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Drug Policies and the Issues that Influence Them

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					                  Overview
   National Strategy & Prevention
   A Short History of Drugs and Drug Laws
   Prop 215/ LA Dispensaries/ Pot Docs
   Countries w/ Permissive Drug Policies
   Prop 19
   The Drug War: A Success or Failure
   Prohibition
   Marijuana & Drug Trafficking
   Is Marijuana Harmful
   Is Marijuana Addictive
   Is Marijuana Medicine
   Effects on use Rates
   Public Safety
   Incarceration
   Employment and the Economy
          The National Strategy
Interdiction and Enforcement…Stopping the
   supply of drugs

Treatment…Helping people who are already
   addicted

Prevention…Stopping the demand for drugs
        Three National Programs

 The High Intensity Drug Trafficking Area
  (HIDTA)
 The National Media Campaign
 The Drug Free Communities Program (DFC)
      DDR Initiative Goals

Goal 1: Develop and strengthen collaboration between
  communities and law enforcement organizations,
  and among agencies and federal, state, local and
  tribal governments to support the efforts of
  community coalitions to prevent and reduce
  substance abuse among youth.

Goal 2: Reduce substance abuse among youth and,
  over time, among adults by addressing the
  factors that increase the risk of substance abuse
  and promoting the protective factors in a
  community.
Drug Demand Reduction Program
          Prevention Strategy:
        Community Norm Change
1.   Information Dissemination
2.   Training and Education
3.   Alternative Activities
4.   Early Intervention        20%
5.   Access to Services        80%
6.   Systems Change
7.   Policy Change
Why is Community Norm
 Change so Important?

  Because Attitudes
   Drive Behavior
               Legalization of Marijuana: Independent Polls 2009



             Rasmussen Reports     40%

                      CBS           41%

                   Zogby
                SUPPORT              44%


        ?
        RR       14%

    C            7%

    Z            4%


               Rasmussen Reports         46%

                            CBS               52%

                        Zogby                 52%

0                                        50                        100
                        Trends in Acceptance: U.S. Population

Compilation of All Past Legalization Polls                Marijuana Usage Rates By Age
Gallop, Rasmussen, CBS, Zogby, etc.1969 - 2009                    SAMHSA 2007




 •13 states have some form of decriminalization on the books
 • 14 states permit medical use of marijuana
A Short History of Drugs
and Why We Have Laws to Control Them
        Short History of Drugs

Humans have used drugs of one sort or another for
thousands of years.

Wine was used at least from the time of the early
Egyptians; narcotics from 4000 B.C.
           Short History of Drugs

Chinese scholar-emperor Shen Nung, who lived in 2735 BC
compiled a book about herbs, a forerunner of the medieval
pharmacopoeias that listed all the then-known medications.

From this book we know that medicinal use of marijuana has
been dated to 2737 BC in China.
            Short History of Drugs


A reversal of the traditional search for botanical drugs occurred
in Greece in the fourth century BC, when Hippocrates
(estimated dates, 460-377 BC), the "Father of Medicine,"
became interested in inorganic salts as medications.
           Short History of Drugs

Pre-Columbian Mexicans used many substances, from tobacco
to mind-expanding (hallucinogenic) plants, in their medicinal
collections.

The most fascinating of these substances are sacred
mushrooms, used in religious ceremonies to induce altered
states of mind, not simply drunkenness.
          Short History of Drugs

But not until the 19th cent. A.D. were the active substances in
drugs extracted.

There followed a time when some of these newly discovered
substances morphine, laudanum, cocaine were completely
unregulated and prescribed freely by physicians for a wide
variety of ailments.
                      Opium Wars
1839–42 and 1856–60, two wars between China and Western countries.

These wars were the climax of disputes over trade and diplomatic relations
between China under the and the British Empire.


After the inauguration of the
Canton System in 1756, which
restricted trade to one port and
did not allow foreign entrance to
China, the British East India
Company faced a trade imbalance
in favor of China and so invested
heavily in opium production to
redress the balance.
                          1st Opium War
British merchants began smuggling opium into China from Bengal in order to balance
their purchases of tea for export to Britain.

In 1839, China enforced its prohibitions on the importation of opium by destroying at
Guangzhou (Canton) a large quantity of opium confiscated from British merchants.

Great Britain, which had been looking to end China's restrictions on foreign trade,
responded by sending
gunboats to attack several
Chinese coastal cities.
             1st Opium War cont.
China, unable to withstand modern
arms, was defeated and forced to sign
the Treaty of Nanjing (1842) and the
British Supplementary Treaty of the
Bogue (1843).

These provided that the ports of
Guangzhou, Jinmen, Fuzhou, Ningbo,
and Shanghai should be open to British
trade and residence; in addition Hong
Kong was ceded to the British.
                        2nd Opium War
A second war broke out following an
allegedly illegal Chinese search of a
British-registered ship, the Arrow, in
Guangzhou.

British and French troops took
Guangzhou and Tianjin and compelled
the Chinese to accept the treaties of
Tianjin (1858), to which France,
Russia, and the United States were
also party.

China agreed to open 11 more ports,
permit foreign legations in Beijing,
sanction Christian missionary activity,
and legalize the import of opium.
                  2nd Opium War cont.

China's subsequent attempt to block the entry
of diplomats into Beijing as well as Britain's
determination to enforce the new treaty terms
led to a renewal of the war in 1859.

This time the British and French occupied
Beijing and burned the imperial summer
palace (Yuan ming yuan).

This resulted in the Beijing conventions of
1860, by which China was forced to reaffirm
the terms of the Treaty of Tianjin and make
additional concessions, which concluded the
hostilities.
                      The International
                      Opium Convention

Signed at The Hague on January 23, 1912 during the , was the first international
drug control treaty .

It was registered in League of Nations Treaty Series on January 23, 1922. The
United States convened a 13-nation conference of the International Opium
Commission in 1909 in Shanghai, China in response to increasing criticism of the
opium trade.

The treaty was signed by Germany, the United States, China, France, the United
Kingdom, Italy, Japan, the Netherlands, Persia, Portugal, Russia, and Siam.
                 Chinese Immigration
Large-scale immigration began in
the mid 1800's due to the
California Gold Rush.

"I work on four-mou land [less
than one acre, a larger than
average holding] year in and year
out, from dawn to dusk, but
after taxes and providing for
your own needs, I make $20 a
year. You make that much in one
day. No matter how much it cost
to get there, or how hard the
work is, America is still better
than this."-A Chinese farmer
        Short History of Drugs

The problems of addiction were recognized
gradually.
             Short History of Drugs

Legal measures against drug abuse in the United States were first
established in 1875, when opium dens were outlawed in San
Francisco.
                   Opium in America
                  The Medicine Shows
In late nineteenth-century America, physicians were scarce and poorly
educated.

1883: J. B. Mattison (American doctor) suggested 30%-40% of American
doctors were addicted

Many people placed their faith in patent medicines, pitched by traveling
salesmen who never failed to entertain the crowds before offering cure-
alls.
Medicine Shows

    Medicine shows flourished in the late 19th
    century, particularly in the Midwestern United
    States and the rural South. They had their
    origin in the patent medicine vendors who set
    up booths at local fairs

    These shows featured music, comedy, juggling,
    and overblown rhetoric mixed with
    testimonials and stunts to demonstrate cures.
    Admission was free, with the performers
    making a living from the sale of cure-alls.
                      Medicine Shows

The magical tonics contained mostly alcohol with
opium or cocaine added and an assortment of
other ingredients.

The drugs ensured a quick feeling of wellness for
customers buying the elixir for the first time, and
provided the seller with possible customers who
became addicted to the medicine. In essence,
these were the first drug dealers.

A good comparison, however, the sellers probably
had little knowledge or understanding of the
addictive nature of the products they sold.
        United States Historical Overview


                    Circa 1900
Between 2% and 5% of adults are addicted to drugs.

