Mark Kleiman

Last active
2 years, 10 months ago
  • Good question. There’s no research-based answer.

    Marijuana use correlates with, and statistically predicts, use of other drugs, as alcohol and tobacco correlate with and statistically predict marijuana use. The data are consistent with the claim that making marijuana more available would increase use of other drugs, but equally consistent with the idea that people who want to use one drug are simply more likely to want to use another.

    Yes, it’s possible that making marijuana legally available would prevent some use of cocaine by keeping some people from establishing the habit of illicit purchase and connections with black-market dealers. But the probability of cocaine use conditional on marijuana use is 33% in the U.S.; in the Netherlands, where you don’t need a drug dealer to supply your pot, the comparable rate is 22%, and cocaine is much more expensive there than it is here.

    So I’d rule all claims “not proven.”

  • Alcohol and tobacco are both specifically exempted in the law. Otherwise they’d both be Schedule I, since both are abusable and neither is used medically. (Nicotine use used medically to treat tobacco addiction, but tobacco itself is not.)

  • An unnecessary patient would be any of the majority of “medical” marijuana buyers who are simply long-time pot-smokers pretending to have some non-specific ailment to get a card.

  • Yes, a slam dunk: as long as you ignore the risks.
    Right now, something more than 2 million people self-report that their marijuana use is interfering with their lives. How much that figure would go up if marijuana were legal is unknown, and would party depend on the details of legalization policy.
    Would you still regard the question as a slam dunk if that number doubled? Tripled? Quadrupled? And is there any reason to think that quadrupling is not among the possible outcomes of flat-out legalization?

  • When the Controlled Substances Act was passed in 1969, marijuana was already banned by federal law, and the new statute simply maintained the status quo. The formal definition of a Schedule I drug is (1) high abuse potential and (2) no currently accepted medical use. The courts have upheld the DEA’s claim that “currently accepted medical use” means FDA approval, or at least enough evidence to support FDA approval. Note that the law is incoherent: the other schedules all involve drugs with accepted medical use. So there’s no place to put a drug that’s not a prescription medicine but has only moderate abuse potential. Any drug not in medical use that has any abuse potential at all is automatically Schedule I.

    That could be changed (1) by changing the law or (2) by developing a specific strain or blend of marijuana with a reproducible profile of active agents, and then running that material through the process of showing safety and efficacy in two large-scale clinical trials. That would be a difficult process, but not impossible; GW Pharma is likely to succeed with Sativex, a THC/CBD blend designed for sublingual administration rather than smoking. But it costs money.

    That’s the formal story. The political story is different.

  • WSIPP is the correct name, and I agree it’s a good outfit, though its specialty is research reviews rather than original work. As to a legalized state becoming a research Mecca, it would depend heavily on funding. There’s much more money around for biomedicine than for policy work, and finding funders for policy work who don’t want to dictate the answers before the research is done is never easy.

  • If you believe in the precautionary principle, yes, uncertainty is a reason for inaction. But you could equally say that the costs of the current policy are known and not small, while the costs of legalization are to some extent speculative, so why take a certain hit to avoid an uncertain risk? It seems to me that Beau Kilmer’s point is the central one: since we’re uncertain, we should try to act in ways that (1) allow us to observe the consequences and (2) are easy to reverse if things go sideways.

  • Any prediction about what the federal government would do is pretty much a guess. (Depending partly on who gets elected President, which makes it pretty perverse for the marijuana advocates in Colorado to threaten to swing the state to Romney.)

    One question is how much of the marijuana grown and sold in a state that legalized would wind up crossing state lines. Without tight controls, Washington or Colorado or Oregon could wind up supplying the whole continent. If that happens, the pressure on the feds to crack down would be very strong. If not, they might decide to give the experiment a good leaving-alone.

  • My understanding is that the Council wants to allow the original 160-something dispensries – the ones the pre-existed the failed moratorium – to re-open. But I’m not following that closely.

  • LA has been trying to limit the number and behavior of the dispensaries for years, and the dispensaries simply defied those limits. So the City Council decided to shut everything down and start over.

  • One possibility is that voters – and not just conservative voters – use a politician’s stance on “moral” issues (i.e., purity issues such as sex and drugs) as a measure of the politician’s personal moral soundness. If that’s right, some voters who vote for a medical marijuana initiative might vote against a politician who voted for the same law in the legislature, after being told that the politician supported “drug legalization.” That would explain why the campaign for liberalizing marijuana laws has had so much more success at the ballot box than in the legislative halls.

  • Perhaps the LA City Council was reflecting public opinion rather than defying it. You don’t have to be a drug-war hawk to doubt that LA needed to have more medical dispensaries than the Netherlands has coffeeshops, or to think that some of those dispensaries were very bad neighbors. Virtually none of them were actually in compliance with state law, which permits only “cooperatives;” the dispensaries are almost all organized as for-profit businesses.

