Pubdate: Fri, 17 Jun 2016
Source: Toronto Star (CN ON)
Page: A15
Copyright: 2016 The Toronto Star
Author: Colin Dormuth
Note: Colin Dormuth is an associate professor in the department of 
anesthesiology, pharmacology and therapeutics at the University of 
British Columbia in Victoria.


As an epidemiologist and a parent, I am perplexed with the recent 
momentum toward legalizing marijuana. Of all the arguments I have 
heard, I have yet to hear any that are compelling enough to remove 
the drug from prescription status.

One argument I have heard is that marijuana is harmless. This 
argument ignores the fact that numerous studies have reported harm in 
peer-reviewed academic journals. A summary of the evidence, published 
in the New England Journal of Medicine in 2014, concluded, "Marijuana 
use has been associated with substantial adverse effects, some of 
which have been determined with a high level of confidence." Some of 
those effects were addiction to marijuana and other substances, motor 
vehicle accidents and chronic bronchitis.

Other effects were reported with either high or medium confidence. 
Some of the medium-confidence effects were schizophrenia and abnormal 
brain development in young people. In order to believe the harmless 
argument, you have to believe that all of the studies reporting harms 
were wrong.

Even from people who don't think marijuana is harmless, you still 
hear the argument that it should be legal because it is not as bad as 
alcohol. The not-as-bad type of argument is also known as the fallacy 
of relative privation. The fallacy is that pointing to something 
worse does not justify anything. The not-as-bad argument asks people 
to dismiss one bad thing by asking them to focus on another bad 
thing. It is a show of falling dominoes with all of two tiles.

Society is replete with awful things it tolerates, like poverty, 
while it puts its foot down on much more minor things, like deer in 
urban Victoria. The only time the not-as-bad argument holds water is 
when only one bad thing has to be chosen from multiple bad options. 
But the government is not suggesting prohibition in exchange for 
allowing people to light up or eat up. The plan is to pile vice on top of vice.

Another argument is that marijuana is a medicinal herb and therefore 
should be freely available. If you think so, can I interest you in a 
warfarin brownie? Warfarin is a blood thinner that doctors have 
prescribed for decades to prevent life-threatening clots. Its 
discovery came after cattle were observed bleeding to death after 
eating feed derived from sweet clover. Warfarin has been shown to be 
a life-saving drug in some people at the right dose. Too much and it can kill.

A good therapy can also cause harm, which is why many drugs are 
available by prescription. If marijuana is removed from prescription 
status, then what other drugs should be exempted? Antibiotics? 
Anticoagulants? Analgesics (like opioids)? Antipsychotics? I could 
keep going with the A's but what is really needed is a framework for 
these decisions.

Then we have the 'I'm not hurting anyone' argument. This is no 
different than arguing we can get rid of seat belt and helmet laws. 
While marijuana won't split your skull open like a fall from a 
motorcycle, driving a motorcycle before work won't degrade your 
cognitive performance for the day. Governments sometimes have to 
protect people from their own judgment, and from imposing a financial 
burden on society.

Harm reduction is the argument the federal government appears to be 
backing, perhaps because it has a veneer of edification which cannot 
be mustered from the other arguments. The Achilles heel of this 
argument is an assumption that legalization will not increase demand 
and swamp any trumpeted benefits with additional adverse events.

Data coming in from Washington state, which voted to legalize 
marijuana in 2012, suggests this concern should be taken seriously 
here. The National Survey on Drug Use and Health in the U.S., which 
has collected data on the use of tobacco, alcohol and illicit drugs 
since 1971, showed that marijuana use in Washington increased almost 
30 per cent since legalization. By comparison, the proportion of the 
total U.S. population using marijuana increased by about 10 per cent 
(the total is inflated with states where marijuana was legalized).

During the same period, the Washington Poison Center reported that 
marijuana-related poisonings, such as accidental ingestion by 
children, increased by more than 50 per cent. The Washington Traffic 
Safety Commission reported the percentage of DUI cases testing 
positive for THC, the main psychoactive component of cannabis, 
increased by a similar amount.

Finally, to anyone who thinks we should legalize marijuana because it 
is happening in the United States, can I interest you in amending the 
Charter of Rights and Freedoms to allow us all to keep and bear arms?
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MAP posted-by: Jay Bergstrom