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An Analysis of Marijuana Policy INTRODUCTION Since the early 1960s the use of marijuana as an intoxi- cant by a growing proportion of the American population has been an issue of major national concern. Despite repeated warnings of possible adverse health consequences and persistent efforts by law enforcement agencies to restrict the supply and use of marijuana, available data indicate that experimentation with or regular use of the drug is no longer restricted to a small minority of Amer- icans. In 1979, for example, 68 percent of young adults between the ages of 18 and 25 reported having tried mari- juana; 35.4 percent reported having used marijuana in the last month. Among adults over age 26, the propor- tion having ever used marijuana has more than doubled since 1971, from 9.2 percent to 19.6 percent (Fishburne et al., 1980; see Table 1, below). Although "the marijuana problem" may be viewed as of recent origin, marijuana is not-a new drug. The canna- bis plant has been cultivated and used both for its in- toxicating properties and for its fiber (hemp) throughout the world for more than 10,000 years (Abel, 1980~. At various times and places attempts have been made to restrict its use as an intoxicant; at other times and places its virtues have been extolled for medical pur- poses, and it has played a significant role in religious ritual. Because cannabis is easily grown--indeed, it is one of the hardiest of all plant ~pecies--its resin has been used for centuries along with tobacco, fermented distillates of grains and fruits (alcohol), and opium derivatives as one means of relieving stresses associ- ated with daily life. 1

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2 Despite its long history, the use of cannabis as an intoxicant was relatively unknown in the United States until the latter part of the nineteenth century, and even then its use as a drug was restricted to a tiny fraction of the population, primarily immigrants from Mexico. The first efforts to restrict its use in this country did not occur until 1911, when Congress, which at that time was considering proposals for federal antinarcotics legislation, listened to arguments that cannabis should be included in the list of illegal drugs. That effort failed, but during the next two decades a number of state legislatures moved to prohibit the possession of marijuana unless prescribed by a physician. It was not until 1937, when the Marijuana Tax Law was enacted, that the federal government became involved in the attempt to control its use. Even this law recognized the industrial uses of hemp and also exempted the seeds of the plant, which were then being sold as bird feed. In 1956, Congress included marijuana in the Narcotics Act of that year and, in 1961, the United Nations adopted the Single Convention on Narcotic Drugs, the terms of which state that each participating country could "adopt such measures as may be necessary to prevent misuse of, and illicit traffic in, the leaves of the cannabis plant." Congress approved participation in the convention in 1967 and three years later passed the Comprehensive Drug Abuse Prevention and Control Act. which provides the basis for current federal prohibitions . . . regarc one marijuana use. Despite this history it was not until the 1960s that most Americans became aware of marijuana. The political and cultural protests of that period focused public at- tention on young people, their life-styles, and their use of drugs, including marijuana. That period created the context in which public policies regarding marijuana use have been debated since the early 1970s. As Abel (1980) points out, for the first time marijuana restricted to minority groups and fringe use was not elements of society: many of the new users were native-born, middle- class, white college students. Without doubt, the polit- ical and cultural context in which marijuana emerged as an issue of national concern has strongly influenced the subsequent policy debate about its use. The policy debate about marijuana use has also brought into sharp focus two conflicting but deeply held beliefs of large and overlapping segments of the American popu- lation. To many, the use of drugs of any kind solely for ., ~ . . . . . . . .

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3 the purpose of producing states of intoxication is abhor- rent, entirely apart from any presumed health effects. At the same time, many people strongly defend the right of individuals to privately indulge their desires, so long as others are not adversely affected. Adding to the complexity of the issues are continuing uncertainties about the health and developmental consequences of mari- juana use, concern over the growing number of adolescent users, the social consequences of prosecuting otherwise law-abiding citizens for possession and use of marijuana, the relationship between the distribution of marijuana and that of other illegal drugs, the costs of enforcement of current laws, and the economic implications of the persistence of very large illegal markets. The next section of this report presents a brief sum- mary of existing evidence regarding the health conse- quences of marijuana use, drawing heavily on the recently completed study by the Institute of Medicine. The third section summarizes existing federal and state laws re- lating to the supply and use of marijuana. The fourth section of the report reviews the conclusions of the report of the National Commission on Marijuana and Drug Abuse (1972~. The next two sections deal, respectively, with policies regarding the use and the supply of mari- juana. The two final sections present a summary of the committee's conclusions regarding major policy options and recommendations for research needed to more ade- quately assess those options. THE DANGERS OF MARIJUANA Marijuana is not a harmless drug. Although available evidence suggests that marijuana may be less likely than opiates, barbiturates, or alcohol to induce psychologi- cal and physical dependence in its users, it has the capacity to reduce the effective functioning of individ- uals under its influence, and prolonged or excessive use may cause serious harmful biological and social effects in many users. The recent report, Marijuana and Health, of the Insti- tute of Medicine (1982 5 [reproduced in the appendix]) concludes: The scientific evidence published to date indicates that marijuana has a broad range of psychological and biological effects, some of

