busted: america's war on marijuana
Mark Kleiman: continued
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INTERVIEWER

What symbolic issues?

KLEIMAN

It's taken to be symbolic of illicit drugs generally. When we argue about marijuana, people really hear an argument about what the legal status ought to be of the currently illicit drugs generally. That's not purely an accident. If you look the groups in favor of changing the legal status of cannabis, most of those organizations are now pushing for wholesale repeal of the drug laws.

So, I think there's a case to be made for treating marijuana very differently, from the way we treat cocaine. In fact, there's no organized group, that, at least that I know, that advocates that. Even the National Organization for the Reform of Marijuana Laws, (NORML) is now, a general-purpose drug policy reform organization interested in lots of things other than cannabis.

And even Marijuana Policy Project, which I think has remained more focused publically, in private the leadership thinks we should probably legalize crack as well.


The other set of symbolic issues is, marijuana represents the '60s. Marijuana represents the Beatles and the anti-war movements and the Greateful Dead, and the Civil Rights Movement and sit-ins, and unisex haircuts and free love, and all of the things that conservatives would like the Baby Boom generation to denounce in themselves. To the cultural conservatives, marijuana represents laziness, disrespect for authority, irresponsibility, and the life lived according to pleasure rather than work or reason. As long as the marijuana debate is really about whether the '60s were a good thing or not we won't have sensible marijuana policy.

On the other hand, lots of people who survived the `60s were left with the impression that pot was no big deal, and what's all the fuss about . But you shouldn't assume that just because pampered, privileged, ambitious middle-class kids could use marijuana in college without doing much damage to themselves or anybody else that much less well-off, much less protected, much younger kids can use it safely. That doesn't follow.

Everybody on both sides of this debate assumes that marijuana must be good or bad. And if it's good it's good for everybody, and if it's bad, it's bad for everybody. Really, though, it's like anything else. It has a distribution of risks. And the distribution of risks depends very much on the social circumstances of the use and on the condition of the users.

Kids in very poor urban neighborhoods, smoking Phillies blunts filled up with marijuana are not like graduate students having a joint every once in a while. It's just not the same experience. Even then, it seems to be pretty clear that the population you look at in the U.S., cannabis use is less associated with violence, than alcohol use. And it's less associated with automobile accidents. When you have marijuana-involved automobile accidents, it's usually marijuana plus alcohol.

So in some ways, even, though marijuana use looks less benign now than it did then, it still maybe less harmful than alcohol use,. One of the great frustrations I have about American drug policy is that we worry about whether the number of high school seniors who used marijuana in the last year has gone up to 30 percent, while ignoring the fact that 35 percent of the high school seniors report having gotten drunk more than twice in the last month.

The number of problem alcohol users among kid is much higher than the total number of marijuana users. And yet we focus on marijuana as if it were the problem. Now you might say, well, that's an illegal drug. But so is alcohol, if you're underage.

And yet getting alcohol on the national drug policy agenda has been fervently resisted by -- You guessed it! -- the alcohol industry. I was told the reason the drug czar's charter didn't include alcohol was that the New York State delegation, pressed by the New York State wine industry, insisted that it be taken out.

INTERVIEWER

Returning to the 'gateway drug' issue. Is there any evidence on one side or the other with that debate?

KLEIMAN

It's clear that kids who use marijuana are more likely to use other drugs, than kids who don't use marijuana. There's no doubt about that. The question is, why? Is the relationship causal? In particular, if we could reduce marijuana use, would that reduce, the use of other drugs? About that we simply don't know.

There any many different ways in which you could imagine marijuana being a gateway to the use of other drugs. It might be a step toward illegal behavior, and therefore other illegal behavior tends to follow. Well, that's one of the arguments of people who want to legalize marijuana is that you could break that link.

Problem: nobody wants to, or at least nobody says they want to, legalize marijuana for kids. People talk about age restrictions, leaving it illegal for kids. Well, wait a minute. You can't have it both ways. I actually think the age restriction for alcohol is now a major problem. I used to be a fan of age restrictions, I've now completely switched, views on that. And, I was, struck by a bolt of insight on the road, not to Damascus, but the Worcester, Massachusetts. There was a huge billboard -- black billboard, plain white letters, that "If you're not 21, it's not Miller Time --yet."