Morphine is the number one drug of addition
     United States Historical Overview


                    1906
      Do to a Nationwide Drug Problem
               Congress Passes
         the Pure Food and Drug Act

       Creates the Food and Drug Administration (FDA)
      Stipulates certain drugs to be sold by prescription
Requires labeling of any medication containing opiates, cannabis
                           or cocaine
     United States Historical Overview


                     1914
                  Harrison Act

The first federal law to criminalize non-medical
use of drugs

Applied to narcotic substances-not marijuana
    United States Historical Overview

                   1913-1927
States begin passing marijuana prohibition laws
  1913 California
  1915 Utah
  1915 Wyoming
  1919 Texas
  1923 Nevada
  1923 Oregon
  1923 Washington
  1923 Arkansas
  1927 Nebraska
               Marijuana Tax Act


                        1937
Federal Governments 1st attempt to specifically regulate
                     marijuana

            Did not outlaw sales or possession outright
          Imposed registration and reporting requirements
                  Imposed the payment of taxes
      United States Historical Overview


                    Lifetime Use Rates
1967: 5% of college students
1969: 22% of adult and high school seniors
1970: 43% of college students
1971; 51% of college students reported lifetime use
     Single Convention on Narcotic Drugs
                             (Adopted 1961)

Is a United Nations international treaty to prohibit production and supply of specific
(nominally narcotic) drugs and of drugs with similar effects except under license for
specific purposes, such as medical treatment and research.

Earlier treaties had only controlled opium, coca, and derivatives such as morphine,
heroin and cocaine. The Single Convention, adopted in 1961, consolidated those
treaties and broadened their scope to include cannabis and drugs whose effects are
similar to those of the drugs specified. The Commission on Narcotic Drugs and the
World Health Organization were empowered to add, remove, and transfer drugs
among the treaty's four Schedules of controlled substances.
        Single Convention on Narcotic Drugs
                    (continued)

                       Possession for personal use
It is unclear whether or not the treaty requires criminalization of drug possession
for personal use. The treaty's language is ambiguous, and a ruling by the
International Court of Justice would probably be required to settle the matter
decisively. The Canadian Le

The Dain Commission of Inquiry into the Non-Medical Use of Drugs (Canada,1972
)report cites circumstantial evidence suggesting that states must prohibit
possession for personal use.

 It has generally been assumed that "possession" in Article 36 includes possession
for use as well as possession for the purpose of trafficking. This is a reasonable
inference from the terms of Article4, which obliges the parties "to limit exclusively
to medical and scientific purposes the production, manufacture, export, import,
distribution of, trade in, use and possession of drugs.“
         United States Historical Overview

                          1970
    Passage of the Comprehensive Drug Abuse
        Prevention and Control Act (CSA)

For the purpose of consolidating various drug laws into a
comprehensive statute and fulfilling the 1961 UN Drug
Convention.
Created a closed regulatory system
        Unlawful to manufacture, distribute, dispense, or
     possess any controlled substance unless authorized by
                              CSA
Created a system of scheduling drugs
Prohibited therapeutic use of marijuana as a medicine
       United States Historical Overview



                        1979
             Marijuana use peaked in 1979
30 million Americans smoked marijuana as compared to
 just a few hundred thousand users in the early 1960’s
                  U.S. Takes Action

President Carter appointed Lee Dogoloff as new drug policy
advisor
Joined by parents and others alarmed at the levels of drug
use they took action
                 Strengthening anti-drug policies
    Helps form National Federation of Parents for a Drug Free
                             Youth
           Educated policy makers and the community

Result: Past 30 day use ages 18 to 25 dropped from 36 % in
1979 to 11% in 1992
        Supplementary Treaties


The 1971 Convention on Psychotropic Substances
         Controls LSD, Ecstasy, and other psycoactive drugs

The 1988 United Nations Convention Against Illicit Traffic in Narcotic
Drugs and Psychotropic Substances
         Adds additional enforcement mechanisms for fighting
         drug traffickers
    The Convention on the Rights of the Child
is the first legally binding international instrument to incorporate the full range of
human rights—civil, cultural, economic, political and social rights.

In 1989, world leaders decided that children needed a special convention just for
them because people under 18 years old often need special care and protection
that adults do not.

The leaders also wanted to make sure that the world recognized that children have
human rights too.

Article 3 of the CRC states that "in all actions concerning children… the best
interests of the child shall be a primary consideration." Thus, policies affecting
children at all levels of society and government should have the child's best interest
as the primary concern.

Article 33 protects children from the illicit use of narcotic drugs and psychotropic
substances as defined in the relevant international treaties, and to prevent the use
of children in the illicit production and trafficking of such substances.
Prop 215, Marijuana Dispensaries
       and the Pot Docs
   Dennis Peron, Activist / Oakland
     Cannabis Club / Co-Author of Prop 215
                                                                                “Its pictures, its photos, it
                                                                                “Essentially, you are only
                                                                                 “Kind wire. a… kind
                                                                                     “Build a coalition and
                                                                                 a A.P. of like (Right) of of
                                                                                      going to get these
                                                                                         So I citizens,
                                                                                  uhh.senior have c… not
                                                                                like a fantasy story that I
                                                                                  people to agree about
                                                                                  created an illusion, but
                                                                                       housewives and
                                                                                can do something during
                                                                                 marijuana as medicine.
                                                                                      professionals what
                                                                                    I’ve articulated and
                                                                                   the war on drugs like
                                                                                   (Yes.) But if you think
                                                                                       marijuana… I’ve
                                                                                 that. Do it for three and
                                                                                doctors and lawyers and
                                                                                    about marijuana and
                                                                                 nurses. (Ummm Hmm?)
                                                                                  a half years, and uhhh,
                                                                                changed the face from a
                                                                                  how do we use it, why
                                                                                      get away hippie,
                                                                                    You know with it.” to
                                                                                   long-hairedpolitics is
                                                                                       we use it, it is a
                                                                                        (LAUGHTER)
                                                                                           Rogers.
                                                                                    Hazelillusions. (Uh,
                                                                                     medicinal reason.”
                                                                                            huh.)”
                                                                                 (Right, shadows on the
                                                                                           walls.).”




Source: Medical Marijuana: A Smoke Screen, Drug Free America Foundation, Inc.
        Ed Rosenthal, Convicted, 01/29/2003 Drug
                                        Trafficking

          a be honest, there
 “I have to latent glaucoma,
   another reason this umm
is “You know uhh, why talk
     which has never been
    “And that is because…
   do use marijuana, only in
      diagnosed. And the
 Iabout medical marijuana.
           reason…
  foreign countries, outside
   have toI LIKE limit and all
             mile TO
 Ithe threetell you that I also
  use but there is a reason
    the reasonHIGH!”
          GET it medically.”
  that,marijuana has never
    why diagnosed is that
   been uhh I do use it….” I
     have been treating it.”




                        Source: Medical Marijuana: A Smoke Screen, Drug Free America Foundation, In
    Medical Marijuana Statutes
    Compassionate Use           Medical Marijuana
        Act of 1996              Program of 2003

   AKA- Proposition 215       AKA - SB 420

   Voter enacted              Enacted by the
                                California Legislature
   Codified in
    H.S. § 11362.5             Codified in H.S. §
                                11362.7 et seq.
   Hereinafter the “CUA”
                               Hereinafter, the “MMP”
        PURPOSE OF CUA/MMP
• Help Seriously Ill

• Decriminalized Activity:
  – Cultivation (Individual / Group)
  – Use (Individual)
  – Furnishing (Primary Care Giver Only)

• Accessible
                Purpose of MMP

   MMP ID Card Program
    – Issued by County Health Departments
    – Quantity Limits
   MMP ID Cardholder Arrest Immunity
   Individual Affirmative Defenses
   Group Cultivation Affirmative Defense
    – Combine Resources to Cultivate
      WALL STREET JOURNAL

• 100 Dispensaries

  – 20 mile stretch of Ventura
    Boulevard

  – 1 dispensary every ¼ mile!