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4 which, at least under certain conditions, are harmful to human health. Unfortunately, the available information does not tell us how ser- ious this risk may be. Overall, the report concludes (p. 5~: [W]hat little we know for certain about the ef- fects of marijuana on human health--and all that we have reason to suspect--justifies serious national concern. The complete summary of the Institute of Medicine report appears as the appendix to this report. Over the past 40 years, marijuana has been accused of causing an array of antisocial effects, including: in the 1930s, provoking crime and violence; in the early 1950s, leading to heroin addiction; and in the late 1960s, making people passive, lowering motivation and productivity, and destroying the American work ethic in young people. Although beliefs in these effects persist among many people, they have not been substantiated by scientific evidence. Concerns about how marijuana affects citizenship, motivation, and job performance have become less salient in recent years as marijuana has moved more into the mainstream of society and has become less exclusively associated with radicals, hippies, or disadvantaged minorities. Though there is still widespread belief that heavy marijuana use may be incompatible with a responsible, productive life, evidence that marijuana has not adversely affected either the productivity or the sense of social responsibility of some groups of users (see, e.g., Hochman and Brill, 1973) has tempered earlier fears of a widespread "amotivational syndrome." Research that correlates marijuana use with undesirable behavior, such as alienation or inattention to school studies, has not established the direction of causality or ruled out spurious associations (see, e.g., Beachy et al., 1979~. This issue, however, continues to be the subject of lively controversy and the Institute of Medi- cine report (1982:125) concludes that "it appears likely that both self-selection and authentic drug effects con- tribute to the 'motivational' problems seen in some chronic marijuana users." Recently, a body of literature has accumulated that reports on links between marijuana use and such health

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5 impairments as lung disease, chromosome damage, reduced reproductive function, and brain dysfunction (summarized in Institute of Medicine, 1982, and National Institute on Drug Abuse, 1980~. In some areas--for example, effects on the nervous system and behavior and on the cardio- vascular and respiratory systems--there is clear evidence that marijuana produces acute short-te~m effects (Insti- tute of Medicine, 1982:2,3~: With a severity directly related to dose, marijuana impairs motor coordination and affects tracking ability and sensory and perceptual functions impor- tant for safe driving and the operation of other machines. . . . [It also] increases the work of the heart, usually by raising the heart rate and, in some persons, by raising blood pressure. There is as yet no such clear evidence on the possible long-tenm effects in these areas, or of other potential health consequences of marijuana use; further research is needed. In addition, most studies on human popula- tions have been laboratory studies of young, healthy adult males. Differential effects of marijuana use on the elderly, on pregnant women, on groups that are psychiatrically vulnerable or at risk tor disease or dysfunction, and particularly on adolescents have not been studied systematically. In our view, the most troublesome aspects of mari- juana use are its potential effects on the development of adolescents. Parents as well as a number of clini- cians and researchers are concerned that the social and intellectual development of teenagers may be harmed by chronic marijuana use. There is good evidence that intoxication may seriously impair such important skills as comprehension and retention of newly presented educa- tional materials (Institute of Medicine, 1982~. Rapidly growing tissues have been shown to be particularly vul- nerable to some, although by no means all, toxic agents, and there is at least a possibility that toxic effects may be subtle and not clearly manifest until adulthood. Scientifically, these are difficult relationships to identify, and the research to date is still insuf ficient to strongly support any relationship. Perhaps more significant than any lasting biological effect is the effect of the drug in different patterns of use on emotional development, on the formation of habits, and on the acquisition of coping skills for

