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Health and Societal Costs of Marijuana vs. Alcohol and Tobacco: Prohibitionists' Concerns Answered and Refuted

A pragmatic regulatory framework allowing for the limited legal use cannabis would best mitigate the potential health risks and societal costs associated with its use.
 
 
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It is no surprise that lifelong prohibitionist William Bennett recently took to the mainstream blogosphere to criticize Pat Robertson’s about face on the issue of marijuana legalization.

“Evangelical patriarch Rev. Pat Robertson has long been a leader in the conservative movement advocating for a better civil and moral society,” Bennett opined on CNN.com. “But his recent support of marijuana legalization couldn't be more wrongheaded.”

Bennett’s specific criticisms of legalization — that it would simultaneously allow for “open and unrestricted drug use” by all, and that the plant’s perceived social costs would outweigh any economic benefits reaped by regulation — are predictable, but they are nonetheless worth addressing.

The ex-Drug Czar’s first allegation can be dismissed outright. No one in drug policy reform is suggesting that marijuana be legalized without proper regulations — including restrictions regarding who can commercially produce pot, distribute it, and consume it. By contrast, under America’s present prohibition, no such controls exist — which is why teens today claim that they enjoy easier access to illicit cannabis than they do legal alcohol or cigarettes.

Bennett’s latter charge — that regulating cannabis would dramatically increase societal costs — deserves more critical analysis. Bennett bases this allegation largely upon the premise that present taxes on alcohol and cigarettes fail to adequately pay for the social costs associated with these drugs' use and abuse. True enough and perhaps a persuasive argument if, in fact, one was debating whether to criminally prohibit the use of booze and cigarettes (a public policy option that Bennett, a one-time heavy consumer of both substances, would no doubt oppose, despite the drugs’ heavy social toll).  Nevertheless, Bennett’s premise is all but irrelevant to the marijuana legalization debate. Here’s why:

Cannabis is safer than alcohol.

Alcohol is toxic to healthy cells and organs, a side effect that results directly in about 35,000 deaths in the United States annually from illnesses such as cirrhosis of the liver, ulcers, cancer and heart disease. Heavy alcohol consumption can depress the central nervous system — inducing unconsciousness, coma and death — and is strongly associated with increased risks of injury. According to US Centers for Disease Control, alcohol plays a role in about 41,000 fatal accidents a year and in the commission of about 1 million violent crimes annually. Worldwide, the statistics are even grimmer. Stated a February 2011 World Health Organization report, alcohol consumption causes a staggering 4 percent of all deaths worldwide, more than AIDS, tuberculosis or violence.

By contrast, the active compounds in marijuana, known as cannabinoids, are relatively nontoxic to humans. Unlike alcohol, marijuana is incapable of causing a fatal overdose, and its use is inversely associated with aggression and injury. According to a just-published review in the Journal of Psychopharmacology, “A direct comparison of alcohol and cannabis showed that alcohol was considered to be more than twice as harmful as cannabis to users, and five times more harmful as cannabis to others (society). … As there are few areas of harm that each drug can produce where cannabis scores are more [dangerous to health] than alcohol, we suggest that even if there were no legal impediment to cannabis use, it would be unlikely to be more harmful than alcohol.”

Cannabis is far safer than tobacco.

According to a 2009 white paper by the Canadian Center on Substance Abuse, health-related costs per user are eight times higher for drinkers than they are for those who use cannabis, and are more than 40 times higher for tobacco smokers. It states: "In terms of (health-related) costs per user: tobacco-related health costs are over $800 per user, alcohol-related health costs are much lower at $165 per user, and cannabis-related health costs are the lowest at $20 per user."

A previous analysis commissioned by the World Health Organization agreed, stating, "On existing patterns of use, cannabis poses a much less serious public health problem than is currently posed by alcohol and tobacco in Western societies." So then why is the federal government so worried about adults consuming it in the privacy of their own homes?

Some tax revenue is better than no tax revenue.

According to a 2007 George Mason University study, U.S. citizens each year spend about $113 billion on marijuana. Under prohibition, all of this spending is directed toward an underground economy and goes untaxed. That means state and local governments are presently collecting zero dollars to offset any existing societal and health costs related to recreational marijuana use. Therefore, the imposition of any retail tax or excise fee would be an improvement over the current situation.

In sum, concerns expressed by Bill Bennett and his likeminded prohibitionists regarding the potential health implications and social costs associated with cannabis do not validate the drug’s continued criminalization. Just the opposite is true. As acknowledged by no less than Bennett himself, there are numerous adverse health consequences associated with alcohol, tobacco and prescription pharmaceuticals – all of which are far more dangerous and costlier to society than cannabis – and it’s precisely because of these consequences that these products are legally regulated and their use is restricted to particular consumers and specific settings. Similarly, a pragmatic regulatory framework allowing for the limited legal use cannabis by adults would best mitigate the potential health risks and societal costs associated with its use.