          Wall Street Journal: September 2009
           L.A. City Council:

•STARBUCKS IN L.A. creating the
  "This is not about COUNTY (2009)
  Starbucks of marijuana sales. It's about
  creating access for people who really
     -840
  need it…”
POT SHOPS IN L.A. COUNTY (2009)
  – Ed Reyes, Councilman, City of Los Angeles
      -966
              National Law Journal, Nov. 2009
                Los Angeles Times, Nov. 2009
          MARIJUANA DISPENSARY
                         TIMELINE

                  No Known Dispensaries




1996                                                   2003



     California Voters              California Legislature
           Pass                             Passes
Compassionate Use Act (CUA)   Medical Marijuana Program (MMP)
         MARIJUANA DISPENSARY
                            TIMELINE

                                            187 Known
                            98 Known        Dispensaries
         4 Known           Dispensaries
       Dispensaries

2004      2005                2006             2007         2008


                                              July:       August:
                                             City of    CA Attorney
    People v. Urziceanu                   Los Angeles     General
   Suggests Cooperatives                   Declares a    Guidelines
    Can Be Reimbursed                     Moratorium      Issued
                                          w/ Loophole
          MARIJUANA DISPENSARY
                        TIMELINE


                          481
                 New Dispensary Applications




February 25, 2009                              June 24, 2009


    United States                                   City of
   Attorney General                               Los Angeles
     Implies DEA                                    Closes
   Will Not Pursue                                 Loophole
     Dispensaries
          MARIJUANA DISPENSARY
                           TIMELINE


                              187 Max
                            Dispensaries Allowed



January 2010                       June 7, 2010


   City Of Los Angeles       Ordinance Became      Between 200
         Adopted                   Active             To 350
 Ordinance No. 181069 To
  Regulate Dispensaries
      DISPENSARIES
   IN CALIFORNIA ARE:

           ILLEGAL
  Sales of Marijuana are NOT
Authorized under California Law
             Legal Question

• Can Medical Marijuana Dispensaries
  (Collectives or Cooperatives):

  – SELL marijuana over the counter?
                            CUA
• Section 11362.5 (d) provides:

   – limited affirmative defenses
   – to marijuana patients and their primary   caregivers

   – who “Possess      or Cultivate” marijuana.
  Prop. 215 Ballot Pamphlet

• PROPONENTS OF 215 SAID:

  – The proposition “only allows marijuana to be
    grown for a patient’s personal use.”

  – “Police officers can still arrest anyone who
    grows too much, or tries to sell it.”
 CA Attorney General MMJ Guidelines
• Pg C. 1.
       Storefront Dispensaries: Although medical
  marijuana “dispensaries” have been operating in
  California for years, dispensaries, as such, are not
  recognized under the law.
                  Agreements
•   CUA drafters
•   Attorney General’s Office
•   Proponents of medical marijuana
•   Law Enforcement


    – The CUA does   not authorize sales.
          Why So Many?

• Confusion at Inception

• Complacent during Growth

• Fearful when Scrutinizing

     PRACTICAL vs. LEGAL ANALYSIS
            Dispensary Operators
•   Prior illegal selling (veiled legitimacy)
•   Links to other dispensaries
•   Links to criminal street gangs
•   Links to organized crime
•   Migration to California
SQUARE PEG IN ROUND HOLE

•PRIMARY CARE GIVER
   •Form Used PRIOR to Mentch Decision

•COLLECTIVE
   •Form Used AFTER Mentch Decision

•DEFINITION OF CULTIVATE
   •Means MORE than Cultivation: Sales
           Dispensary Patrons
• 98% to 98.5%:
   – Soft Tissue

• 70%:
   – Under age of 40

• Fridays at 2:00 PM –
  Sundays at noon:
   – Primary foot traffic
INDICAS              G      1/8 1/4             1/2 SATIVAS                      G         1/8       1/4        1/2
A.C.C. OG            20    65      130         n/a     SKYW ALKER                20        65        130        n/a
Juicy Fruit          20    60      120         230     Sour D                    20        55        110        210
Hindu Ku$h           20    60      120         230     Maui W owie               20        55        110        210
Sour OG              20    60      120         230     GOO                       20        55        110        210
Chem Dawg
Platinum Bubba
Purple Erkle
                     20
                     20
                     20
                           60
                           60
                           60
                                 Dispensary Operations
                                   120
                                   120
                                   120
                                               230
                                               230
                                               230
                                                       Hawaiian Haze
                                                       Headband
                                                       Snow W reck
                                                                                 20
                                                                                 20
                                                                                 20
                                                                                           55
                                                                                           55
                                                                                           55
                                                                                                     110
                                                                                                     110
                                                                                                     110
                                                                                                                210
                                                                                                                210
                                                                                                                210
Butter OG            20    60      120         230     Train W reck              20        55        110        210
Bananna Kush         20    55      110         210     Super Snow Cap            20        55        110        210
G.D.P.               20    55      110         220     W hite Haze               18        50        100        190
Afgoo                20    55      110         210     Day Train                 18        50        100        190
Grape
Purple Kush         • Commercial
                     20
                     20
                           55
                           55
                                   110
                                   110
                                               210
                                               210
                                                       Green Peace
                                                       Orange Crush
                                                                                 15
                                                                                 15
                                                                                           45
                                                                                           45
                                                                                                     90
                                                                                                     90
                                                                                                                170
                                                                                                                170
Grape Ape            18    50      100         190     Northern Lights           15        45        90         170
Afgani
L.A. Confidential
                      Enterprise
                     18
                     18
                           50
                           50
                                   100
                                   100
                                               190
                                               190
                                                       TNT
                                                       L.A. Outdoor
                                                                                 15
                                                                                 15
                                                                                           45
                                                                                           40
                                                                                                     90
                                                                                                     80
                                                                                                                170
                                                                                                                150
Ogre O.G.            18    50      100         190
Shiskaberry
HYBRIDS
                    • Cash BusinessCONCENTRATES
                     15    45       and
                                   90          170
                                                       Hash Oil
                                                                                                G
                                                                                                30
                                                                                                      G 1/2

Blue Cheese
Blue Dream            Tax Evasion
                     20
                     20
                           60
                           60
                                   120
                                   120
                                               230
                                               230
                                                       Honey Bud
                                                       G.D.P. F.M.
                                                                                                30
                                                                                                30
Rainbow Ku$h         20    55      110         210     Super Sour F.M.                          30
Lambread
Mango
Strawberry Cough
                    • Marketing
                     20
                     20
                     20
                           55
                           55
                           55
                                   110
                                   110
                                   110
                                               210
                                               210
                                               210
                                                       Maui W owie F.M.
                                                       AOTA Hash
                                                       Master Kush Bubble Hash
                                                                                                30
                                                                                                30
                                                                                                30
AK-47
Lion W reck
Sugar Shack
                    • Black Market Prices
                     20
                     20
                     18
                           55
                           55
                           50
                                   110
                                   110
                                   100
                                               210
                                               210
                                               190
                                                       Marble Hash
                                                       Moroccan Hash
                                                       Amberglass                     20
                                                                                                28
                                                                                                20

Purple Diesel        18    50      100         190     Crushed Honey Bud                                   30
Purple Maui          18    50      100         190     GD Pre Loaded Pipe             20
Holiday Gift Box     $55   Set conists of 7(.5grams)
   Skywalker, S.F.V Ku$h, Ogre OG, Chem Dog
        Green Peace, and Green Crack

RED VELVET CUPCAKES                10
                  Community
• Crime Rates
• Locations:
  – Next to libraries, day cares, half-way houses,
    schools, places of worship
• Advertising:
  – Flyers, Freebies, Minors
• Proliferation
                  Courtroom

• Indifference
   – Judges and Jurors
• Failure
   – Seriously Ill
   – Courtroom Losses
• Confusion
   – Judges, Prosecutors, Defense, Public
• Inconsistent Results
                  DOCTORS
• Cottage Industry

• Money Making Machines

• Irresponsible

• No Oversight

• Immunity!
Number of Patients a “Pot Doctor” Can See


           DAY    DATE      NO.   COST    TOTAL
           TUE   10/05/04   39    $150      $5,850
           WED   10/06/04   29    $150      $4,350
           THU   10/07/04   43    $150      $6,450
           FRI   10/08/04   55    $150      $8,250
         $175,00056per month
          SAT 10/09/04 $150 $8,400
           SUN   10/10/04   22    $150      $3,300
           MON   10/11/04   49    $150      $7,350
           $2.1 7million per year
                    29
                 days       3            $43,950
       RECENT TRENDS



