Drugs

Burning Questions for the Authors of 'Marijuana Is Safer'

The authors of a new book on misconceptions about marijuana respond to the torrent of comments on an excerpt published on AlterNet.

On August 6, AlterNet posted an excerpt from the new book Marijuana Is Safer: So Why Are We Driving Americans to Drink? (Chelsea Green, 2009).  Reader response was overwhelming. Within hours, the excerpt was AlterNet's most trafficked and commented upon features of the week. 

Co-authors Paul Armentano and Steve Fox have responded a selection of several of the comments, as well as some of the most common questions they have received since Marijuana Is Safer was released.

AlterNet: What do you believe are the biggest misconceptions about marijuana?

Paul Armentano: There are two broad misconceptions about marijuana.  On one side, you typically have those opposed to any change in marijuana policy claiming that the plant is far more dangerous to the user and to society than it actually is.  On the other side, you sometimes have proponents of cannabis law reform arguing that it is virtually harmless.  Both positions are incorrect, and we go to great lengths to explain this fact in Marijuana Is Safer.  The bottom line: no potentially mind-altering substance is harmless, including marijuana.  But by any measurable standard, marijuana is much safer than alcohol, and our book provides readers with an objective frame of reference – the legally regulated use of alcohol by adults – for which they can objectively compare the use of marijuana.  For those readers who don’t believe that marijuana is safer than booze, our book will change they way they think about pot; for those readers who already support changing our antiquated and draconian pot policies, our book will change the way they talk about marijuana.

AlterNet: In Marijuana Is Safer, you compare and contrast the relative harms and legal status of marijuana and alcohol. So, in what ways is marijuana safer? 

Steve Fox:  Marijuana is safer than alcohol in virtually every way that matters.  First, marijuana is far less toxic.  Alcohol, quite literally, is a poison. That is why excessive alcohol use often causes vomiting.  The body is rejecting the poison.  And, as most people know, consuming too much alcohol can result in an overdose death.  Marijuana, on the other hand, isvirtually non-toxic  to healthy cells and major organs.  In fact, the active components in marijuana – known as cannabinoids -- actually mimic chemicals naturally produced by the body (so-called endocannabinoids) that are necessary for the maintenance of proper health.  Further, unlike alcohol, marijuana does not depress the central nervous system, making an overdose impossible, regardless of how much a person consumes.  (There are no recorded marijuana overdose cases in history.)  Beyond overdose deaths, the U.S. government estimates that consumption of alcohol is the primary cause of about 35,000 American deaths annually. And those are deaths attributed just to the adverse health impacts of alcohol ingestion on the body – not deaths from alcohol-induced accidents or incidents. The comparable government figure for marijuana deaths is zero. 

That said, contrasting the health effects of the two substances on the body is just one part of the equation.  The more troubling aspect of steering Americans toward alcohol is that alcohol use is far more likely to be associated with violent crime.  We devote almost an entire chapter in the book to detailing the multitude of alcohol-driven offenses.  We discuss campus-based sexual assaults and other acts of student-on-student violence.  We also provide federal government statistics demonstrating the staggering number of alcohol-related violent crimes in this country.  We even include information about alcohol-related violence from around the world.  By contrast, marijuana use is not associated with an increased likelihood of violent behavior – or even risk of serious injury.  Just the opposite.  It is actually more likely to tamp down tensions and aggressive behavior, as the former chief of the Seattle Police Department explains in the foreword to the book.

AlterNet: But isn’t marijuana smoking is at least as dangerous in terms of lung disease and cancer as is smoking tobacco?

Paul Armentano: No it isn’t, and there’s now a large body of evidence available in the scientific literature affirming this.  For example, a retrospective cohort study of 65,000 people by Kasier Permanente concluded that marijuana use is not associated with tobacco-related cancers or with cancer of the colon, lung, skin, prostate, breast, or cervix, among others.  More recently, a 2006 population case-control study, funded by the U.S. National Institutes of Health and conducted by the University of California at Los Angeles, reported that lifetime use of cannabis was not positively associated with cancers of the lung or aerodigestive tract, and further noted that certain moderate users of the drug experienced a reduced cancer risk compared to non-using controls.  And finally, the results of a just-published case-controlled study in the August 2, 2009 edition of the journal Cancer Research Prevention found that lifetime marijuana use was associated with a ‘significantly reduced risk’ of cancer, specifically head and neck squamous cell carcinoma. 

