These increases would result in significant direct and indirect costs to society, including higher public health expenditures due to drug overdoses, fetal malformations and other drug-related incidents, such as car accidents; loss of productivity due to worker absenteeism and accidents at work; and more drug-induced violence, child abuse and other crimes, not to mention educational disorders. “You can only see how an entire state changes over time,” Bailey said. “Data like ours allows you to look at individuals and how drug use and behaviour change over time, and then we can link that to policy changes.” What becomes immediately apparent, even with an occasional review of these issues — and the list presented here is by no means exhaustive — is that there is a wide range of regulatory permutations for each drug. However, until all key alternatives are clear and detailed, the potential costs and benefits of each alternative cannot be responsibly assessed. This fundamental point can be illustrated in relation to the two central issues most likely to influence public opinion. What would happen to drug use under more permissive regulatory regimes? And what would happen to the crime? In the fall of 2015, I wrote a JPN editorial supporting the proposal to legalize cannabis for non-medical purposes in Canada.1 This brief comment elicited one of the biggest reactions of my career. Strong opinions were expressed, with about half agreeing, the other half not. The members of the editorial board of this journal were no less divided, promoting the first use of a statement that “the opinions expressed in this editorial are those of the authors.” See above. Now, almost 4 years later, I`m investigating how confirmation holds. The top 2 concerns in 2015 continue to dominate discussions: the potential increase in car accidents and an exacerbation of cannabis-related psychosis. Researchers are studying perceptions of harm because people are more likely to exhibit behavior that they consider relatively safe, Bailey said.
In the 1960s and 1970s, for example, the perception of harms from many drugs was generally low, and use was higher than in the decades that followed, when perceived harm increased. “A rate of adolescent use that remains stable is not enough if it decreases normally. We need to pay more attention to preventing youth use in the context of legalization, as we want to maintain the declines we saw before legalization was implemented,” Bailey said. Many arguments seem to make legalization a convincing alternative to today`s prohibitionist policies. In addition to undermining black market incentives to produce and sell drugs, legalization could eliminate, or at least significantly reduce, the very problems that cause the greatest public concern: the crime, corruption and violence that accompany the functioning of illicit drug markets. It can also be assumed that it would reduce the damage caused by the lack of quality controls on illicit drugs and slow the spread of infectious diseases due to needle parts and other unsanitary practices. In addition, governments could abandon costly and largely futile efforts to suppress the supply of illegal drugs and prison offenders and spend the money saved to educate people not to take drugs and to treat those who become addicted. “This study contributes to our understanding of the racial and ethnic changes in cannabis use that occur after marijuana use among adults in the United States was legalized,” Martins said. “But longer-term studies in all racial and ethnic groups will be needed to see if the prevalence of daily cannabis use and cannabis use disorders remains unchanged.
It is far too early to see an increase in the likelihood of cannabis use disorders; This transition among users can only take place a few years after regular cannabis use. Proponents of legalization acknowledge that consumption is likely to increase, but counter that it is not clear that the increase would be very large or would last for a very long time, especially if legalization were combined with appropriate public education programs. They also cite historical evidence to support their claims, noting that opium, heroin and cocaine use had already begun to decline before prohibition came into effect, that alcohol use did not suddenly increase after prohibition was repealed, and that the decriminalization of cannabis use in 11 U.S. states did not trigger a dramatic increase in use in the 1970s. Some also point to the legal sale of cannabis products through regulated outlets in the Netherlands, which also does not appear to have significantly increased consumption by Dutch nationals. Public opinion polls, which show that most Americans would not rush to try previously banned drugs that suddenly became available, are also being used to support the pro-legalization case. The legalization of marijuana in Washington state could counteract a steady decline in teen use, according to a new study from the University of Washington. As is clear, the legalization of drugs is not a political option suitable for simplistic or superficial debate. It requires dissection and verification of an order that has been remarkably absent, despite the attention it constantly receives. Apart from the discussion of some very broadly defined proposals, there has been no detailed assessment of the operational importance of legalisation.
There is not even a generally accepted lexicon of terms that allows for an intellectually rigorous exchange. As a result, legalization means different things to different people. Some, for example, use legalization interchangeably with “decriminalization,” which generally refers to the lifting of criminal penalties for possession of small amounts of drugs for personal use. Others equate legalization, at least implicitly, with complete deregulation, without acknowledging the extent to which currently legally available drugs are subject to strict controls. The best data comes from the United States, where some jurisdictions have had medical marijuana (MML) laws since the 1990s and the legalization of non-medical use since 2012. In these states, the number of road deaths decreased after the introduction of the mML and increased after legalization.2,3 Increases lasted no more than a year, averaged an additional 1.1 deaths per million, and reflected changes in states without legalization2,3 (Box 1a). A recent Canadian study supports these findings. In drivers treated in trauma centres (n = 2318), there was no association between accident liability and blood levels of Δ-9-tetrahydrocannabinol (THC) < 5 ng/ml and only a weak and non-significant association with levels ≥ 5 ng/ml (p = 0.35)13 (Box 1b).
Not only would this discourage people from making the kind of flippant, if not flippant, claims, both for and against, that have permeated previous debates about legalization, but it could also stimulate a broader and equally critical assessment of current U.S. drug control programs and priorities. The UW research participants are some of the children of participants in a larger and older longitudinal study: the Seattle Social Development Project. This study followed hundreds of people — since they were in fifth grade in Seattle elementary schools in the 1980s — to assess a range of conditions, behaviors, and lifestyle choices. The results of interviews with 233 of their children, before and after marijuana legalization, were included in this new study. Bailey notes that prior to the legalization of marijuana, rates of marijuana use among teens and other drugs had declined in recent decades. That Bill Clinton “inhaled” when he tried marijuana as a student was about what the last presidential campaign came closest to the drug problem. However, the current one could be very different. For the fourth year in a row, a state-sponsored survey by the University of Michigan found an increase in drug use among U.S. high school students. After a decade or more of declining drug use, Republicans will surely blame President Clinton for the bad news and attack him for not pursuing the high-profile stance of the Bush and Reagan administrations on drugs.