pros and cons of legalizing drugs essay

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Should drugs be legalized? Legalization pros and cons

Source: Composite by G_marius based on Chuck Grimmett's image

Should drugs be legalized? Why? Is it time to lift the prohibition on recreational drugs such as marijuana and cocaine? Can we stop drug trafficking? if so what would be the best way to reduce consumption?

Public health problem

Drugs continue to be one of the greatest problems for public health . Although the consumption of some substances has declined over time, new drugs have entered the market and become popular. In the USA, after the crack epidemic, in the 80s and early 90s, and the surge of methamphetamine, in the 90s and early 21st century, there is currently a prescription opioid crisis . The number of casualties  from these opioids, largely bought in pharmacies, has overtaken the combined deaths from cocaine and heroine overdose. There are million of addicts to these substances which are usually prescribed by a doctor. This is a relevant twist to the problem of drugs because it shows that legalization or criminalization may not always bring the desire solution to the problem of drug consumption. On the other hand there is also evidence of success in reducing drug abuse through legal reform. This is the case of Portuguese decriminalization of drug use, which has show a dramatic decrease in drug related crime, overdoses and HIV infections. 

History of prohibition of drugs

There are legal recreational drugs , such as alcohol and  tobacco , and other recreational drugs which are prohibited. The history of  prohibition of drugs is long. Islamic Sharia law, which dates back to the 7th century, banned some intoxicating substances, including alcohol. Opium consumption was later prohibited in China and Thailand. The  Pharmacy Act 1868 in the United Kingdom was the first modern law in Europe regulating drug use. This law prohibited the distribution of poison and drugs, and in particular opium and derivates. Gradually other Western countries introduced laws to limit the use of opiates.  For instance in San Francisco smoking opium was banned in 1875 and in Australia opium sale was prohibited in 1905 . In the early 20th century, several countries such as Canada, Finland, Norway, the US and Russia, introduced alcohol prohibitions . These alcohol prohibitions were unsucessful and lifted later on. Drug prohibitions were strengthened around the world from the 1960s onward. The US was one of the main proponents of a strong stance against drugs, in particular since Richad Nixon declared the "War on Drugs ." The "War on Drugs" did not produced the results expected. The demand for drugs grew as well as the number of addicts. Since production and distribution was illegal, criminals took over its supply.  Handing control of the drug trade to organized criminals has had disastrous consequences across the globe. T oday, drug laws diverge widely across countries. Some countries have softer regulation and devote less resources to control drug trafficking, while in other countries the criminalization of drugs can entail very dire sentences. Thus while in some countries recreational drug use has been decriminalized, in others drug traficking is punished with life or death sentences.

Should drugs be legalized?

In many Western countries drug policies are considered ineffective and decriminalization of drugs has become a trend. Many experts have provided evidence on why drugs should be legal . One reason for legalization of recreational drug use is that the majority of adicts are not criminals and should not be treated as such but helped in other ways. The criminalization of drug users contributes to generating divides in our societies. The "War on Drugs" held by the governments of countries such as USA , Mexico, Colombia, and Indonesia, created much harm to society. Drug related crimes have not always decline after a more intolerant government stance on drugs. Prohibition and crime are often seen as correlated.

T here is also evidence of successful partial decriminalization in Canada, Switzerland, Portugal and Uruguay. Other countries such as Ireland seem to be following a similar path and are planning to decriminalize some recreational drugs soon.  Moreover, The United Nations had a special session on drugs on 2016r,  UNGASS 2016 , following the request of the presidents of Colombia, Mexico and Guatemala. The goal of this session was  to analyse the effects of the war on drugs. explore new options and establish a   new paradigm in international drug policy in order to prevent the flow of resources to organized crime organizations. This meeting was seen as an opportunity, and even a call, for far-reaching drug law reforms. However, the final outcome failed to change the status quo and to trigger any ambitious reform.

However, not everyone is convinced about the need of decriminalization of recreational drugs. Some analysts point to several reasons why  drugs should not be legalized  and t he media have played an important role in shaping the public discourse and, indirectly, policy-making against legalization. For instance, t he portrayal of of the issue in British media, tabloids in particular, has reinforced harmful, dehumanising stereotypes of drug addicts as criminals. At the moment the UK government’s response is to keep on making illegal new recreational drugs. For instance,  Psychoactive Substances Bill aims at criminalizing legal highs . Those supporting the bill argue that  criminalization makes more difficult for young people to have access to these drugs and could reduce the number of people who get addicted. 

List of recreational drugs

This is the  list of recreational drugs  (in alphabetic order) which could be subject to decriminalization in the future:

• Amfetamines (speed, whizz, dexies, sulph)
• Amyl nitrates (poppers, amys, kix, TNT)
• Cannabis (marijuana, hash, hashish, weed)
• Cocaine (crack, freebase, toot)
• Ecstasy (crystal, MDMA, E)
• Heroin (H, smack, skag, brown)
• Ketamine  (K, special K, green)
• LSD (acid, paper mushrooms, tripper)
• Magic mushrooms (mushies, magics)
• Mephedrone (meow meow, drone, m cat)
• Methamfetamines (yaba, meth, crank, glass)
• Painkillers, sedatives and tranquilizers (chill pills, blues, bricks)

Pros and cons of legalization of drugs

These are some of the most commonly argued pros of legalization :

• Government would see the revenues boosted due to the money collected from taxing drugs.
• Health and safety controls on these substances could be implemented, making recreational drugs less dangerous.
• Facilitate access for medicinal use. For instance cannabis is effective treating a range of conditions. Other recreational drugs could be used in similar ways.
• Personal freedom. People would have the capacity to decide whether they experiment with drugs without having to be considered criminals or having to deal with illegal dealers.
• Criminal gangs could run out of business and gun violence would be reduced.
• Police resources could be used in other areas and help increase security.
• The experience of decriminalization of drugs in some countries such as Portugal and Uruguay, has led to a decrease in drug related problems. 

Cons of decriminalizing drug production, distribution and use:

• New users for drugs. As in the case of legal recreational drugs, decriminalization does not imply reduction in consumption. If these substances are legal, trying them could become "more normal" than nowadays.
• Children and teenagers could more easily have access to drugs.
• Drug trafficking would remain a problem. If governments heavily tax drugs, it is likely that some criminal networks continue to produce and smuggle them providing a cheaper price for consumers.
• The first few countries which decide to legalize drugs could have problems of drug tourism.
• The rate of people driving and having accidents due drug intoxication could increase.
• Even with safety controls, drugs would continue to be a great public health problem and cause a range of diseases (damamge to the brain and lungs, heart diseases, mental health conditions).
• People may still become addicts and die from legalized drugs, as in America's opioid crisis.

What do think, should recreational drugs be legalized or decriminalized? Which of them?  Is legalising drugs being soft on crime?  Is the prohibition on drugs making the work of the police more difficult and diverting resources away from other more important issues? Join the discussion and share arguments and resources on the forum below .

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Should Illegal Drugs Be Legalized?

The American Civil Liberties Union (ACLU) stated in its Jan. 6, 1995 paper titled “Against Drug Prohibition”:

“The best evidence of prohibition’s failure is the government’s current war on drugs. This war, instead of employing a strategy of prevention, research, education and social programs designed to address problems such as permanent poverty, long term unemployment and deteriorating living conditions in our inner cities, has employed a strategy of law enforcement. While this military approach continues to devour billions of tax dollars and sends tens of thousands of people to prison, illegal drug trafficking thrives, violence escalates and drug abuse continues to debilitate lives… Those who benefit the most from prohibition are organized crime barons, who derive an estimated $10 to $50 billion a year from the illegal drug trade. Indeed, the criminal drug laws protect drug traffickers from taxation, regulation and quality control… In the same way that alcohol prohibition fueled violent gangsterism in the 1920s, today’s drug prohibition has spawned a culture of drive-by shootings and other gun-related crimes… The recent steep climb in our incarceration rate has made the U.S. the world’s leading jailer… Nonviolent drug offenders make up 58 percent of the federal prison population, a population that is extremely costly to maintain… Some people, hearing the words ‘drug legalization,’ imagine pushers on street corners passing out cocaine to anyone — even children. But that is what exists today under prohibition… In the long run, ending prohibition could foster the redirection of public resources toward social development, legitimate economic opportunities and effective treatment, thus enhancing the safety, health and well-being of the entire society.” May 25, 2005

