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As Marijuana Becomes Legalized, Will More People Use It?

Dr. Malik Burnett and Amanda Reiman, PhD, MSW

Dear Doctors,

I don’t know if this is a silly question, but my friend keeps saying that marijuana shouldn’t be legal because then more people will use it. But, if marijuana use is safer than alcohol and not associated with some of the same harmful behaviors, then would more people using it be such a bad thing?

Just wondering

Dear Just Wondering,

Your question is not silly at all. Data like use rates of various substances, injury rates, death rates, graduation rate are all considered “metrics.”

This means that we look at these numbers as ways to determine whether certain programs or policies are successful in achieving the desired outcome. For example, if there is a patch of ice on the sidewalk and people keep slipping, we might put salt down with the goal of reducing the chance of someone hurting themselves. An appropriate metric to determine whether our salt intervention was successful would be if less people slipped on the sidewalk.

But, sometimes the metric chosen is not appropriate for determining the success of an intervention or policy. Take crime for example. If interventions to reduce crime are successful, the outcome would be less crime. However, many police departments use the number of arrests to as a metric to determine success.

This is inappropriate because more arrests actually mean more crime is occurring not less. In actuality, an empty prison would be a sign of successful crime prevention, not the mass incarceration extravaganza we have in the United States.

So, on to your question about marijuana use rates as a metric for success. Since the inception of the war on drugs, we have had two metrics for determining success: the number of people arrested for drug use/selling, and the rates at which people use drugs. We have already determined that the arrest metric is inappropriate, but how about the use metric?

Let’s look at it this way. Let’s say a new kind of car is invented and it is cheaper, faster, safer and less harmful to the environment than any other car on the road. People are flocking to buy this car, even people who have never had a car before. This results in an increase in the number of people driving a car. Using the marijuana logic, this increase alone is a bad thing because more people driving will surely lead to more accidents.

However, if the increased driving is in this new, safe, environmentally friendly car, perhaps car use itself is not the right metric. Perhaps a better metric to determine whether having all these new drivers would be outcomes like car accidents, and exhaust emissions. In other words, an increase in a given behavior does not necessarily mean there will be more of the harms associated with that behavior, and there may in fact be less. And in fact, a recent study published in Nature determined that marijuana is the safest recreational drug, including alcohol and tobacco.

Let’s take a look at places where marijuana has been liberalized, either through medical approval, decriminalization or full adult use legalization. In Colorado, fatal car crashes are down six percent since legalization, and arrests for marijuana are down 10 percent. Many would say that less people getting in trouble for marijuana is a better metric of success than marijuana use rates given the harms of a marijuana arrest compared to the drug itself.

Furthermore, a recent report by the Criminal Justice Policy Foundation found that states with more liberal marijuana laws enjoyed a reduction in youth risk outcomes such as prescription drug overdose and school drop-out rate.

Over the past 40 years, the war on drugs has not impacted the rates at which people use drugs. Perhaps it is time to choose another metric, one that is appropriate for determining actual harms to society.


The Doctors

Dr. Malik Burnett is a former surgeon and physician advocate. He also served as executive director of a medical marijuana nonprofit organization. Amanda Reiman, PhD, holds a doctorate in Social Welfare and teaches classes on drug policy at the University of California-Berkeley.

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