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Marijuana: Much More Than You Wanted To Know

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❶I have seen the withdrawal from alcohol, and it can be life threatening.

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Starting in the s, several states decriminalized possession of marijuana — that is, possession could not be penalized by jail time. It could still be penalized by fines and other smaller penalties, and manufacture and sale could still be punished by jail time.

Starting in the s, several states legalized medical marijuana. People with medical marijuana cards, which in many cases were laughably easy to get with or without good evidence of disease, were allowed to grow and use marijuana, despite concerns that some of this would end up on the illegal market.

Starting last week, Colorado legalized recreational use of marijuana, as well as cultivation and sale subject to heavy regulations.

Washington will follow later this year, and other states will be placing measures on their ballots to do the same. One should be able to evaluate to what degree marijuana use rose after these policy changes, and indeed, many people have tried — with greater or lesser levels of statistical sophistication.

The worst arguments in favor of this proposition are those like this CADCA paper , which note that states with more liberal marijuana laws have higher rates of marijuana use among teenagers than states that do not.

The proper counterspell to such nonsense is Reverse Causal Arrows — could it not be that states with more marijuana users are more likely to pass proposals liberalizing marijuana laws?

The states involved are places like Colorado, California, Washington, and Oregon. I think that speaks for itself. A slightly more sophisticated version — used by the DEA here — takes the teenage marijuana use in a state one year before legalization of medical marijuana and compares it to the teenage marijuana use in a state one or several years after such legalization.

They often find that it has increased, and blame the increase on the new laws. This falls victim to a different confounder — marijuana use has undergone some very large swings nationwide, so the rate of increase in medical marijuana states may be the same as the rate anywhere else. Indeed, this is what was going on in California — its marijuana use actually rose slightly less than the national average.

What we want is a study that compares the average marijuana use in a set of states before liberalization to the average marijuana use in the country as a whole, and then does the same after liberalization to see if the ratio has increased. They survey thousand of high school seniors on marijuana use in seven states that decriminalize marijuana both before and for five years after the decriminalization, and find absolutely no sign of increased marijuana use in fact, there is a negative trend.

There is only a hint of some different results. Overall I think the evidence is pretty strong that decriminalization probably led to no increase in marijuana use among teens, and may at most have led to a small single-digit increase.

In practice, decriminalization does not affect the average user very much — even in states without decriminalization, marijuana possession very rarely leads to jail time. The next major milestone in cannabis history was the legalization of medical marijuana. Other studies find pretty much the same. Indeed, for about ten years after medical marijuana legalization, the federal government kept on prosecuting marijuana users even when their use accorded with state laws, and many states had so few dispensaries that in reality not a whole lot of medical marijuana was being given out.

When we examined decriminalization, we found that the studies based on surveys of teens looked pretty good, but that the one study that examined outcomes — marijuana-related ER visits — was a lot less encouraging.

I have two theories. First, maybe medical marijuana use and decriminalization increase use among adults only.

Second, we know that medical marijuana has twice as much THC as street marijuana. Nearly everyone who teaches in Colorado says there has been an explosion of marijuana-related problems since medical marijuana was legalized. Meanwhile, the actual surveys of Colorado high school students say that marijuana use, if anything, is going down.

A Colorado drug warrior has some strong objections to the survey results, but they center around not really being able to prove that there is a real downward trend which is an entirely correct complaint without denying that in fact they show no evidence at all of going up.

The consensus on medical marijuana seems to be that it does not increase teen marijuana use either, although there is some murky and suggestive evidence that it might increase illicit or dangerous marijuana use among adults. There is less information on the effects of full legalization of marijuana, which has never been tried before in the United States.

To make even wild guesses we will have to look at a few foreign countries plus some econometric simulations. No one will be surprised to hear that the first foreign country involved is the Netherlands, which was famously permissive of cannabis up until a crackdown a few years ago.

Despite popular belief they never fully legalized the drug and they were still pretty harsh on production and manufacture; distribution, on the other hand, could occur semi-openly in coffee shops.