Benson Roe, MD, Professor and Chief Emeritus at the School of Medicine at the University of California at San Francisco, wrote in his article (accessed on Nov. 18, 2005) titled “Why We Should Legalize Drugs,” posted on the Schaffer Library of Drug Policy’s website :

“[N]owhere can be found reliable, objective scientific evidence that [illicit drugs] are any more harmful than other substances and activities that are legal. In view of the enormous expense, the carnage and the obvious futility of the ‘drug war,’ resulting in massive criminalization of society, it is high time to examine the supposed justification for keeping certain substances illegal. Those who initiated those prohibitions and those who now so vigorously seek to enforce them have not made their objectives clear. Are they to protect us from evil, from addiction, or from poison?… The concept of evil is derived from subjective values and is difficult to define. Just why certain (illegal) substances are singularly more evil than legal substances like alcohol has not been explained… Addiction is also a relative and ubiquitous phenomenon… Some people are more susceptible to addiction than others and some ‘needs’ are more addictive than others. Probably the most addictive substance in our civilization is tobacco – yet no one has suggested making it illegal… And ‘poison’ is also a misleading shibboleth. The widespread propaganda that illegal drugs are ‘deadly poisons’ is a hoax. There is little or no medical evidence of long term ill effects from sustained, moderate consumption of uncontaminated marijuana, cocaine or heroin. If these substances – most of them have been consumed in large quantities for centuries – were responsible for any chronic, progressive or disabling diseases, they certainly would have shown up in clinical practice and/or on the autopsy table. But they simply have not!” Nov. 18, 2005

Joseph D. McNamara, PhD, former chief police in Kansas City, MO and San Jose, CA, stated during a symposium organized by the National Review for its July 1, 1996 cover story titled “Abolish the Drug Laws”:

“About $500 worth of heroin or cocaine in a source country will bring in as much as $100,000 on the streets of an American city. All the cops, armies, prisons, and executions in the world cannot impede a market with that kind of tax-free profit margin. It is the illegality that permits the obscene markup, enriching drug traffickers, distributors, dealers, crooked cops, lawyers, judges, politicians, bankers, businessmen… Sadly, the police have been pushed into a war they did not start and cannot win. It was not the police who lobbied in 1914 for passage of the Harrison Act, which first criminalized drugs… If drugs had been outlawed because the police had complained that drug use caused crime and disorder, the policy would have been more acceptable to the public and won more compliance. And the conviction that the use of certain drugs is immoral chills the ability to scrutinize rationally and to debate the effects of the drug war… To enforce drug laws the police have to resort to undercover work, which is dangerous to them and also to innocent bystanders. Drug enforcement often involves questionable ethical behavior by the police, such as… letting a guilty person go free because he enticed someone else into violating the law… Police scandals are an untallied cost of the drug war. The FBI, the Drug Enforcement Administration, and even the Coast Guard have had to admit to corruption. The gravity of the police crimes is as disturbing as the volume… The drug war is as lethal as it is corrupting. And the police and drug criminals are not the only casualties.” July 1, 1996

The Cato Institute, a Libertarian think-tank, makes the following policy recommendations to the 108th Congress in its Dec. 2004 “Cato Handbook for Congress”:

“There are a number of reasons why Congress should end the federal government’s war on drugs. First and foremost, the federal drug laws are constitutionally dubious… Congress never asked the American people for additional constitutional powers to declare a war on drug consumers. That usurpation of power is something that few politicians or their court intellectuals wish to discuss… [D]rug prohibition is a classic example of throwing money at a problem. The federal government spends some $19 billion to enforce the drug laws every year—all to no avail. For years drug war bureaucrats have been tailoring their budget requests to the latest news reports. When drug use goes up, taxpayers are told the government needs more money so that it can redouble its efforts against a rising drug scourge. When drug use goes down, taxpayers are told that it would be a big mistake to curtail spending just when progress is being made… One of the broader lessons that [recent presidents and congresses] should have learned is this: prohibition laws should be judged according to their real-world effects, not their promised benefits… Congress should repeal the Controlled Substances Act of 1970, shut down the Drug Enforcement Administration, and let the states set their own policies with regard to currently illegal drugs… Repeal of prohibition would take the astronomical profits out of the drug business and destroy the drug kingpins who terrorize parts of our cities… Not only would there be less crime; reform would also free federal agents to concentrate on terrorism and espionage and free local police agents to concentrate on robbery, burglary, and violent crime.” Dec. 2004

Kathleen Parker, a syndicated columnist, wrote in an Aug. 3, 2002 article for Townhall.com titled “In Drug War, Honesty is Best Policy,” that:

“There isn’t space here to outline all the arguments for and against legalization of some drugs, but it’s clear that: drugs are easy to get; the drug subculture thrives in part because it is forbidden and therefore attractive; dollar for dollar, the billions we funnel into this ‘war’ would be better spent on education, prevention and treatment. Would it not be better to control those substances, tax them, limit their availability to minors as we try to do with alcohol, rather than criminalize a huge segment of the population that probably includes many of our neighbors and even our own children? The genie in the bottle is truth, and the truth is that all drugs are not awful, evil or equally harmful… Truth is also this: Drug abuse is different from drug use, just as alcoholism is different from the weekend cocktail party. Rather than fight the abuse war from a moral, shame-on-you posture, which doesn’t work with any age, we might try a medical model that educates with facts and urges human wisdom… Think of it as an investment in credibility so that potential users tune in to the discussion on consequences that needs to follow.” Aug. 3, 2002

The Drug Enforcement Administration (DEA), in the summary of its May 2003 booklet titled “Speaking Out Against Drug Legalization,” stated:

“We have made significant progress in fighting drug use and drug trafficking in America. Now is not the time to abandon our efforts.The Legalization Lobby claims that the fight against drugs cannot be won. However, overall drug use is down by more than a third in the last twenty years, while cocaine use has dropped by an astounding 70 percent… The Legalization Lobby claims that the United States has wasted billions of dollars in its anti-drug efforts. But for those kids saved from drug addiction, this is hardly wasted dollars. Moreover, our fight against drug abuse and addiction is an ongoing struggle that should be treated like any other social problem. Would we give up on education or poverty simply because we haven’t eliminated all problems? Compared to the social costs of drug abuse and addiction—whether in taxpayer dollars or in pain and suffering—government spending on drug control is minimal. Legalization of drugs will lead to increased use and increased levels of addiction. Legalization has been tried before, and failed miserably… Alaska’s experiment with Legalization in the 1970s led to the state’s teens using marijuana at more than twice the rate of other youths nationally. This led Alaska’s residents to vote to re-criminalize marijuana in 1990… Most non-violent drug users get treatment, not jail time. The Legalization Lobby claims that America’s prisons are filling up with users. Truth is, only about 5 percent of inmates in federal prison are there because of simple possession. Most drug criminals are in jail—even on possession charges—because they have plea-bargained down from major trafficking offences or more violent drug crimes.” May 2003

John Walters, Director of the Office of National Drug Control Policy (ONDCP), wrote in a July 19, 2002 op-ed article titled “Don’t Legalize Drugs” in the Wall Street Journal that:

“The charge that ‘nothing works’ in the fight against illegal drugs has led some people to grasp at an apparent solution: legalize drugs… Better, the argument goes, for the government to control the trade in narcotics. That should drive down the prices (heroin would be ‘no more expensive than lettuce,’ argues one proponent), eliminate violence, provide tax revenue, reduce prison crowding, and foster supervised injection facilities. Sounds good. But is it realistic?… Legalizers overstate the social costs of prohibition, just as they understate the social costs of legalization… Legalization, by removing penalties and reducing price, would increase drug demand. Make something easier and cheaper to obtain, and you increase the number of people who will try it… Legalizers like to argue that government-supervised production and distribution of addictive drugs will eliminate the dangers attributed to drug prohibition. But when analyzing this ‘harm reduction’ argument, consider the abuse of the opiate OxyContin, which has resulted in numerous deaths, physicians facing criminal charges, and addicts attacking pharmacies. OxyContin is a legally prescribed substance, with appropriate medical uses—that is, it satisfies those conditions legalizers envision for cocaine and heroin. The point is clear: The laws are not the problem… Legalization is a dangerous mirage. To address a crime problem, we are asked to accept a public health crisis. Yet if we were to surrender, we would surely face both problems—intensified.” July 19, 2002

