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What is marijuana legalization to you? Is it largely a health issue, a criminal matter, or a question of personal choice? Is medical marijuana a miracle or a myth? Would the legalization of marijuana increase the risks facing individuals and society, or reduce them?

If you haven’t yet had a chance to vote on marijuana legalization, you likely will in the next few years. Twenty-three states and Washington DC allow the medical use of marijuana. Colorado and Washington have legalized recreational marijuana use, and voters in Alaska, Oregon, and Washington DC have followed suit (they have legal hoops to jump through before the measures are implemented).

The hot pot debate
Next page: Two experts, one from each side of the legalization movement, predict the major consequences of marijuana legalization and address the concerns of the opposing side.

Kevin Sabet is the co-founder of anti-marijuana advocacy group Smart Approaches to Marijuana (SAM). He was senior advisor to the White House Office of National Drug Control Policy under President Obama.

Allen St. Pierre is the executive director of the National Organization for the Reform of Marijuana Laws (NORML), a non-profit organization.

Why does marijuana affect human functioning and behavior?

  • Marijuana contains at least 60 chemicals called cannabinoids.
  • Cannabinoids bind with cannabinoid receptors (proteins on the surface of cells) in the brain and body.
  • Cannabinoids activate cells in the brain regions that influence memory, thinking, mood, motor coordination (movement), problem solving, and pleasure.
  • THC, a cannabinoid, is responsible for the mind-altering effects of marijuana.

Does marijuana cause short-term brain impairments?

  • For sure.
  • Marijuana use affects critical thinking, attention, memory, and coordination—not in a good way.
  • Marijuana use can double the risk of a driving accident, studies suggest. It impairs coordination and judgment, and slows reaction time. Driving under the combined influence of alcohol and marijuana is even more dangerous.

Does marijuana cause long-term brain impairments?

  • Maybe.
  • Early onset (starting regular marijuana use as a teen) is associated with a lower IQ in adulthood. Chronic users who started young are less likely to graduate from college, and they earn lower incomes.
  • It is unclear to what extent marijuana use drives these outcomes. For example, teens who use marijuana may also be spending less time in the classroom, and that could explain their lower scores on IQ tests later.
  • Chronic users believe their marijuana habit has hurt them. In a 2003 study, most chronic users said marijuana use had damaged their physical health, emotional health, social life, and career.
  • Withdrawing from marijuana can cause temporary irritability, agitation, and insomnia.

Why students support or oppose legalization

In 2014, more than half (55 percent) of Americans support legalizing marijuana, according to a CNN poll—a huge jump from 18 percent in 1991. Among people age 18-29, two-thirds are in favor, according to a Gallup poll in late 2013. Student Health 101 asked college students to rank their concerns or hopes relating to marijuana legalization. Many students with opposing views were able to find common ground. Here’s what you said:

Students’ top reasons for supporting legalization:

  • Medical treatments for disease and pain
  • Increases in state tax revenues from marijuana taxation
  • Cost savings in the War on Drugs

The top concerns of students who supported legalization were:

  • Risks of driving under the influence
  • Tension between federal and state laws

Students’ top reasons for opposing legalization:

  • Risks of driving under the influence
  • The implied message to kids that marijuana use is safe
  • The potential for dependency or addiction

Students who opposed recreational legalization agreed that:

  • Medical use makes sense
  • The tax revenues could be helpful

Does regular marijuana use cause physical health problems?

The possible health effects of regular marijuana
use are still being researched and debated.
Some risks have been fairly well documented, including:

Cough and chest infections
Regular marijuana smoking is associated with coughing and phlegm, bronchitis, and increased susceptibility to respiratory infections.

Heart and lung problems in some users
Marijuana use initially increases the heart rate and blood pressure. In most young, healthy users, the cardiovascular effects are not associated with serious health problems. Marijuana use is riskier for people with pre-existing cardiovascular disease.

Medical marijuana: miracle or myth?

Potential health benefits:
Marijuana interacts with human cells in diverse ways, offering the potential for a range of medical uses.
Scientists are interested in the potential therapeutic effects of marijuana on glaucoma (an eye condition that can cause blindness), some cancers, autoimmune disease, inflammation, pain, seizures, gastro-intestinal disorders, cocaine addiction, anxiety, and post-traumatic stress disorder, among other health conditions.

Beware the hype:
Pressure to legalize medical marijuana has resulted in advocates exaggerating the health benefits. Marijuana has medical potential, but is not a miracle drug. “A more balanced, science-based approach is desperately needed,” says the Society for Science-Based Medicine, which critically evaluates medical treatments and claims.

The therapeutic benefits of marijuana have not been proven to outweigh its health risks, according to the National institute on Drug Abuse (NIDA).