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6 stress situations. Indeed, although the many issues raised by the use of intoxicants to escape stressful challenge have not been systematically studied, the evi- dent attractiveness of marijuana to many adolescents, and its possible dose-related interference with the study and hard work needed for intellectual development in the crucial high school years, make this a special matter for concern. This is particularly so in light of the fact that, unlike alcohol, marijuana is used by many adolescents during school hours. Finally, reports of the effects of marijuana use on automobile driving skills are worrisome. This Committee has reviewed the scientific literature surveys of marijuana effects on health and behavior, in- cluding the major recent study conducted by the Institute of Medicine (1982) and those by the National Institute on Drug Abuse (1979; 1980), Tashkin et al. (1978), Nahas (1977), and Fried (1977~. We agree with the conclusion of the Institute of Medicine report that it is likely that long-term heavy marijuana use will be shown to re- sult in measurable damage to health, just as long-term chronic tobacco and alcohol use have proven to cause such damage. It is evident that the full impact of marijuana use on human health will not be clear without careful epidemiological studies involving substantial popula- tions of users--a matter of some decades--even though it is predictable that this drug--like all others--will cause harm in some of its users, particularly in its heaviest users, and among these, in its heaviest adoles- cent users. At this time, however, our judgment as to behavioral and health-related hazards is that the re- search has not established a danger both large and grave enough to override all other factors affecting a policy Decision. OVERVIEW OF CURRENT MARIJUANA POLICIES Current federal and state marijuana laws are in part governed by international treaty. The major federal law relevant to marijuana is the Comprehensive Drug Abuse Prevention and Control Act of 1970, which repealed all prior federal legislation and reduced federal penalties for possession and sale. Although marijuana possession and sale are still prohibited, possession has been re- duced from a felony to a misdemeanor offense; the maxi- mum penalty for a first offense is $5,000 and one year's

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imprisonment. The Act also provides for conditional dis- charge, by which first offenders found guilty of simple possession or casual transfer (which is treated as simple possession) may be placed on probation for up to one year (Congressional Digest, 1979~. The Uniform Controlled Substance Act of 1970, drafted by the National Conference of Commissioners on Uniform State Laws, was designed to make state laws more compat- ible with the new federal law. Like the federal act, the Uniform Act reclassified marijuana as a hallucinogen rather than a narcotic and reduced the penalty for pos- session from the felony to the misdemeanor level; a majority of the states have adopted the Uniform Act. Eleven states have withdrawn the criminal sanction from possession for personal use. In these states, arrest has been replaced with a traffic-ticket type of citation and a small fine is the sole al lowable penalty. About 30 states include some provision for conditional dis- charge of first offenders, and about a dozen of them provide for all records of the offense to be expunged. The Alaska Supreme Court ruled in 1975 that possession for personal use by adults at home was protected by the constitutional right to privacy and hence was not subject to any penalty (Rosenthal, 1979~. State penalties for second-offense possession and for selling marijuana are extremely variable. (See National Organization for the Reform of Marijuana Laws and Center for Study of Non-Medical Drug Use, 1979, for summary tables of state marijuana laws.) Sale is almost always a felony, with maximum sentences ranging from two years to life, although casual transfer, or "accommodation," is sometimes exempt from felony treatment. All but 15 jurisdictions punish cultivation as heavily as they do sale; the Uniform Act includes the two in the same classification (manufacture), with the same penalty provisions. Federal prohibition of small-scale possession is vir- tually unenforced. At the March 1977 House of Represen- tatives hearings on decriminalization, the chief of the criminal division of the Department of Justice testified that the federal government no longer effectively prose- cutes the use of marijuana, "nor do we, under any conceivable way, in the Federal Government have the resources to do so" (Select Committee on Narcotics Abuse and Control, 1977:13~. In terms of its effects from a law enforcement point of view, the present official fed- eral policy of complete prohibition does not differ in ',,

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8 fact from a policy of prohibition of supply only. Com- plete prohibition is the federal law, but partial prohi- bition is the practice. However, the law, even though partly unenforced, has probably had a restraining in- f luence on the willingness of states to adopt policies of less than complete prohibition. The states tradi- tionally have followed the federal lead in drug abuse legislation, although they are not legally required to do so (see the testimony of Jay Miller, American Civil Liberties Union, to the Select Committee on Narcotics Abuse and Control, 1977~. In summary, in most states and according to federal law, U.S. marijuana policy is one of complete prohibition--that is, prohibition of both supply and use. Major alternatives to complete prohibition include prohibition of supply only--called partial prohibition-- and regulation.* Prohibition of supply only means having no penalty (or only civil penalties) for use, possession, or, sometimes, "casual transfer" of small quantities of marl juana, while having criminal penalties for manufac- ture, importation, or commercial sale of marijuana. Regulation means not only eliminating penalties for use but also allowing controlled production and distribution. Within each of the three broad policy options-- complete prohibition, prohibition of supply only, and regulation--numerous subsidiary policy choices exist. For example, a policy of complete prohibition necessi- tates decisions about the resources to be devoted to en- forcement, the appropriate penalties to be imposed for violations, and whether marijuana should be made avail- able for any medical uses. Under a policy of prohibi- tion of supply only, decisions must still be made about penalties and permitted medical uses. In addition, one must also determine how to distinguish between users *In this discussion, we use the terms "complete prohibi- tion, " and "prohibition of supply and use" interchange- ably. We also use the tens "partial prohibition," "prohibition of supply only," and "decriminalization" as equivalent. We generally prefer the terms "partial pro- hibition," or "prohibition of supply only" since many people seem to regard decriminalization as the equivalent of legalization or regulation--which it most certainly is not. (The policy of partial prohibition has also been called the vice model.) Finally, we use "regulation" and "legalization" as equivalent terms.