The Drug Free America Foundation stated in its “Myths About the Drug War” posted on its website (accessed Nov. 18, 2005):

“Under a legalization scenario, a black market for drugs would still exist. If drugs were legal for those over 18 or 21, there would be a market for everyone under that age. People under the age of 21 consume the majority of illegal drugs, and so an illegal market and organized crime to supply it would remain—along with the organized crime that profits from it. After Prohibition ended, did the organized crime in our country go down? No. It continues today in a variety of other criminal enterprises. Legalization would not put the cartels out of business; cartels would simply look to other illegal endeavors… While ‘government drugs’ could conceivably be priced low enough to eliminate competition, perhaps by having taxpayers subsidize them to discourage a black market, the combination of low price and wide availability would result in greater consumption, and consequently increased addiction. Increased consumption and addiction lead to drug-related crime. This government regulation argument ignores the dangerously addictive nature of drugs. And finally, under a legalization scenario, a black market for drugs would still exist. If drugs were legal for those over 18 or 21, there would be a market for everyone under that age –a faction of the population that can be targeted by those looking to profit from the sale of drugs.” Nov. 18, 2005

Charles D. Mabry, MD, Assistant Professor at the College of Medicine at the University of Arkansas, wrote in an Oct. 2001 article titled “Physicians and the War on Drugs: The Case Against Legalization,” published in the Bulletin of the American College of Surgeons that:

“Does making addictive drugs illegal work? Cocaine and potent narcotics were freely sold in America until the first two decades of the 20th century, and the number of patients addicted dropped sharply once availability was curtailed… More recently, several European countries have experimented with various attempts to legalize or decriminalize some illegal drugs. These experiments have resulted in a rise in the number of drug-addicted patients and a corresponding increase in the crime rate… The National Center on Addiction and Substance Abuse has stated the situation concerning illicit drugs in this country most eloquently: ‘Drugs are not a threat to American society because they are illegal; they are illegal because they are a threat to American society.’… There is another stark reality: In some cases, the only thing that forces someone who is addicted to drugs and spiraling out of control into therapy is the threat (or reality) of incarceration. Do away with laws prohibiting sale of these drugs, and you do away with the only hope of help for so many people who are addicted but just can’t stop themselves.” Oct. 2001

Ann Coulter, JD, author, wrote in her Oct. 3, 2000 article “Don’t Do Drug Legalization” for Townhall.com that:

“The most superficially appealing argument for drug legalization is that people should be allowed to do what they want with their own bodies, even if it ruins their lives. Except that’s not true. Back on Earth, see, we live in a country that will not allow people to live with their own stupid decisions. Ann has to pay for their stupid decisions. ‘We’ have to ‘invest’ in ‘our’ future by supporting people who freely choose to inject drugs in their own bodies and then become incapable of holding jobs, obtaining housing and taking care of their children. So it’s not really quite accurate to say drugs hurt no one but the user, at least until we’ve repealed the welfare state… Drugs enslave people. So do cigarettes and alcohol, the drug legalizers say… Assume alcohol and cigarettes induce dependency, ruin lives, cause disease, depression, countless traffic injuries and fatalities, and increase the incidence of homicide and suicide. This is supposed to be an argument for legalizing another drug like them?” Oct. 3, 2000

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The Evidence—and Lack Thereof—About Cannabis

Research is still needed on cannabis’s risks and benefits. 

Lindsay Smith Rogers

Although the use and possession of cannabis is illegal under federal law, medicinal and recreational cannabis use has become increasingly widespread.

Thirty-eight states and Washington, D.C., have legalized medical cannabis, while 23 states and D.C. have legalized recreational use. Cannabis legalization has benefits, such as removing the product from the illegal market so it can be taxed and regulated, but science is still trying to catch up as social norms evolve and different products become available. 

In this Q&A, adapted from the August 25 episode of Public Health On Call , Lindsay Smith Rogers talks with Johannes Thrul, PhD, MS , associate professor of Mental Health , about cannabis as medicine, potential risks involved with its use, and what research is showing about its safety and efficacy. 

Do you think medicinal cannabis paved the way for legalization of recreational use?

The momentum has been clear for a few years now. California was the first to legalize it for medical reasons [in 1996]. Washington and Colorado were the first states to legalize recreational use back in 2012. You see one state after another changing their laws, and over time, you see a change in social norms. It's clear from the national surveys that people are becoming more and more in favor of cannabis legalization. That started with medical use, and has now continued into recreational use.

But there is a murky differentiation between medical and recreational cannabis. I think a lot of people are using cannabis to self-medicate. It's not like a medication you get prescribed for a very narrow symptom or a specific disease. Anyone with a medical cannabis prescription, or who meets the age limit for recreational cannabis, can purchase it. Then what they use it for is really all over the place—maybe because it makes them feel good, or because it helps them deal with certain symptoms, diseases, and disorders.

Does cannabis have viable medicinal uses?

The evidence is mixed at this point. There hasn’t been a lot of funding going into testing cannabis in a rigorous way. There is more evidence for certain indications than for others, like CBD for seizures—one of the first indications that cannabis was approved for. And THC has been used effectively for things like nausea and appetite for people with cancer.

There are other indications where the evidence is a lot more mixed. For example, pain—one of the main reasons that people report for using cannabis. When we talk to patients, they say cannabis improved their quality of life. In the big studies that have been done so far, there are some indications from animal models that cannabis might help [with pain]. When we look at human studies, it's very much a mixed bag. 

And, when we say cannabis, in a way it's a misnomer because cannabis is so many things. We have different cannabinoids and different concentrations of different cannabinoids. The main cannabinoids that are being studied are THC and CBD, but there are dozens of other minor cannabinoids and terpenes in cannabis products, all of varying concentrations. And then you also have a lot of different routes of administration available. You can smoke, vape, take edibles, use tinctures and topicals. When you think about the explosion of all of the different combinations of different products and different routes of administration, it tells you how complicated it gets to study this in a rigorous way. You almost need a randomized trial for every single one of those and then for every single indication.

What do we know about the risks of marijuana use?  

Cannabis use disorder is a legitimate disorder in the DSM. There are, unfortunately, a lot of people who develop a problematic use of cannabis. We know there are risks for mental health consequences. The evidence is probably the strongest that if you have a family history of psychosis or schizophrenia, using cannabis early in adolescence is not the best idea. We know cannabis can trigger psychotic symptoms and potentially longer lasting problems with psychosis and schizophrenia. 

It is hard to study, because you also don't know if people are medicating early negative symptoms of schizophrenia. They wouldn't necessarily have a diagnosis yet, but maybe cannabis helps them to deal with negative symptoms, and then they develop psychosis. There is also some evidence that there could be something going on with the impact of cannabis on the developing brain that could prime you to be at greater risk of using other substances later down the road, or finding the use of other substances more reinforcing. 

What benefits do you see to legalization?

When we look at the public health landscape and the effect of legislation, in this case legalization, one of the big benefits is taking cannabis out of the underground illegal market. Taking cannabis out of that particular space is a great idea. You're taking it out of the illegal market and giving it to legitimate businesses where there is going to be oversight and testing of products, so you know what you're getting. And these products undergo quality control and are labeled. Those labels so far are a bit variable, but at least we're getting there. If you're picking up cannabis at the street corner, you have no idea what's in it. 

And we know that drug laws in general have been used to criminalize communities of color and minorities. Legalizing cannabis [can help] reduce the overpolicing of these populations.

What big questions about cannabis would you most like to see answered?

We know there are certain, most-often-mentioned conditions that people are already using medical cannabis for: pain, insomnia, anxiety, and PTSD. We really need to improve the evidence base for those. I think clinical trials for different cannabis products for those conditions are warranted.

Another question is, now that the states are getting more tax revenue from cannabis sales, what are they doing with that money? If you look at tobacco legislation, for example, certain states have required that those funds get used for research on those particular issues. To me, that would be a very good use of the tax revenue that is now coming in. We know, for example, that there’s a lot more tax revenue now that Maryland has legalized recreational use. Maryland could really step up here and help provide some of that evidence.

Are there studies looking into the risks you mentioned?