This is true even among teenagers, and covers both heavy use as well as occasional experimentation.

The second foreign country involved is Portugal, which was maybe more of a decriminalization than a legalization case but which is forever linked with the idea of lax drug regimes in the minds of most Americans. They decriminalized all drugs including heroin and cocaine in , choosing to replace punishment with increased treatment opportunities, and as we all have been told , no one in Portugal ever used drugs ever again, or even remembers that drugs exist.

There are many more people receiving drug treatment, but that might just be because Portugal upped its drug treatment game in a separate law at the same time they decriminalized drugs. Finally, we let the economists have their say. Conclusion for this section: Marijuana smoke contains a lot of the same chemicals in tobacco smoke and so it would not be at all surprising if it had some of the same ill effects, like cardiovascular disease and lung cancer.

Much more concerning are the attempts to link marijuana to cognitive and psychiatric side effects. Meier et al analyzed a study of a thousand people in New Zealand and found that heavy marijuana use was linked to an IQ decline of 8 points. Rogeberg developed an alternative explanation — poor people saw their IQs drop in their 20s more than rich people because their IQs had been artificially inflated by schooling; what Meier et al had thought to be an effect of cannabis was really an effect of poor people having an apparent IQ drop and using cannabis more often.

Other studies, like Fried et al find the same effect, and there is a plausible biological mechanism cannabinoids something something neurotransmitters something brain maturation. As far as I can tell the finding still seems legit, and marijuana use does decrease IQ. More serious still is the link with psychosis. A number of studies have found that marijuana use is heavily correlated with development of schizophrenia and related psychotic disorders later in life.

But of course correlation is not causation, and many people have come up with alternative theories. For example, maybe people who are already kind of psychotic use marijuana to self-medicate, or just make poor life choices like starting drugs.

Maybe people of low socioeconomic status who come from broken homes are more likely to both use marijuana and get schizophrenia. Maybe some gene both makes marijuana really pleasant and increases schizophrenia risk. I know of three good studies attempting to tease out causation.

Arseneault et al checks to see which came first — the marijuana use or the psychotic symptoms — and finds it was the marijuana use, thus supporting an increase in risk from the drug. Griffith-Lendering et al try the same, and find bidirectional causation — previous marijuana use seems to predict future psychosis, but previous psychosis seems to predict future marijuana use.

A very new study from last month boxes clever and checks whether your marijuana use can predict schizophrenia in your relatives , and find that it does — presumably suggesting that genetic tendencies towards schizophrenia cause marijuana use and not vice versa although Ozy points out to meet that the relatives of marijuana users are more likely to use marijuana themselves; the plot thickens.

When a meta-analysis tries to control for all of these factors, they get a relative risk of 1. Is this true, or just the confounders they failed to pick up? One argument for the latter is that marijuana use has increased very much over the past 50 years. If marijuana use caused schizophrenia, we would expect to see much more schizophrenia, but in fact as far as anyone can tell which is not very far schizophrenia incidence is decreasing. The decrease might be due maybe! The effect of this variable is insufficiently known to pretend we can tease out some supposed contrary effect of increased marijuana use.

Also, some people say that schizophrenia is increasing in young people , so who knows? The exact nature of the marijuana-psychosis link is still very controversial. Some people say that marijuana causes psychosis. Still others say all it does is get people who would have developed psychosis eventually to develop it a few years earlier. You can read a comparison of all the different hypotheses here. This claim seems tailor-made to torture statisticians.

We know that marijuana users are definitely more likely to use other drugs later — for example, marijuana users are 85x more likely than non-marijuana users to use cocaine.

RAND comes very close to investigating this properly by saying that when the Dutch pseudo-legalized marijuana, use of harder drugs stayed stable or went down , but all their study actually shows is that the ratio of marijuana users: The best that can be said is that there is no direct causal evidence for the gateway theory and some good alternative explanations for the effect.

