September 25, 2016 by Seth Leibsohn (Source)

This November, several states will vote on whether to legalize marijuana for recreational use, and the proponents of legalization have seized on a seemingly clever argument: marijuana is safer than alcohol.  The Campaign to Regulate Marijuana Like Alcohol, an effort of the Marijuana Policy Project (or MPP), has taken this argument across the country.  Their latest strategy is labeled Marijuana vs. Alcohol.  It is a very misleading, even dangerous, message, based on bad social science and sophistic public deception.

Citing out-of-date studies that go back ten years and more, even using that well-known scientific journal,Wikipedia, the MPP never references current research on the harms of today’s high potency and edible marijuana, studies that come out monthly if not more frequently.  Indeed, their Marijuana vs. Alcohol page concludes with a 1988 statement about the negligible harms of marijuana—but that is a marijuana that simply does not exist anymore, neither in mode nor potency.  Today’s marijuana is at least five times more potent, and sold in much different form.  And the science of marijuana and its effects on the brain have come some distance since 1988 as well.

So out-of-date is the science and knowledge of marijuana from thirty years ago, it would be malpractice in any other field to suggest that kind of information about a drug having any contemporary relevance at all.  One almost wonders if the MPP thinks public health professors still instruct their students on how to use microfiche to perform their research as they prepare to write their papers on 5k memory typewriters.

It is simply misleading in a public health campaign to cite dated research while at the same time ignore a larger body of current evidence that points in the opposite direction of a desired outcome.  At great potential peril to our public health, political science (in the hands of the marijuana industry) is far outrunning medical science.  But the danger is clear: with the further promotion, marketing, and use of an increasingly known dangerous substance, public health and safety will pay the price.

Consider three basic problems with the industry’s latest campaign:

I.  Comparisons of relative dangers of various drugs are simply impossible and can often lead to paradoxical conclusions.  It is impossible to compare a glass of chardonnay and its effects on various adults of various weights and tolerance levels with the inhalation or consumption of a high-potency marijuana joint or edible.  Is the joint from the 5 percent THC level or the 25 percent level?  How about a 30 mg—or stronger—gummy bear?  A glass of wine with dinner processes through the body in about an hour and has little remaining effect.  A marijuana brownie or candy can take up to 90 minutes to even begin to take effect.

Consider a consumer of a glass of wine who ate a full meal and waited an hour or more before driving and a consumer of a marijuana edible taking the wheel of a plane, train, automobile, or anything else.  The wine drinker would likely be sober, the marijuana consumer would just be getting high, and, given the dose, possibly very high at that.

True, marijuana consumption rarely causes death, but its use is not benign.  Last year, an ASU professor took a standard dose of edible marijuana, just two marijuana coffee beans. The effect?  “[E]pisodes of convulsive twitching and jerking and passing out” before the paramedics were called.  Such episodes are rare for alcohol, but they are increasingly happening with marijuana.

Beyond acute effects, the chronic impact of marijuana is also damaging.  Approximately twice the percentage of regular marijuana users will experience Marijuana Use Disorder than will alcohol users experience Alcohol Use Disorder—both disorders categorized by the Diagnostic Statistics Manual (DSM).[1]   Marijuana is also the number one substance of abuse for teens admitted to treatment, far higher than the percentage who present with alcohol problems.  In fact, the most recent data out of Colorado shows 20 percent of teens admitted for treatment have marijuana listed as their primary substance of abuse compared to less than one percent for alcohol.

Still, the Campaign persists in its deceptions—as if they have not even read their own literature.  One online marketing tool it recently deployed was the “Consume Responsibly” campaign.  Delve into that site and you will find this warning: “[Smoked marijuana] varies from person to person, you should wait at least three to four hours before driving a vehicle.”  And: “Edible marijuana products and some other infused products remain in your system several hours longer, so you should not operate a vehicle for the rest of the day after consuming them.”  Who has ever been told that they should not operate a vehicle for four hours, much less for the rest of the day, if they had a glass of wine or beer?  Safer than alcohol?  This is not even true according to the MPP’s own advice.

Beyond unscientific dose and effect comparisons, there is a growing list of problems where marijuana use does, indeed, appear to be more harmful than alcohol.  According to Carnegie Mellon’s Jonathan Caulkins: “Marijuana is significantly more likely to interfere with life functioning” than alcohol and “it is moderately more likely to create challenges of self-control and to be associated with social and mental health problems.”

Additionally, a recent study out of UC Davis revealed that marijuana dependence was more strongly linked to financial difficulties than alcohol dependence and had the same impacts on downward mobility, antisocial behavior in the workplace, and relationship conflict as alcohol.

II.  The marijuana industry pushes and promotes the use of a smoked or vaped substance, but never compares marijuana to tobacco.  Indeed, the two substances have much more in common than marijuana and alcohol, especially with regard to the products themselves and the method of consumption (though we are also seeing increasing sales of child-attractive marijuana candies).  But why is the comparison never made?  The answer lies in the clear impossibility.

