More on “medical” marijuana

The California “recommendation” system for medical marijuana access is such a total joke and mess that the California Medical Association just endorsed the complete legalization of marijuana. Given the failure of regulations and taxes to deal with the massive public health disasters associated with alcohol and tobacco, the CMA recommendation to treat cannabis like alcohol isn’t obviously a good idea, but the sentiment is understandable.

Footnote Too bad that the loudmouth flack for the California Police Chiefs Association missed a great opportunity to STFU.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

33 thoughts on “More on “medical” marijuana”

  1. The cited justification of reducing prison costs for California marijuana users does not generate confidence in the CMA on this one.

    1. The primary motivation for the statemente–that marijuana’s harms do not justify its prohibition–does indeed generate confidence in the CMA.

      And I think we know enough about cannabis to say that its public health costs, even under the kind of expanded use that Keith H. and Mark K. insist will accompany legalization, will be far less than those associated with tobacco and alcohol.

      1. Legal alcohol and tobacco causes 500,000 deaths a year. If we adopted as the societal standard that to be sold legally in supermarkets, a product has to kill fewer people than that, then, yes, a lot of things, including marijuana, that are now illegal would indeed be sold legally in supermarkets.

        1. So what’s your point? You seem to be arguing for alcohol and tobacco prohibition. Where would you set the bar, and why should we tolerate alcohol and tobacco use if below that? Your numbers actually reinforce the point — the public health costs directly attributable to marijuana use aren’t now, and even if usage doubled under legalization still wouldn’t be a statistically significant drop in that bucket. The public costs of prohibition and enforcement are another matter altogether.

          1. My point is that whether something is less damaging that alcohol or tobacco is not a good standard for safety — if it were we would get rid of seat belts, sell hand grenades at drug stores and allow drunk driving.

          2. I certainly agree that booze and tobacco are a misplaced bar. Frankly, their relevance in the marijuana debate is almost nil.

            But what of it? Those two drugs are so unrelated to pot it’s silly.

            I’d love to know why, exactly you (and Mark as well) would disagree with the following statement: The unlimited use of marijuana in the US would have practically zero negative consequences to our society.

            Really…the stuff is so close to harmless it’s ridiculous. It’s probably unwise to drive while high, but really I can say for sure it’s nothing like drunk driving. Personal drive may get slightly attenuated for regular users, but so does the propensity to violence.

            So please tell me, based on actually observed effects of this particular type of drug use: who cares how much or how many? Seriously.

            NOTE TO RESUME MAN: RESPONSE AT THE BOTTOM OF COMMENT SECTION

          3. Keith: I got that the first time. So why should we tolerate alcohol and tobacco if we can’t tolerate other things far less harmful?

    2. I don’t even understand this comment. Legalizing marijuana will, if nothing else, be good for existing recreational users. They will be able to have their fun and not risk jail (and they may also receive a safer product as well).

      I understand the argument that other harms outweigh this (even though I don’t think they come close to doing so). But denying that legalization would benefit pot users is crazy. Of course it would.

  2. Can’t you at least acknowledge that marijuana is, medically speaking, far less dangerous than alcohol or (smoked) tobacco? What kind of public health disaster are you fearing here?

      1. Mark has argued that legalization will, inevitably, bring with it an increase in abusive use–and I think he’s right. However, he has also argued that the costs of the increased use will demonstrably be greater than the current costs of prohibition, and has never (that I’ve seen) pointed to any actual cost-benefit analysis. So, once again, I’d really like to see his numbers.

  3. Massive logic breakdown in this post.

    California (and the entire USA) might have a poor approach to dealing with alcohol and tobacco abuse. That poor approach could still be miles better than California’s (and the USA’s) approach to dealing with marijuana. And it is … we don’t jail people for growing, selling or consuming tobacco or alcohol.

    By the way … Are you comparing California’s way of dealing with alocohol or tobacco abuse unfavorably to some other jurisdiction? Or merely to the Kleiman ideal (which would be a lot less compelling).

  4. What about the benefits of legalized M.J.? I hear it’s “fun”. What metric can we use to measure that benefit? It might be also beneficial to remove the black market for said product.

    It is probably the second most violated law, next to jaywalking.

  5. There are alternatives other than drug war and commercial legalization. The CMA document would have been better had it noted that fact.

    1. Half measures are either going to (1) deny users the safest, most pure, best produced products that a commercial system would provide or (2) if such products aren’t blocked, be entirely equivalent to commercial legalization.

      A couple of lines noting that half measures are a bad idea was probably all that was needed.

      1. Isn’t this kind of absolute faith in an invisible hand more appropriate to a discussion of hallucinogens?

        1. What faith? I’m talking about a regulated product. Just like any other food and drug.

          Think we would have safer birth control pills if they were illegal or had to be homemade?

  6. Yet another demonstration that Mark considers the repeal of Prohibition a huge mistake.

    Mark, can you at least admit that the criminalization has it’s own costs? Huge prison populations? Organized crime? Militarization of police? Erosion of civil liberties? Financing narco-terrorism? The “drug war exception” to pretty much every clause of the Constitution?

    It’s like your vision of the ideal society is a bunch of healthy prison inmates. Healthy because they’re being forced to do whatever you think is best for them. Prison inmates because, well, they’re being forced to do whatever you think is best for them…

    The foundation of all your policy recommendations seems to me to be the assumption that government is entitled to force people to do whatever is healthy. You’d apply that to alcohol, tobacco, and a huge range of psychoactive chemicals. How about fat? Sugar? Exercise? Where do you draw the line, and on what basis?

    Because I have this sneaking suspicion you draw the line only on the basis of what you think you can get away with, and would be all for ordering people to do morning calisthenics if you thought it politically feasible.