Let us accept their word for it and never speak of this matter again. Marijuana does not have a detectable effect on mortality and there is surprisingly scarce evidence of tobacco-like side effects.

It probably does decrease IQ if used early and often, possibly by as many as 8 IQ points. The gateway drug hypothesis is too complicated to evaluate effectively but there is no clear casual evidence in its support. The whole thing seethes with indignation and makes me want to hug the drug czar and tell him everything will be okay.

The percent of normal law-abiding people who just had a gram or two of marijuana and were thrown in jail is a rounding error, and the stories of such you read in the news are extremely dishonest read the document for examples. Federal numbers are even lower; in the entire federal prison system, they could only find 63 people imprisoned with marijuana possession as the sole crime, and those people were possessing a median of one hundred fifteen pounds of marijuana enough to make over , joints.

NORML claims that there are 40, people in prison for marijuana use, but they admit that half of those people were arrested for using harder drugs and marijuana was a tack-on charge, so they seem to agree with the Feds about around 20, pure marijuana prisoners. SAM agrees that only 0.

I see no reason to doubt any of these numbers. A much more serious problem is marijuana-related arrests, of which there are , a year. These costs are often borne by poor people who will have to give up all their savings for years to pay them back.

This finding — that marijuana and alcohol substitute for each other — has been spotted again and again. There are however a few dissenting opinions: Also, possibly marijuana use increases smoking? Overall conclusion for this section: Decriminalization and legalization of medical marijuana seem, if we are to trust the statistics in I saying they do not increase use among youth, like almost unalloyed good things.

Although there are some nagging hints of doubt, they are not especially quantifiable and therefore not amenable to analysis. Lest you think I am being unfair, note that this is well below the percent increase predicted by the survey that asked 18 year olds if they would start using marijuana if it were legal. Right now about 1. Those , teens would lose 8 IQ points each. There were road traffic accident fatalities in the US last year.

There may be additional positive effects of alcohol substitution from, for example, less liver disease. The searchable public database of utility weights for all diseases God I love the 21st century tells me that schizophrenia has a QALY weight of 0.

It generally starts around 20 and lasts a lifetime, so each case of schizophrenia costs us 0. Therefore, the total burden of the 3, added schizophrenia cases is 43 kiloQALYs. My own survey tells me that being in prison has a QALY weight around 0.

Assume the average road traffic death occurs at age 30, costing 40 years of potential future life. The arrests are going to require even more fudging than normal. I am going to arbitrarily round this up to one one-hundredth of a QALY to account for emotional trauma and the burden of fines, then even more arbitrarily round this up to a tenth of a QALY to account for possibility of getting a criminal record.

This sets the burden of , arrests at 70 kiloQALYs. Costs from legalization compared to current system: Except that this is extremely speculative and irresponsible. By far the largest component of the benefits of legalization turned out to be the effect on road traffic accidents, which is based on only two studies and which may on further research turn out to be a cost. And by far the largest component of the costs of legalization turned out to be the effect on IQ, and we had to totally-wild-guess the QALY cost of an IQ point loss.

The wiggle room in my ignorance and assumptions is more than large enough to cover the small gap between the two policies in the results. There is not a sufficiently obvious order-of-magnitude difference between the costs and benefits of marijuana legalization for a evidence-based utilitarian analysis of costs and benefits to inform the debate.

You may return to your regularly scheduled wild speculation and shrill accusations. For example, it suggests that whether marijuana legalization is positive or negative on net depends almost entirely on small changes in the road traffic accident rate. We should probably stop caring about health effects of marijuana and about imprisonment for marijuana-related offenses, and concentrate all of our research and political energy on how marijuana affects driving.

People in the comments have pointed out several important factors left out, including: The tricky one would be comparing the costs of the drug war. Compare alcohol, which is a hard drug and hugely harmful, but so stupidly easy to make that banning it is handing buckets of free money to organised crime, blindness and brain damage from methanol in badly-distilled spirits, etc.

