An Analysis of Marijuana Policy: Part I

Notice: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The National Research Council was established by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and of advising the federal government. The Council operates in accordance with general policies determined by the Academy under the authority of its congressional charter of 1863, which establishes the Academy as a private, nonprofit, self-governing membership corporation. The Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in the conduct of their services to the government, the public, and the scientific and engineering communities. It is administered jointly by both Academies and the Institute of Medicine. The National Academy of Engineering and the Institute of Medicine were established in 1964 and 1970, respectively, under the charter of the National Academy of Sciences.

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National Research Council

210 Constitution Avenue Washington D. C. 20410

June 21, 1982

Dr. William Pollin, Director
National Institute on Drug Abuse
Parklawn Building
Room 10-05
5600 Fishers Lane
Rockville, Maryland 20857

Dear Dr. Rollin:

I transmit, herewith, a report of the National Research Council's Committee on Substance Abuse and Habitual Behavior: "An Analysis of Marijuana Policy" prepared at the request of the National Institute on Drug Abuse.

The Committee on Substance Abuse and Habitual Behavior, composed of 18 experts in the several relevant disciplines, has weighed carefully the available data regarding the costs, risks, and benefits of the major policy alternatives regarding the control of marijuana use and supply. The Committee is clear in pointing to the deficiencies of this body of evidence and cautions about the hazards of formulating policy recommendations based solely or in part thereon. In this regard, I call your attention to the following statement by Louis Lasagna and Gardner Lindzey contained in the Preface to the report:

The Committee wishes to make clear what it regards as the limits of this report for the selection of policy alternatives. Scientific judgment can estimate the prevalence of different kinds of use, risks to health, economic costs, and the like under current policies and try to project such estimates for new policies. It can come to some conclusions based on those estimates. But selection of an alternative is always a value-governed choice, which can ultimately be made only by the political process.

This caveat notwithstanding, the Committee has derived from its examination of the scientific data a conclusion about the major policy choices facing the nation with respect to marijuana ,complete prohibition, prohibition of supply only, and regulatory approaches. Specifically, the Committee concurs with the judgment of the National Commission on Marijuana and Drug Abuse, rendered in 1971, that a policy of prohibition of supply only is preferable to a policy of complete prohibition of supply and use.

What must be understood by the public, the media, and all who read the committee's report is that its decision to endorse a policy chance was not fashioned from scientific information--old or new--alone. Rather it was the analysis of a combination of factors which affect policy decisions, including the cost and efficacy of enforcement practices. Values were necessarily involved in balancing these factors and there are those within the membership and governing bodies of the Academies and the National Research Council who might not have come to the same policy conclusions, after reviewing the same data my own view is that the data available to the Committee were insufficient to justify on scientific or analytical grounds changes in current policies dealing with the use of marijuana. In this respect I am concerned that the Committee may have gone beyond its charge in stating a judgment so value-laden, that it should have been left to the political process.

I have one further concern that cannot go unaddressed. I fear that this report, coming as it does from a well known and well-respected scientific organization, will be misunderstood by the media and the public to imply that new scientific data are suddenly available that justify changes in public attitudes on the use of marijuana. This would be unfortunate at a time when daily use trends by high school students are down significantly. As the Committee's discussion of marijuana's behavioral and health-related effects clearly demonstrates, there is no new scientific information exonerating marijuana. In fact, the review by our Institute of Medicine, published a few months ago, reevaluated existing scientific evidence and concluded, as have others, that marijuana is a harmful drug whose use justifies serious national concern.

I wish to remind you that this is a committee report; the only position that can be inferred with respect to the National Research Council on the issue of marijuana policy is that the National Research Council is satisfied that the Committee was competent to examine the issue and diligent in carrying out its task. Despite my personal disagreement, I believe that the Committee has performed a useful service by illuminating many of the complex issues surrounding this highly controversial subject.

Yours sincerely

Frank Press

Chairman

Committee on Substance Abuse and Habitual Behavior

Louis Lasagna (Chair), Department of Pharmacology and Toxicology, University of Rochester School of Medicine and Dentistry

Howard S. Becker, Department of Sociology, Northwestern University

Peter Dews, Department of Psychiatry and Psychobiology, Harvard University

John L. Falk, Department of Psychology, Rutgers University

Daniel X. Freedman, Department of Psychiatry, University of Chicago

Jerome H. Jafee, Veterans Administration Hospital, Newington, Connecticut, and University of Connecticut School of Medicine, Farmington, Connecticut

Denise Kandel, Department of Psychiatry and School of Public Health, Columbia University, and New York State Psychiatric Institute

John Kaplan, Stanford University School of Law

Gardner Lindzey (past chair), Center for Advanced Study in the Behavioral Sciences, Stanford, California

