By Thomas W. Clark, addictions researcher, Boston

KEEP MARIJUANA ILLEGAL - FOR TEENS

Recent surveys, both in Canada and the US, have documented a dramatic rise in marijuana use among adolescents since 1992. This increase has caused much official consternation, and after four years of relative silence on the issue the Clinton administration will mount a new, 195 million dollar media campaign against drugs, with adolescent marijuana use a major focus.

Teens, it turns out, don’t seem particularly worried about pot. The rise in the number of young people who have tried marijuana over the last five years has been accompanied by a decline in the risk they perceive of smoking it occasionally. Meanwhile, the use of hard drugs such as cocaine and heroin has stayed far below that of marijuana, and adolescents perceive these substances as far more risky to use than pot.

Perhaps teens recognize what the National Institute on Drug Abuse (NIDA) has been at pains recently to deny: that there are valid distinctions between soft and hard drugs in addictiveness and potential for harm, and that such distinctions can inform one’s choice of psychoactive substance. Occasional use of marijuana is perceived by many, mostly older, adolescents as no more harmful than using alcohol or tobacco.

Teens, in short, are not stupid, and in this case their perceptions are pretty much on the mark. Although certainly not risk free (few psychoactive substances are), marijuana compares favorably to alcohol and tobacco with regard to health hazards and potential for abuse. Consequently, the attempt to tar it with the same brush as cocaine and heroin simply backfires, undercutting the credibility of both NIDA and beleaguered parents, who are asked to instill fear of the "evil weed" into their increasingly skeptical children.

Much is made of pot being a gateway drug which leads to further experimentation and addiction, but as even NIDA admits, most of those who try marijuana don’t progress to other drugs or become addicts. Except for powerfully reinforcing drugs like cocaine, heroin and methamphetamine, it’s not the particular substance one encounters that usually leads to abuse.

Rather, it’s a combination of risk factors - parents’ and peers’ substance use, poor social adjustment, low expectations of achievement, and idle after school hours - which increase the probability of abuse and dependence. If marijuana is a gateway to hard drugs at all, it is most likely due to its illicit and counter-cultural status: the purveyors of pot can put your adolescent in touch with the local crack connection, while the glamour of defying the ban on marijuana may transfer to using more dangerous substances.

None of this is to deny that using marijuana has its risks and long term effects, and its use by developing adolescents should therefore remain illegal and be strongly discouraged. As the disastrous health consequences of cigarette smoking make clear, the psychoactive ingredient of marijuana, delta-9-tetrahydrocannabinol (THC), would best be ingested without inhaling the carcinogenic byproducts of a burning plant. (Marijuana may actually be worse than tobacco in this respect.)

While not nearly as devastating as chronic alcoholism, the regular and prolonged use of THC may compromise short term memory and perhaps other cognitive functions, and preliminary research, although by no means definitive, has also implicated THC as an immune system suppressor. Even though non-smoked THC is approved for medical purposes, and thus has been found safe and effective for some applications, its recreational use (as for alcohol and nicotine) should remain occasional, and restricted to those over 21. (In Canada, the legal age for alcohol use is 18 or 19, depending on the province, and for purchase of tobacco is 18.) Pregnant women should avoid it, and the penalties that now apply to drunk driving should also apply to those who drive under the influence of THC.
(Ed. note: I think that the legal age for marijuana should be 18. Off topic, I think that this should also be the legal age for alcohol. If a person is old enough to vote and fight for the country, then they are old enough to smoke a joint or drink a beer. Although alcohol use causes a lot of problems with young people, they should be taught to drink responsibly, not treated like children.)

Lab animals cannot be induced to consistently self-administer THC, as they can with opiates, amphetamines, cocaine, alcohol and nicotine. Nevertheless, NIDA has made much of recent research, published in the journal Science, showing that cannabis acts on the same reward mechanisms in the brain as do other drugs.

Rats given large and regular doses of THC or a synthetic equivalent showed withdrawal symptoms when doses were abruptly stopped. (Ed. note: It is surprising that this author would not know that this occurred only after the injection of s synthetic "blocker.") But this rather unsurprising result, which holds for alcohol and nicotine as well, doesn’t show THC to be especially problematic, just that its heavy use may in some cases lead to habituation. The fact remains that marijuana is simply not in the same class as heroin and crack, drugs which act far more powerfully and specifically on those brain sites implicated in dependence. This means that its increased availability following decriminalization for adults would not result, as some fear, in an epidemic of cannabis abuse.