For more on what the actual costs of getting arrested are, as well as how hard you have to try to get arrested as a white professional, I recommend this piece. Black people are proportionally more likely to be arrested by about four times , but , white people were still arrested for possession of marijuana each year — and they still make up well above half of the total. Ah, I was going by memory. Wikipedia says blacks are Say if someone first gains a criminal record at 25 and it has a lasting negative impact for the length of their career until age 65, it only needs to have a yearly impact of 0.

So it does match up to what outside observers or at least whichever officer checked the box perceive. Could it be that when marijuana is legal more people are happy to admit that their medical emergency is marijuana-related? Or, indeed, to go to hospital? It was discussed in the paper.

The 8 IQ points statistic is very interesting. What would be really interesting to know is that same figure for alcohol. How much does drinking alcohol at a young age stunt your IQ? Each way it could turn out opens a new perspective to the question. I am much less convinced of the value of IQ scores even as someone of stupendously high IQ and non-stupendous real-world achievements as I am given the recent data on motivation as a factor in IQ scores.

Anyone questioning this will have seen the studies I mean. Here is a criticism of popular interpretations of that study. The main issue is that the predictive validity of IQ testing, which is the whole reason we care about IQ, is not challenged by the results of that study. But there are other issues as well. You skipped hedonistic effects! Maybe take a stab in the dark for QALY-adjustment-for-marijuana-being-difficult-and-risky-to-acquire?

For a lower bound, guess the number of people who would give up one year of their life to decriminalize marijuana. Per my alcohol example above. Which is where e. I know how easy it is to make because my house is basically a mead brewery. Any thoughts on actual medical value, as compared with synthetic cannabinoids that followed more traditional routes for testing, approval, manufacturing, and regulation?

My impression from talking to advocates of medical marijuana was that it was basically a play for increased acceptance of general use. Most of the questions are tradeoffs for marijuana legalization, and assuming that the answers bear even a slight semblance to reality suggest non-negligible QALYs. Smoking a couple nights a week roughly corresponding to drinking habits gives more than a percent increase in quality of life in less than a percent of a year?

Do you expect the average person to find it more than twice as pleasant as normal experience, or that it would have positive flow-through effects on the rest of their life?

I expect the median person to have a negligible difference in utility. I expect a small number of people to provide most of the utility here. I predict with high confidence that more than 1 out of people is willing to make this trade, and that this is a conservative estimate.

The number of people willing to give up one year of life for one year of access to marijuana is much, much less than 0. What about the availability of the synthetic cannabinoids prescription only? Also, a couple of links are broken because of the inclusion of a couple of extraneous asterisks. However, I would have guessed that the main result of legalization would be that much of the stigma attached to marijuana use would gradually disappear over the course of a decade or two.

Same deal for marijuana as a gateway drug: I would expect that a culture more tolerant of drug use would develop over the course of a decade or more. Of course this is speculative and hard to test, but long term social effects are important.

As cars become increasingly automated the effect of legalization on car accidents should drop. So your analysis suggests we expect legalizing to be a net benefit now, but become a net cost in ten-twenty years? True, but statistics for medical marijuana users tend to skew much younger than you would suspect if you naively thought everyone who gets a script for medical marijuana is actually getting it for medical reasons.

Seconded, adding that my own use of legal hallucinogens has always led to insight, artistic and not, that have held up well in sobriety. Any utilitarian analysis of drug use cannot leave out a consideration of the positive good that comes out of drug use. I would very much recommend what Mark Kleiman and others have written on the subject mostly at samefacts.

One major point he has made, which this touches on, is that the extent to which marijuana substitutes for or complements alcohol overwhelms pretty much all other effects. If weed decreases drinking significantly, than even if you make very pessimistic assumptions on every other axis legalization is still probably a very good idea, and vice versa. As can be observed in the alcohol market, a large majority of sales comes from the small minority of consumers who abuse it, meaning that advertisers have a huge incentive to encourage overuse.