Gerald McClearn, College of Human Development, Pennsylvania State University

Charles P. O'Brien, Veterans Administration Hospital, Philadelphia, an(] Department of Psychiatry, University of Pennsylvania

Judith Rodin, Department of Psychology, Yale University

Stanley Schachter, Department of Psychology, Columbia University

Thomas C. Schelling, John F. Kennedy School of Government, Harvard University

Richard L. Solomon, Department of Psychology, University of Pennsylvania

Frank Stanton, New York (formerly, president, Columbia Broadcasting System)

Albert Stunkard, Department of Psychiatry, University of Pennsylvania

Richard F. Thompson, Department of Psychology, Stanford University

Peter K. Levison, Study Director
Dean R. Gerstein, Senior Research Associate
Deborah R. Maloff, Research Associate
Marie A. Clark, Administrative Secretary

Preface

In 1978 the Committee on Substance Abuse and Habitual Behavior began a study of marijuana policy at the request and with the support of the National Institute on Drug Abuse. Sharp increases in marijuana use along with suggestions for reform of existing marijuana laws from scientists and policy makers prompted a renewed look at those laws. In addition, the National Commission on Marijuana and Drug Abuse, in its 1973 final report, Drug Use in America: Problem in Perspective, had recommended that a follow-up commission be appointed to review possible changes in the situation four years later. That recommendation was not Implemented, so the Committee took as a framework for its task the assessment that the Commission recommended, especially the assessment of new evidence regarding the effects of recent changes In state marijuana policies.

The Committee conducted Its study with awareness of the intensity of past controversies about marijuana use in U.S. society. In the four years since the Committee began Its work, there has been an increase in visible concern among many parents about marijuana use among youth, its potential risks to the health of children, and the possibility that heavy use by some young people may seriously threaten their education. Parents who have experienced problems with their own children, or observed those of others, have organized to make marijuana policies - major item on current political agendas. In comparison with the situation at the inception of thin study, there is today greater rancor in public discussion, press reports, legislative hearings, and policy-oriented technical meetings related to marijuana use.

This is the context in which the Committee completed Its review of the evidence and arguments of earlier studies and weighed the significance of subsequent evidence for the major policy alternatives. Every policy has potentially good and potentially bad effects, and policy choices involve difficult comparisons of such effects. It is important to recognize that to allow the inertia developed by existing policies to prevent change is itself a choice.

The Committee is aware that analyzing a topic that is the subject of heated social debate has its hazards. Many of those participating in the marijuana debate have already selected what they take to be the admissible terms of the discussion and look with disfavor on anyone's insistence on a wider set of considerations. For example, some would settle the issue on physiological grounds alone: whether cannabis products, in the dose ranges customarily used by most people, cause tissue damage. Defenders of marijuana use may seize on the ambiguity or absence of evidence for such damage and ignore any other effects on education or safety; those opposed to marijuana use may emphasize the possibility of chronic disease that is suggested by some laboratory findings and Ignore the social, political, and economic costs of fighting a well-established custom.

This report does not review and analyze every conceivable policy nuance or option. It addresses the major choices--both because these families of alternative policies subsume many variants and because the choice among these major options must be discussed before specific, perhaps new, policy instruments can be designed.

The Committee wishes to make clear what it regards as the limits of this report for the selection of policy alteratives. Scientific judgment can estimate the prevalence of different kinds of use, risks to health, economic costs, and the like under current policies and can try to project such estimates for new policies. It can come to some conclusions based on those estimates. But selection of an alternative Is always a value-governed choice, which can ultimately be made only by the political process. The role of scientific evidence in this process is not inconsiderable, even though, at times, the strongest evidence may be pushed aside and the wildest speculation prevail. But the weight of the evidence Is only one factor in the process of policy formation; ultimately, that process Involves value choices.

In completing its report, the Committee has benefited from many people in formulating, revising, and updating the analyses and data. A very early version of this report was discussed at the Committee's annual conference in 1979, and subsequent versions benefited from comments by staff of the National Institute on Drug Abuse and of the National Research Council. The final draft received close and constructive attention by members of the National Research Council's Commission on Behavioral and Social Sciences and Education, the Institute of Medicine, and the Report Review Committee of the National Academy of Sciences.

We have also maintained a close liaison with the staff and members of the Institute of Medicine's Committee to Study the Health-Related Effects of Cannabis and Its Derivatives, on which three members of our Committee also served, and whose recently published report, Marijuana and Health, significantly contributed to our work.