Moreover, those concerned with potential health risks associated with smoking marijuana can choose to vaporize it. Vaporization heats marijuana to a temperature where active cannabis vapors form, but below the point of combustion – therefore enabling consumers to significantly reduce their intake of potentially noxious smoke.  In 2007, a team of investigators at San Francisco General Hospital in California compared the combustible contents of smoked marijuana cigarettes to marijuana vapors and determined: “Vaporization of marijuana does not result in exposure to combustion gases and [was] preferred by most subjects compared to marijuana cigarettes. … [It] is an effective and apparently safe vehicle for THC delivery.”

AlterNet: What about the claim that the consumption of marijuana is likely to be a strong contributory factor in a number of severe psychoses including bipolar illness, mania, depression, schizophrenia and others.

Paul Armentano: This is serious question and we address it in our book. To date, allegations linking marijuana use and the development of mental illness in otherwise healthy adults have been based on specious evidence.  That is why a recent comprehensive review by the British Advisory Council on the Misuse of Drugs determined, “The evidence for the existence of an association between frequency of cannabis use and the development of psychosis is, on the available evidence, weak.”

That is not to say that some people, such as those predisposed to certain mental illnesses, may not face some increased risks from marijuana use, just as these same people face increased risks of an adverse reaction from consuming alcohol.  However, health risks connected with drug use, when scientifically documented, should not be seen as legitimate reasons for criminal prohibition, but instead, as reasons for legal regulation. If there does exist a minority population of citizens who may be genetically prone to potential harms from cannabis (such as those predisposed to schizophrenia), then a regulated system would best identify and educate this sub-population to pot's potential risks so that they may refrain from its use, if they so choose.

AlterNet: One commenter posted: “Pot is not safer than alcohol because it accumulates in the body over a long period of time. You can detect pot in your urine for a long time after consumption.”  How do you respond to this allegation?

Paul Armentano: The commenter is correct that alcohol’s active psychoactive ingredient, ethanol, is water-soluble while marijuana active components, the cannabinoids, are fat-soluble.  That said, ethanol, is converted by the body almost immediately to acetaldehyde, a known carcinogen.  This is why you see studies finding such a strong association between even moderate alcohol use and cancer.  In short, just because alcohol is water-soluble and leaves the body rather quickly does not mean it is not harmful to health. 

By contrast, cannabinoids are surprisingly non-toxic so their persistence in the body poses no serious threat to health.  In fact, it’s this slow half-life that likely prevents cannabis users from suffering from substantial abstinence symptoms (e.g., physical withdrawal) when they cease using it.  Of course, marijuana’s excretion pattern is hardly unique.  Plenty of other legal drugs, such as certain prescription steroids or even vitamin D, are fat-soluble and have similarly slow elimination times.  About the only serious downside of pot’s pharmacokinetics is that its presence can be detected on certain drugs tests for days and sometimes weeks after past use, making cannabis consumers far more susceptible to discrimination in the workplace.

AlterNet: Several posters raised concerns pertaining to marijuana and driving? How does marijuana’s affects impact driving compared to alcohol?

Paul Armentano:  Alcohol and marijuana have contrasting effects on psychomotor skills and performance.  Specifically, alcohol intoxications is associated with more aggressive driving while marijuana use is associated with more cautious behavior.  This is not to imply that marijuana will not adversely impact psychomotor skills.  Marijuana most certainly can impact psychomotor performance and driving under the influence of pot ought to be discouraged – both via public education campaigns as well as criminal and administrative penalties.  However, evidence of marijuana’s culpability in on-road driving accidents and injury is nominal compared to that of booze.

AlterNet: Another commenter posted: "How about we not use drugs or alcohol? How about we don't ‘push’ anything?" How do you respond?