Large national studies are done every year or every other year to collect data, so we already have a pretty good sense of the prevalence of cannabis use disorder. Obviously, we'll keep tracking that to see if those numbers increase, for example, in states that are legalizing. But, you wouldn't necessarily expect to see an uptick in cannabis use disorder a month after legalization. The evidence from states that have legalized it has not demonstrated that we might all of a sudden see an increase in psychosis or in cannabis use disorder. This happens slowly over time with a change in social norms and availability, and potentially also with a change in marketing. And, with increasing use of an addictive substance, you will see over time a potential increase in problematic use and then also an increase in use disorder.

If you're interested in seeing if cannabis is right for you, is this something you can talk to your doctor about?

I think your mileage may vary there with how much your doctor is comfortable and knows about it. It's still relatively fringe. That will very much depend on who you talk to. But I think as providers and professionals, everybody needs to learn more about this, because patients are going to ask no matter what.

Lindsay Smith Rogers, MA, is the producer of the Public Health On Call podcast , an editor for Expert Insights , and the director of content strategy for the Johns Hopkins Bloomberg School of Public Health.

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Drug Legalization?: Time for a real debate

Subscribe to governance weekly, paul stares ps paul stares.

March 1, 1996

• 11 min read

Whether Bill Clinton “inhaled” when trying marijuana as a college student was about the closest the last presidential campaign came to addressing the drug issue. The present one, however, could be very different. For the fourth straight year, a federally supported nationwide survey of American secondary school students by the University of Michigan has indicated increased drug use. After a decade or more in which drug use had been falling, the Republicans will assuredly blame the bad news on President Clinton and assail him for failing to carry on the Bush and Reagan administrations’ high-profile stand against drugs. How big this issue becomes is less certain, but if the worrisome trend in drug use among teens continues, public debate about how best to respond to the drug problem will clearly not end with the election. Indeed, concern is already mounting that the large wave of teenagers—the group most at risk of taking drugs—that will crest around the turn of the century will be accompanied by a new surge in drug use.

As in the past, some observers will doubtless see the solution in much tougher penalties to deter both suppliers and consumers of illicit psychoactive substances. Others will argue that the answer lies not in more law enforcement and stiffer sanctions, but in less. Specifically, they will maintain that the edifice of domestic laws and international conventions that collectively prohibit the production, sale, and consumption of a large array of drugs for anything other than medical or scientific purposes has proven physically harmful, socially divisive, prohibitively expensive, and ultimately counterproductive in generating the very incentives that perpetuate a violent black market for illicit drugs. They will conclude, moreover, that the only logical step for the United States to take is to “legalize” drugs—in essence repeal and disband the current drug laws and enforcement mechanisms in much the same way America abandoned its brief experiment with alcohol prohibition in the 1920s.

Although the legalization alternative typically surfaces when the public’s anxiety about drugs and despair over existing policies are at their highest, it never seems to slip off the media radar screen for long. Periodic incidents—such as the heroin-induced death of a young, affluent New York City couple in 1995 or the 1993 remark by then Surgeon General Jocelyn Elders that legalization might be beneficial and should be studied—ensure this. The prominence of many of those who have at various times made the case for legalization—such as William F. Buckley, Jr., Milton Friedman, and George Shultz—also helps. But each time the issue of legalization arises, the same arguments for and against are dusted off and trotted out, leaving us with no clearer understanding of what it might entail and what the effect might be.

As will become clear, drug legalization is not a public policy option that lends itself to simplistic or superficial debate. It requires dissection and scrutiny of an order that has been remarkably absent despite the attention it perennially receives. Beyond discussion of some very generally defined proposals, there has been no detailed assessment of the operational meaning of legalization. There is not even a commonly accepted lexicon of terms to allow an intellectually rigorous exchange to take place. Legalization, as a consequence, has come to mean different things to different people. Some, for example, use legalization interchangeably with “decriminalization,” which usually refers to removing criminal sanctions for possessing small quantities of drugs for personal use. Others equate legalization, at least implicitly, with complete deregulation, failing in the process to acknowledge the extent to which currently legally available drugs are subject to stringent controls.

Unfortunately, the U.S. government—including the Clinton administration—has done little to improve the debate. Although it has consistently rejected any retreat from prohibition, its stance has evidently not been based on in- depth investigation of the potential costs and benefits. The belief that legalization would lead to an instant and dramatic increase in drug use is considered to be so self-evident as to warrant no further study. But if this is indeed the likely conclusion of any study, what is there to fear aside from criticism that relatively small amounts of taxpayer money had been wasted in demonstrating what everyone had believed at the outset? Wouldn’t such an outcome in any case help justify the continuation of existing policies and convincingly silence those—admittedly never more than a small minority—calling for legalization?

A real debate that acknowledges the unavoidable complexities and uncertainties surrounding the notion of drug legalization is long overdue. Not only would it dissuade people from making the kinds of casual if not flippant assertions—both for and against—that have permeated previous debates about legalization, but it could also stimulate a larger and equally critical assessment of current U.S. drug control programs and priorities.

First Ask the Right Questions

Many arguments appear to make legalization a compelling alternative to today’s prohibitionist policies. Besides undermining the black-market incentives to produce and sell drugs, legalization could remove or at least significantly reduce the very problems that cause the greatest public concern: the crime, corruption, and violence that attend the operation of illicit drug markets. It would presumably also diminish the damage caused by the absence of quality controls on illicit drugs and slow the spread of infectious diseases due to needle sharing and other unhygienic practices. Furthermore, governments could abandon the costly and largely futile effort to suppress the supply of illicit drugs and jail drug offenders, spending the money thus saved to educate people not to take drugs and treat those who become addicted.

However, what is typically portrayed as a fairly straightforward process of lifting prohibitionist controls to reap these putative benefits would in reality entail addressing an extremely complex set of regulatory issues. As with most if not all privately and publicly provided goods, the key regulatory questions concern the nature of the legally available drugs, the terms of their supply, and the terms of their consumption (see page 21).

What becomes immediately apparent from even a casual review of these questions—and the list presented here is by no means exhaustive—is that there is an enormous range of regulatory permutations for each drug. Until all the principal alternatives are clearly laid out in reasonable detail, however, the potential costs and benefits of each cannot begin to be responsibly assessed. This fundamental point can be illustrated with respect to the two central questions most likely to sway public opinion. What would happen to drug consumption under more permissive regulatory regimes? And what would happen to crime?

Relaxing the availability of psychoactive substances not already commercially available, opponents typically argue, would lead to an immediate and substantial rise in consumption. To support their claim, they point to the prevalence of opium, heroin, and cocaine addiction in various countries before international controls took effect, the rise in alcohol consumption after the Volstead Act was repealed in the United States, and studies showing higher rates of abuse among medical professionals with greater access to prescription drugs. Without explaining the basis of their calculations, some have predicted dramatic increases in the number of people taking drugs and becoming addicted. These increases would translate into considerable direct and indirect costs to society, including higher public health spending as a result of drug overdoses, fetal deformities, and other drug-related misadventures such as auto accidents; loss of productivity due to worker absenteeism and on-the-job accidents; and more drug-induced violence, child abuse, and other crimes, to say nothing about educational impairment.

Advocates of legalization concede that consumption would probably rise, but counter that it is not axiomatic that the increase would be very large or last very long, especially if legalization were paired with appropriate public education programs. They too cite historical evidence to bolster their claims, noting that consumption of opium, heroin, and cocaine had already begun falling before prohibition took effect, that alcohol consumption did not rise suddenly after prohibition was lifted, and that decriminalization of cannabis use in 11 U.S. states in the 1970s did not precipitate a dramatic rise in its consumption. Some also point to the legal sale of cannabis products through regulated outlets in the Netherlands, which also does not seem to have significantly boosted use by Dutch nationals. Public opinion polls showing that most Americans would not rush off to try hitherto forbidden drugs that suddenly became available are likewise used to buttress the pro-legalization case.

Neither side’s arguments are particularly reassuring. The historical evidence is ambiguous at best, even assuming that the experience of one era is relevant to another. Extrapolating the results of policy steps in one country to another with different sociocultural values runs into the same problem. Similarly, within the United States the effect of decriminalization at the state level must be viewed within the general context of continued federal prohibition. And opinion polls are known to be unreliable.

More to the point, until the nature of the putative regulatory regime is specified, such discussions are futile. It would be surprising, for example, if consumption of the legalized drugs did not increase if they were to become commercially available the way that alcohol and tobacco products are today, complete with sophisticated packaging, marketing, and advertising. But more restrictive regimes might see quite different outcomes. In any case, the risk of higher drug consumption might be acceptable if legalization could reduce dramatically if not remove entirely the crime associated with the black market for illicit drugs while also making some forms of drug use safer. Here again, there are disputed claims.