Two former Committee members, Troy Duster and Michael Agar, assisted in the early preparation of the report. At later stages we were very ably assisted by the staff of the Commission on Behavioral and Social Sciences and Education, in particular David Goslin, executive director, and Eugenia Grohman, associate director for reports. Without their help, it is doubtful that we could have completed this task. Finally, we are indebted to the staff and members of the Committee, for their diligence, patience, and commitment to a difficult assignment.

Louis Lasagna, Chair
Gardner Lindzey, Chair, 1977-1980
Committee on Substance Abuse and Habitual Behavior

An Analysis of Marijuana Policy

Introduction

Since the early 1960s the use of marijuana as an intoxicant by a growing proportion of the American population has been an issue of major national concern. Despite repeated warnings of possible adverse health consequences and persistent efforts by law enforcement agencies to restrict the supply and use of marijuana, available data indicate that experimentation with or regular use of the drug is no longer restricted to a small minority of Americans. In 1979, for example, 68 percent of young adults between the ages of 18 and 25 reported having tried marijuana; 35.4 percent reported having used marijuana in the last month. Among adults over age 26, the proportion having ever used marijuana has more than doubled since 1971, from 9.2 percent to 19.6 percent (Fishburne et al., 1980; see Table 1, below).

Although "the marijuana problem" may be viewed as of recent origin, marijuana is not a new drug. The cannabis plant has been cultivated and used both for its intoxicating properties and for its fiber (hemp) thoughout the world for more than 10,000 years (Abel, 1980). At various times and places attempts have been made to restrict its use as an intoxicant; at other times and places its virtues have been extolled for medical purposes, and it has played a significant role in religious ritual. Because cannabis is easily grown--indeed, it is one of the hardiest of all plant species--its resin has been used for centuries along with tobacco, fermented distillates of grains and fruits (alcohol), and opium derivatives as one means of relieving stresses associated with daily life.

Despite its long history, the use of cannabis as an intoxicant was relatively unknown in the United States until the latter part of the nineteenth century, and even then its use as a drug was restricted to a tiny fraction of the population, primarily immigrants from Mexico. The first efforts to restrict its use in this country did not occur until 1911, when Congress, which at that time was considering proposals for federal antinarcotics legislation, listened to arguments that cannabis should be included in the list of illegal drugs. That effort failed, but during the next two decades a number of state legislatures moved to prohibit the possession of marijuana unless prescribed by a physician. It was not until 1937, when the Marijuana Tax Law was enacted, that the federal government became involved in the attempt to control its use. Even this law recognized the industrial uses of hemp and also exempted the seeds of the plant, which were then being sold as bird feed. In 1956, Congress included marijuana in the Narcotics Act of that year and, in 1961, the United Nations adopted the Single Convention on Narcotic Drugs, the terms of which state that each participating country could "adopt such measures as may be necessary to prevent misuse of, and illicit traffic in, the leaves of the cannabis plant." Congress approved participation in the convention in 1967 and three years later passed the Comprehensive Drug Abuse Prevention and Control Act, which provides the basis for current federal prohibitions regarding marijuana use.

Despite this history it was not until the 1960s that most Americans became aware of marijuana. The political and cultural protests of that period focused public attention on young people, their life-styles, and their use of drugs, including marijuana. That period created the context in which public policies regarding marijuana use have been debated since the early 1970s. As Abel (1980) points out, for the first time marijuana use was not restricted to minority groups and fringe elements of society: many of the new users were native-born, middleclass, white college students. Without doubt, the political and cultural context in which marijuana emerged as an issue of national concern has strongly influenced the subsequent policy debate about its use.

The policy debate about marijuana use has also brought into sharp focus two conflicting but deeply held beliefs of large and overlapping segments of the American population. To many, the use of drugs of any kind solely for the purpose of producing states of intoxication is abhorrent, entirely apart from any presumed health effects. At the same time, many people strongly defend the right of individuals to privately indulge their desires, so long as others are not adversely affected. Adding to the complexity of the issues are continuing uncertainties about the health and developmental consequences of marijuana use, concern over the growing number of adolescent users, the social consequences of prosecuting otherwise law-abiding citizens for possession and use of marijuana, the relationship between the distribution of marijuana and that of other illegal drugs, the costs of enforcement of current laws, and the economic implications of the persistence of very large illegal markets.

The next section of this report presents a brief summary of existing evidence regarding the health consequences of marijuana use, drawing heavily on the recently completed study by the Institute of Medicine. The third section summarizes existing federal and state laws relating to the supply and use of marijuana. The fourth section of the report reviews the conclusions of the report of the National Commission on Marijuana and Drug Abuse (1972). The next two sections deal, respectively, with policies regarding the use and the supply of marijuana. The two final sections present a summary of the committee's conclusions regarding major policy options and recommendations for research needed to more adequately assess those options.