Consider: Almost every claim about marijuana’s harms in relation to alcohol has to do with the deaths associated with alcohol.  But, hundreds of thousands more people die from tobacco than alcohol.  Based on their measures of mortality, which is safer: alcohol or tobacco?  Can one safely drink and drive?  No.  Can one smoke as many cigarettes as one wants while driving?  Of course. So, what’s the more dangerous substance?  Mortality does not answer that question.

Alcohol consumption can create acute problems, while tobacco consumption can create chronic problems.  And those chronic problems particularly affect organs like the lungs, throat, and heart.  But what of the chronic impact on the brain?  That’s the marijuana risk, and, seemingly, society is being told that brains are less important than lungs.  Nobody can seriously believe that, which is why these comparisons simply fail scrutiny.

This illustrates but one of the problems in comparing dangerous substances. As Professor Caulkins recently wrote:

The real trouble is not that marijuana is more or less dangerous than alcohol; the problem is that they are altogether different….The country is not considering whether to switch the legal statuses of alcohol and marijuana. Unfortunately, our society does not get to choose either to have alcohol’s dangers or to have marijuana’s dangers. Rather, it gets to have alcohol’s dangers…and also marijuana’s dangers.

Further, marijuana problems are associated with alcohol problems.  New research out of Columbia University reveals that marijuana users are five times more likely to have an alcohol abuse disorder.  Society doesn’t just switch alcohol for marijuana—too often, one ends up with use of both, compounding both problems.

The larger point for voters to understand:  The marijuana legalization movement is not trying to ban or end alcohol sales or consumption; rather, it wants to add marijuana to the dangerous substances already available, including alcohol.  This is not about marijuana or alcohol, after all.  It’s about marijuana andalcohol.

We can see this effect in states like Colorado, with headlines such as “Alcohol sales get higher after weed legalization.”  And, according to the most recent federal data[2], alcohol use by teens, as well as adults, has increased in Colorado since 2012 (the year of legalization). If alcohol is the problem for the MPP, in their model state–Colorado–alcohol consumption has increased with marijuana legalization.  Legalizing marijuana will, in the end, only make alcohol problems worse.

III.  The legalization movement regularly cites to one study in the Journal of Scientific Reports to “prove” that marijuana is safer than alcohol.  But this study leads to odd conclusions in what the authors, themselves, call a “novel risk assessment methodology.”  For instance, the researchers find that every drug, from cocaine to meth to MDMA to LSD, is found to be safer than alcohol. (See this graph).  By the MPP standard, we should thereby make these substances legal as well.  But, seeing such data in its full light, we all know this would be nonsensical.

Further, the authors specifically write that they only looked at acute effects and did not analyze “chronic toxicity,” and cannot judge marijuana and “long term effects.”  Indeed, they specifically write in their study the toxicity of marijuana“may therefore be underestimated” given the limitations of their examination.  Yet legalizers ignore these statements.  Always.  It simply does not fit their narrative.

What long-term effects are we talking about?  To cite the New England Journal of Medicine: “addiction, altered brain development, poor educational outcomes, cognitive impairment,” and “increased risk of chronic psychosis disorders.”  Now think about what it will mean to make a drug with those adverse effects more available, and for recreational use.

Finally, the very authors of the much-cited Journal of Scientific Reports study specifically warn their research should be “treated carefully particularly in regard to dissemination to lay people….especially considering the differences of risks between individuals and the whole population.”  But this is precisely what commercialization is about—not individual adult use but making a dangerous drug more available to “the whole population.”

Given what we know in states like Colorado, we clearly see that legalization creates more availability which translates into more use, affecting whole populations—Colorado college-age use, for example, is now 62 percent higher than the national average. [See FN2, below].

And the science is coming in, regularly.  Indeed, the same journal the MPP points to in its two-year old “novel” study, just this year published another study and found:

[N]eurocognitive function of daily or near daily cannabis users can be substantially impaired from repeated cannabis use, during and beyond the initial phase of intoxication. As a consequence, frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic.

That is why these comparisons of safety and harm are—in the end—absurd and dangerous.  In asking what is safer, the true answer is “neither.”  And for a variety of reasons.  But where one option is impossible to eliminate (as in alcohol), society should not add to the threat that exists:  One doesn’t say because a playground is near train tracks you should also put a highway there.  You fence off the playground.

That, however, is not the choice the MPP has given us.  They are not sponsoring legislation to reduce the harms of alcohol, they are, instead, saying that with all the harms of alcohol, we should now add marijuana.  But looking at all the problems society now has with substance abuse, the task of the serious is to reduce the problems with what already exists, not advance additional dangers.

If the MPP and its Campaigns to Regulate Marijuana Like Alcohol are serious about working on substance abuse problems, we invite them to join those of us who have labored in these fields for years.  One thing we do know: adding to the problems with faulty arguments, sloppy reasoning, and questionable science, will not reduce the problems they point to.  It will increase them.  And that, beyond faulty argument and sloppy reasoning, is public policy malfeasance.

[1] See http://archpsyc.jamanetwork.com/article.aspx?articleid=2464591 compared tohttp://archpsyc.jamanetwork.com/article.aspx?articleid=2300494

[2] 2011/2012 National Survey on Drug Use and Health compared to 2013/2014.