But the horse is already well clear of the barn. In recent surveys many teens say that it’s nearly as easy to get marijuana as alcohol and cigarettes. Drug enforcement hawks will reply that this means stricter sanctions are necessary, but how strict are we willing to get to suppress a drug that, used in moderation and in a non-smoked form, is no more risky (subtracting the risks of criminal prosecution) than having an occasional glass of wine with dinner?

Such policy questions should be addressed while keeping in mind the contingent history of our relationship with psychoactive substances. Since things could have turned out quite differently, we shouldn’t suppose that our current legal selection of drugs is ultimately correct. Marijuana, not tobacco, might have become the fashionable ingredient for cigarettes in European salons, and alcohol might now be illegal had prohibition survived. What then drives the ideology that would forbid any marijuana use, and that absurdly classifies it with much more dangerous substances?

Some opponents of decriminalizing marijuana fear that it would set us on a slippery slope toward accepting any and all drugs, but this fear is irrational precisely because all drugs are not the same. We justly balk at sanctioning the use of substances that are highly addictive and harmful, as in the growing effort to curtail tobacco sales to minors. Other opponents, most of them hardly teetotalers, share the conventional prejudice that getting high on pot is somehow morally suspect. They suppose that some intoxicants (the currently legal ones, it just so happens) are fine while the rest are corrupting, and that therefore we shouldn’t expand our repertoire of even mildly altered states. But if the effects of alcohol, nicotine and caffeine used in moderation are perfectly acceptable, why not those of THC, used in moderation?

Some will object that moderation in the use of marijuana is exactly what cannot be guaranteed; that decriminalizing pot for adults would inevitably increase the number of users (some teenagers included) that abuse the drug and fall prey to its possibly damaging long-term effects. Granting this point, the issue then becomes whether the social and personal benefits of lifting the ban on marijuana outweigh the harms of a potential increase in abuse.

This is exactly parallel to the dilemma faced by those who wanted to end alcohol prohibition: since prohibition helped to reduce alcohol-related addiction, disease and accidents, how could one responsibly advocate its repeal? Nevertheless, prohibition ended when it became clear that the personal liberty to enjoy alcohol, restrained by reasonable public health and law enforcement safeguards, was deemed a greater good than heavy-handed attempts to reduce alcohol-related harms.

Similarly, it is difficult to justify the staggering costs of the marijuana ban - the person-hours of drug enforcement, the ultimately futile attempts at crop eradication, the overloaded courts, and the draconian jail sentences (in the US) - when weighed against the small increase in abuse that decriminalization for adults might entail. If we want proportionality between the sanctions against a drug and its potential for harm, then criminal penalties for personal marijuana use should be abolished.

If we fail to reconsider our current policy, and continue to exaggerate the evils of any and all cannabis use, teenagers will judge adults hypocritical and continue to light up joints as they chant "Just say no!". A better course would be to introduce teens to the responsibilities, pleasures and risks of adult life by informing them accurately about drugs and addiction, just as we do (or should do) for sexuality, diet, exercise and careers. A scientifically grounded consideration of psychoactive substances, unclouded by the prohibitionist reflex, will show THC, like alcohol, to be comparatively harmless when used responsibly by adults. By being straight with kids, and ourselves, about pot’s active ingredient, we’ll gain credibility and strengthen the case against truly dangerous and addictive drugs. If we respect our children’s intelligence, the chances are they’ll behave more intelligently.

In our public health campaigns we should vigorously advise against smoking marijuana, while exploring safer means of ingesting recreational THC which standardize a moderate dose and guarantee purity.

(Ed. note: The experience of Marinol users suggests that the use of THC alone probably poses greater risks and far less pleasure than whole marijuana. Vaporization will eliminate most of the risk for heavy smokers and the risk to occasional smokers is too small to justify worry.)

As with alcohol and nicotine, we should limit its availability to adolescents by establishing a minimum age for possession, enforced by appropriate sanctions. Use of THC by adults could be regulated by prohibiting any sales or public consumption, with civil penalties - not jail sentences - for infractions. Whatever course we adopt, there are clearly many policy options short of commercial legalization that would improve upon the absurdly punitive status quo. There would, of course, be many devils in the details of regulating decriminalization, but none nearly as onerous as our foolish obsession with attaining a cannabis-free culture.

Even with the most enlightened policies, some cannabis use by teens will inevitably continue, but we won’t be denying them the drug on the spurious basis that there is something especially bad about THC. We’ll be denying it for the same good reasons we deny them nicotine, alcohol, or any other psychoactive substance: successful physical and psychological maturation is jeopardized by adolescent drug use, and at their age they’ve got more important things to do, such as fashioning a life that doesn’t revolve around looking cool or getting high.