The Dangers of Marijuana

Marijuana is not a harmless drug. Although available evidence suggests that marijuana may be less likely than opiates, barbiturates, or alcohol to induce psychological and physical dependence in its users, it has the capacity to reduce the effective functioning of individuals under its influence, and prolonged or excessive use may cause serious harmful biological and social effects in many users.

The recent report, Marijuana and Health, of the institute of Medicine (1982:5[reproduced in the appendix]) concludes:

The scientific evidence published to date indicates that marijuana has a broad range of psychological and biological effects, some of which, at least under certain conditions, are harmful to human health. Unfortunately, the available information does not tell us how serious this risk may be.

Overall, the report concludes (p. 5):

[W]hat little we know for certain about the effects of marijuana on human health--and all that we have reason to suspect--justifies serious national concern.

The complete summary of the Institute of Medicine appears as the appendix to this report.

Over the past 40 years, marijuana has been accused of causing an array of antisocial effects, including: in the 1930s, provoking crime and violence; in the early 1950s, leading to heroin addiction; and in the late 1960s, making people passive, lowering motivation and productivity, and destroying the American work ethic in young people. Although beliefs in these effects persist among many people, they have not been substantiated by scientific evidence.

Concerns about how marijuana affects citizenship, motivation, and job performance have become less salient in recent years as marijuana has moved more into the mainstream of society and has become less exclusively associated with radicals, hippies, or disadvantaged minorities. Though there is still widespread belief that heavy marijuana use may be incompatible with a responsible, productive life, evidence that marijuana has not adversely affected either the productivity or the sense of social responsibility of some groups of users (see, e.g., Hochman and Brill, 1973) has tempered earlier fears of a widespread "amotivational syndrome." Research that correlates marijuana use with undesirable behavior, such as alienation or inattention to school studies, has not established the direction of causality or ruled out spurious associations (see, e.g., Beachy et al., 1979). This issue, however, continues to be the subject of lively controversy and the Institute of Medicine report (1982:125) concludes that "it appears likely that both self-selection and authentic drug effects contribute to the 'motivational' problems seen in some chronic marijuana users."

Recently, a body of literature has accumulated that reports on links between marijuana use and such health impairments as lung disease, chromosome damage, reduced reproductive function, and brain dysfunction (summarized in Institute of Medicine, 1982, and National Institute on Drug Abuse, 1980). In some areas--for example, effects on the nervous system and behavior and on the cardiovascular and respiratory systems--there is clear evidence that marijuana produces acute short-term effects (institute of medicine, 1982:2,3):

With a severity directly related to dose, marijuana impairs motor coordination and affects tracking ability and sensory and perceptual functions important for safe driving and the operation of other machines . . . . (It also] increases the work of the heart, usually by raising the heart rate and, in some persons, by raising blood pressure.

There is as yet no such clear evidence on the possible long-term effects in these areas, or of other potential health consequences of marijuana use; further research is needed. In addition, most studies on human populations have been laboratory studies of young, healthy adult males. Differential effects of marijuana use on the elderly, on pregnant women, on groups that are psychiatrically vulnerable or at risk for disease or dysfunction, and particularly on adolescents have not been studied systematically.

In our view, the most troublesome aspects of marijuana use are its potential effects on the development of adolescents. Parents as well as a number of clinicians and researchers are concerned that the social and intellectual development of teenagers may be harmed by chronic marijuana use. There is good evidence that intoxication may seriously impair such important skills as comprehension and retention of newly presented educational materials (Institute of Medicine, 1982). Rapidly growing tissues have been shown to be particularly vulnerable to some, although by no means all, toxic agents, and there is at least a possibility that toxic effects may be subtle and not clearly manifest until adulthood. Scientifically, these are difficult relationships to identify, and the research to date is still insufficient to strongly support any relationship.

Perhaps more significant than any lasting biological effect is the effect of the drug in different patterns of use on emotional development, on the formation of habits, and on the acquisition of coping skills for stress situations. indeed, although the many issues raised by the use of intoxicants to escape stressful challenge have not been systematically studied, the evident attractiveness of marijuana to many adolescents, and its possible dose-related interference with the study and hard work needed for intellectual development in the crucial high school years, make this a special matter for concern. This is particularly so in light of the fact that, unlike alcohol, marijuana is used by many adolescents during school hours. Finally, reports of the effects of marijuana use on automobile driving skills are worrisome.