And I said to myself, "Right! If you're an adolescent, the thing you most desperately want in the world is to be grown up," and that's why Miller Brewing wants kids to see this billboard. The age restriction for alcohol makes alcohol use a badge of adulthood. What could be more attractive to kids than a badge of adulthood? So the "Let's make it legal for adults but keep it illegal for kids" line now strikes me as just completely implausible.

Marijuana use could get people into illicit drugs simply cause it gets them to cross the line between legal and illegal behavior. It can get them into illicit drugs because it gets them, to know people who sell illicit drugs, who might be prepared to sell them things other than cannabis.

It could get them into other illicit drugs because kids who smoke a lot of marijuana wind up dealing to support their habits. And once you're dealing then you really know people who are involved in illicit drug activities and have both money and access.

For all of those reasons, it's not clear whether tightening marijuana policy would actually reduce, or increase, the use of other drugs. The strong gateway model, which is that somehow marijuana causes fundamental changes in the brain and therefore people inevitably go on from marijuana to cocaine or heroin, is false, as shown by the fact that most people who smoke marijuana don't. That's easy. But of course nobody really believes the strong version.

The version that people believe, and it's not unreasonable is the tantalizer theory. Somebody has a marijuana experience, has several marijuana experiences, enjoyed them, is looking for something new. And somebody comes along and says, "Well, this other drug is similar to that experience in some ways, but better in other ways."

That seems to me a more plausible story as applied to the psychedelics than it is about either heroin or cocaine. I can really imagining somebody saying to a college student, "Okay, you've had marijuana, that's all right for kids. But, you should really try mushrooms. Now that's for grown-ups. It's a comparable experience, but it's stronger, better, nicer, higher, whatever."

That version of the gateway story seems to be quite likely to be true for some kids. How important it is, I don't know. On the other hand, maybe if kids learn by experience that changing their consciousness chemically is a fun thing to do, they'll want to do it in new and different ways. Of course, they've already learned that from caffeine and alcohol. It's not clear how important it is to have marijuana in the mix.

The right thought-experiment to do is, imagine we could influence marijuana consumption. Would that drive down consumption of, cocaine, heroin, inhalants, psychedelics, whatever, target drug you have? I think we simply don't know. And it's not that the appropriate experiment couldn't be done, but the appropriate experiment has not been done. You'd have to do it on a regional basis. You'd have to pick a state. Pick the state of Washington, say, and just do a lot of stuff; enforcement, prevention, treatment, whatever, to press marijuana use down in Washington and not do all of those things in Oregon. Look up ten years later and see what's happened to cocaine consumption, among kids who grew up in Washington compared to kids who grew up in Oregon. Maybe we could do that experiment. But nobody's done it, perhaps because it might get the "wrong" answer. In the meantime, we just don't know.

INTERVIEWER

And that's basically what you're saying, in all these points. Do the research.

KLEIMAN

For many of these things what I say is do the research, because if we did the research, we'd know whether cannabis was useful medically, and what it was useful for, and to whom it was useful to.

I'm much less confident that we could do the gateway research in a way that would yield a convincing answer. And even if we concluded at the end of the day, that yes, if we could press marijuana use down, that really will have a beneficial impact on cocaine use, it's not clear we know how to do that. It's not that we've been reluctant to press down on marijuana use because people really weren't sure it was a bad thing. We've been working hard at getting marijuana use down. And I'm not sure we're seeing the impacts we'd like to see either on cannabis use or on everything else.

One counter example, not of marijuana as a gateway, but of a possible gateway to marijuana, shows how these gateways statistics can be treacherous. If you look at kids who smoke cigarettes they're about three times as likely to use marijuana as kids who don't smoke cigarettes. Three quarters of the cigarette smokers, also smoke some marijuana. Only about one-quarter of the non-cigarette smokers among kids use marijuana. And that's a pretty strong relative risk. That would lead you to predict, if you didn't know anything else that a collapse in cigarette smoking would lead to a collapse in marijuana use.

Yet the collapse in cigarette use among African-American teenagers during the early 1990s - which, alas, is now being reversed - was not accompanied by any comparable drop in the use of marijuana. The relationships among drugs are much more complicated than a simple gateway idea would allow for. I certainly agree that one of things we should be worried about, in terms of marijuana use by kids or anybody else, is its effect on use of other drugs. Note -- that can be positive or negative. Maybe marijuana is a substitute for alcohol. There's a little bit of evidence that it is, and some evidence the other way.