Pot

Delivery

Services
    EDIBLE MANUFACTURING

• No FDA Oversight

• No State or Local Heath Dept. Oversight

• No Quality Controls:
     • How it was made
     • Where it was made
     • Who it was made by
     • What it was made with
The Result
    Countries with
Permissive Drug Policies
       Gray Debate - Portugal

Crime would be greatly reduced if we legalized
marijuana. For this, please focus upon the results in
Portugal, where they decriminalized the use of all
drugs back in 2001. Mr. Glenn Greenwald of the
CATO Institute published a report about the results
just a few months ago, and he reported that when
this occurred, overall drug usage became slightly
lower, but problem drug usage was reduced by about
half!
         Gray Debate - Portugal

The reason behind this was twofold. First, under the prior
criminal system, drug addicted people legitimately feared
their own government, so they were highly unlikely to bring
their problems to the government. But now that people
would only receive an administrative citation for the use or
possession of drugs, which would require them to appear
before a medical staff to discuss their drug usage (and this
staff was not at all connected to the criminal justice system),
the drug addicted people were now willing to enter treatment
programs is much, much greater numbers.
      Gray Debate - Portugal

Second, now that the government was no
longer spending such large amounts of money
on the investigation, prosecution, and
incarceration of drug-addicted people, they
had much more money to use for drug
treatment. So those treatment programs were
funded. This is seen as a truly effective
program, and is one we should not only study,
we should emulate.
Decriminalization of Drugs




 Portugal
                         Portugal…
•July 2001: law takes effect that decriminalizes every single drug,
         provided that it is for personal use only.
•Persons will never be criminally charged for any of it, unless they
         possess quantity exceeding an estimated 10 day supply.
                  Portugal…

Cato Institute - Washington think-tank committed to
libertarianism that has been a long-time advocate of
drug legalization sent Mr. Glenn Greenwald an
American lawyer and writer, fluent in Portuguese, to
come to Portugal

Mission: develop a study concerning the results of
the Portuguese drug decriminalization policy.
Portugal…
  A lesson to the world. A model worth
             being replicated.




Reported by: TIME Magazine which had a record number of viewing hits that day.
Also reported by The Moderate Voice, The Kansas City Star, the Pittsburgh Tribune-
                  Review, The Examiner and Scientific American,
   Glenn Greenwald’s Conclusion

–“The total number of drug-related deaths has actually decreased from
the pre-decriminalization year of 1999 (when the total was close to 400) to
2006 (when the total was 290)”.

And regarding consumption, it gives the general notion of decreasing
tendencies affirming that:
        -“Prevalence rates for the 15 to 19 age group have actually
        decreased in absolute terms since decriminalization.”
        -“Most significantly, the number of newly reported cases of HIV
and AIDS among drug addicts has declined substantially every year since
2001.”
                   Portugal…


The decriminalization of drugs in Portugal did not
decrease levels of consumption.

   •Consumption of drugs in Portugal increased 4.2%
                Portugal…



The percentage of people who have experimented
with drugs at least once in their lifetime increased
from 7.8% in 2001 to 12% in 2007 (IDT-Institute for
Drugs and Drug Addiction Portuguese, 2008).
                 Portugal…


Cocaine Consumption: “the latest data (surveys
from 2005-2007) confirms the increasing trend
during the last year in France, Ireland, Spain, The
United Kingdom, Italy, Denmark and Portugal”
(EMCDDA 2008).
                Portugal…


While rates of use of cocaine and amphetamine
doubled in Portugal, seizures of cocaine have
increased sevenfold between 2001 and 2006, the
sixth highest in the world (WDR-World Drug Report,
2009).
                         Portugal…
Report mainly focus on an age span population comprised between 13 and
19 years old.

Only a brief reference is made to the adjacent 20 to 24 age group, that
already doesn’t show any mild decrease, but rather a boosted 50% increase.


                                  +50%


                                         +50%
                  Portugal…


•In Portugal, since decriminalization has been
implemented, the number of homicides related to
drugs has increased 40%.


•“It was the only European country with a significant
increase in (drug-related) murders between 2001
and 2006″ (WDR, 2009).
      Portugal…



So much for Portugal
            Gray Debate - Holland

And if we followed the experience of Holland, where all drugs were decriminalized
several decades ago, after 6 to 12 to maybe 18 months, probably usage would
decrease as well.

The Minister of Health of Holland held a news conference numbers of years ago
and said that their country, where anyone 16 years of age or older can go to a
coffee house and get marijuana, they only have half the marijuana usage per
capita as we do in the United States -- even for teenagers!! And then he went on
to explain why by saying that "We have succeeded in making pot boring." Of
course, we glamorize it in our country by having it illegal, and by having an
incredible profit margin to sell it to us, our neighbors and our children.

We must learn from Holland's experience. This is more fully discussed in my book
"Why Our Drug Laws Have Failed." Holland does have one problem, however, that
they do not know what to do about, and that problem is that a full third of the
people who use and abuse drugs in their country are foreigners. I have no
suggestions, but obviously since we are so much larger, we wouldn't be as likely to
have the problem.
 Decriminalization of Drugs



The Netherlands
              Dutch Drug Policy

1976
The Dutch government made a big decision in changing
their Opiumwet (Druglaws), by separating drugs in two
major classes, hard drugs and soft drugs.

Heroin, Cocaine, XTC and Amphetamines, chemical
drugs with unacceptable hazards for national health,
were and are considered "Hard drugs".

Cannabis products like hash and marihuana, natural
products, without chemical addition, were and are
considered "Soft drugs".
                   Coffee Shops

In the Netherlands, the selling of cannabis is "illegal, but
not punishable", so the law is not enforced in
establishments following these nationwide rules:
       • no advertising
       • no hard drug sales on the premises
       • no sales to anyone under the age of 18
       • no sales transactions exceeding 5 grams
       • no public disturbances
       • no sales to anyone under 18 years of age
        Are the Dutch More Likely to Use
                   Cannabis?
Three features of the rankings are noteworthy
• US rate exceeds the Dutch rate, but they are fairly close
• Both the US and the Netherlands rank high relative to most other nations
• Many European countries have rates of student marijuana use that either match or exceed the
Dutch rate
    Are Dutch youth more likely to try
                cannabis
Dutch students do indeed rank higher for lifetime prevalence of cannabis than
for tobacco use, getting drunk, or use of other illicit drugs.
Are the Dutch More Likely to Escalate
        Their Cannabis Use?

                            Netherlands         European Average       USA
Frequency of lifetime
use of cannabis

10-19 occasions                       4                  2                   3
20-39 occasions                       2                  1                   3
40+ occasions                         7                  3                   8



The Dutch youth are somewhat more likely to have used frequently, and they are
somewhat more likely to start using early (before age 13), compared to their
European neighbors
           THE COMMERCIALIZATION
                 HYPOTHESIS



In the 1984 to 1996 period, which we characterize as a progression from
depenalization to de facto legalization, these surveys reveal that the lifetime
prevalence of cannabis in Holland has increased consistently and sharply.

For the age group 18-20, the increase is from 15% in 1984 to 44% in 1996; past
month prevalence for the same group rose from 8.5% to 18.5%...
           Coffee Shop Reality


Enforcement of these rules didn't have real teeth
until 1997, when officials began closing coffee shops
for non-compliance.

Between 1997 and 2007, the number of retail
cannabis outlets dropped 40 percent, from 1,179 to
702
           Dutch Policy Change

A March 19, 2005 article in the Observer noted that
the number of Dutch cannabis coffee shops had
dropped from 1,500 to 750 over the previous five
years.

The "no-growth" policies of many Dutch cities affect
new licensing. This policy slowly reduces the number
of coffee shops, since no one can open a new one
after a closure.
Decriminalization of Drugs



The United Kingdom
  Cannabis classification in the United
               Kingdom

Between 1928 and 2004 it was classified as a
class B drug.