The concept of medical marijuana isn’t new.
For the history of of medical marijuana since 2,900 BC.

Why are we still arguing about the effects of marijuana?

Researchers studying the health, behavioral, and developmental effects of marijuana use have to wrestle with various complicating factors. These factors can lead to mixed results and raise questions about the accuracy and relevance of the study findings. They include:

  • The effects of the drug are variable
    The effects of marijuana depend on how the drug is used, how much is used and how often, who’s using it and in what circumstances.
  • It’s hard to know what’s causing what
    It can be difficult to filter out the effects of marijuana use from the effects of other substances, emotional health issues, and other factors.
  • Study participants may not be typical users
    Studies may rely too heavily on users who are seeking treatment, whose struggles may be worse average. This can introduce bias.
  • Older studies may be losing relevance
    Most research has involved marijuana of lower potency than is generally used today, so the findings might understate the effects. That said, it’s not clear that higher potency contributes to greater use or worse outcomes.
  • Political agendas
    The intense politics around marijuana legalization increase the likelihood that evidence will be misinterpreted, misrepresented, and biased.
  • Researchers’ limited access to the drug
    Legal restrictions limit scientists’ access to marijuana, a barrier to conducting clinical trials of marijuana-based medications and other studies.

“Why we should oppose marijuana legalization”

Potential problems with legalization Here’s why marijuana should be illegalRebuttal
Corporations profiting from health issues and addiction“We’re really worried about creating Tobacco 2.0, the next big industry that thrives off addiction for profit.”“Is cannibis addictive like a cigarette? No. In terms of pharmacology, you can’t make the same analogy.”
Road risk: driving under the influence“Marijuana essentially doubles the risk of a car crash. It’s the number one killer on the road, after alcohol, when it comes to substances.”“No one should drive an automobile under the influence of any drugs, legal or illegal.”
Increased potency and more addiction“Today’s marijuana is not the marijuana of 30 years ago. The potency is much higher, and so there’s a great potential for addiction, mental illness, and other harms.”“This is a direct effect of the failure of Prohibition. Under alcohol Prohibition, people went from consuming wine and beer to hard spirits. People are not punished based on potency but how much they possess.”
A barrier to student learning“Kids who use marijuana drop out of school at higher rates. When you get high, you’re not learning.”“Any student should not try to learn in an impaired state, regardless of which drug they might be using.”
Developmental impact to the brain“The brain develops up to age 30. It’s why you learn to swim and read when you’re young. Anything can affect how your brain is wired, including marijuana.”“Here’s what that arguments implies: Until…your [brain has stopped developing], you are not yet an adult. You can’t make informed decisions like using alcohol and marijuana, having sex, entering into contracts, or going off to war.”

“Why we should support marijuana legalization”

Potential benefits of marijuana legalizationHere’s why marijuana should be legalRebuttal
Improved and expanded treatments for diseases“If Marinol [a cannabis-based medication] worked, 23 states wouldn’t have medical marijuana laws. Marijuana contains a broader range of cannabinoids [potentially therapeutic chemical compounds].”“We don’t smoke opium to get the effect of morphine, and we don’t need to smoke marijuana to get its medicinal effects. Marijuana-based medicines, like Marinol, are already in use.”
More effective drugs policy“Since the War on Drugs began in 1968, the Mexican-American border has been virtually porous. The avenues for smuggling drugs are also used to smuggle people, weapons, cash, terrorists, and dirty bombs.”“Since the late 1970s, drug use has fallen. It doesn’t mean that everything we’ve done since is perfect, but marijuana is used far less than our legal drugs.”
Reduced racial discrimination in law-enforcement and criminal justice“The data are clear about the 4:1 ratio of blacks to whites being arrested [for marijuana offenses]. There’s also a gender disparity.”“Unfortunately, both men and people of color are disproportionately held accountable for all crimes.”
Reduced access among children, and other harms of Prohibition“Children access marijuana more easily than regulated products like alcohol and tobacco. Alcohol kills 100,000-125,000 people a year but Prohibition was worse on society and individuals than the actual abuse of the drug was.”“Our legal drugs are used far more than our illegal ones. Making something illegal reduces the chance of exposure and normalization. Our legal drugs are promoted by massive industries to make money.””
Tax revenues for investment in public services“Tax dollars are generated through licenses, fees, and taxes, for good societal ends.”“Every dollar in alcohol tax brings $10 in social costs, including accidents and health damage.”


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Kristen Pope is a freelance writer and the managing editor of JHStyle Magazine based in Jackson Hole, Colorado. Her writing credits include the International Journal of Wilderness, Mountain Outlaw, Teton Family Magazine, Big Sky Weekly, and Dishing. Her MS in natural resources is from Humboldt State University in California.