This Committee has reviewed the scientific literature surveys of marijuana effects on health and behavior, including the major recent study conducted by the Institute of Medicine (1982) and those by the National Institute on Drug Abuse (1979; 1980), Tashkin et al. (1978), Nahas (1977), and Fried (1977). We agree with the conclusion of the Institute of Medicine report that it is likely that long-term heavy marijuana use will be shown to result in measurable damage to health, just as long-term chronic tobacco and alcohol use have proven to cause such damage. It is evident that the full impact of marijuana use on human health will not be clear without careful epidemiological studies involving substantial populations of users--a matter of some decades--even though it is predictable that this drug--like all others--will cause harm in some of its users, particularly in its heaviest users, and among these, in its heaviest adolescent users. At this time, however, our judgment as to behavioral and health-related hazards is that the research has not established a danger both large and grave enough to override all other factors affecting a policy decision.

Overview of Current Marijuana Policies

Current federal and state marijuana laws are in part governed by international treaty. The major federal law relevant to marijuana is the Comprehensive Drug Abuse Prevention and Control Act of 1970, which repealed all prior federal legislation and reduced federal penalties for possession and sale. Although marijuana possession and sale are still prohibited, possession has been reduced from a felony to a misdemeanor offense; the maximum penalty for a first offense is $5,000 and one year's imprisonment. The Act also provides for conditional discharge, by which first offenders found guilty of simple possession or casual transfer (which is treated as simple possession) may be placed on probation for up to one year (Congressional Digest, 1979).

The Uniform Controlled Substance Act of 1970, drafted by the National-Conference of Commissioners on Uniform State Laws, was designed to make state laws more compatible with the new federal law. Like the federal act, the Uniform Act reclassified marijuana as a hallucinogen rather than a narcotic and reduced the penalty for possession from the felony to the misdemeanor level; a majority of the states have adopted the Uniform Act. Eleven states have withdrawn the criminal sanction from possession for personal use. In these states, arrest has been replaced with a traffic-ticket type of citation, and a small fine is the sole allowable penalty; About 30 states include some provision for conditional discharge of first offenders, and about a dozen of them provide for all records of the offense to be expunged. The Alaska Supreme Court ruled in 1975 that possession for personal use by adults at home was protected by the constitutional right to privacy and hence was not subject to any penalty (Rosenthal, 1979).

State penalties for second-offense possession and for selling marijuana are extremely variable. (See National organization for the Reform of Marijuana Laws and Center for Study of Non-Medical Drug Use, 1979, for summary tables of state marijuana laws.) Sale is almost always a felony, with maximum sentences ranging from two years to life, although casual transfer, or "accommodation," is sometimes exempt from felony treatment. All but 15 jurisdictions punish cultivation as heavily as they do sale; the Uniform Act includes the two in the same classification (manufacture), with the same penalty provisions.

Federal prohibition of small-scale possession is virtually unenforced. At the March 1977 House of Representatives hearings on decriminalization, the chief of tile criminal division of the Department of Justice testified that the federal government no longer effectively prosecutes the use of marijuana, "nor do we, under any conceivable way, in the Federal Government have the resources to do so" (Select Committee on Narcotics Abuse and Control, 1977:13). In terms of its effects from a law enforcement point of view, the present official federal policy of complete prohibition does not differ in fact from a policy of prohibition of supply only. Complete prohibition is tile federal law, but partial prohibition is the practice. However, the law, even though partly unenforced, has probably had a restraining influence on the willingness of states to adopt policies of less than complete prohibition. The states traditionally have followed the federal lead in drug abuse legislation, although they are not legally required to do so (see the testimony of Jay Miller, American Civil Liberties Union, to the Select Committee on Narcotics Abuse and Control, 1977). in summary, in most states and according to federal law, U.S. marijuana policy is one of complete prohibition--that is, prohibition of both supply and use.

Major alternatives to complete prohibition include prohibition of supply only--called partial prohibition-and regulation.* Prohibition of supply only means having no penalty (or only civil penalties) for use, possession, or, sometimes, "casual transfer" of small quantities of marijuana, while having criminal penalties for manufacture, importation, or commercial sale of marijuana. Regulation means not only eliminating penalties for use but also allowing controlled production and distribution.

*In this discussion, we use the terms "complete prohibition," and "prohibition of supply and use" interchangeably. We also use the terms "partial prohibition," to prohibition of supply only," and "decriminalization" as equivalent. We generally prefer the terms "partial prohibition," or "prohibition of supply only" since many people seem to regard decriminalization as the equivalent of legalization or regulation- --which it most certainly is not. (Tile policy of partial prohibition has also been called the vice model.) Finally, we use "regulation" and "legalization" as equivalent terms.

