July 30,
2012
Physicians
should take lead against efforts in Colorado, Washington and Oregon.
TheAmerican Society of Addiction Medicine (ASAM) opposes proposals to legalize
marijuana anywhere in the United States, including three state measures on
November 2012 ballots.
Legalization
initiatives in Colorado, Washington and Oregon create unacceptable risks to
public health, according to a white paper approved by the ASAM Board of
Directors at its July 25 meeting. Physicians and other health professionals
must learn more about the real health threats posed by marijuana use, all of
which are made worse by legalization. Physicians should encourage public
education about these facts and lead efforts against ballot initiatives to
legalize marijuana, the report said.
ASAM
is the nation’s foremost association of physicians dedicated to the diagnosis
and treatment of the disease of addiction.
“ASAM
has brought to bear its commitment to science and public health in taking a
strong position against marijuana legalization,” said Robert DuPont, M.D., the
report co-author, who is a former White House Drug Czar and former director of
the National Institute on Drug Abuse (NIDA). “ASAM can provide leadership to
all physicians and all medical associations about the dangerous and seductive
mirage of drug legalization, including marijuana legalization, as a so-called
solution to serious health problems resulting from drug use.”
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 in Washington 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.
“Children
who use marijuana are more likely to struggle in school, because it impairs
their ability to concentrate and retain information during their peak learning
years when their brains are developing,” said Andrea Barthwell, M.D., the
report co-author who is a former ASAM president and former Deputy Director for
Demand Reduction in the Office of National Drug Control Policy. “Even
short-term use can cause problems with memory, learning, cognitive development
and problem solving. Research shows a clear link between adolescent marijuana
use and a decrease in academic achievement.”
ASAM
has previously issued policy statements urging that people addicted to
marijuana, like those addicted to any drug, should receive treatment rather
than punishment for their illness. That position, however, makes no reference
to the question of legalization, the report stated.
“ASAM
believes that addiction should be primarily treated as a health issue rather
than a criminal justice issue,” said Stuart Gitlow, M.D., ASAM Acting
President. “But that does not mean we would support a social experiment
dramatically changing the legal status of marijuana and resulting in an upsurge
in marijuana use. Health problems caused by marijuana would grow with increased
use; marijuana addiction rates would undoubtedly rise. ASAM must oppose any
public policy changes that would cause a significant increase in addictive
substance use.”
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