Pubdate: Sun, 1 Nov 1998
Source: Boston Globe (MA)
Contact:  http://www.boston.com/globe/ 
Copyright: 1998 Globe Newspaper Company.
Author: Thomas W. Clark

A REALISTIC PRESCRIPTION TO MIX MARIJUANA AND MODERATION

The number of teenagers who use marijuana has increased dramatically since
1992, state and national surveys show, and this increase is causing much
official consternation. After four years of relative silence on the issue,
the Clinton administration has mounted a widely heralded media campaign
against drugs - including marijuana use by adolescents.

But teenagers, it turns out, don't seem particularly worried about pot. The
rise in the number of young people who have tried marijuana over the last
six years, surveys show, has been accompanied by a decline in the risk they
perceive in smoking it occasionally. Meanwhile, the use of hard drugs such
as cocaine and heroin has stayed far below that of marijuana, and
adolescents perceive these substances as far more risky.

Perhaps teenagers recognize what the National Institute on Drug Abuse, or
NIDA, has been at pains recently to deny: that there are valid distinctions
between soft and hard drugs in addictiveness and potential for harm, and
that such distinctions can inform one's choice of psychoactive substance.

Teenagers, in short, are not stupid, and in this case their perceptions are
pretty much on the mark. Although certainly not risk-free, marijuana
compares favorably to alcohol and tobacco with regard to health hazards and
potential for abuse.

Consequently, the attempt to tar it with the same brush as cocaine and
heroin is backfiring, undercutting the credibility of both NIDA and
beleaguered parents, who are asked to instill fear of the ``evil
weed'' into their increasingly skeptical children.

Indeed, while marijuana should remain illegal for teenagers, there is
little reason to keep it illegal for adults.

Much is made of pot being a gateway drug that leads to further
experimentation and addiction, but, as even NIDA admits, most of those
who try marijuana don't progress to other drugs or become addicted.

Rather, it's a combination of risk factors - parents' and peers'
substance use, poor social adjustment, low expectations of
achievement, and idle after-school hours - that increases the
probability of abuse and dependence. 

If marijuana is a gateway to hard drugs at all, it is most likely due to
its illicit and countercultural
status: The purveyors of pot can put your adolescent in touch with the
local crack connection, while the glamour of defying the ban on
marijuana may transfer to using more dangerous substances.

Yet using marijuana has its risks, and its use by adolescents should
remain illegal and be strongly discouraged. Just as it is harmful to
smoke cigarettes, it is harmful to inhale the carcinogenic byproducts
of marijuana along with its psychoactive ingredient -
delta-9-tetrahydrocannabinol, or THC. 

While not nearly as devastating as chronic alcoholism, the regular and
prolonged use of THC may
compromise short-term memory and, perhaps, other cognitive functions.
Even though non-smoked THC is approved for medical purposes, and thus
has been found safe and effective for some applications, its
recreational use should remain occasional, and restricted to those
over 21. Pregnant women should avoid it, and the penalties that now
apply to drunken driving should also apply to those who drive under
the influence of THC. 

But despite its bad official press, THC actually ranks lowest in addictive
potential of all commonly used substances, even below caffeine, according
to two independent ratings by NIDA and
the University of California. Lab animals cannot be induced to

consistently self-administer THC, as they can with opiates,
amphetamines, cocaine, alcohol, and nicotine. 

Nevertheless, NIDA has made much of research - published last year in the
journal Science -
showing that cannabis acts on the same reward mechanisms in the brain
as do other psychoactive substances. But this rather unsurprising
finding doesn't show THC to be especially problematic, just that its
heavy use may in some cases lead to habituation. 

The fact remains that marijuana is simply not in the same class as heroin
and crack, drugs
that act far more powerfully and specifically on those brain sites
implicated in dependence. This means that its increased availability
following decriminalization for adults would not result, as some fear,
in an epidemic of cannabis abuse.

The best argument, perhaps, for keeping marijuana illegal across the
board is that we simply don't need another widely available
intoxicating substance, however benign, that might deflect adolescents
from the necessary business of putting their lives together. But the
horse is already well clear of the barn. In recent surveys, many
teenagers say that it's as easy to get marijuana as alcohol and cigarettes.