Opponents of more permissive regimes doubt that black market activity and its associated problems would disappear or even fall very much. But, as before, addressing this question requires knowing the specifics of the regulatory regime, especially the terms of supply. If drugs are sold openly on a commercial basis and prices are close to production and distribution costs, opportunities for illicit undercutting would appear to be rather small. Under a more restrictive regime, such as government-controlled outlets or medical prescription schemes, illicit sources of supply would be more likely to remain or evolve to satisfy the legally unfulfilled demand. In short, the desire to control access to stem consumption has to be balanced against the black market opportunities that would arise. Schemes that risk a continuing black market require more questions—about the new black markets operation over time, whether it is likely to be more benign than existing ones, and more broadly whether the trade-off with other benefits still makes the effort worthwhile.

The most obvious case is regulating access to drugs by adolescents and young adults. Under any regime, it is hard to imagine that drugs that are now prohibited would become more readily available than alcohol and tobacco are today. Would a black market in drugs for teenagers emerge, or would the regulatory regime be as leaky as the present one for alcohol and tobacco? A “yes” answer to either question would lessen the attractiveness of legalization.

What about the International Repercussions?

Not surprisingly, the wider international ramifications of drug legalization have also gone largely unremarked. Here too a long set of questions remains to be addressed. Given the longstanding U.S. role as the principal sponsor of international drug control measures, how would a decision to move toward legalizing drugs affect other countries? What would become of the extensive regime of multilateral conventions and bilateral agreements? Would every nation have to conform to a new set of rules? If not, what would happen? Would more permissive countries be suddenly swamped by drugs and drug consumers, or would traffickers focus on the countries where tighter restrictions kept profits higher? This is not an abstract question. The Netherlands’ liberal drug policy has attracted an influx of “drug tourists” from neighboring countries, as did the city of Zurich’s following the now abandoned experiment allowing an open drug market to operate in what became known as “Needle Park.” And while it is conceivable that affluent countries could soften the worst consequences of drug legalization through extensive public prevention and drug treatment programs, what about poorer countries?

Finally, what would happen to the principal suppliers of illicit drugs if restrictions on the commercial sale of these drugs were lifted in some or all of the main markets? Would the trafficking organizations adapt and become legal businesses or turn to other illicit enterprises? What would happen to the source countries? Would they benefit or would new producers and manufacturers suddenly spring up elsewhere? Such questions have not even been posed in a systematic way, let alone seriously studied.

Irreducible Uncertainties

Although greater precision in defining more permissive regulatory regimes is critical to evaluating their potential costs and benefits, it will not resolve the uncertainties that exist. Only implementation will do that. Because small-scale experimentation (assuming a particular locality’s consent to be a guinea pig) would inevitably invite complaints that the results were biased or inconclusive, implementation would presumably have to be widespread, even global, in nature.

Yet jettisoning nearly a century of prohibition when the putative benefits remain so uncertain and the potential costs are so high would require a herculean leap of faith. Only an extremely severe and widespread deterioration of the current drug situation, nationally and internationally—is likely to produce the consensus—again, nationally and internationally that could impel such a leap. Even then the legislative challenge would be stupendous. The debate over how to set the conditions for controlling access to each of a dozen popular drugs could consume the legislatures of the major industrial countries for years.

None of this should deter further analysis of drug legalization. In particular, a rigorous assessment of a range of hypothetical regulatory regimes according to a common set of variables would clarify their potential costs, benefits, and trade- offs. Besides instilling much-needed rigor into any further discussion of the legalization alternative, such analysis could encourage the same level of scrutiny of current drug control programs and policies. With the situation apparently deteriorating in the United States as well as abroad, there is no better time for a fundamental reassessment of whether our existing responses to this problem are sufficient to meet the likely challenges ahead.

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Pros and Cons of Legalizing Marijuana

• Legalization Pros
• Scientific Evidence

The pros and cons of legalizing marijuana are still being debated. Today, 38 U.S. states and the District of Columbia allow for the medical use of marijuana. A growing number allow recreational use.

However, as a Schedule I controlled substance, marijuana is illegal under federal law. This Drug Enforcement Administration designation means that marijuana is considered to have "no currently accepted medical use and a high potential for abuse." It also limits medical studies into the potential benefits of cannabis .

This article explains the positions of those who want to legalize marijuana as well as the arguments of those who do not want to see marijuana legalized.

The Pros of Legalizing Marijuana

Americans overwhelmingly support the legalization of marijuana. In fact, according to the Pew Research Center, 88% of Americans support legalizing marijuana. Of those, 59% say it should be legal for medical and recreational use, and 30% say it should be legal for medical reasons only.

Several possible health benefits of medical marijuana have been proposed:

• Nausea : Marijuana is effective in relieving nausea and vomiting. Studies have shown that cannabis can decrease nausea caused by chemotherapy and almost eliminate vomiting.
• Spasticity : Marijuana can relieve pain and spasticity associated with multiple sclerosis.
• Appetite : Marijuana can help treat appetite loss associated with conditions like  HIV/AIDS and certain types of cancers.
• Chronic pain : Marijuana can relieve certain types of chronic pain, including neuropathic pain, which is caused by nerve damage.

Arguments in favor of using medical marijuana include:

• It's safer : Marijuana is safer than some other medications prescribed to treat pain. For example, some people may use it instead of opioids for pain management. Opioids are highly addictive and are typically not recommended for long-term use in treating chronic pain.
• You can use it in many ways : You do not need to smoke cannabis for its benefits. Products such as topical pain relief treatments, edibles, and other non-smoking applications are now available.
• It's natural : People have used marijuana for centuries as a natural medicinal agent with good results.

Recreational Marijuana

Marijuana is legal for recreational use in 20 states and the District of Columbia. In 20 other states, marijuana has been decriminalized. This means there are no criminal penalties in these states for minor marijuana-related offenses like possession of small amounts or cultivation for personal use.

The Cons of Legalizing Marijuana

Those who oppose the legalization of marijuana point to the health risks of the drug, including:

• Memory issues : Frequent marijuana use may seriously affect your short-term memory.
• Cognition problems : Frequent use can impair your cognitive (thinking) abilities.
• Lung damage : Smoking anything, whether it's tobacco or marijuana, can damage your lung tissue. In addition, smoking marijuana could increase the risk of lung cancer .
• Abuse : Marijuana carries a risk of abuse and addiction.
• Accidents : Marijuana use impairs driving skills and increases the risk for car collisions.

The fact that the federal government groups it in the same category as drugs like heroin, LSD, and ecstasy is reason enough to keep it illegal, some say. As Schedule I drugs are defined by having no accepted value, legalization could give users the wrong impression about where research on the drug stands.

Scientific Evidence Remains Limited

In the past, clinical trials to determine if marijuana is effective in treating certain conditions have been restrictive and limited. However, as medical marijuana becomes more common throughout the world, researchers are doing more studies.

Expert reviews of current research continue to say more studies are needed. In addition, many hurdles involve controlling the quality and dosing of cannabis with what is legally available to researchers.

One review of research noted that the long-term effects of cannabis are still unknown. Without more research into dosage and adverse effects, scientific evidence of risks and therapeutic effects remains soft.

Researchers need to evaluate marijuana using the same standards as other medications to understand whether it is valuable for managing any conditions.

Until the federal government downgrades marijuana from a Schedule I drug, widespread clinical trials are unlikely to happen in the United States.

Medical marijuana is increasingly available in the U.S. It is often used to treat chronic pain, muscle spasms, nausea, and vomiting, and to increase appetite. However, it can affect thinking and memory, and increase the risk of accidents, plus smoking it may harm the lungs and lead to cancer.

More studies are needed to understand the benefits of medical marijuana. However, unless the federal government removes it as a Schedule I controlled substance, research, access, and legality will remain complicated.

National Conference of State Legislatures. State medical cannabis laws .

United States Drug Enforcement Administration. Drug scheduling .

Pew Research Center. Americans overwhelmingly say marijuana should be legal for recreational or medical use .

