Up in smoke

Marijuana laws and why they matter

By Kaitlin Wright and Kristen Pope

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?

Marijuana in its dried form has been legal for medicinal purposes in Canada since 2001. But it is still illegal to grow, buy, or sell cannabis recreationally—even though 6 out of 10 Canadians think the recreational use of cannabis should be legal, according to a 2014 Angus Reid poll. This year, Liberal Party leader Justin Trudeau promises to make marijuana legalization a top issue in his 2015 federal campaign.

studentvoice

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. Neither believes that Canada’s current marijuana laws suffice: One argues for decriminalization (the absence of criminal penalties regarding marijuana possession or use); the other, legalization.

Dr. Meldon Kahan is Medical Director of the Substance Use Service department at Women’s College Hospital in Toronto, Ontario.

Dana Larsen is a founding director of the Vancouver Medical Cannabis Dispensary, former editor of Cannabis Culture Magazine, and a founding board member of Sensible BC, a cannabis legalization advocacy group.

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 or university, 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

Fifty-eight percent of young Canadian adults (18—34) support the legalization of recreational marijuana, according to a 2012 poll by Angus Reid. Student Health 101 asked college and university 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 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 provincial 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 illegal	Rebuttal
Risk of increased use of marijuana, bringing increased harms	“Rates will jump once [marijuana] is heavily marketed. That means increased rates of addiction, cognitive impairment, accidents, and impaired work and school performance.”	“The legal status of cannabis doesn’t affect rates of use, so why spend a billion dollars a year on police and prisons? Why not regulate it like we do with alcohol to ensure that it’s as safe as possible and sold to adults?”
Increased potency and more addiction	“Suppliers are breeding more potent strains, presumably to keep their customers happily stoned. The harms are related to the dose.”	“More potent cannabis means safer cannabis, as less smoke has to be consumed for the desired effect. Prohibition prevents patients from accessing non-smoked forms.”
Smarter ways to address problems associated with criminalization	“People who use marijuana recreationally shouldn’t have a criminal record or be put in jail. But decriminalization can achieve that.”	“Cannabis users shouldn’t go to jail, but they should buy their product from an underground market? The best way to ensure our communities’ safety is through legalization and regulation.”
Medical benefits are already available	“As a painkiller, smoked marijuana is more dangerous and probably less effective than legal and readily available medications containing  marijuana properties.”	“Cannabis can be taken through a vaporizer, as a food or tincture, or even in a cream or salve. Without prohibition, patients could choose these non-smoked alternatives.”
Legalization won’t stop the black market	“The black market will thrive if people can grow or purchase marijuana as cheaply and conveniently as the legal product. The markets feed each other: Medical marijuana users are the major source of cannabis for addicted youth in California.”	“People can brew their own beer and wine at home, but there is no thriving black market in home brew because adults can legally buy alcohol. The underground black market is created by prohibition.”

“Why we should support marijuana legalization”

Potential benefits of marijuana legalization	Here’s why marijuana should be legal	Rebuttal
Reduced crime and safer communities	“Prohibition creates harm and danger in our communities. Legalization would end unregulated grow operations and prevent gangs from controlling the market.”	“Legalization will increase use, harming families and communities. Unregulated grow operations will continue if their product is less expensive and more accessible.”
Reduced racial discrimination	“Regions with higher First Nations populations have over five times more cannabis charges than the national average. We need cannabis laws based on modern science, not bigotry.”	“Racial minorities are disproportionately affected by drug laws, and there’s strong evidence that addiction treatment is more effective than jail. Decriminalization achieves this.”
Safer alternative to alcohol	“Alcohol is linked to serious health risks. Many people who promote cannabis prohibition ignore the greater risks from alcohol. Adults who prefer using cannabis are making a less risky choice.”	“Legalization of marijuana will not lessen the harms of alcohol: It might even increase them. Marijuana and alcohol together are more likely to cause car accidents than either drug alone.”
Increased revenues for smarter public spending	“Prohibition costs Canadians one billion dollars per year. Regulation would bring in the same amount in new tax revenue. We could be spending that money on health care or public education.”	“The money saved through legalization could also be saved through decriminalization. Legalization will increase health care and social costs.”
Reduced access among children	“Prohibition means there are no safety regulations, no age limits, and no government oversight. Legalization means rules and regulations to keep our kids safer.”	“Regulations won’t help because cannabis use in youth is determined by social attitudes—the belief that cannabis use is harmless and glamorous—and marketing.”