Drug enforcement hard-liners will reply that this means stricter
sanctions are necessary, but how strict are we willing to get to
suppress a drug that, used in moderation and in a non-smoked form, is
no more risky (subtracting the risks of criminal prosecution) than
having an occasional glass of wine with dinner?

Some opponents of decriminalizing marijuana fear that it would set us
on a slippery slope toward accepting any and all drugs, but this fear
is irrational precisely because all drugs are not the same. We justly
balk at sanctioning the use of substances that are highly addictive
and harmful, as in the growing effort to curtail tobacco sales to
minors. 

Other opponents, most of them hardly teetotalers, share the
conventional prejudice that getting high on pot is somehow morally
suspect. They suppose that some intoxicants (the currently legal ones,
it just so happens) are fine, while the rest are corrupting, and that
therefore we shouldn't expand our repertoire of even mildly altered
states. 

But if the effects of alcohol, nicotine, and caffeine used in

moderation are perfectly acceptable, why not those of THC, used in
moderation?

Some will object that moderation in the use of marijuana is exactly
what cannot be guaranteed; that decriminalizing pot for adults would
inevitably increase the number of users (some teenagers included) that
abuse the drug and fall prey to its possibly damaging long-term
effects. Granting this point, the issue then becomes whether the
social and personal benefits of lifting the ban on marijuana outweigh
the harms of a potential increase in abuse. 

This is the same dilemma faced by those who wanted to end alcohol
prohibition: Since
Prohibition helped to reduce alcohol-related addiction, disease, and
accidents, how could one responsibly advocate its repeal?

Nevertheless, Prohibition ended when it became clear that the personal
liberty to enjoy alcohol, restrained by reasonable public health and
law-enforcement safeguards, was deemed a greater good than heavyhanded
attempts to reduce alcohol-related harms.

Similarly, it is difficult to justify the staggering costs of the
marijuana ban - the person-hours of drug enforcement, the ultimately
futile attempts at crop eradication, the overloaded courts, and the
draconian jail sentences - when weighed against the small increase in
abuse that decriminalization for adults might entail. 

If we want proportionality between the sanctions against a drug and its
potential
for harm, then criminal penalties for personal marijuana use should be
abolished. 

If we fail to reconsider our current policy, and continue
to exaggerate the evils of any and all cannabis use, teenagers will
judge adults hypocritical and continue to light up joints as they
chant, ``Just say no!'' 

By being straight with kids, and ourselves, about marijuana's active
ingredient, we'll gain credibility and strengthen the case against truly
dangerous and addictive drugs.
Respect our children's intelligence, and chances are they'll behave
more intelligently.

In our public health campaigns, we should strongly advise against
smoking marijuana, while exploring safer means of ingesting
recreational THC - in food or drink, perhaps - which standardize a
moderate dose and guarantee purity. As with alcohol and nicotine, we
should limit its availability to adolescents by establishing a minimum
age for possession, and enforce that law vigorously.

Legal use of marijuana by adults could be restricted to private,
personal consumption, with civil penalties - not jail sentences - for
sales or public use. Whatever course we adopt, there are clearly many
policy options short of commercial legalization that would improve
upon the absurdly punitive status quo. There would, of course, be many
devils in the details of regulating decriminalization, but none nearly
as onerous as our foolish obsession with attaining a cannabis-free
culture.

Even with the most enlightened policies, some cannabis use by
teenagers will inevitably continue, but we won't be denying them the
drug on the spurious basis that there is something especially bad
about THC. We'll be denying it for the same good reasons we deny them
nicotine, alcohol, and most other psychoactive substances: successful
physical and psychological maturation is jeopardized by adolescent
drug use, and at their age they've got more important things to do,
such as fashioning a life that doesn't revolve around looking cool or
getting high.

Thomas W. Clark is a research associate at Health and Addictions
Research Inc. of Boston, a nonprofit research and evaluation company
specializing in behavioral health and criminal justice. The views here
do not reflect policies endorsed by Health and Addictions Research
Inc.

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Checked-by: Rich O'Grady