Within each of the three broad policy options-complete prohibition, prohibition of supply only, and regulation--numerous subsidiary policy choices exist. For example, a policy of complete prohibition necessitates decisions about the resources to be devoted to enforcement, the appropriate penalties to be imposed for violations, and whether marijuana should be made available for any medical uses. Under a policy of prohibition of supply only, decisions must still be made about penalties and permitted medical uses. in addition, one must also determine how to distinguish between users and suppliers whether cultivation should be permitted; how stronger preparations of the cannabis plant, such as hashish, should be treated; whether to criminalize smallscale casual transfers, made with or without payment; and what should be done about certain specific behaviors, such as the public use of marijuana and the operation of motor vehicles under the influence of the drug. Under a policy of regulation, some of the issues to be decided are the type of control system (e.g., state monopoly or licensed sale), the rules as to potency and quality, and appropriate penalties for violation of tile system's rules.

The variety of choices within each of the broad policy options suggests that none can be characterized in a monolithic way. Some regulatory systems could be so stringent as to have results similar to prohibitory laws: e.g., a regulatory system that raised tile price drastically above what the illegal market charges. Similarly, lack of enforcement could strongly reduce the impact of a prohibitory option. As we have already noted, this latter effect has already occurred in some jurisdictions in which the law provides for complete prohibition but users are not in fact prosecuted.

A Review of the Report of the National Commission on Marijuana and Drug Abuse

An attempt to describe a full array of policy options together with associated benefits and detriments of each of them was made by the National Commission on Marijuana and Drug Abuse in its 1972 report, Marijuana: A Signal of Misunderstanding. With respect to the major policy choices, the Commission did a thorough job. Tile members and staff recognized the limited knowledge base for their deliberations and subsequently recommended that a second commission be appointed to review the situation four years later. Such a follow-up commission was never appointed. It seems appropriate, then, that titis Committee reappraise the Commission's work in light of subsequent research findings, especially those relating to recent changes in marijuana policies.

The Commission examined the spectrum of social policies available to control marijuana use and the benefits and detriments of implementing each policy. The legal. alternatives presented included those identified above: complete prohibition; prohibition of supply only; and regulatory approaches. The Commission emphasized that choosing among the three approaches requires consideration of the social milieu, cultural values, and practicalities of implementation. The Commission considered such social conditions particularly important in examining marijuana controls because both use of the drug and the laws prohibiting supply and use had symbolic importance, representing a clash of values between a dominant culture that opposed marijuana use and a large minority that either used marijuana or condoned its use. The probable effects of the various policies considered by the Commission include changes in use patterns, enforcement costs, and influence on related social concerns such as the marketing of other illicit drugs and general respect for law.

The Commission commented on all three broad policy options. It suggested first that total prohibition has resulted in costly enforcement, alienation of the young, discrimination through selective enforcement, some deterrence of supply (especially to middle-aged and middleclass potential users), but minimal deterrence of use by those with access to the drug. Second, the Commission stated its belief that prohibition of supply only wotAd support the official policy of discouraging use, but at the same time would recognize the practical difficulties of attempting to eliminate use. The report listed a number of choices that might be made under a system of partial prohibition and described some of the practical problems they might entail (e.g., the need to distinguish between casual and commercial distributors). Finally, the Commission described regulation as a policy that only mildly disapproved of occasional use and that concentrated on controlling excessive use, but was mostly designed to lower the costs of prohibiting the drug. The Commission argued that marijuana consumption would increase considerably if complete prohibition were replaced by regulation. in addition, the Commission considered a major drawback of any regulatory system to be that its elimination of the main symbol of society's disapproval--criminal sanctions--would cause resentment among the nonuser majority of the population. Marijuana was described as being symbolic of countercultural lifestyles: "the drug's symbolism creates a risk of strong political reaction to any liberalization of the present laws by older members of the society" (National Commissioned on Marijuana and Drug Abuse, 1972, Appendix Volume 11:1149).

On balance, the Commission concluded that, since the threat of punishment had not apparently deterred the millions of people who had already used marijuana, the replacement of complete by partial prohibition would not produce a significant increase in marijuana use. Consequently, the Commission recommended that individual marijuana users should not be subject to criminal prosecution for their private use or possession of small amounts of the drug, and that, on balance, the best policy was one of prohibition of supply only. In accordance with this view, the Commission recommended that federal and state laws should be amended to achieve partial prohibition. In the decade since the Commission report, a number of states have changed their laws in varying ways. These legal changes can be viewed as natural experiments, and one can use the data from them to reassess the Commission's conclusions regarding these policies.

The Use of Marijuana: Comparing Complete and Partial Prohibition

To compare the two types of marijuana control policies presently used in the United States--prohibition of supply and use and prohibition of supply only---we need to consider only the one particular in which they differ: the application of criminal sanctions against marijuana users. To compare the effects of the two policies, we can examine the effects of the prohibition of use and determine whether prohibition results in more costs than benefits or vice versa.