In Jan 2004 cannabis was transferred from class
B of the Act to class C, removing the threat of
arrest for possession.

On 26 January 2009, cannabis was reclassified
as a class B drug
                      The Independent
                     Sunday, 18 march 2007
                  Cannabis: An Apology
In 1997, this newspaper launched a campaign to decriminalise the drug. If
only we had known then what we can reveal today…

Record numbers of teenagers are requiring drug treatment as a result of
smoking skunk

More the 22,000 people were treated last year for cannabis addiction – and
almost half of those affected were under 18

With doctors and drugs experts warning that skunk can be as damaging as
cocaine and heroin, leading to mental health problems and psychsis for
thousands of teenager,

The Independent on Sunday has today reversed its landmark campaign
for cannabis use to be decriminalised.
Proposition 19
                  Prop 19
The Regulate, Control and Tax Cannabis act of
                   2010.


    It is important to know that prop
       19 would have done none of
     what it’s title claimed. It was a
       very poorly written initiative
        pushing a very bad concept.
Who wrote Prop 19



        Richard Lee
Owner: Oaksterdam University,
  The Bulldog Coffee Shop
                 Prop 19
    would not do what it’s title claimed


•Would not regulate marijuana: did not
establish a CA FDA
•Would not establish a Marijuana Control
Board
•Would not provide any mechanism for the
State to tax marijuana
             Prop 19
      What it Would Not Do
•Would not solve the gang or cartel
problem
•Would not control marijuana and keep
it out of the hands of youth
                   Prop 19
             What it Would Do

•Legalize one ounce of marijuana for personal
consumption

•Allow each of the 478 cities and 58 counties to
regulate and tax the sale transportation and growing
of Marijuana (Actually deregulate)

•Increase Youth Use
Richard Lee’s investment

     $1.6 million dollars
                    Prop 19
             What it Would Do
•Would have increased youth use
•Would have put business in jeopardy with drug
free workplace
•Could have cost the state billions of dollars (Federal
contracts and education monies)
•Would have put a burden on the public health
system
•Would have put the state in direct conflict with
federal law
Conflict with Federal Law

             Supremacy Clause
              U.S. Constitution
       Article VI, Section 1,Clause 2
Asserts and establishes federal laws made
   in pursuance of the Constitution and
 treaties made by the United States with
foreign nations shall be the “Supreme Law
                of the Land”
      Supremacy Clause

Everyone must follow federal law in the
face of conflicting state law.

A state statute is void to the extent that it
actually conflicts with a valid federal
statute
      Federal Statements
U.S. Atty. Gen. Eric H. Holder Jr. stated, “We will
vigorously enforce the CSA against those
individuals and organizations that possess,
manufacture or distribute marijuana for
recreational use, even if such activities are
permitted under state Law”.

U.S. Dir. of ONDCP Gil Kerlikowske stated, “all
options are open to the federal government”.
Conflict with Federal Law
       The Options


  Take California to Court
  Withhold Federal Dollars
  Use the Powers of Arrest
                           Proposition 19 Results
                                 Defeated
Vote tally: (as of November 16, 2010)
No votes: 5,061,119
Yes votes: 4,366,381
Difference: 694,738 (No votes)
 Public Opinion Towards
 Marijuana Legalization:
History and Current State

 Heinz College Policy Modeling Class presentation prepared for Professor Jon Caulkins by:
Ngiste Abebe, Carolyn Coulson, Juli Digate, Rebecca Erwin, Christina Farber, Nick Shahverdi,
   Inyoung Song, Joe Vesely, and Greg Zavacky – edited by Jon Caulkins and Kevin Sabet


                                                                                          122
                   Outline
• History and trends in legalization support
• Proposition 19
• Could a vote for legalization pass?




                                               123
                            Trends in support of legalization
                           correlate with perceived risk of use
                                45%
Percentage of People Agreeing




                                40%

                                35%

                                30%

                                25%

                                20%

                                15%

                                10%

                                5%

                                0%
                                      1985   1987   1989   1991   1993   1995   1997   1999   2001   2003   2005   2007   2009

                                                           No or Slight Risk       Favor Legalization                      124
                                       Trends in legalization also mirror
                                      trends in marijuana-related arrests
No. of Marijuana – Related Arrests



                                     1,000,000                                                                        50%




                                                                                                                             Percentage Favoring Legalization
                                      900,000                                                                         45%

                                      800,000                                                                         40%

                                      700,000                                                                         35%

                                      600,000                                                                         30%

                                      500,000                                                                         25%

                                      400,000                                                                         20%

                                      300,000                                                                         15%

                                      200,000                                                                         10%

                                      100,000                                                                         5%

                                            0                                                                         0%



                                                 #MJ Arrests   Favor Legalization, GSS   Favor Legalization, Gallup
                                                                                                                            125
Prop 19 is not the only ballot initiative
  to receive more than 39% support
                                         Marijuana Legalization Ballot Initiatives Since 2000
Percentage Favoring Legalization




                                   60%
                                   55%
                                   50%
                                                                                             46%
                                   45%                        44%       44%
                                                                                  41%
                                          40%      39%
                                   40%
                                   35%
                                   30%
                                   25%
                                   20%
                                   15%
                                   10%
                                   5%
                                   0%
                                         Alaska   Nevada     Alaska    Nevada   Colorado   California
                                         2000      2002      2004       2006      2006       2010
                                                                                                 126
         Reasons why people oppose
           legalization from op-eds
100%

90%

80%                                         Other

70%                                         Increased Crime
60%
                                            Adverse Health
50%                                         Effects
40%
                                            Increased Hard Drug
                                            Use
30%                                         Increased Use by
                                            Youth
20%

10%

 0%
       60's   70's     80's   90's   00's

                     Decade                              127
        Reasons why people support
          legalization from op-eds
100%

90%

80%                                          Other

70%
                                             Economic
60%
                                             Decreased Violence
50%

40%                                          Ineffectiveness of
                                             Drug Control
30%
                                             Treat Like Alcohol
20%

10%

 0%
       60's   70's      80's   90's   00's

                     Decade                               128
             Rationales for and against Prop 19
                                    Reason                                    Groups
             Measure will only change dynamic of marijuana crime         Law enforcement
                Inability to prosecute for driving under influence       Law enforcement
Opposition




             Inability to fire someone for working under influence      Education, business
                    Ineligibility for federal grants/contracts          Education, business
             Legal approval of drug detrimental to individuals and
                                                                              Various
                                       society
               Marijuana growers (legal and not) lose revenue           Marijuana growers
             Medical MJ users/dispensaries unclear of future status   CA Cannabis Association

               Allows law enforcement to focus on more violent
                                                                         Law enforcement
                                      crimes
                   Regulation of existent marijuana industry             Law enforcement
Support




                    Reduction of violent crimes related to
                                                                         Law enforcement
                               trafficking/dealing
                  Potential tax revenue for keeping local jobs             Labor groups
                   Increase in civil liberties and public safety         Civil rights groups
                 Lessens systematic racism in law enforcement            Civil rights groups
                                                                                                129
                                      Yes on Proposition 19 by
                                80%
                                           demographic
Percentage Voting For Prop 19



                                70%

                                60%

                                50%

                                40%

                                30%

                                20%

                                10%

                                0%




                                                                 130
                                      Yes on Proposition 19 by age
                                80%
Percentage Voting For Prop 19



                                70%

                                60%

                                50%

                                40%

                                30%

                                20%

                                10%

                                0%




                                                                     131
                                Yes on Proposition 19 by gender
                                80%
Percentage Voting For Prop 19



                                70%

                                60%

                                50%

                                40%

                                30%

                                20%

                                10%

                                0%




                                                                  132
                                Yes on Proposition 19 by income
                                80%
Percentage Voting For Prop 19



                                70%

                                60%

                                50%

                                40%

                                30%

                                20%

                                10%

                                0%




                                                                  133
                         Yes on Proposition 19 by party and
                                  political ideology
                                80%

                                70%
Percentage Voting For Prop 19




                                60%

                                50%

                                40%

                                30%

                                20%

                                10%

                                0%




                                                          134
1 in 11 of those who voted ‘No’ agree
 that MJ should be legalized but did
    not like the specifics of Prop 19


     Yes on
      Yes on                                   No on
        19:
  PropProp46%                      Yes on
                   No on                       Legalization:
       19:                        Prop 19:
                Prop 19: 54%                   49%
       46%                          46%



                                         No on
                         No on
                                        Prop 19:
                          Prop
                                          5%
                         19: 9%

                                                               135
Dynamics for future legalization efforts
  •   Quality of legislation
  •   Marijuana testing capabilities
  •   Federal policy
  •   State vs. national trends
  •   Voter demographics




                                       136
Has the War on Drugs Failed or
      Are We Better Off?
    Has the War on Drugs Failed or
          Are We Better Off?