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9 and suppliers; whether cultivation should be permitted ; how stronger preparations of the cannabis plant, such as hashish, should be treated; whether to criminalize amall- scale casual transfers, made with or without payment; and what should be done about certain specific behaviors, such as the public use of marijuana and the operation of motor vehicles under the influence of the drug. Under a policy of regulation, some of the issues to be decided are the type of control system (e.g., state monopoly or licensed sale), the rules as to potency and quality, and appropriate penalties for violation of the system's rules. The variety of choices within each of the broad policy options suggests that none can be characterized in a monolithic way. Some regulatory systems could be so stringent as to have results similar to prohibitory laws: e.g., a regulatory system that raised the price drastically above what the illegal -=rket charges. Similarly, lack of enforcement could strongly reduce the impact of a prohibitory option. As we have already noted, this latter effect has already occurred in some jurisdictions in which the law provides for complete prohibition but users are not in fact prosecuted. A REVIEW OF THE REPORT OF THE NATIONAL COMMISSION ON MARIJUANA AND DRUG ABUSE An attempt to describe a full array of policy options together with associated benefits and detriments of each of them was made by the National Commission on Marijuana and Drug Abuse in its 1972 report, Marijuana: A Signal of Misunderstanding. With respect to the major policy choices, the Commission did a thorough job. The members and staff recognized the limited knowledge base for their deliberations and subsequently recommended that a second commission be appointed to review the situation four years later. Such a follow-up commission was never appointed. It seems appropriate, then, that this Come mittee reappraise the Commiasion's work in light of subsequent research findings, especially those relating to recent changes in marijuana policies. The Commission examined the spectrum of social poli- cies available to control marijuana use and the benefits and detriments of implementing each policy. m e legal alternatives presented included those identified above: complete prohibition; prohibition of supply only; and

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10 regulatory approaches. The Commission emphasized that choosing among the three approaches requires considera- tion of the social milieu, cultural values, and practi- calities of implementation. The Commission considered such social conditions particularly important in exam- ining marijuana controls because both use of the drug and the laws prohibiting supply and use had symbolic importance, representing a clash of values between a dominant culture that opposed marijuana use and a large minority that either used marijuana or condoned its use The probable effects of the various policies considered by the Commission include changes in use patterns, en- forcement costs, and influence on related social concerns such as the marketing of other illicit drugs and general respect for law. The Commission commented on all three broad policy options. It suggested first that total prohibition has resulted in costly enforcement, alienation of the young, discrimination through selective enforcement, some deter- rence of supply (especially to middle-aged and middle- class potential users), but minimal deterrence of use by those with access to the drug. Second, the Commission stated its belief that prohibition of supply only would support the official policy of discouraging use, but at the same time would recognize the practical difficulties of attempting to eliminate use. The report listed a number of choices that might be made under a system of partial prohibition and described some of the practical problems they might entail (e.g., the need to distin- guish between casual and commercial distributors). Finally, the Commission described regulation as a policy that only mildly disapproved of occasional use and that concentrated on controlling excessive use, but was mostly designed to lower the costs of prohibiting the drug. The Commission argued that marijuana consumption would increase considerably if complete prohibition were replaced by regulation. In addition, the Commission considered a major drawback of any regulatory system to be that its elimination of the main symbol of society's disapproval--criminal sanctions--would cause resentment among the nonuser majority of the population. Marijuana was described as being symbolic of countercultural life- styles: "the drug's symbolism creates a risk of strong political reaction to any liberalization of the present laws by older members of the society" (National Commis- sion on Marijuana and Drug Abuse, 1972, Appendix Volume II:1149~.

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11 On balance, the Commission concluded that, since the threat of punishment had not apparently deterred the millions of people who had already used marijuana, the replacement of complete by partial prohibition would not produce a significant increase in marijuana use. Conse- quently, the Commission recommended that individual mari- juana users should not be subject to criminal prosecution for their private use or possession of small amounts of the drug, and that, on balance, the best policy was one of prohibition of supply only. In accordance with this view, the Commission recommended that federal and ~ tate laws should be amended to achieve partial prohibition. In the decade since the Commission report, a number of states have changed their laws in varying ways. These legal changes can be viewed as natural experiments, and one can use the data from them to reassess the Commis- sion's conclusions regarding these policies. THE USE OF MARIJUANA: COMPARING COMPLETE AND PARTIAL PROHIBITION To compare the two types of marijuana control policies presently used in the United States--prohibition of supply and use and prohibition of supply only--we need to consider only the one particular in which they differ: the application of criminal sanctions against marijuana users. To compare the effects of the two policies, we can examine the effects of the prohibition of use and determine whether prohibition results in more costs than benefits or vice ver$a. In recent years the prohibition of marijuana use has come under increasing criticism. Many students of the U.S. marijuana situation, including the National Commis- sion on Marijuana and Drug Abuse, members of Congress, political analysts, and legal experts, have suggested that existing laws prohibiting marijuana use be repealed. These suggestions have been prompted by the failure of current policies to deter large numbers of users, the consequent criminalization of large numbers of young Americans, and the high social costs of such law en- forcement. A number of professional associations ant agencies have also gone on record in support of the removal of all criminal penalties for the private pos session and use of marijuana as a means of reducing the economic costs of law enforcement and the social costs of arrest or imprisonment (criminalization) of young

