Pubdate: Tue, 01 Jul 2014
Source: Rapid City Journal (SD)
Copyright: 2014 The Rapid City Journal
Author: Ruth Marcus, Washington Post


 From her perch as head of the National Institute on Drug Abuse, Nora 
Volkow watches anxiously as the country embarks on what she sees as a 
risky social experiment in legalizing marijuana.

For those who argue that marijuana is no more dangerous than tobacco 
and alcohol, Volkow has two main answers: We don't entirely know, 
and, simultaneously, that is precisely the point.

"Look at the evidence," Volkow said in an interview on the National 
Institutes of Health campus here, pointing to the harms already 
inflicted by tobacco and alcohol. "It's not subtle -- it's huge. 
Legal drugs are the main problem that we have in our country as it 
relates to morbidity and mortality. By far. Many more people die of 
tobacco than all of the drugs together. Many more people die of 
alcohol than all of the illicit drugs together.

"And it's not because they are more dangerous or addictive. Not at 
all -- they are less dangerous. It's because they are legal. ... The 
legalization process generates a much greater exposure of people and 
hence of negative consequences that will emerge. And that's why I 
always say, 'Can we as a country afford to have a third legal drug? 
Can we?' We know the costs already on health care, we know the costs 
on accidents, on lost productivity. I let the numbers speak for themselves."

Volkow, 58, speaks rapidly, even urgently, in an accent that lingers 
from her childhood in Mexico. The great-granddaughter of Soviet 
communist Leon Trotsky, Volkow grew up in the Mexico City home where 
Trotsky was fatally attacked. It is easy to imagine, in her 
passionate determination, some of her ancestor's revolutionary 
fervor, melded with a scientist's evidentiary rigor.

As Colorado and Washington state approve the sale of marijuana for 
recreational use and other states consider following suit, Volkow 
says, the notion that legalization represents a modest, cost-free 
move is dangerously overblown. The evidence on the supposed safety of 
marijuana -- particularly marijuana in its modern, far-more potent 
form -- is far from clear enough to take this leap.

"I think that what we are seeing is a little bit of wishful thinking 
in the sense that we want to have a drug that will make us all feel 
good and believe that there are no harmful consequences," she said. 
"When you are intoxicated, your memory and learning are going to go 
down. When you are intoxicated, your motor coordination is going to 
go down. When you are repeatedly using marijuana, there is an 
increased risk for addiction. And if you are an adolescent and you 
are taking marijuana, there is a higher increased risk for addiction 
and there is also a higher risk for long-lasting decreases in 
cognitive capacity -- that is, lowering of IQ."

Adolescents are a chief focus of Volkow's worry, to the extent that 
when I observe that tobacco use is clearly worse for teens, she 
challenges that easy assumption.

"Wait a second. ... Nicotine does not interfere with cognitive 
ability. So if you are an adolescent and you are smoking marijuana 
and going to school, it's going to interfere with your capacity to 
learn. So what is worse, as an adolescent right now? To have 
basically something that is jeopardizing your development 
educationally or to smoke a cigarette that when you are 60 years of 
age is going to lead to impaired pulmonary function and perhaps 
cancer? ... I would argue that you do not want to mess with your 
cognitive capacity, that that is a very large price to pay."

Legalization advocates counter with two contradictory arguments: That 
marijuana is already readily available to teenagers who want it, and 
that the new laws impose strict controls on sales to minors. Volkow 
is unconvinced, arguing that the evidence from alcohol suggests that 
the already large number of teenagers who have tried marijuana by the 
time they graduate from high school -- nearly half, according to the 
Centers for Disease Control and Prevention -- will only increase, 
along with the already rising number of those who use it on a daily basis.

"Our kids are sensitive to norms, so if they feel that marijuana is 
harmful, their consumption goes down," Volkow said. Legalization 
sends the opposite message.

Vokow herself has never smoked pot -- or, as she tends to say, "taken 
marijuana" -- and she isn't tempted now that it is legally available 
in some places. "I'm not going to negate that I am curious," she 
said. "But I am terrified about doing anything that would interfere 
with my cognitive capacity. ... I don't like to contaminate my 
perception of the world. I have too much respect for my brain."
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