• We are better off
• - 1978 was the peak of drug use – we have
  since then reduced drug use by 50% - we cut
  consumption in half.
• - From a Public Health standpoint, no other
  disease has been reduced by 50% in the last
  20 years: diabetes, cancer, obesity, HIV.
Illicit Drug Use Trends 1974-1998
                    Sweden

• We need to look at Sweden’s balanced approach to
  drug use issues:
• - they invest in their youth through prevention
  programs
• - they provide support for the addicted through
  treatment and recovery services
• - they take their law enforcement of drug use and
  dealing seriously
• This is a model we should strive to achieve rather
  than throw the baby out with the bath water and go
  to full legalization.
                             Sweden

In February 2007 the UN Office on Drugs and Crime released a study entitled:
    Sweden’s Successful Drug Policy: A Review of the Evidence. [FN1] The
    Swedish drug control policy has been guided by the goal of achieving a
    drug-free society and the unequivocal rejection of drugs and their
    trafficking. The report noted that: "The clear association between a
    restrictive drug policy and low levels of drug use is striking."
   In 1969, the Government of Sweden approved a ten-point program for
   increasing public efforts against the drug problem. The ten-point program
   was heavy on law enforcement measures but also covers demand
   reduction issues, in particular, the provision of treatment services to
   addicts and the prevention of drug abuse.
   Sweden has the lowest drug use rate in Europe.
Prohibition
                     Prohibition

    THE CLAIM
•      Ending Drug Prohibition will:
•      Eliminate drug cartels, DTO’s as it eliminated
       organized crime
•      Eliminate drug profits as it did when we
       ended Alcohol Prohibition.
•      Reduce Drug Use
•      Eliminate the black market
•      Give Citizens the opportunity to have a safer
       recreational alternative to Alcohol
Alcohol Use Trends 1850-1997
             Prohibition History
                  Last Call

America had been awash in drink from the start
 – wading in it, swimming in it, at times
 drowning in it

In 1839 an English traveler Frederik Marryat
  marveled at the role liquor played in American
  life and wrote in A Diary in America:
           Prohibition History
                Last Call

I am sure the Americans can fix nothing
without a drink. If you meet, you drink; if you
part, you drink; if you make acquaintance, you
drink: if you close a bargain, you drink; they
quarrel in their drink and they make it up with
a drink.
            Prohibition History
                 Last Call

They drink because it is hot; they drink
because it is cold. If successful in elections,
they drink and rejoice; if not, they drink and
swear; they begin to drink early in the
morning, they leave off late at night; they
commence it early in life, and they continue it,
until they soon drop into the grave.
              Prohibition History
                   Last Call

Benjamin Franklin first compiled a list of terms
  for “Drunk,” in 1722 and came up with 228
  examples including
•     Juicy
•     Thawed
•     Had a thump over the head with
  Sampson’s jawbone
             Prohibition History
                  Last Call

By 1810 the number of distilleries in our young
  nation had increased fivefold to more than
  14,000
              Prohibition History
                   Last Call

By 1830 American adults were guzzling, per
  capita, a staggering seven gallons of per
  alcohol a year

1.7 bottles of a standard 80-proof liquor per
  person per week

Nearly 90 bottles a year for every adult in the
 nation
           Prohibition History
                Last Call

By 1830 Harvard literature professor George
Ticknor told Thomas Jefferson that if the
consumption of liquor continued at its current
rat, “we will be hardly better than a nation of
Sots.”
              Prohibition History
                   Last Call

1840
Six habitual drinkers pledged their commitment
  to total abstinence starting the Washingtonian
  movement

They asked other habitual drinkers to sign a
  pledge of abstinence.
               Prohibition History
                    Last Call

By 1840 one of the most devoted adherents to the
  work was Phineas Taylor Barnum

They had changed many lives, through their mission of
  peach and love. We also saw that large numbers
  who were saved by these means fell back again to a
  lower position than ever, because the tempter was
  permitted to live and throw out his seductive toils
  Our watch word now was, Prohibition!
                    Prohibition

THE REALITY
Legalization will not eliminate drug profits. It will simply shift
them out of the pockets of traffickers and into the hands of
legitimate businesses. Once this happens then it will be in the
economic interest of businesses to promote their products
and to package them in attractive ways.

People may claim that the government can regulate this but
how well has that worked with alcohol and tobacco? Once
drugs are "legal" then drug sellers can hire lawyers and
lobbyists and make donations to political campaigns to further
their cause. They will pursue their marketing opportunities
and will seek to reduce government regulation.
                               Prohibition

THE CLAIM
The claims are that the US experiment with alcohol prohibition proves that problems result
when a government attempts to make a popular substance illegal. The legalizers claim that
there were increases in organized criminal organizations who sold alcohol illegally. The
legalizers claim that it is better to legalize, tax and regulate drugs than to make them illegal.


A look at the history of Prohibition shows that this argument is deeply flawed for two
reasons:
1. The circumstances surrounding Prohibition are so different than those of today that it is
not helpful in analyzing present-day policy;
2. Prohibition was successful and did not create all the negative consequences that the
legalizers claim it did.

David Teasley, an analyst with the Congressional Research Service of the US Library of
Congress, did an in-depth analysis entitled, "Drug legalization and the Lessons of Prohibition."
Teasley concluded that:
                 Prohibition
A comprehensive analogy between Prohibition and
the modern drug problem is problematic in at least
two major ways. First between the two eras there
are significant differences that tend to undermine
the pro-legalization analogy. Second, many
arguments of the pro-legalizers are weakened by
their reliance upon a widely held set of popular
beliefs about Prohibition rather than upon historical
evidence. Such attempts to create this analogy based
upon these popular beliefs about Prohibition serve
only to confuse the debate over legalization of illicit
drugs.
What differences exist between the time of
Prohibition and now?
               Prohibition

(1) During prohibition the government sought
to restrict the consumption of alcohol
although lacking the consensus of the nation.
Even during Prohibition most people had
experience with and accepted alcohol. That is
not the same today for illicit drugs. Prohibition
went against the national consensus whereas
the current drug policies do not.
               Prohibition

(2) Prohibition laws were different than illicit
drugs laws today. During Prohibition it was
only illegal to sell alcohol and not to drink it.
Today, it is both illegal to sell and to possess
and use illicit drugs. Today’s laws can be used
to target the users while those of Prohibition
could not.
                Prohibition


(3) Criminal penalties for illicit drug use are
  more severe today than in the 1920's so there
  is a more potent deterrent effect.
              Prohibition

(4) During Prohibition the US was "dry" while
the international community was "wet" and
thus the US was at odds with the international
community (much alcohol was imported from
Canada). However, today the international
community is resolute when it comes to drug
policy as witnessed by three U.N. conventions
on the use of illegal drugs.
                Prohibition

 (5) During Prohibition the structure of the
government agencies designed to carry out the
Prohibition laws was unstable, narrow and filled with
political appointees. Today the U.S. national drug
strategy involves over a dozen federal agencies
coordinated by the Office of National Drug Control
Policy. The government bodies that enforce our drug
policies are much larger, with better resources, and
are much more professional than their Prohibition
counterparts.
                       Prohibition