INTERVIEWER

What about DARE?

KLEIMAN

Dare is a wonderful tool for police-community relations, especially in poor neighborhoods. Getting poor kids to meet a police officer, and getting a police officer to meet poor kids, on a civil, friendly basis, is a wonderful thing to do. Police officers love it, and police departments love it, and neighborhoods love it, and kids love it, and parents love it, and everybody loves it.

What DARE is not is a complete drug prevention program. And, in fact, the evaluations have been pretty uniformly discouraging. It' s very hard to see any evidence that kids who go through DARE are better off in terms of their marijuana use, alcohol use, nicotine use, in middle school, than the non-DARE kids. One study just came out suggesting there may be some delayed sleeper effect of DARE in reducing the use of harder drugs, of cocaine, heroin, inhalants in high school. Everyone is waiting to see if that can be replicated.

So I think DARE is a fine thing to do. I don't think DARE's an adequate thing to do in place of doing real drug education. There's a good argument for focusing less on drugs and doing more education, at younger ages. You don't want to talk to second graders about drugs. But you can talk to second graders about the problem of impulsiveness. You can talk to second graders about their health as something that they want to maintain, and about a class of health-risk behaviors that threaten it.

So if you can get them in the mind-set of being good stewards of their own bodies, then, later, you can start talking about the details, about illicit drugs, about alcohol, about nicotine, about sex, about inadequate exercise, about bad eating habits, about all of the other things that are bad for you . But I think, given the lack of evidence that we really know how to deliver effective drug education, I think we need to start delivering a broader health-promotion message, younger, and see if that works.

There are good pilot-program data that suggest that there are training programs you could do for grade-school teachers: intervening, not around drug use, but around problem behavior, on kids who act out in class. Kids whose teachers have had that training, are much less likely to start smoking when they hit the sixth grade than kids whose teacher's haven't had that training.

Now if that's true, if you can replicate that experimentally, and, what's always the harder problem, if you can replicate it at scale, getting it done by ordinary by first-grade teachers around the country, then you can maybe have a big impact.

We need to make drug education less an ideological effort and more a practical effort. Right now, any drug education program that delivers strong anti-drug messages is perfectly satisfactory to people who insist on anti-drug education, whether or not it changes the actual behavior of the kids.

And in fact, what you find about the mass-media anti-drug ads is that they have very little impact on the behavior of drug users. They strengthen the anti-drug attitudes of non-users. Well, if you think about it, who designs them? Who gets them on TV? Who pays for them? Who evaluates them? People who have strong anti-drug attitudes. And so you can have a phenomenon of preaching very successfully to the choir, and missing the sinners entirely.

INTERVIEWER

So, in short, we don't really know the effect of driving the price up of marijuana?

KLEIMAN

In short we don't know much about the effect of driving up the price. We also don't know very much about how much additional enforcement we require to drive up the price even more, or how much the price would fall if we did a little less enforcement. I have to admit, I was wrong. I very much underestimated the impact of the big marijuana enforcement increase of the '8Os on marijuana prices. We were very successful in pushing price up.

But even at its peak price, marijuana remained a very cheap intoxicant compared to beer. It's not clear that you can price kids out of this market, even at current prices, which tend to be about 10 dollars a gram, an enormous sum historical standards. Part of what's happened is that as cannabis has gotten somewhat more potent the size of a marijuana cigarette has fallen to about a quarter of a gram.. That means that a joint is about two and a half dollars' worth of marijuana. And with the more potent stuff, two or even three people can share that joint, and get as high as they want to be. That means that the price of getting stoned is about a dollar. You can't do nearly that well on beer.

The limit on the effectiveness on marijuana enforcement is that it's so easy to produce. That makes it hard to make it very expensive.

INTERVIEWER

So where do you see us going? I mean in terms of national policy on marijuana? You really think there's hope of staking out a middle ground here?

KLEIMAN

The best hope is to focus the attention of the country on the drugs that are doing most of the damage. Cocaine, heroin, methamphetamine, alcohol, nicotine.

I think marijuana deserves a relatively low priority on the list of drug policy targets. And I think if it weren't so tied up with other, symbolic issues, it might get the obscurity it deserves.

 

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