    The history of medical marijuana in California is a history of deception by advocates and complete failure in administration: a warning to everyone.

  • The spectrum of potential policies is really quite wide.

    1. Prohibition with stiff enforcement against sellers and users.
    2. Prohibition with stiff enforcement against sellers but not against users.
    3. Formal decriminalization, where possession for use isn’t a crime at all, with or without stiff enforcement against sellers.
    4. Prohibition with minimal enforcement, as currently applies to non-commercial gambling, or prohibition with enforcement directed mostly at preserving public order, as currently applies to commercial sex in most big cities.
    5. Legalization of production for personal use or in non-profit cooperatives.
    6. Legalization of production and commercial sale through a state monopoly.
    7. Legalization of production and commercial sale through private enterprise.

    Under 6 or 7, prices could be set by law or forced up by taxation (with the current illicit price a practical upper limit) and regulations could cover such things as minimum age for purchase, maximum purchase quantity, potency or ratio of THC to CBD, and marketing activity.

    So it doesn’t make much sense to be for or against “legalization” until you specify what sort of legalization you’re for or against.

  • The goal of the book is to inform the debate, not to dictate an answer. We think that voters and other policy-makers ought to be able to make their choices with as many facts as possible, rather than having to base them on duelling soundbites. As Socrates pointed out a long time ago, the beginning of wisdom is knowing what you don’t know. And that’s what we agree on: that facts and not prejudices ought to drive decisions.

    Alcohol prohibition didn’t abolish problem drinking, but it cut back on it substantially (as shown by declining death rates from liver disease). It also caused the rise of an illicit market, which eventually led the country to get rid of it. Marijuana may be on the same course. If so, some problems will decrease and other problems will decrease. That’s life in the big city.

  • No doubt opposition to what Andy Weil calls “stoned thinking” undlies some of the opposition to marijuana. But “never” is a long time. I wouldn’t be surprised if Washington State voted to legalize this year.

  • Yes, the treaties were largely a U.S. project. But that doesn’t mean the U.S. is the sole, or the most passionate, supporter of prohibition today. Sweden, Russia, Singapore, and most of Africa are now noticeably more hawkish than the U.S. is.

  • Right. And no, legalization doesn’t have to mean “no restrictions.” Taxes and regulations are always possible. But they aren’t self-enforcing; if you make the taxes high enough and the regulations tight enough, the black market comes back.

  • Thanks to Bev Wright and the rest of the Firedoglake crew for setting up this salon, and to Pete Guither for hosting it.

    Pete’s opening post provides a very fair summary of the book. And I’m sure he won’t be alone in being a little frustrated by our reluctance to make magisterial pronouncements that come down on one side or the other of close empirical controversies. Pete cites as an example the effect of marijuana legalization on heavy drinking, which we point out as a key uncertainty that could easily shift a reasonable person from favoring to opposing legalization or from opposing it to favoring it, simply because the alcohol problem is so much larger than the marijuana problem on every dimension (including incarceration).

    Now it’s true that there are studies of the cross-elasticity of demand between the two drugs, and it wouldn’t be unreasonable to say that the weight of the evidence tilts somewhat toward substitution rather than complementarity, which is the way Pete would like it to point. But our assertion is that even if those studies were univocal – which is far from being the case – they wouldn’t deserve much total weight, because the effect on alcohol use of a moderate-sized change in marijuana prices while marijuana remains illegal (or the effect on marijuana use of a moderate-sized change in alcohol price, still with marijuana illegal) simply isn’t a strong predictor of the effect on heavy drinking of marijuana legalization and the massive price drop likely to result from it. And the effects might depend on policy details: Would it be legal to add alcohol to cannabis-infused drinks, or cannabinoids to beer? Could bars provide marijuana, along with alcohol, for on-premises consumption?

    Nor are the short-run effects – which is all the studies can get at – necessarily similar to, or even in the same direction as, the long-run effects. (Over a period of decades, would having two legal intoxicants rather than one change attitudes toward intoxication? Would the legal marijuana industry ally with the legal alcohol industry to oppose tax and regulatory changes hostile to either, as the industries producing beer, wine, and distilled spirits now ally with one another? There’s simply no way of knowing the answers to such questions.)

    So what we say in the book is what we still believe:

    1. The effect of marijuana policy on heavy drinking deserves great weight in considering which marijuana policy to choose;

    2. The effect could be substantial, but it could go either way;

    3. Currently available information doesn’t resolve the question either of magnitude or of direction; and

    4. No research performed under prohibition can give us much insight about the effects of legalization.

    As a result, the decision to legalize or not, and if so under what rules, will have to be made in the dark. That’s not where we wanted to be, but that’s where we are. We. Just. Don’t. Know.

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