For this reason Kleiman favors legalizing use and production by individuals and nonprofit coops, but not commercial sale. The ban on tobacco billboards might not be a law, but a voluntary restriction, agreed to in return for resolving the lawsuit over lying about cancer. An advertizing ban would make things better, but regardless of the specific mechanisms involved, full legalization will put a large amount of wealth and therefor influence in the hands of agents with a strong incentive to increase abuse.

Kleiman is a professor of public policy at UCLA and blogger at samefacts. Last year he became the top marijuana policy advisor to the Washington state government. Respectfully, I would ponder how much difference the legalization of advertising would have on the use of pot. Two packs a day 40 cigarettes is a pretty reasonable number for a heavy smoker, but I doubt even Wiz Khalifa regularly smokes 40 joints a day. This whole thing reads to me like a discussion of prohibition that somehow fails to mention organized crime.

The whole idea behind prohibition was that alcohol has all these bad effects and if you named they would go away. And you can argue about how much alcohol related problems increased or decreased during and after prohibition, but there was a huge secondary crime problem that seems crazy to ignore.

Now I have no idea how much is going to change with just marijuana legalization, but the effect seems like it could potentially be large. Especially if other drugs are displaced. Cannabis is a plant. It contains over 80 neurologically active chemicals. The composition varies a lot based on varietal.

The chemicals that have painkilling properties are not the ones that make you high. THC is not a very good painkiller. That kind of experimentation is in its infancy. It could lead to drugs cannabis-extracted or synthetic which are safer, more effective, and more reliable than any medical marijuana is now. The chronically ill often have to find kludges that work for them, by trial and error and informal networks of advice. There ought to be a tighter feedback loop between medical science and what people actually do to get relief.

The cannabidiol thing is folk knowledge. When science is working right, folk knowledge will eventually get tested by experiments and either confirmed or disconfirmed. In the introduction, you wrote: I was previously in favor of full legalization. If I were to take these results at face value, then I would switch to only supporting decriminalization: Reduced traffic fatalities is only part of it.

Intuitively, it seems like an alcoholic is much more likely to do active harm to the people around them than a marijuana addict is. Since the overall net effect of full legalization remains unclear, the heuristic that things should only be banned if their harms can be clearly demonstrated leads me to continue supporting full legalization, though with somewhat more reservations than before.

The proper response would be to stop caring about marijuana in general and just concentrate on reducing driving accidents. I hope you meant to imply this? In the long run we should stop caring about everything but x-risk and maybe malaria. For at least some of them, it is not victims of psychosis that they bear in mind but the hippies that irritated them in decades past.

In fairness, I do find that marijuana, like alcohol, makes people more tedious. Am I being unfair or was Hendrix an exception? It kills your willpower and makes you lazy, but it also lets you interpret the world in a different light and therefore makes you more creative and a more original thinker. Our anecdotal neighbor, a disabled veteran, got a license for medical marijuana. This enabled him to cut out seventy of the pain pills he had been taking per day.

At least the pain pills he ordered from the VA pharmacy.

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The Current Status of Medical Marijuana - In the year , Michigan voted in the use of marijuana for medical purposes. I will be exploring two papers, the first is Prohibition Works: Keeping Marijuana Illegal, the second is Legalization of Marijuana.

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The tricky one would be comparing the costs of the drug war. Compare alcohol, which is a hard drug and hugely harmful, but so stupidly easy to make that banning it is handing buckets of free money to organised crime, blindness and brain damage from methanol in badly-distilled spirits, etc.. I do concur that busting people’s asses for driving while .

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Aug 08,  · Over the last year, Dr. Sanjay Gupta has been working on a new documentary called "Weed." The title "Weed" may sound cavalier, but the content is not. Marijuana is now legal in two states, and legal for medical use in 23 states and the District of Columbia. Polls show the majority of Americans support cannabis legalization, and more and more of the country is joining the legalization trend.