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22 CO - C) - 0 o CO o so C) U. s so :e 0 _, a; o v lo P4 c EN em He ED off` o 0 0 o' 0 UP ~ ,_ Cal ~ c A .O ~o ~ ~0 ~ ~e O0 ~0\ 0 ~ ~e~ OO ~O ID ~_' - 0`0 UPUP e ~O e ~UP0` 0UP ~Id ~~ Cal0 O~ - ~O lo . ~1 0 C: : 0 0 0 a: ~:^ _. ~_1 0 _t O (U C ^' e'4 ~ ~C O ~ ~ ~erl E! _1 ~V 0 =~ ~ O 0 3 o v 0 0 o 0 C~ o S" o o o C o e~ e ~0 . 0 0 er1 0 0 _' JJ o 0 ~C o e :^ e ~80 ~ ~1 O ~1 ~u,

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23 had leveled off by 1979 and has since shown a decline. In an annual survey of national apples of some 17,000 high school seniors, Johnston et al. (1982) found that 7.0 percent of the class of 1981 reported tally mari- juana use, compared with 6.0 percent in 1975 ant 10.7 percent in 1978, the peak gear (see Table 2~. There has been a similar bent in initial use at younger ages. Although the present policy of prohibition of supply is not preventing the current levels of marijuana use, including use among the very young, it is probable that most strategies under a regulatory policy would result in an overall increase in use. Even more important than overall use rates, however, are likely changes in con- numption patterns; such patterns are the most difficult changes to predict. The smallest increases in numbers of users can be expected to occur among those to whom marijuana in now most readily available - the goung- Johnston et al. (1982) found that close to 90 percent of the high school seniors in their national sample survey report that marijuana is "fairly easy. or "very easy" for them to get. This percentage remained relatively stable over the seven years, 1975-1981. At the same time, the reported availability of most other illegal drugs (except cocaine) declined considerably. For exam- pie, while 46.2 percent of the 1975 high school seniors said that LSD would be "fairly easy" or very easy" to get, only 32.2 percent of the class of 1978 gave those responses. It would appear, therefore, that the reports of easy availability are not due to a tendency of adoles- cents to report any illegal drug as easy to get, but re- flect their actual access to the drug. It might also be noted that only 13.9 percent of the class of 1978 re- ported having no friends who smoke marijuana; thus it is reasonable to expect that at least 86 percent have a f ac- tual basin for estimating the availability of the drug. Other survey data corroborate these f indings . Radosevich et al. (1979) report that a 1975 national survey by the Drug Abuse Council found that at least 70 percent of the high school students in their sample re- ported marijuana "easy to get,- and O'Donnell et 81e (1976) found similar results. There are no contrary reports for recent years. In sum, one can be reasonably confident that, at least with respect to older adoles- cents, the prohibition against supply does not succeed in suppressing access to marijuana. (The effect on price is discussed below.)

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24 Regulation could be expected to provide the greatest increase in availability to those to whom the drug is now least available, i.e., older adults who are not in contact with marijuana sellers or a drug-using subculture and who are most likely to avoid illegal "connections." It has been argued that a serious cost of the adoption of a regulatory policy for marijuana is the likelihood that such a change might delude many people into believ- ing that the drug is safe. _ ~_ _ ~_ _ ~ ~ _ ~ ~ ., ~ ~ _ As noted above, there Is no ~nalcac~on cnat the elimination of penalties for mari- juana use has caused the drug to be regarded as any less dangerous. Moreover, alcohol and tobacco are almost universally regarded as involving risks to health, and these drugs are already made available under regulatory systems. To the extent that marijuana use causes harm, one is necessarily concerned about policy changes that will lead to increases in use. As we have noted, however, it is a fact that marijuana is already widely available despite the legal prohibition of supply and that, despite the best efforts of government under any foreseeable set of conditions, it will continue to be. Though a regulatory policy would increase the availability of the drug, esti- mates of the size of these increases, and associated in- creases in harm, must be weighed against estimates of the costs and weaknesses of continuing prohibitions of supply. Tn ^ - mom; theme tats ; Q.!~. ; Q He_ m^~" -it I---- -age-, _- arc__ _~ __ "~_ harm would be done, overall, by retaining the partly effective, costly prohibition of supply or by moving to a system of legalized regulated sales--wherein presumably more people would use more marijuana, but some of the costs imposed by prohibition of supply would be removed. Regulatory Systems: Some Concrete Aspects To this point, a policy of regulation has been discussed rather abstractly in contrast with the more concrete dis- cussion of prohibition policies. Experimentation with varying systems of regulation followed by adjustment and readjustment based on experience would be necessary be- fore those most appropriate for particular circumstances could be developed. This can be a complex matter. For instance, U.S. alcohol policy, developed with the repeal of Prohibition, consists of an umbrella of national pol- icy and a wide variety of supporting state and local regulation. The national policy umbrella includes