We cannot analogize the history of Prohibition with today’s drug policies
because there is not that much in common. Prohibition was on balance a
successful policy for the following reasons:
There is no doubt that prohibition curbed alcohol abuse as its use declined
by over 50 percent. Deaths from cirrhosis of the liver fell from 29.5 per
100,000 in 1911 to 10.7 in 1929. Admissions to mental hospitals for
alcohol psychosis fell from 10.1 per 100,000 in 1919 to 4.7 in 1928. Suicide
rates decreased 50 percent and the incidence of alcohol-related arrests
also declined 50 percent.
We cannot legitimately compare Prohibition with our current efforts to
control drugs because there are too many differences in the laws, the
political establishment, the moral consensus, and the international
community.
Marijuana and Drug Trafficking
           Prop 19 & Drug Trafficking
                 RAND Study

• Mexican DTOs’ gross revenues from moving
  marijuana across the border into the United States
  and selling it to wholesalers is likely less than $2
  billion, and our preferred estimate is closer to $1.5
  billion.
• California accounts for about one-seventh of U.S.
  marijuana consumption
• If California were to legalize marijuana affecting
  revenues from supplying marijuana to California,
  DTO export revenue losses would be very small, on
  the order of 2–4 percent
          Prop 19 & Drug Trafficking
              RAND Study cont.

• There is no quick, politically feasible fix to
  reducing the DTO violence in Mexico. As a
  number of other researchers have noted,
  there are fundamental issues related to the
  justice system that need to be addressed
  before anyone can expect significant
  improvements in the security situation in
  Mexico
Is Marijuana Harmful?
           Acute Effects of Marijuana –
             During Intoxication (1)
•   Euphoria
•   Calmness
•   Appetite stimulation
•   Altered perception of time
•   Impairs coordination and balance
•   Acute psychosis; Panic (anxiety)
•   Increases heart rate: 20 - 100%
      – Some evidence for increased risk of heart attack, may be exacerbated in
        vulnerable individuals (e.g., baby boomers)
• Impaired Driving
      – Increased risk of accidents
      – Increased culpability
1. Hall W & Degenhard L (2009). Adverse health effects of non-medical cannabis use. Lancet, 374:1383-1391.
             Acute Effects of Marijuana –
                 During Intoxication
• Cognitive Dysfunction (1)
       – Impaired short-term memory
               • Difficulty with complex tasks
               • Difficulty learning
       – Impaired decision-making
               • Increased risky sexual behavior – HIV
• Increased Risk of Injuries (2)
       – 30% higher according to one Kaiser study
       – Increased risk of hospitalized injury from all causes: self-inflicted, motor
         vehicle, assaults
       – Individuals admitted into hospitals with marijuana abuse/dependence as
         their primary diagnosis have median lengths of stay that are twice to
         three times longer than those experienced by patients admitted for
         alcohol, cocaine or heroin and therefore result in higher average charges
1. NIDA, Research Report Series: Cannabis Abuse, 2010 & Hall W & Degenhard L (2009). Adverse health effects of non-medical
   cannabis use. Lancet, 374:1383-1391..
2. Polen, M.R; Sidney, S.; Tekawa, I.S.; Sadler. M.; and Friedman, G.D. Health care use by frequent marijuana smokers who do not
   smoke tobacco. West J Med 158:596-601, 1993.
   Pacula RL, Ringel J, Dobkins C, and K Truong, "The Incremental Health Services Cost Associated with Marijuana Use," Drug and
   Alcohol Dependence, 92:248-257, 2008.
                                Emergency Department
                                 Marijuana Mentions
                       In 2008, there were >370,000 ED visits with Marijuana mentions
                      140,000

                      120,000
Number of ER Visits




                      100,000

                       80,000                                               18 to 24
                                                                            35 and older
                       60,000
                                                                            25 to 34
                       40,000                                               12 to 17

                       20,000

                           0
                                2004   2005     2006     2007    2008

 Source: SAMHSA, Drug Abuse Warning Network, 2008.
       Long-Term Effects of Marijuana
•Cognitive Impairment (1)
       – Deficits in learning, memory, attention, executive function
       – Greater impulsivity, less cognitive flexibility
       – Reversible with prolonged abstinence
•Negative Impact on Educational Outcomes (2)
       – Greater drop out rates
       – General dissatisfaction with life achievement, mental health, social
         relationships




1. Solowij, N., et al. (2002). Cognitive functioning of long-term heavy cannabis users seeking treatment. Journal of the American
   Medical Association, 287, 1123-1131. and Schweinsburg AD, Brown, SA, & Tapert, SF (2008). The influence of cannabis use on
   neurocognitive functioning in adolescents. Current Drug Abuse Reviews, 1:99-111.
2. Macleod, J.; Oakes, R.; Copello, A.; Crome, I.; Egger, M.; Hickman, M.; Oppenkowski, T.; Stokes-Lampard, H.; and Davey Smith,
   G. Psychological and social sequelae of cannabis and other illicit drug use by young people: A systematic review of longitudinal,
   general population studies. Lancet 363(9421):1579-1588, 2004.
       Long-Term Effects of Marijuana
• Brain Effects (1)
      – Structural abnormalities have not been consistently identified.
      – But chronic users show consistent alterations in brain activation of
        higher cognitive networks.
      – Emerging preliminary evidence suggests that heavy cannabis use
        during adolescence may affect normal brain development.
• Respiratory system (2)
      – Increases cough, phlegm production, and wheezing.
      – Increased bronchitis, worsening of asthma symptoms or cystic fibrosis
        symptoms
      – No increase in emphysema
      – Conflicting evidence for lung/upper airway cancer

1. Giedd. J. N. (2004). Structural magnetic resonance imaging of the adolescent brain. Annals of the NY Academy of
   Sciences, 1021, 77-85. and Hall W & Degenhard L (2009). Adverse health effects of non-medical cannabis use.
   Lancet, 374:1383-1391.
2. Tetrault, J.M., et al. Effects of cannabis smoking on pulmonary function and respiratory complications: a systematic
   review. Arch Intern Med 167, 221-228 (2007).
   Tashkin, DP (2005). Smoked cannabis as a cause of lung injury. Monaldi Archives for Chest Disease, 63(2):93-100.
   NIDA, Research Report Series: Cannabis Abuse, 2010.
   Hall W & Degenhard L (2009). Adverse health effects of non-medical cannabis use. Lancet, 374:1383-1391.
       Long-Term Effects of Marijuana
• Mental illness
       – Population studies have found evidence of an association between
         cannabis use and increased risk of schizophrenia (and/or psychotic
         symptoms), and to a lesser extent, depression, anxiety, and suicidal
         behavior/ideation. (1)




1. McGrath, et al. (2010). Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort
      of young adults. Archives of General Psychiatry, 67(5):440-447.
   Room, R., Fischer, B., Hall, W., Lenton, S. and Reuter, P. (2010). Cannabis Policy: Moving Beyond Stalemate, Oxford, UK: Oxford
      University Press.
   Large, M., Sharma S, Compton M., Slade, T. & O., N. (2011). Cannabis use and earlier onset of psychosis: a systematic meta-
      analysis. Archives of General Psychiatry. 68. Also see Arseneault L, et al. (2002). Cannabis use in adolescence and risk for
      adult psychosis: longitudinal prospective study. British Medical Journal. 325, 1212-1213.
          Long Term Effects of Marijuana
     Addiction: About 9% of users may become dependent, 1 in 6
         who start use in adolescence, 25-50% of daily users




                                                                  *            *
               Estimated Prevalence of Dependence Among Users
Source: Wagner, F.A. & Anthony, J.C. From first drug use to drug dependence; developmental periods of risk for dependence upon
cannabis, cocaine, and alcohol. Neuropsychopharmacology 26, 479-488 (2002).
     Dependence on or Abuse of
  Specific Illicit Drugs in the Past Year
   Among Persons 12 or Older, 2008
         Sedatives            126
         Inhalants             175
             Heroin               282
       Stimulants                  351
  Hallucinogens                    358
    Tranquilizers                    451
           Cocaine                                        1,411
   Pain Relievers                                                1,716
        Marijuana                                                                                                     4,199