Badowski ME. A review of oral cannabinoids and medical marijuana for the treatment of chemotherapy-induced nausea and vomiting: a focus on pharmacokinetic variability and pharmacodynamics . Cancer Chemother Pharmacol. 2017;80(3):441-449. doi:10.1007/s00280-017-3387-5

Filippini G, Lasserson TJ, Dwan K, et al. Cannabis and cannabinoids for people with multiple sclerosis . Cochrane Database Syst Rev . 2019;2019(10):CD013444. doi:10.1002/14651858.CD013444

American Cancer Society. Marijuana and Cancer .

Hill KP. Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: A clinical review . JAMA. 2015;313(24):2474-83. doi:10.1001/jama.2015.6199

Choo EK, Feldstein Ewing SW, Lovejoy TI. Opioids out, cannabis in: Negotiating the unknowns in patient care for chronic pain . JAMA . 2016;316(17):1763-1764. doi:10.1001/jama.2016.13677

Corroon J, Sexton M, Bradley R. Indications and administration practices amongst medical cannabis healthcare providers: a cross-sectional survey . BMC Fam Pract. 2019;20(1):174. doi:10.1186/s12875-019-1059-8

The Council of State Governments. State approaches to marijuana policy .

Harvard Health Publishing, Harvard Medical School. The Effects of Marijuana on your Memory .

Ghasemiesfe M, Barrow B, Leonard S, Keyhani S, Korenstein D. Association between marijuana use and risk of cancer: a systematic review and meta-analysis . JAMA Netw Open. 2019;2(11):e1916318. doi:10.1001/jamanetworkopen.2019.16318

Preuss U, Huestis M, Schneider M et al. Cannabis use and car crashes: A review . Front Psychiatry . 2021;12. doi:10.3389/fpsyt.2021.643315

Deshpande A, Mailis-Gagnon A, Zoheiry N, Lakha SF. Efficacy and adverse effects of medical marijuana for chronic noncancer pain: Systematic review of randomized controlled trials . Can Fam Physician. 2015;61(8):e372-81.

Hill KP, Palastro MD, Johnson B, Ditre JW. Cannabis and pain: a clinical review .  Cannabis Cannabinoid Res . 2017;2(1):96-104. doi:10.1089/can.2017.0017

Maida V, Daeninck PJ. A user's guide to cannabinoid therapies in oncology . Curr Oncol. 2016;23(6):398-406. doi:10.3747/co.23.3487

Meier MH, Caspi A, Cerdá M, et al. Associations between cannabis use and physical health problems in early midlife: A longitudinal comparison of persistent cannabis vs tobacco users. JAMA Psychiatry. 2016;73(7):731-40. doi:10.1001/jamapsychiatry.2016.0637

By Angela Morrow, RN Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.

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Legalizing Marijuana: Pros and Cons

To the Editor:

Much of the country — with The New York Times regrettably in the vanguard — is advocating the reckless addition of a third drug, marijuana, to two drugs currently legal for adults: alcohol and tobacco. These two legal drugs are the leading causes of preventable illness.

The legal status of a drug has dramatic impact on its use. In the last 30 days, 52 percent of Americans 12 and older used alcohol, 27 percent used tobacco and only 7 percent used marijuana. The dramatically lower level of marijuana use reflects its illegal status, not its appeal. Why is it in our nation’s interest to see marijuana use climb? Since when is smoking a program that we promote?

The best policy to protect public health is one that reduces, not increases, marijuana use. There are plenty of ways to achieve this goal, including a strong public education effort focused on the negative health effects of marijuana.

There are reasons why employers, including the United States government, prohibit marijuana use in the workplace. There are reasons why marijuana emergency room admissions are reported at the rate of 1,250 a day and 455,000 a year, and why highway crashes double for marijuana users.

We cannot ignore the negative effects that legalization would have on under-age use and addiction, highway safety, treatment costs, mental health problems, emergency room admissions, workplace accidents and productivity, and personal health.

PETER BENSINGER ROBERT L. DuPONT Chicago, July 30, 2014

Mr. Bensinger was administrator of the Drug Enforcement Administration from 1976 to 1981. Mr. DuPont, president of the Institute for Behavior and Health, was director of the National Institute on Drug Abuse from 1973 to 1978. They are co-founders of Bensinger, DuPont & Associates, which provides employee assistance program, gambling helpline and drug-testing services.

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Should Medical Marijuana Be Legal?

• History of Medical Marijuana

The use of medical marijuana dates to ancient civilizations, though historians are undecided about whether the first medical use of cannabis was in China, where the plant is indigenous.

Archaeologists unearthed traces of cannabis with high levels of THC (the main psychoactive component of cannabis) in wooden bowls dating to 500 BCE in the Jirzankal Cemetery in China, marking the earliest instance of marijuana use found to date. Read more history…

Pro & Con Arguments

Pro 1 Marijuana is beneficial as a medicine with fewer risks than opioids and other prescribed drugs. Medical marijuana is most commonly used for pain in the US. “While marijuana isn’t strong enough for severe pain (for example, post-surgical pain or a broken bone), it is quite effective for the chronic pain that plagues millions of Americans, especially as they age,” explains primary care physician and cannabis specialist, Peter Grinspoon. [ 22 ] Marijuana also offers pain relief for patients who are suffering the pain of multiple sclerosis or general nerve pain. In contrast with marijuana, the commonly prescribed drugs for these ailments are often heavily sedating, which can impair quality of life. [ 22 ] Marijuana, particularly CBD (the main nonpsychoactive component in cannabis), has also shown potential to treat high blood pressure, inflammation and related neuropathic pain, anxiety disorders (including generalized anxiety, panic, social anxiety, obsessive-compulsive, and post-traumatic stress disorders), gastrointestinal (GI) disorders (including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), Crohn’s, and ulcerative colitis), epilepsy and other seizure syndromes, as well as the prevention of drug and alcohol addiction relapse and alleviation of the effects of chemotherapy. [ 23 ] [ 24 ] [ 25 ] [ 26 ] [ 27 ] [ 28 ] [ 29 ] [ 30 ] “Medical marijuana” also includes drugs chemically derived from marijuana, rather than only preparations of the plant itself. According to the National Institutes of Health, “THC itself has proven medical benefits in particular formulations.” [ 31 ] In the US, the FDA approved THC-based Marinol and Cesamet to treat nausea in chemotherapy patients and for appetite stimulation in AIDS patients. Also FDA-approved is the CBD-based Epidiolex, which treats Dravet and Lennox-Gastaut syndromes in children. Sativex, a THC- and CBD-based drug for multiple sclerosis (MS) patients, is approved for use in the UK, Canada, and some European countries. [ 31 ] The bottom line: marijuana has been used as medicine for thousands of years. The drug should be legalized and studied to reap the full benefits. Read More

Pro 2 Marijuana is safer than some legal drugs and preferred by patients. Many patients prefer marijuana for pain because it is less addictive and carries less risk of overdose than opiates. [ 22 ] [ 32 ] Three researchers from the University of British Columbia BC Centre on Substance Use in Vancouver, argue: “Although cannabis use is neither risk free nor a panacea, the risks it poses of physical dependence and accidental overdose compared with opioid use are substantially lower—indeed, fatal overdose with cannabis has never been documented and is thought to be impossible. Especially in the era of the opioid overdose crisis, the common sequelae [results] of opioid use disorder (e.g., fatal overdose, acquisition or transmission of blood-borne diseases) are hardly comparable to those of cannabis use disorder at either individual or population levels. The lower relative risks associated with cannabis are reflected in substantially lower rates of cannabis-associated morbidity, mortality and societal costs compared with opioids in Canada, despite much higher levels of exposure. Simply put: it is not perception that cannabis has fewer relative harms than opioids; it is evidence.” [ 33 ] Marijuana can also be used instead of NSAIDs (Advil and Aleve, for example) if someone has kidney problems, ulcers, or gastroesophageal reflux disease (GERD), making it potentially safer for people with those conditions. [ 22 ] Studies also show many patients prefer to use marijuana instead of lorazepam , clonazepam , and alprazolam for anxiety disorders and instead of sertraline , trazodone , or bupropion for depression. [ 34 ] Read More

