more aggressive in doing studies in the states that have legalized it. I'm more than happy to do a year or two of experiments on the liberal enclaves of Seattle and Denver. But sooner or later, marijuana is bound to be legalized nationally. Legislatures will want the cash. Politicians will have too great a temptation to let the potential big, easy money just go up in smoke.

Doug:
Your analysis left out the most important impact of legalizing pot: fewer people would go to prison. For this fact alone, I'd be in favor of making it legal regardless of any health issues. But perhaps a good side-effect of making it legal is that more people would be aware of the downsides. And we'd save a whole lot of money by keeping people out of prison. And make more money from taxes. Win, win, win!

David:
Of course, using that argument, nothing should be illegal. Then, no one would go to jail. Cocaine, heroin, methamphetamine, and anything else should just be available out on the streets. Heck, let's legalize murder, so that no one has to go to jail. We'll save trillions!

Doug:
If you use my argument to argue that everything should be legal, then you skipped over some basic points. But I agree that we need more studies. We should always be looking for more data on all topics, including gun use and safety. But let's not lose focus that this would be a substantial change in prison populations, and would have a positive effect on many people's lives, and those of their families.

David:
I was waiting for you to slip guns in to a topic that has nothing to do with guns. I knew you wouldn't be able to help yourself. But, I agree that there are many things that politicians make laws about before they have any useful data. They come up with solutions before they even know what the problem is. As Grouch Marx said, "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies."

Doug:
Actually, I think it was Ernest Benn who said that. But why do you always get to decide what the topic is, and what can and can't be discussed? I like to be consistent with my positions. By pointing out that I believe that everything should be studied, I'm showing a consistency, regardless of topic of study.

David:
Just trying to keep you focused.

Doug:
Right. Sure. It sounded like you were "waiting for me to slip in guns" so that you could casually dismiss the point that congress has limited studies into gun violence, and climate change. We should not limit the study of anything.

Speaking of focused, my point was on reducing the people in prison. To which you replied: "Murder should be legal?" and "You said the word 'gun'!"

David:
Your argument is to eliminate what is considered a crime in order to avoid arresting people. I continued that narrative. If nothing is criminal, then there would be no crimes. Hence, no one would go to jail.

Doug:
But here is a suggestion: in order to purchase weed (or any tobacco for that matter) you have to show proof of healthcare insurance. That would do a lot to boost participation into Obamacare, and give an indication that this may have an impact on your health that you may have to pay for.

David:
That would certainly work, except that it isn't constitutional. There is no other drug that requires you to prove you have insurance in order to be allowed to buy it. This whole discussion is about allowing Americans to have more freedoms (by allowing legalization of marijuana). It figures you would want to add government restrictions in order to allow that.

Doug:
You don't get to declare what is and isn't constitutional. And showing proof of insurance doesn't limit any freedom---it makes you more free. But it also requires you to be responsible for your own health. Win, win!

David:
Right. In order to purchase a product, the government requires you to prove that you first purchased a separate product. Yay freedom!

Doug:
You can think of healthcare insurance as a "product the government made me buy" or you can think of it as a basic right to life that you own through one means or another. If you want to smoke weed, or tobacco, fine. But I'm not going to pay for your healthcare. See how that makes you free? So, yes, legalize pot. But also make sure that you can handle the impairment, and long term effects on health. There are solutions to these problems.

David:
But why stop at smoking, then? Owning insurance is a basic right to life? Boy, anything you wish to do could require you to get government permission in your world-view, which is not very libertarian.

By the way, Gary Johnson just called. He can't remember now if he approves of this discussion or not, but he did say that the world leader he admires most is Tommy Chong, the President of Aleppo.  Go figure.

1 comment:

  1. Perfect timing! The lead editorial today in the Wall Street Journal is about the legalization of marijuana. Perhaps everyone is desiring some escape from this election season.
    http://www.wsj.com/articles/a-brave-new-weed-1478043007

    ReplyDelete

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