                         0        500       1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500
                                                     Number in Thousands
Substance Abuse and Mental Health Services Administration. (2009). Office of Applied Studies. Treatment Episode Data Set (TEDS): 2009
Discharges from Substance Abuse Treatment Services, DASIS.
                          Increased Marijuana Treatment
                            Admissions 1993 and 2007
                          60
                                                                                 1993   2007
                          50
  Percent of Admissions




                          40

                          30

                          20

                          10

                          0
                               Alcohol            Cocaine                    Heroin     Marijuana



Source: Treatment Episode Data Set, US Health and Human Services, 1993 & 2007.
                            Treatment Admissions
                                by Drug, 2007
               25   22.3
               20              18
                                         15.8
                                                     13.6
     Percent




               15

               10                                                9.2
                                                                             7.9
                                                                                   5
                5                                                                      3.7
                                                                                             0.5
                0




Source: Treatment Episode Data Set, US Health and Human Services, 1993 & 2007.
                       Average Potency: Increased THC Content in Seized Marijuana,
                                               1983-2009

                                       Potency Range: 4% to 27%

                  10
                   9
                   8
                   7
    Percent THC




                   6
                   5
                   4
                   3
                   2
                   1
                   0

                                                  Year

Sources: The University of Mississippi Potency Monitoring Project
                         What Does Increased
                           Potency Mean?
• Potential for greater exposure, more adverse
  health effects, higher rates of addiction
• ER visits involving marijuana have been going
  up

Dependence rates increased between 1992-
 2002 in specific subgroups (1)
1.   Compton, W., Grant, B., Colliver, J., Glantz, M., Stinson, F. Prevalence of Cannabis Use Disorders in the United States: 1991-
     1992 and 2001-2002 Journal of the American Medical Association.. 291:2114-2121.
Is Marijuana Medicine?
        Is Marijuana Medicine?

• Whole plant is not medicine
• Some constituents, and their synthetics, are:
  – Never smoked
  – Dronabinol (Marinol ®) is synthetic THC delivered
    by pill (Schedule III)
  – Nabilone (Cesamet ®) mimics synthetic THC, also
    delivered by pill (Schedule II)
• Other medications in development currently
  – Today, over 100 DEA-licensed researchers to
    research marijuana and its constituents
      Bypassing the FDA Process
Before FDA approves a drug as medicine, testing is
done to:
    Determine the benefits and risks of the drug
    Determine how it may interact with other
    drugs
    Assure standardization of the drug
    Determine the appropriate dosage levels
    Identify and monitor side effects
    Identify the safe means of administering the
    drug
           “Medical” Marijuana

The IOM Report (ONDCP commissioned in 1999)
• Constituents of the marijuana plant show
  promise for treating pain, nausea, wasting

• It is justified to conduct research into marijuana’s
  active ingredients for conditions or diseases such
  as pain and nausea, as well as on non-smoked
  delivery systems
• “..(t)here is little future in smoked marijuana as
  a medically approved medication.”
             Cannabinoid-based
            FDA Approved Drugs
• Sativex is in the process of being studied
  • Approved in Canada and throughout Europe
  • Administered via an oral spray

 Research on the efficacy of
 cannabinioids is not
 focused on raw/crude
 marijuana, but in the
 individual components that
 may have medical use
Effects on Use Rates
      Consequences of Legalizing
             Marijuana
• 8 out of 10 states with the highest percentage of
  those aged 12-25 who used Marijuana in the past 30
  days were in states that allowed the cultivation and
  the sale of marijuana for “medicinal” purposes.

• Such states are also the majority of states in the top
  ten for first time marijuana use rates.

• Decreases of perception of harm.
               Changes in Attitude Lead to
                    Changes in Use
           Marijuana Use and Perceived Risk among 12th Graders, 1975 to 2009
                                   Past Year Use            Perceived Risk
          60

          50

          40
Percent




          30

          20

          10

           0
               75    78    81     84    87     90      93      96     99     02   05   08
                                                Year
          Source: The Monitoring the Future study, the University of Michigan
     Consequences of Legalizing
            Marijuana
•The younger youth begin to use marijuana, the
 more likely they are to be addicted to
 marijuana or other substances later in life.
•Increased crime in states with “medicinal”
 marijuana laws, especially in states with
 dispensaries.
• Increases in drugged driving rates.
Public Safety
  Are There Public Safety Issues with
             Marijuana

• Marijuana is directly linked to impaired driving.
• Drivers who test positive for marijuana or self-report
  using marijuana are more than twice as likely as
  other drivers to be involved in motor vehicle crashes.
• Three decades of education on drunk driving and
  tough laws have had the direct effect of reducing
  alcohol-related car crashes dramatically in the last
  thirty years.
       Public Safety Continued

• A recent survey by the U.S. Department of
  Transportation found that 1 in 12 tested
  positive for marijuana.
• Published research finds that marijuana
  impairs motor coordination, reaction time,
  attentiveness, and perception of time and
  speed.
       Public Safety Continued

• In a study of seriously injured drivers admitted
  to a Level-1 shock trauma center, more than a
  quarter of all drivers tested positive for
  marijuana.
• New Zealand found that habitual marijuana
  users were 9.5 times more likely to be
  involved in crashes
Incarceration
            Do our Drug Laws
     Incarcerate People Needlessly?
People are not in prison or jail on the state or federal
  level for simply smoking marijuana.

• For Federal prisoners, who represent 13 percent of
  the total prison population, about half (51 percent)
  had a drug offense as the most serious offense in
  2009.
• Federal data show that the vast majority (99.8
  percent) of Federal prisoners sentenced for drug
  offenses were incarcerated for drug trafficking.
       Incarceration Continued

• There are very few people in state or Federal
  prison for marijuana-related crimes.

• A rigorous government analyses of who is in
  jail or prison for marijuana found that less
  than 0.7% of all state inmates were behind
  bars for marijuana possession only
       Incarceration Continued

• Among sentenced prisoners under state
  jurisdiction in 2008, 18% were sentenced for
  drug offenses.

• In total, one tenth of one percent (0.1
  percent) of state prisoners were marijuana
  possession offenders with no prior sentences.
Employment and the Economy
    Will legalizing Marijuana Effect
    Employment and the Economy?


• The Federal Government is against legalization
  and have stated that they will use their
  powers to fine industries and pull Federal
  Contracts worth billions of dollars from States
  to “vigorously enforce the Controlled
  Substance Act”
 Employment and the Economy cont.

• People who smoke marijuana reduce their
  choices of employment, and because of that
  we will lose industries because the Federal
  Government makes it mandatory to have
  Drug-Free Work Place Policies, which means
  you can’t employ or keep marijuana users (the
  drug stays in the system for up to 30 days,
  which means employee will fail drug tests, and
  lose productivity and ability to perform certain
  tasks).
 Employment and the Economy cont.

• To test the idea of taxing marijuana to solve state budget
  issues, we only need to look at drugs that have been legalized.
• In 2005, the State of California spent $19.9 billion dollars on
  substance abuse and addiction or $545.09 per capita on
  alcohol and tobacco.
• The State of California only collected $1.4 billion dollars in tax
  revenue or $38.69 per capita on the sale of alcohol and
  tobacco. Thus, the taxes collected on these substances DO
  NOT EXCEED the social and healthcare costs related to their
  widespread use. If we legalize marijuana, it is likely we will
  follow this same path.
 Employment and the Economy cont.

• The costs of legalizing marijuana would
  outweigh any possible tax that could be
  imposed. In the United States, illegal drugs
  already cost $180 billion a year in healthcare,
  lost productivity, crime, and other
  expenditures. That number would only
  increase under legalization because the use of
  marijuana would increase.
           A Thought

 Many years ago, the philosopher
 Thucydides was asked “When will
   justice come to Athens?” The
philosopher replied “Justice will not
come to Athens until those who are
not injured become as indignant as
      those who are injured.”
Thank You

				
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