Pro 3 Americans have agreed for decades that medical marijuana should be legal. Widespread American approval of marijuana is seen in the many states that have legalized its use. Since California legalized medical marijuana in 1996, 36 states and DC have followed suit as of December 2022. [ 19 ] Of those living in the United States, 83.5% live in a state (or DC) with legal medical marijuana. Only 16.5% live in one of the 13 states without legal medical marijuana. [ 19 ] [ 45 ] Additionally, polls and elections for more than 20 years have shown Americans united on the legalization of medical marijuana. [ 35 ] Of 96 polls and elections collected by ProCon between 2000 and 2022, only three had less than 50% support for legalizing medical marijuana. Two were elections in South Dakota (Nov. 2006 and Nov. 2010); however, South Dakota legalized medical marijuana in 2020. [ 35 ] The third was a poll of 960 physicians nationwide by researchers at Rhode Island Hospital for presentation to the American Society of Addiction Medicine in Apr. 2001. The doctors were split fairly evenly: 36% believed they should be able to legally prescribe medical marijuana, 26% were unsure, and 38% were against the practice. [ 35 ] However, a 2021 study found 70.7% of physicians at the 2019 American College of Emergency Physicians’ Annual Conference “believed that cannabis has medical value,” and, further, that 79.6% of the physicians would choose marijuana over opioids if cannabis were found to be more effective, and 52.3% would choose marijuana if it were found to be equally as effective as opioids. [ 36 ] Approval of legalization crosses party lines as well as age and race demographics in what Pew Research Center deemed “overwhelming support” in an Apr. 16, 2021, poll. Among Democrats, 95% believed medical marijuana should be legal, joined by 87% of Republicans. [ 21 ] 92% of white Americans would legalize medical marijuana, along with 91% of Black Americans, 89% of Asian Americans, and 87% of Hispanic Americans. [ 21 ] The largest support among age groups for medical marijuana comes from those aged 18-29 (94%) and 65-74 (93%). However, no age group dropped below 85% approval (those aged 75+). [ 21 ] Medical marijuana enjoys so much support among Americans that many now approve of the legalization of recreational marijuana as well. [ 21 ] Read More

Con 1 Medical legalization of marijuana makes a drug that is dangerous to children, teenagers, and young adults more readily available. Whether medical marijuana is legalized for everyone or only adults, legalization provides everyone more access to the drug. [ 38 ] “An ‘unintended consequence’ of marijuana legalization is the impact on the pediatric population. From prenatal exposure to unintentional childhood exposures, through concerns of adolescence abuse and marijuana use for medicinal indications in children, marijuana exposure can affect pediatric patients at every stage in childhood. Regardless of the stage or reason of exposure, concerns exist about short-term and long-term consequences in a child’s physical and mental health,” argues Sam Wang, Associate Professor of Pediatrics-Emergency Medicine at the University of Colorado School of Medicine. [ 39 ] Adult use of marijuana, medical or otherwise, during pregnancy can cause child development problems during and after pregnancy. If exposed to marijuana before birth, children may be more susceptible to “increased hyperactivity, impulsivity, and inattention symptoms” and problems with “visual-motor coordination, processing speed, [and] visual memory.” [ 31 ] [ 39 ] [ 40 ] [ 41 ] Any drug at home poses potential risks for children, but medical marijuana edibles look like regular treats (gummy bears, hard candies, and chocolate bars, to name a few), yet are infused with potent marijuana. And, unlike a regular treat, a marijuana infused edibles should be carefully portioned for the correct dosage. A child accidentally eating an entire marijuana candy bar could overdose and end up in serious medical distress. Within just five years, accidental cannabis exposures in kids aged one to six who ate edibles increased 1,375% from 207 cases in 2017 to 3,054 in 2021. [ 39 ] [ 42 ] [ 47 ] The danger does not decrease as children age. According to the National Institutes of Health, “heavy chronic marijuana consumption in young people under the age of 25 has been associated with decreased cognitive and executive function.” Researchers are not yet certain whether the damage is permanent, but one New Zealand study found teens who smoked marijuana heavily and developed a marijuana use disorder lost 8 IQ points on average between ages 13 and 38. [ 40 ] Read More

Con 2 Marijuana has dangerous side effects. The National Institutes of Health offers a litany of negative mental side effects, including “altered senses (for example, seeing brighter colors), altered sense of time, changes in mood, impaired body movement, difficulty with thinking and problem-solving, impaired memory, hallucinations (when taken in high doses), delusions (when taken in high doses), [and] psychosis (risk is highest with regular use of high potency marijuana).” [ 40 ] Physical side effects include breathing problems such as “daily cough and phlegm, more frequent lung illness, and a higher risk of lung infections,” an increased heart rate (which, in turn, increases the risk of heart attack), and Cannabinoid Hyperemesis Syndrome (“regular cycles of severe nausea, vomiting, and dehydration, sometimes requiring emergency medical attention”). [ 40 ] Further, between 9% and 30% of people who use marijuana are at risk of developing a substance use disorder. And, with THC levels steadily increasing, the potential for addiction only grows as users need more and more marijuana to feel the desired effects. [ 40 ] [ 43 ] Colorado legalized medical marijuana in 2000 and recreational marijuana in 2012. The state saw a 40% increase in cannabis-related emergency room (ER) visits between 2012 and 2014. Colorado hospitals have seen a 50% increase in marijuana-related cyclic vomiting syndrome. Burn admissions also increased. [ 44 ] However, these are the known side effects. Because the drug has not been studied as thoroughly as other drugs, there may be unexpected consequences to medical marijuana use. [ 44 ] Read More

Con 3 Recreational marijuana only should be decriminalized while researchers properly study the medicinal effects of the drug. Decriminalizing recreational marijuana means possession of a small amount for personal use does not carry the risk of arrest, jail time, or a criminal record, but instead are ticketed like a minor traffic violation, according to NORML (National Organization for the Reform of Marijuana Laws), which reports 26 states have partially or fully decriminalized recreational marijuana. [ 46 ] However, the medical benefits and safety of marijuana have not been studied enough to determine if the benefits outweigh the risks associated with the drug. Additional study also allows more specific-use analysis (for example, does a particular marijuana derivative help a particular ailment, and does marijuana treat a condition not yet associated with the drug?). [ 38 ] Sarah C. Hull, cardiologist at Yale School of Medicine, explains why we should not rush into legalization of medical marijuana: “Decriminalization of marijuana will create significant opportunities to conduct this research, but common-sense regulation based on science must be implemented simultaneously to create an ethical policy framework. This should aim to promote public health through comprehensive education programs and protection of vulnerable populations such as adolescents, while recognizing the right of autonomous adults to make decisions about their own health but not to act in a way that might compromise the health of others. [ 38 ] Hull argues further that “significant criminal penalties” should not be attached to adult possession or use of marijuana as such punishments have “entrench[ed] systemic racism.” [ 38 ] She concludes, “There is substantial need for more research to guide specific policy development going forward, and in the meantime, recreational use (though not medicinal use) should be generously taxed to fund research efforts as well as addiction treatment in order to enhance benefits to society.” [ 38 ] As with any drug, marijuana should be thoroughly studied for medical applications before being widely used as medicine. “Once we understand on the brain level what effect it is having on cognition, then we can see how it can be applied for all sorts of purposes, but first we need to know exactly what it’s doing. If it’s going to be introduced to society in a big way, we need to know what the potential harms and benefits are,” argues Earl Miller, cognitive neuroscientist at the Massachusetts Institute of Technology’s Picower Institute for Learning and Memory. [ 44 ] Read More

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Legalizing Marijuana: Pros and Cons Essay

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The History of Marijuana Criminalization and Legalization

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Marijuana is known as one of the most popular and widespread drugs in the world. Historical records suggest that cannabis was used in prehistoric societies for religious ceremonies, as well as for meditation and relaxation. Nowadays, most governments prohibit the recreational use of marijuana; however, in most states of the U. S., it is legal to use cannabis for medical purposes and in some of the states – for recreational ones. The focus of this paper will be on the impact of the legalization of the U.S. economy with possible positive and negative sides of the matter.

Marijuana was outlawed in the USA in the 1930s when the Marijuana Tax Act was issued. After the law was issued, several states decriminalized possession in small amounts, and some of them legalized medicinal marijuana. In 2009, as it appeared in a poll conducted by the authorities, the citizens were concerned about the strict drug laws, and several new policies, including, for instance, the Ogden memo, have been adopted ever since (Zambiasi and Stillman 2). The first states that legalized recreational marijuana were Washington and Colorado in 2012 (Zambiasi and Stillman 1-2), and currently, it is legal in nine states and the District of Columbia.