  7. Given the failure of regulations and taxes to deal with the massive public health disasters associated with alcohol and tobacco

    I don’t think that’s a given at all. The problems associated with this kind of issue can only be mitigated — it’s delusional to entertain the idea that they could be eliminated. Any “massive public health disasters associated with alcohol and tobacco” are far less massive than they would be if those were contraband. You can die from nicotine poisoning just from handling raw tobacco leaves with bare hands, so don’t try growing this at home without good gloves and a bit of research on the dangers, smokers. In the case of alcohol, it’s not just hypothetical — we’ve actually seen what happens when the government fails to “deal with the massive public health disasters associated with alcohol” through “regulations and taxes”, both in terms of violent crime and quality and “safety” of the product. There’s really only one way I can think of to make a dangerous drug with a 1:4 “buzz dose” to potentially fatal overdose ratio (I’m talking about alcohol, of course) even more dangerous, and that is to cede control of it to criminal organizations through prohibition.

    There are alternatives other than drug war and commercial legalization. The CMA document would have been better had it noted that fact.

    I’m all ears. I’d love to hear a workable alternative to regulated and taxed legalization that doesn’t cede control over quality and distribution to a black market.

  8. Mark Kleiman says:

    “There are alternatives other than drug war and commercial legalization. The CMA document would have been better had it noted that fact.”

    Actually, are there really alternatives? If something is legal (to the point that alcohol and tobacco are), I can see a stable situation. If there’re illegal, is there stable state short of where we are now? Remember, Mark, you’ve seen the drug wars escalate, and cause massive collateral damage to people and society (think of how many things crawled out of the drug war swamp into the rest of police work).

    The real, existing history is that illegality led to a massive disaster.

  9. While I favor legalization over continued criminalization, it seems to me there is a preferable alternative: the government decriminalizes consumption but supplies the substances at cost-plus expenses. While I have no problem personally with legalization because I cannot imagine corporations effectively monopolizing the field like they do so much else, I have some sympathy for it applying this measure to marijuana as a “gateway policy” to a saner approach to the really serious drugs. Start with marijuana not because the logic is strong there (marijuana is not physically addictive) but because if it works, the logic could expand to drugs that are addictive.

    Under this kind of scheme there can never be any significant profit in the drug business because a very low cost reliable quality alternative always exists. There would also be no incentive for becoming a dealer in an addictive substance and no incentive to try and “hook” others. State stores for such substances would not be entirely unheard of given the state liquor stores in libertarian paradises like New Hampshire.

    The income from these stores would easily make them self-sustaining. I doubt there would be more addicts than we have now, but if we had them, they would not need to commit crimes against others to afford their habit.

    So we get

    1. no magnet for organized crime
    2. no high prices encouraging additional illegal behavior by users
    3. no adulterated drugs with nasty unexpected side effects
    4. no incentive to enlarge the number of users by dealers or by corporate producers
    5. no lives ruined by prison
    6. no deaths and injuries of innocent people in the wake of incompetent police raids.
    7. vastly lower court loads and prison populations

    Downside?
    Possibly more users, but if so they will have ready access to treatment outlets, perhaps made available at the stores and possibly also funded by profits from drug sales so long as the price remains so low as to keep out money-oriented private competition.

    1. Under this kind of scheme there can never be any significant profit in the drug business because a very low cost reliable quality alternative always exists.

      Precisely why the Jolly Green Giant could never get a foothold in the vegetable market, right?

  10. <i.If something is legal (to the point that alcohol and tobacco are), I can see a stable situation.

    How about “legal to the point home-butchered rabbit is”? Legal to grow, legal to eat, illegal to sell.

    1. Earlier, to Mark, I said “I’m all ears. I’d love to hear a workable alternative to regulated and taxed legalization that doesn’t cede control over quality and distribution to a black market.“. Danged if you didn’t come up with one, in theory anyway, though in practice I imagine there would still be a thriving black market.

  11. “Under this kind of scheme there can never be any significant profit in the drug business because a very low cost reliable quality alternative always exists.”

    I suspect there’d still be a considerable black market under your scenario, simply because “reliable” quality isn’t the same as “good” quality. The government might very well produce a product which is reliably low quality.

    1. Spoken like a true pothead! I can’t imagine the average high times reader being happy with govt chronic

  12. Spoken like a guy whose favorite psychoactive substance is Mountain Dew, but who’s aware that there are graduations of quality in pretty much anything. There are moderately successful government run alcohol distribution monopolies in some states, but you’ll notice that they aren’t marketing alcohol brewed by the government.

    But your remark does demonstrate something that keeps the drug legalization movement down. We have a war on drugs. And anybody who expresses a desire that drugs be re-legalized is immediately presumed to be a person who uses, or wishes to use them. Not only an immediate ad hominem attack, but a veiled threat, since we ARE in a ‘war’, and people suspected of using drugs can be subjected to all sorts of attacks, perfectly legally.

    It is, of course, quite possible to want drugs re-legalized, and to also think that anybody who uses them is a fool who richly deserves the natural harmful consequences of doing so. Rather than having them redistributed to the rest of us in the form of a police state.

  13. Unfortunately Resume man, I can’t seem to reply below your comment. I am glad we agree that the alcohol/tobacco bar is not the right one, let us hope therefore that people stop invoking it as if it were meaningful. In terms of MJ causing zero harm, in Holland, where it is not even illegal but decriminalized, pot potency has soared and many people seek treatment for MJ addiction with no legal pressure. That is a good sign the damage would not be non-zero, even not taking into account that under legalization you would have advertising, promotions and scientists working full-time to increase addictiveness.

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