Category Archives: Drug Policy

Drug Abuse Expert says Gateway Theory is Fact

Former NIH Drug Abuse Director Sends Letter to Canada Task Force on Marijuana

To the Canadian Task Force on Marijuana Legalization and Regulation:

By way of introduction, I was the first Director of the National Institute of Health’s National Institute on Drug Abuse (NIDA), the United States’ principal agency devoted to scientific research on drugs of abuse, including marijuana. I am currently the President of the Institute for Behavior and Health, Inc., a non-profit organization devoted to reducing illegal drug use, and Clinical Professor of Psychiatry at Georgetown University School of Medicine. I urge you to not underestimate the significant negative public health impacts of marijuana legalization.

In response to the discussion paper, Toward the Legalization, Regulation and Restriction of Access to Marijuana, I would like to share with you some important information specifically related to the discussion of the gateway theory. Marijuana is in fact a “gateway” drug – but importantly, it is not the only gateway drug. Alcohol and tobacco are also gateway drugs. By this I mean that their use is highly correlated with one another and nearly always precipitates the use of other substances. Recent analysis of data from the US National Household Survey on Drug Use and Health (NSDUH) confirm that among young people aged 12 to 17, using one of these three primary drugs of abuse dramatically increases the likelihood of use of the other two, as well as use of other illicit drugs. Similarly, the decision not to use any of these three drugs is negatively correlated with use of the other two drugs (as well as other illicit drugs). This finding has significance for Canada and the US, as well as any other nation considering adding marijuana as a third legal drug for adults. More use of marijuana means more use of other drugs, including the two currently legal drugs. As such, given that the vast majority of substance use disorders, i.e., addiction, can be traced to initiation of substance use during adolescence, there must be significant focus on prevention.

Marijuana is not a harmless drug as it is often perceived to be today. In the US, marijuana accounts for more substance use disorders than any other drug (other than alcohol). Of the 7.1 million Americans aged 12 and older with substance use disorders related to illicit drugs, nearly 60% are dependent on or abuse marijuana (Center for Behavioral Health Statistics and Quality, 2015). The only drug that causes more substance use disorders than marijuana is alcohol.

Making marijuana more easily accessible and subsequently increasing its use by the public should be of serious concern to the Canadian government and its citizens. Recent research has shown that daily or near-daily marijuana users in the US consume most of the drug, with the poor and less-educated representing a disproportionate number of marijuana users (Davenport & Caulkins, 2016). Protecting the vulnerable populations – from youth to the disadvantaged – must be a national and global priority.

I urge you to support policies and programs that seek to reduce drug use, including marijuana use, and to improve public health. Making marijuana more accessible and its use more acceptable is not in the interest of public health.

Sincerely,

Robert L. DuPont, MD
President
Institute for Behavior and Health, Inc.

Editors Note:  The New York Times opinion series “Room for Debate” asked if marijuana should be legalized in the face of today’s heroin and opioid crisis and if it is a gateway drug. IBH President Robert L. DuPont, MD contributed to the series stating that marijuana use is positively correlated with other drug use; marijuana users consume more legal and illegal drugs than non-users. Rather than legalize drugs, effective prevention is needed. He clearly states that establishing marijuana “as a third legal drug, along with tobacco and alcohol, will increase drug abuse, including the expanding opioid epidemic.”

SAM Canada on the Canadian Statement to the UN General Assembly on April 20, 2016

by Pamela McColl, Smart Approaches to Marijuana Canada   pjmmccoll@shaw.ca

We are greatly disappointed that Canada used its precious time on the global stage to promote the legalization – and thus commercialization – of cannabis. This statement sent a powerful message from our government that profits come ahead of public health.

Not mentioned was the global call among scientists this week that cannabis harms should be widely publicized. This new call to action has been released from scientists around the world, reflecting “a growing consensus among experts that frequent cannabis use can increase the risk of psychosis in vulnerable people and lead to a range of other medical and social problems. ” according to the The Guardian. It was reported that researchers now believe the evidence for harm is strong enough to issue clear warnings. This is in line with a recent World Health Organization report on the harms of cannabis.

Legalizing cannabis creates the potential for broad scale development, manufacture, and marketing of marijuana products.

This dynamic becomes even more pernicious when coupled with the higher addiction rates among underage marijuana users. One of the best ways to develop and capture heavy users is to encourage use at the earliest age possible, when dependence is more likely to develop. This mirrors business strategy by the multi-billion-dollar tobacco industry

It is therefore no surprise that the marijuana industry is borrowing another page from the tobacco playbook by marketing colorful, kid-friendly edible marijuana products. These “edibles,” such as the ones shown below—including marijuana-laced candies, lollipops, gummy bears, and sodas—already account for roughly 50% of the Colorado marijuana market.