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25 controls on importation, taxation, potency, packaging, labeling, advertising, use in federal jurisdictions (e.g., parks, military installations), and use in systems regulated by the federal government (e.g., air transpor- tation); it also provides funds and guidelines for the treatment of casualties of excessive use. Under the umbrella policy, states and local jurisdictions regulate taxes, retail sales , hours of availability, age limits, and the like, where supply is legal, or prohibit sales entirely. Some states have monopoly systems for package sales, others use licensed private stores. Historically, under this system, the strictness of controls has re- flected local sentiment about the consumption of alcohol. Al though few "dry" jurisdictions exis t today, various degrees of local ''dryness" were quite widespread until very recently (National Research Council, 1981) . Control ling Use A regulated system of marijuana sale might attempt to moderate use by inhibiting the frequency of use and the amounts used as well as by prescribing conditions of purchase and use. However, it is likely that under a regulatory system consumption would in great part be controlled by informal social norme--as it is today. Manipulating the price of the drug is an obvious means of inhibiting use. It has been argued that most adults would be willing to pay a higher price for legal mari- juana than they currently pay for illegal supplies in return for not having to seek out "connections" and being relieved of the feeling that they may be supporting or- ganized crime. A high price would be comparatively more restrictive for young people--precisely those whom one would most want to discourage from use--since, though they seem affluent compared with young people in previous times, their budgets are in fact more constrained than those of adults. The possibility of illegal markets selling to young people remains, but today's kind of illegal market for marijuana would probably shrink greatly under a regulatory system in the same way that illegal alcohol distribution systems have become so scarce. Young users would be much more likely to gain access to marijuana by diversion from the legal market-- as they do today for alcohol--or from homegrown plants than from a wholly illegal chain of distributors. Such a development would make marijuana selling Bless prof- itable and status-producing occupation among the young.

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26 It has been suggested that if legal limits were im- posed on the potency of legally available marijuana, a substantial illegal market for high-potency forms of the drug, including hashish, would still exist. Since it is likely that there would continue to be some users who prefer high-potency foes of cannabis, this is a reason- able concern. But there is no compelling a priori reason to believe that a legal structure for retail marijuana sales, which includes limits on potency, would result in any increase in the availability and use of high-potency products. Home Cultivation Cultivation of marijuana by users is another issue that would have to be confronted in devising a regulatory system. Growing marijuana without payment of a tax might be treated as a revenue offense. Without criminal pen- alties or vigorous enforcement, however, deterrent effects would be minimal since marijuana can be grown indoors anywhere in the United States using artificial light--and at comparatively little expense. A recent British study of options for marijuana control (Logan, 1979) suggests that, from a law enforcement perspective, it is not feasible to attempt to control home cultiva- tion. Whether users would take the trouble to grow their own marijuana would depend in part on the legal price. The relatively high prices that might be charged in order to discourage use and to increase revenues would also tend to encourage home cultivation. Whatever its disad- vantages, however, the use of homegrown marijuana at least would not bring users into contact with those who illegally sell the drug. With respect to young people, moreover, marijuana under cultivation is much harder for children to hide from parents than is the purchased pre- pared drug, and cultivation by juveniles could remain illegal if age limits on use were imposed. Nonetheless, the treatment of home cultivation represents a major issue for the design of a regulatory system. Public Education Excessive use may be discouraged by policies aimed at public education and at the use of the media, including a ban on commercial advertising. Although information