In recent years the prohibition of marijuana use has come under increasing criticism. Many students of the U.S. marijuana situation, including the National Commission on Marijuana and Drug Abuse, members of Congress, political analysts, and legal experts, have suggested that existing laws prohibiting marijuana use be repealed. These suggestions have been prompted by the failure of current policies to deter large numbers of users, the consequent criminalization of large numbers of young Americans, and the high social costs of such law enforcement. A number of professional associations and agencies have also gone on record in support of the removal of all criminal penalties for the private possession and use-of marijuana as a means of reducing the economic costs of law enforcement and the social costs of arrest or imprisonment (criminalization) of young people who are otherwise not criminally involved or labeled. The organizations and agencies that have expressed this view include the American Medical Association, the American Bar Association, the American Public Health Association, the Canadian Commission of Inquiry into the Non-Medical Use of Drugs, the National Council of Churches, the National Advisory Commission on Criminal Justice Standards and Goals, the National Commission on Marijuana and Drug Abuse, among others. Eleven states, with one-third of the nation's population, have adopted some version of partial prohibition or "decriminalization." (In Oregon, Alaska, Maine, Colorado, California, Ohio, Minnesota, Mississippi, New York, North Carolina, and Nebraska, citations and small fines have replaced arrests and incarceration for use-only marijuana-related offenses.)

At first glance, criminalizing the selling of marijuana might appear inconsistent with failing to punish its purchase. But in the drafting of laws, a line is often drawn between legal and illegal conduct so that the maximum reduction in the proscribed behavior can be gained at minimum social cost. Frequently it turns out that laws aimed solely at suppressing sales are more cost-effective In reducing both the possession and use of a substance than are laws that attempt to suppress possession directly. There are several reasons for this. First, there are fewer sellers than buyers; this permits a concentration of law enforcement efforts where they do the most good. Second, juries are likely to be more sympathetic to a "mere" user, who may be ill-advised, than to a dealer making a profit from the weaknesses of others. Offenses treated under the vice model (partial prohibition) range from gambling--the person who takes illegal bets is guilty of a crime while the person who places them is not--to the offense of selling new automobiles not equipped with seat belts--the seller, not the buyer, is guilty of an offense. Even Prohibition in 1919 never criminalized the possession or use of alcohol, only its manufacture and sale.

Effects of Partial Prohibition

Probably the most important fact about a policy of prohibition of supply only is that where It has been adopted it has apparently not led to appreciably higher levels of marijuana use than would have existed if use were also prohibited. The National Commission on Marijuana and Drug Abuse's speculations about the lack of change in use patterns resulting from repeal of prohibitions on use have been confirmed by data since 1972. Reports from California, Oregon, and Maine indicate no appreciable increase in use following decriminalization of use, at least in the short term.

Oregon, the first state to repeal prohibition of use (in October 1973) has been studied in a series of Drug Abuse Council surveys (National Governors' Conference, 1977). Surveys in 1974 and 1975 showed no major increase following decriminalization. While the percentage of adults who were current users had increased by January 1977 (from 20 to 24 percent), use had increased similarly nationwide in the same period, suggesting that the causes .for the adult increase in Oregon were the same as those for increases in the rest of the country rather than the result of changes in the law. Indeed, the percentage of adult ever-users in Oregon in 1976 (24 percent) was lower than the average percentage of adult ever-users in the western United States (28 percent) in 1975-1976, although higher than the national average (21.3 percent). (it should be noted that aggregate use rates in the western United States are heavily weighted by use rates in California, the largest western state, which had relatively high rates even prior to the state repeal of prohibition of use.) That the increase in use in Oregon from 1973 to 1976 was probably not due to the new law is suggested by other survey data. Only a small proportion of nonusers said fear of legal prosecution was a reason for nonuse in 1974, 1975, and 1976 (National Governors' Conference, 1977). on the question of the fear of health dangers, Drug Abuse Council survey data show that such fear decreased significantly over those years but has increased since 1976.

The state of Maine, which repealed criminal penalties for marijuana use in May 1976, surveyed the effects of legislation in July and August 1978 (State of Maine Department of Human Services, 1979). Its study concluded that the change from criminal to civil penalties has not caused a large increase in marijuana use: less than 1 percent of all adults and 3.1 percent of all high school students reported any increase in their use as a result of the new law; 3.5 percent of adult regular users and 7 percent of high school regular users reported any increase in their use directly attributable to the change in the law. There is also preliminary evidence, based on a nationwide study of high school students between 1975 and 1979, that "any increase in marijuana use in the decriminalized states, taken as a group, was equal to or less than the increases being observed in the rest of the country where decriminalization was not taking place" (Johnston, 1980:5). It could be argued that because de facto repeal of prohibition of use has been taking place throughout the country, one should not expect to see larger increases in use in states that legally decriminalize than in others. Even if this is true, however, the important point is that the legal change to decriminalization does not, in itself, appear to lead to increases in use.