Additionally, these market dynamics explains the marijuana industry’s efforts to drive potency of its products as high as possible. As noted earlier, the average potency of smoked marijuana has increased at least six-fold since the 1960s (to around 14% in the US), with edibles and concentrates pushing the rate even higher, up to 95%. The industry has also opposed recent attempts to cap potency at 15% in Colorado.

And the effects of legalization in Colorado have been devastating from a public health perspective. A report from the state of Colorado released this week highlighted their immense challenges.

As a network of more than 300 NGOs have said this week at the UN, we need to prevent, not promote, drug use and addiction. Instead of promoting the use of a dangerous drug, this is what should have been Canada’s theme too.

According to Macleans Canada, here’s the text of Health Minister Jane Philpott’s speech on April 20, 2016.

California Legislator Writes Bill Favoring Convicted Felon

By Roger Morgan, Take Back America Campaign. Follow the campaign on Facebook and Twitter with the hashtag #StopPot

California is already in violation of federal laws pertaining to Controlled Substances. To make matters worse assembly member Rob Bonta of Oakland wants to give license to felons to grow and/or sell pot.  Steve DeAngelo, a pot mogul, denies that the bill was written to favor him. Continue reading California Legislator Writes Bill Favoring Convicted Felon

Marijuana Legalization Based on False Premises

False Premises about Marijuana is Misleading Americans

Sven-Olov Carlsson opened the 5th Annual World Federation of Drugs Conference with an address challenging current popular premises in drug policy at this time. When discussing marijuana, Carlsson said the false premises for legalization is misleading Americans.

The United States has replaced drug prevention strategy with a  “Harm Reduction” strategy.  We need to look at the current heroin epidemic and acknowledge that the United States loses 129 people each day to drug overdose deaths, up from 78 a day a few years ago.   We have less than 5% of the world’s population and nearly 60% of the world’s drug users.  Let’s prevent initiation into drug use and bring down the desire to do drugs.

false-premise
Sven-Olov Carlsson is President of World Drug Federation. Photo: Drug News

Speaking in Vienna last week, Carlsson said, “A successful drug policy makes clear that drug use is unacceptable. ” Carlsson described the false premises surrounding marijuana in his presentation. Here are excepts from his speech with very minor edits:

  • The first false premise is that The Criminalization of Drugs Fuels the HIV/AIDS Epidemic. It does not.

The prohibition of illegal drug use does not encourage the spread of HIV/AIDS. Rather it reduces illegal drug use among HIV/AIDS patients, as well as the non-infected population thereby reducing the population vulnerable to HIV/AIDS infection by contaminated needles.

Illegal drug use exacerbates weaknesses of the immune system, making individuals with AIDS more susceptible to infection and death. Marijuana use causes impaired immunity and opens the door for the virus that causes Kaposi’s Sarcoma, life-threatening for individuals with HIV/AIDS. Marijuana also contains bacteria and fungi that put users at risk for infection.

Illegal drug use among AIDS patients is life threatening because these drugs lessen the effectiveness of anti-retroviral (ARV) medications.

Non-medical drug use is associated with increased risky sexual behaviors, which promote transmission of HIV/AIDS in a way that needle exchange cannot prevent.

  • The second false premise is that the Criminal Justice System and the Public Health System are Conflicting Approaches to Drug Policy. They are not.

The Criminal Justice System and the Public Health System Are Complementary and Not Conflicting Approaches to Drug Policy.

Prevention and treatment are programs that promote public safety and public health. “Harm reduction” tolerates, and thus perpetuates, non-medical drug use.

“Harm reduction” seeks to reduce the “harm” caused by non-medical drug use without stopping the use itself.  Substance abuse prevention and treatment work to stop non-medical drug use. Making non-medical drug use as a crime is an important public health strategy that reduces many of the “harms” produced by illegal drug use.

The challenge of future drug policy is to find ways to encourage the legal and justice systems to work better together with prevention and treatment to achieve goals that neither can do alone.

Treatment systems can work together with the criminal justice system by incorporating new, effective and evidence-based strategies to reduce illegal drug use among criminal offenders. These approaches also reduce the commission of new crimes and associated incarceration.

  • The third false premise is that Major Costs of illegal Drug Use are generated by the criminal justice system itself. It is not.

The greatest costs of illegal drug use are not generated by criminal justice system but by the non-medical drug use itself.

The costs include not only sickness and death but also reduced productivity and the high healthcare costs generated by illegal drug use.

The future of an improved drug policy is not to legalize intoxicating drugs of abuse, including marijuana.

It is the development of a balanced, restrictive drug policy that prevents drug use and intervenes with drug users to provide them with a path to life-long recovery.

Instead of legalizing drugs, an enlightened drug policy can harness the criminal justice system to thwart drug markets, facilitate entry into treatment and restrict incarceration to egregious offenders.