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27 on how to use drugs, on drug hazards, and on the attri- butes of drugs is passed along most effectively through informal channels (see, e.g., Hanneman, 1972), media and education programs can make such information far more readily available. Research on the communication of messages to the pub- lic has identified source credibility as a major factor contributing to the persuasive power of a message (McGuire, 1969~. It appears that the public is now ex- tremely wary of some government information programs that attempt to influence health behaviors. The credi- bility of the federal government may be especially sus- pect when it issues health warnings about an illegal substance that it is clearly trying to prohibit. Rosenthal (1979) asserts that distrust of the government and the medical establishment has grown because of past exaggerations and distortions of the effects of some mind-altering drugs. Informal Social Controls In an assessment of possibilities for governmental con- trols under a regulatory system, the operation of infor- mal norms for controlling substance use practices must be taken into account (Maloff et al., 1980~. National experience with alcohol use, for example, provides evi- dence that there are informal rituals and sanctions that generally encourage moderation in the use of recreational drugs. Moreover, moderation is encouraged when a drug is introduced gradually, that is, to a growing population of users, like marijuana in the 1960s and early 1970s. One might expect that when a new drug is introduced into a society, governmental control would be particularly important since no informal controls for teaching people appropriate rules for use would have developed. If a potent drug is made widely available precipitously and very cheaply to a novice population, severe societal disruptions may occur: for example, the gin epidemics of early eighteenth-century England (see Clark, 1976~. Because in the past two decades informal norms for con- trolling marijuana use have spread in the United States under conditions of greatly increased availability of marijuana, there is reason to believe that widespread uncontrolled use would not occur under regulation. In- deed, regulation might facilitate patterns of controlled use by diminishing the "forbidden fruit" aspect of the

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28 drug and perhaps increasing the likelihood that an ado- lescent would be introduced to the drug through families and friends who practice moderate use, rather than through their heaviest-using, most drug-involved peers. Relations Among States As has historically been the case with respect to alco- hol, state governments differ in their approaches to marijuana. So long as present federal law continues to prohibit cultivation and distribution of marijuana, states cannot adopt a regulatory system, although they are legally free to reduce or eliminate their own penal- ties for sale and are not compelled to enforce federal laws. If federal law were changed, however, the insti- tution of a regulatory system in one state would have reverberations in other states. Residents of states that continued to prohibit marijuana could be expected to cross state lines to purchase the drug in a state with a regulated system, thus further compromising the ability of states to enforce prohibition of supply among its residents. Furthermore, states that attempted to curtail consumption by raising prices might find their populations turning to lower-cost marijuana from neigh- boring states with lower prices. This is a familiar situation. Large numbers of both cigarettes and guns are smuggled illegally into New York from other states. Moreover, New Yorkers may travel to New Jersey to gamble in a casino, or Virginians to the District of Columbia to buy cheaper liquor. It is difficult to see how state prohibitions could remain effective if the number of states with regulatory systems grew very large unless the changes occurred in only one region of the country. However, there may be advantages in permitting a state- by-state approach. Conditions governing the costs and benefits both of partial prohibition and of regulation vary among the states. In this area of uncertainty, we may learn from experiment. If one regulatory system proved successful, other states would be more likely to adopt similar systems; similarly, if it worked poorly in one state, other states would be less inclined to adopt a regulatory policy.

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29 Effects on Foreign Relations The 1961 Single Convention on Narcotic Drugs, which now obligates the U.S. government to prevent the importation of marijuana and to prohibit the adoption of a licensing system by any state, is a serious (although not an insur- mountable) obstacle to the adoption of a federal regula- tory policy and the development of state licensing. The treaty allows a signatory to terminate its adherence to the agreement at any time after two years from the date of the convention. Of course the general impact of any move to withdraw from the convention includes a broad foreign policy context, which is beyond the expertise of this Committee to judge. CONCLUSIONS For the last decade, concern with health hazards attrib- utable to marijuana has been rising. The hearts, lungs, reproductive functions, and mental abilities of children have been reported to be threatened by marijuana, and such threats are not to be taken lightly. Heavy use by anyone or any use by growing children should be discour- aged. Although conclusive evidence is lacking of major, long-term public health problems caused by marijuana, they are worrisome possibilities, and both the reports and the a priori likelihood of developmental damage to some young users makes marijuana use a cause for extreme concern. At the same time, the effectiveness of the present federal policy of complete prohibition falls far short of its goal--preventing use. An estimated 55 million Ameri- cans have tried marijuana, federal enforcement of prohi- bition of use is virtually nonexistent, and 11 states have repealed criminal penalties for private possession of small amounts and for private use. It can no longer be argued that use would be much more widespread and the problematic effects greater today if the policy of com- plete prohibition did not exist: The existing evidence on policies of partial prohibition indicates that partial prohibition has been as effective in controlling consump- tion as complete prohibition and has entailed consider- ably smaller social, legal, and economic costs. On balance, therefore, we believe that a policy of partial prohibition is clearly preferable to a policy of complete prohibition of supply and use.