This lack of change is not particularly surprising. The statistical chance that any person would be apprehended for his or her use is, in fact, extremely low throughout the United States (though, as we note below, the large number of users is sufficient to generate a substantial volume of arrests in states that do prohibit use). As a result, it is hard to imagine that the deterrent effect of prohibition laws on any given user would be very great.

It has been suggested that repeal of government prohibitions might change attitudes related to health or morals, perhaps symbolizing that health officials certify marijuana use to be safe. The absence of large increases in marijuana use in repeal states, however, indicates that either the change in policy has not had such a symbolic effect, or that, if it has, its causal significance is not appreciable--though it must be acknowledged that changes of this type might take generations to occur.

Costs of Prohibition of Use

The costs Of Policies directed at the user are not negligible, although actual savings in law enforcement costs attributable to repeal of prohibition of use per se are difficult to estimate. The difficulty arises in part because marijuana arrests have decreased nationally in recent years, reflecting the overall tendency to relax enforcement of marijuana laws, and that change could lead to inaccurate estimates of the impact of repeal. Nevertheless, reduced law enforcement activities seem to have led to substantial savings in states that have repealed laws that prohibit use.

California made a careful study of the economic impact of its law repealing prohibition of use, which went into effect in January 1976 (State Office of Narcotics and Drug Abuse, 1977). The law reduced the penalty for personal possession of one ounce or less of marijuana from a possible felony to a citable misdemeanor, punishable as an infraction with a maximum fine of $100 without regard to prior possession offenses. Criminal custody, booking, and pretrial incarceration procedures were eliminated. Possession of more than one ounce was also made a Misdeanor with a maximum fine of $500, six months in jail, or both. According to the study, these changes resulted in a 74 percent reduction in what the state had been spending yearly to enforce its marijuana laws. (Estimates of what the state had been spending ranged from $35 million to more than $100 million yearly; see National Governors' Conference, 1977.)

In addition to its economic benefits, repealing prohibition of use saves the social costs of criminalizing the marijuana user. In recent years, close to 400,000 people have been arrested each year for marijuana-related offenses despite the general nonenforcement of criminal sanctions for use (Federal Bureau of Investigation, 1980). Only a small fraction of the arrests are made under federal law, largely for importation of marijuana. About 85 percent of all marijuana-related arrests are for possession, usually of one ounce or less (see, e.g., Stare Office of Narcotics and Drug Abuse, 1977).

A study by the National Commission on Marijuana and Drug Abuse of a sample consisting of some 3,000 of the people arrested for marijuana-related offenses in 1970 indicated that the marijuana arrest was usually the arrestee's first experience with the criminal justice system, particularly among juveniles (National Commission on Marijuana and Drug Abuse, 1972). Yet, "it is standard practice for law enforcement agencies to report, such offenses to prospective employers,, licensing agencies, and other authorities as 'narcotic drug arrests"' (testimony of Jay Miller, American Civil Liberties Union, to the Select Committee on Narcotics Abuse and Control, 1977). Thus young users, who are often otherwise law abiding people, are subject to an arrest record, or even a prison term, with implications extending into many aspects of their lives.

Alienation from the rule of law in democratic society may be the most serious cost of current marijuana laws. The National Commission on Marijuana and Drug Abuse was concerned that young people who see no rational basis for the legal distinction between alcohol and marijuana may become cynical about America's political institutions and democratic process. The American Bar Association report (printed in Select Committee on Narcotics and Drug Abuse, 1977) concurs in the view that marijuana laws that criminalize the millions of Americans who have used marijuana engender disrespect for the law.

Public Attitudes Toward Partial Prohibition

Although the National Commission on Marijuana and Drug Abuse concluded that prohibition of supply only would be a better policy than prohibition of supply and use, it felt that a serious disadvantage of such a course would be the upset and moral outrage such a policy would engender. Hindsight now shows that the Commission was mistaken in predicting a strong uniform public reaction to the adoption of partial prohibition policies. Experience since 1973 has shown that repeal of criminal penalties for use of marijuana has not been accompanied by massive public protest in the states in which it occurred and, in fact, has had the approval of the majority of citizens in those states (National Governors' Conference, 1977).

Nationally, attitude trends are consistent with the experience of the repeal states. Roffman (1978) reports that public opinion surveys indicate a slowly increasing preference for a reduction in penalties for marijuana offenses; a 1975 national survey (National institute on Drug Abuse, 1975-1976) found that 52 percent of American adults favored only a fine or probation for small marijuana offenses; and a 1977 Gallup poll showed that 28 percent of the public favored legalization, compared with 12 percent in 1969.