Steve Fox:  Every developed society throughout history has used psychoactive substances -- primarily alcohol and marijuana.  The use of them is essentially unavoidable.  That said, our book is not ‘pushing’ the use of any substance; it is simply acknowledging the objective fact that marijuana is safer than alcohol.  By suggesting that our criminal laws recognize this truth, we would not be ‘pushing’ another vice – rather we would be giving adults the option to choose a less harmful alternative to for relaxation or recreation.  Currently our laws intentionally steer citizens toward the use of alcohol when many of them would prefer to use the far less harmful substance, marijuana.

AlterNet: How important of an issue is this for people who don't smoke pot?

Steve Fox:  It is tremendously important.  As marijuana policy reform advocates have been saying for years, it is unconscionable that we have arrested what is now over 20 million Americans since 1965 for nothing more than violating marijuana laws. Moreover, enforcement of marijuana laws diverts law enforcement time and resources away from preventing and investigating violent crimes. 

But the purpose of our book is to give citizens a new angle to consider.  We want them to understand the consequences of steering the American people away from marijuana and toward alcohol.  We want parents of college-aged and post-college-aged women to think about whether their daughters would be safer at a party, bar or fraternity where people are drinking or at a home or at an event where people are primarily using marijuana.  Would they rather their daughter encounter a group of drunk guys walking home at night or a bunch of guys who were high?  Similarly, we believe people who care about reducing domestic and partner violence – perhaps in their own lives – should consider whether advising past abusers to use marijuana instead of alcohol to unwind might be beneficial. 

By raising these points and posing these questions, we are not trying to start a modern day movement to bring back alcohol prohibition. Far from it.  We believe adults should be allowed to use either substance responsibly.  But we, as a society, should no longer ignore that marijuana is less likely to lead to violent behavior.  We see university presidents across the country trying to reduce dangerous alcohol use in order to prevent accidents and acts of violence on campus.  Some have even proposed lowering the drinking age to accomplish this goal. Yet they have generally been unwilling to consider the possibility of allowing students to use marijuana instead of alcohol.  Why?  It is likely that it would reduce alcohol-related incidents on campus, including sexual assaults and date rapes.  Isn’t that an important goal?

There has never been a public discussion about whether giving adults the option of using marijuana instead of alcohol might actually make our communities safer.  We believe that it is time to have that conversation – and it is one that will be of interest to all Americans. 

AlterNet:  Let's say marijuana becomes legal. How would you envision it being regulated, produced, distributed, and sold?

Paul Armentano: We devote an entire chapter of Marijuana Is Safer to addressing this topic.  In short, rules regulating the sale and use of many legal products, and alcohol in particular, are complex and vary greatly according to state and local laws.  Nowhere in the United States is booze legal in the same manner that oranges are chewing gum are legal.  In virtually all cases, the laws regulating alcohol’s possession, sale, and use are designed to reflect cultural mores, maximize public safety, and discourage abuse – particularly among young people.  We propose that similar standards should govern the regulated sale and use of cannabis.

AlterNet: What's the best argument a marijuana legalization supporter can make, when faced with staunch opposition?

Steve Fox: As we say throughout our book, we believe the most effective response – as opposed to an ‘argument’ – is to help your opponent understand or appreciate that marijuana is not as scary as he or she probably thinks it is.  The goal in any discussion should be to persuade that person to view marijuana as merely another recreational substance – used by most consumers in a manner very similar to the way alcohol is used – but one that is far less harmful than alcohol, both to the users and to society.  Let the person know that far from ‘adding another vice’ for citizens to use, society would actually benefit if people were allowed to responsibly enjoy a less harmful alternative for recreation or relaxation, if that is what they prefer. At worst, the opponent should be hard-pressed to defend the idea that we should punish adults who make the rational choice to use the less harmful substance.

To learn more about Marijuana is Safer: So Why Are We Driving People to Drink?, check out The Great Marijuana Book Bomb.

Paul Armentano is the deputy director of NORML (the National Organization for the Reform of Marijuana Laws). Steve Fox is director of government relations for the Marijuana Policy Project. They are co-authors, along with Mason Tvert of the book Marijuana Is Safer: So Why Are We Driving People to Drink (2009, Chelsea Green).