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30 We believe, further, that current policies directed at controlling the supply of marijuana should be seriously reconsidered. The demonstrated ineffectiveness of con- trol of use through prohibition of supply and the high costs of implementing such a policy make it very unlikely that any kind of partial prohibition policy will be ef- fective in reducing marijuana use Significantly below present levels. Moreover, it seems likely to us that removal of criminal sanctions will be given serious con- sideration by the federal government and by the states in the foreseeable future. Hence, a variety of alterna- tive policies should be considered. At this time, the form of specific alternatives to current policies and their probable effect on patterns of use cannot be determined with confidence. It is pos- sible that, after careful study, all alternatives will turn out to have so many disadvantages that none could command public consensus. To maximize the likelihood of sound policy for the long run, however, further research should be conducted on the biological, behavioral, devel- opmental, and social consequences of marijuana use, on the structure and operation of drug markets, and on the relations of various conditions of availability to pat- terns of use. RECOMMENDATIONS FOR RESEARCH Health and Behavior The pers is tent concern about the health-related effects of marijuana requires both an immediate and a continuing response. First, as the report of the Institute of Medi- cine (1982:5) recommends, there should be "a greatly intensified and more comprehensive program of research into the effects of marijuana on the health of the American people." An important goal of this research program should be the identification of subgroups at high risk for physiological and psychological damage in relation to patterns of use and toses of marijuana. The report presents a detailed agenda of needed research. Second, to the extent that potential health hazards are identified, policy research should address possible nafeguartn and precautions to protect the user. If marijuana use can be scientifically shown to en- tail grave risks--to the brain, the cardiovascular and respiratory systems, or to reproductive functions, for

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31 example--that are currently not known, it can be argued that, as was the case with cigarette smoking, knowledge of those effects will be more effective than criminal enforcement as a deterrent to use. Drug Markets Research on the price elasticity of demand in legal and illegal markets is a clear priority. The result of such research will be important in determining the likelihood of controlling heavy use through price mechanisms and in computing the amount of money--if any--that could be realized in taxation of marijuana. Present knowledge of the structure and activities of drug markets and networks is insufficient to allow pre- diction of the effects of policy changes on them. Re- search in this area is difficult but the questions are important. If many dealers who sell cocaine, PCP, am- phetamines, and barbiturates as well as marijuana would be put out of business if marijuana were available through legal channels, it might result in a curtailed market for a variety of other drubs. On the other hand, ~_ ~ . ' ~ ~ t ~ . ~ . _ ~ t ~ it Is also possible that the market structure as so loosely organized, and dealers so transiently involved, that removing marijuana from the illegal markets would have little effect. To be sure, much research on some of these questions could not be conducted unless a regu- latory system were in place in some state. Nonetheless, some research, particularly ethnographic and economic studies, should be undertaken now to discover the impor- tance of marijuana profits to drug-dealing networks; the transiency, size, and nature of such networks ; etc. It is essential for research in this area to be supported by appropriate government agencies. Ef fects on Use Although many questions remain to be answered before the most informed choices can be made between prohibiting and regulating supply, there are many things that cannot be known unless some jurisdiction tries a regulatory policy. Although adoption of a regulatory policy is likely to result in increased use, little is known about changes in patterns of use that are likely to result. If federal laws prohibiting supply are changed to allow

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32 states to license marijuana sales, epidemiological re- search programs must be ready to monitor any changes in use and their consequences. To do so, research should be organized and operating well in advance of any such policy changes in order to determine rates of use before the change. Although the shift in the law from complete to partial prohibition in 11 states has apparently had little effect on consumption patterns there, we do not know the degree to which legally available marijuana would attract a larger market. The impact on use of educational campaigns, health warnings, and informal social controls under a regulatory system should be investigated. In the absence of the opportunity for states to adopt regulatory policies, there can only be educated guesses about which age groups are likely to increase use or whether individuals who now use marijuana will use more etc. Meanwhile, every bit of analysis to predict the answers to these questions, by surveying public atti- tudes, assessing past experiences with the spread of drug use in society (e.g., alcohol use following the repeal of Prohibition), and critically reviewing the experience of other societies in which marijuana is more readily avail- able, will be valuable. Marijuana regulation would permit systematic provision of comprehensive, clearly communicated health warnings on package inserts or covers, in public health education, by medical practitioners, and by public health interest groups as well as by the government. The extent to which such warnings would have more credibility for users than current health warnings, generated in an atmosphere of prohibition, is an important subject for research. De- spite widespread pessimism about the failures of drug education campaigns, there are encouraging results in educational approaches based on the Stanford Heart Dis- ease Prevention Program experience. With appropriate, research-based models and techniques, public health edu- cation may be an attractive means for limiting excessive use (see, e.g., Maccoby, 1979~.