Pubdate: Sun, 11 Aug 2013
Source: Boston Globe (MA)
Copyright: 2013 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Chris Berdik

DO MEDICAL-MARIJUANA LAWS SAVE LIVES ON THE ROAD?

America's Experiment With Legalizing Pot Yields a Surprise-and a
Puzzle.

As legal marijuana spreads across America, mostly for medical use,
anxiety about its side effects is spreading with it: What other
changes will it bring?

Campaigns against loosening the law tend to focus on its unknown and
possibly dangerous repercussions-a surge in pot smoking, perhaps
opening the door to increased use of harder drugs and to associated
spikes in crime and other societal ills.

Amid the heated debate, a small amount of hard data is starting to
emerge. And among the most intriguing findings is a recent study
suggesting that Massachusetts could enjoy an unexpected boon from last
November's vote to legalize medical marijuana: fewer deaths on our
roads and highways.

A team of economists who specialize in health and risk behaviors
looked at the link between marijuana laws and traffic deaths, and
found that roadway fatalities dropped significantly in states after
they legalized medical marijuana.

On average, deaths dropped 8 to 11 percent in the first full year
after the law went into effect, and fell 10 to 13 percent by year
four. Five years out, the results grew more varied, and faded in some
cases.

The study doesn't include Massachusetts, whose medical-marijuana law
just went into effect in May, well after the researchers had finished
collecting and analyzing their data. But applied to Massachusetts'
most recent traffic fatality statistics, the study's findings would
roughly translate to about 35 lives saved per year.

The notion that loosening the restrictions on a drug-one that's hardly
known for improving reaction times-might actually improve traffic
safety is surprising on the face of it, and the researchers are
careful to say that there's nothing safe about driving under the
influence of marijuana.

But as they try to unpack what might be making the difference, it is
becoming clear that the knowledge emerging from America's new
experiments with marijuana law could significantly change the public
conversation-giving us new data about the effects of drugs on society,
and landing a familiar debate on unfamiliar new ground.

For more than four decades, starting in 1970, a complete prohibition
on pot was the law of the land, both federally and in every state. But
in 1996, California cracked the door to legalization by allowing
medical marijuana, and 19 states have followed.

Two states, Colorado and Washington, have fully legalized marijuana
for recreational use, both last year. Meanwhile, it remains illegal
under federal law to buy, sell, use, or possess pot anywhere, in any
amount.

The state-level legalization trend has been so rapid that there are
thus far relatively few definitive studies on its effects.

For instance, while medical marijuana laws seem to increase pot
smoking generally, there are conflicting findings over whether it
increases use among teenagers.

A scattering of contradictory, often localized, studies have also been
done on changes after legalization in crime, emergency room visits,
and the use of other drugs.

Obviously, each of these categories is complicated, with numerous
factors at work.

Daniel Rees, a University of Colorado economist, and his colleagues
decided to look at one major but narrow public-health statistic:
state-by-state data on traffic fatalities compiled by the National
Highway Traffic Safety Administration. They gathered the numbers and
controlled for other factors, such as the overall nationwide decline
in traffic deaths, and states individually lowering their legal
blood-alcohol limits.

It didn't take long to see a pattern: Medical marijuana laws coincided
with less roadway carnage.

The bulk of the team's work, published this spring in the Journal of
Law and Economics, was spent trying to figure out why. After parsing
the statistics, the researchers themselves chalk the drop in deaths up
to "substitution"-the idea that more pot-smoking means less
booze-swilling. (It is assumed by most drug researchers that some
medical marijuana leaks into the general population, so it's not just
patients who have more access to the drug.) The counter-argument,
often used as a case against legalization, is that cannabis and
alcohol are "complementary," meaning that increased use of one spurs
more consumption of the other.

Once again, studies of this issue have conflicting results, because
it's tough to get precise consumer data about an illegal product.

But Rees and his team say a deeper analysis of their data points to
lower alcohol use as the likely mechanism for the drop in traffic 
fatalities.

For one thing, medical marijuana laws had a smaller impact on the
number of deaths in crashes where alcohol was not a factor-a 7 percent
drop on average, compared to a 13 percent drop in deaths where alcohol
was implicated. In addition, the drop in deaths was more robust among
young adults (between 20 and 40), especially young men, and it was
stronger on nights and weekends.

All of that lines up with what's known about drinking and
driving.

When it comes to traffic safety, says Rees, "the uncomfortable
conclusion is that you'd rather have young adults smoking marijuana
instead of drinking alcohol.

Even I'm uncomfortable with it. But that's where the logic takes
us."

The researchers offer two possible explanations for why more marijuana
use could lead to less drunken driving.

One is that pot smoking takes place in different circumstances than
drinking. Drinking is legal, and drinks are served in many places that
can only be reached by car. People drink at bars, restaurants, ball
games, picnics, concerts, and just about any adult social gathering;
then they drive home. Because recreational marijuana is still illegal
in all but two states, it's used in a much less open range of
environments. In other words, people go out and drink, but stoners
tend to stay home. (This is one factor that may start to change if
legalization takes hold: In early 2013, the first "pot bars" opened in
Colorado and Washington.)

The other possible explanation is straightforward, if definitely not
something you're likely to hear from your local chapter of DARE: It
could be that pot availability leads to drunk drivers being replaced
with stoned drivers, and that stoned drivers are, on average, safer.
In fact, while studies indicate that pot is just as bad as alcohol for
distance perception, reaction time, and hand-eye coordination, it
appears to be less of a danger in simulated and real-world driving
tests. Driving high is by no means safe: A meta-analysis by the
British Medical Journal early in 2012 found that drivers who were high
on marijuana had nearly double the risk of a serious crash compared to
sober counterparts. But driving drunk is worse, causing a tenfold
increase in accident risk for drivers with a blood-alcohol
concentration at the legal limit of 0.08, or a forty-eightfold
increase at the old legal limit of 0.1. The researchers also point out
that drivers under the influence of marijuana may "engage in
compensatory behaviors" such as driving slowly, avoiding sudden, risky
maneuvers, and staying well behind the car in front of them. Perhaps
they are just more cautious than a drunk person would be, even though
they are still impaired.
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MAP posted-by: Matt