Pros and Cons of Legalization

Marijuana legalization may lead to substantial profits for the government. However, new profits often come with additional expenditures. There are positive as well as negative sides of the legalization, regarding the economy. First, marijuana legalization significantly reduces black market production and distribution, allowing businesses to operate legally, leading to a less burdened judicial system. The government will potentially need fewer detention facilities and forces, thus spending less money. According to Saaty, “of the $48.7 billion spent by states and the federal government in 2008, $13.8 billion was strictly used for marijuana enforcement” (1).

Since legalization brings down the costs of production and distribution, the government can impose a tax on marijuana, generating additional revenue. However, establishing a universal way to tax marijuana may be challenging; Colorado and Washington already tax marijuana based on its value, while other states plan to take the weight as a point of reference (Kilmer, “The “10 Ps” of Marijuana Legalization” 56). Moreover, if the tax is too high, it may stimulate the black market.

Marijuana legalization naturally increases its use with all its health risks, entailing significant healthcare expenditures. The government will be forced to establish new testing programs, awareness messaging, and control institutions. According to Kilmer, “from mid-2012 through Fall 2014, the Washington State Liquor and Cannabis Board spent about $9 million to develop the proposed regulations” ( Marijuana Legalization 5). In addition to tourists, drug legalization also attracts migrants. As of 2015, for instance, the number of citizens in Colorado had increased by roughly 3% since marijuana was legalized for recreational use (Zambiasi and Stillman 10). Such population growth, if uncontrolled, inevitably leads to a shortage of job positions, housing, etc.

At the beginning of 2018, federal authorities rescinded the Cole Memorandum that weakened strict prohibition enforcement in states where marijuana was legal. Although this may potentially help regulate the market, the local laws still differentiate from state to state, ruining the overall macroeconomic balance. Considering that, it might be beneficial for the government to enforce similar laws throughout the country to control the market more effectively.

In conclusion, marijuana legalization has its pros and cons that can greatly affect the economy. It may entail not only financial profits but also losses on federal and local levels. It appears that a uniform drug policy throughout the nation might be a solution to some of the problems. It is crucial for the government to find the middle ground in laws and regulations regarding the matter to counterbalance the financial problems.

Kilmer, Beau. Marijuana Legalization, Government Revenues, and Public Budgets . RAND Corporation, 2016.

—. “The “10 Ps” of Marijuana Legalization.” Ideas , vol. 54, 2015, pp. 52–57.

Saaty, Thomas L. “A Marijuana Legalization Model Using Benefits, Opportunities, Costs, and Risks (BOCR) Analysis.” International Journal of Strategic Decision Sciences (IJSDS), vol. 6, no. 2, 2015, pp. 1–11.

Zambiasi, Diego, and Steven Stillman. “The Pot Rush: Is Legalized Marijuana a Positive Local Amenity?” The IZA Institute of Labor Economics Papers, vol. 1, 2018, pp. 1–24.

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Most Americans Favor Legalizing Marijuana for Medical, Recreational Use

Legalizing recreational marijuana viewed as good for local economies; mixed views of impact on drug use, community safety, table of contents.

• The impact of legalizing marijuana for recreational use
• Partisan differences on impact of recreational use of marijuana
• Demographic, partisan differences in views of marijuana legalization
• Views of marijuana legalization vary by age within both parties
• Views of the effects of legalizing recreational marijuana among racial and ethnic groups
• Wide age gap on views of impact of legalizing recreational marijuana
• Acknowledgments
• The American Trends Panel survey methodology

Pew Research Center conducted this study to understand the public’s views about the legalization of marijuana in the United States. For this analysis, we surveyed 5,140 adults from Jan. 16 to Jan. 21, 2024. Everyone who took part in this survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used for the report and its methodology .

As more states pass laws legalizing marijuana for recreational use , Americans continue to favor legalization of both medical and recreational use of the drug.

An overwhelming share of U.S. adults (88%) say marijuana should be legal for medical or recreational use.

Nearly six-in-ten Americans (57%) say that marijuana should be legal for medical and recreational purposes, while roughly a third (32%) say that marijuana should be legal for medical use only.

Just 11% of Americans say that the drug should not be legal at all.

Opinions about marijuana legalization have changed little over the past five years, according to the Pew Research Center survey, conducted Jan. 16-21, 2024, among 5,14o adults.

While a majority of Americans continue to say marijuana should be legal , there are varying views about the impacts of recreational legalization.

About half of Americans (52%) say that legalizing the recreational use of marijuana is good for local economies; just 17% think it is bad and 29% say it has no impact.

More adults also say legalizing marijuana for recreational use makes the criminal justice system more fair (42%) than less fair (18%); 38% say it has no impact.

However, Americans have mixed views on the impact of legalizing marijuana for recreational use on:

• Use of other drugs: About as many say it increases (29%) as say it decreases (27%) the use of other drugs, like heroin, fentanyl and cocaine (42% say it has no impact).
• Community safety: More Americans say legalizing recreational marijuana makes communities less safe (34%) than say it makes them safer (21%); 44% say it has no impact.

There are deep partisan divisions regarding the impact of marijuana legalization for recreational use.

Majorities of Democrats and Democratic-leaning independents say legalizing recreational marijuana is good for local economies (64% say this) and makes the criminal justice system fairer (58%).

Fewer Republicans and Republican leaners say legalization for recreational use has a positive effect on local economies (41%) and the criminal justice system (27%).

Republicans are more likely than Democrats to cite downsides from legalizing recreational marijuana:

• 42% of Republicans say it increases the use of other drugs, like heroin, fentanyl and cocaine, compared with just 17% of Democrats.
• 48% of Republicans say it makes communities less safe, more than double the share of Democrats (21%) who say this.

Sizable age and partisan differences persist on the issue of marijuana legalization though small shares of adults across demographic groups are completely opposed to it.

Older adults are far less likely than younger adults to favor marijuana legalization.

This is particularly the case among adults ages 75 and older: 31% say marijuana should be legal for both medical and recreational use.

By comparison, half of adults between the ages of 65 and 74 say marijuana should be legal for medical and recreational use, and larger shares in younger age groups say the same.

Republicans continue to be less supportive than Democrats of legalizing marijuana for both legal and recreational use: 42% of Republicans favor legalizing marijuana for both purposes, compared with 72% of Democrats.

There continue to be ideological differences within each party:

• 34% of conservative Republicans say marijuana should be legal for medical and recreational use, compared with a 57% majority of moderate and liberal Republicans.
• 62% of conservative and moderate Democrats say marijuana should be legal for medical and recreational use, while an overwhelming majority of liberal Democrats (84%) say this.

Along with differences by party and age, there are also age differences within each party on the issue.

A 57% majority of Republicans ages 18 to 29 favor making marijuana legal for medical and recreational use, compared with 52% among those ages 30 to 49 and much smaller shares of older Republicans.

Still, wide majorities of Republicans in all age groups favor legalizing marijuana at least for medical use. Among those ages 65 and older, just 20% say marijuana should not be legal even for medical purposes.

While majorities of Democrats across all age groups support legalizing marijuana for medical and recreational use, older Democrats are less likely to say this.

About half of Democrats ages 75 and older (53%) say marijuana should be legal for both purposes, but much larger shares of younger Democrats say the same (including 81% of Democrats ages 18 to 29). Still, only 7% of Democrats ages 65 and older think marijuana should not be legalized even for medical use, similar to the share of all other Democrats who say this.

Substantial shares of Americans across racial and ethnic groups say when marijuana is legal for recreational use, it has a more positive than negative impact on the economy and criminal justice system.

About half of White (52%), Black (53%) and Hispanic (51%) adults say legalizing recreational marijuana is good for local economies. A slightly smaller share of Asian adults (46%) say the same.

Criminal justice

Across racial and ethnic groups, about four-in-ten say that recreational marijuana being legal makes the criminal justice system fairer, with smaller shares saying it would make it less fair.

However, there are wider racial differences on questions regarding the impact of recreational marijuana on the use of other drugs and the safety of communities.

Use of other drugs

Nearly half of Black adults (48%) say recreational marijuana legalization doesn’t have an effect on the use of drugs like heroin, fentanyl and cocaine. Another 32% in this group say it decreases the use of these drugs and 18% say it increases their use.

In contrast, Hispanic adults are slightly more likely to say legal marijuana increases the use of these other drugs (39%) than to say it decreases this use (30%); 29% say it has no impact.

Among White adults, the balance of opinion is mixed: 28% say marijuana legalization increases the use of other drugs and 25% say it decreases their use (45% say it has no impact). Views among Asian adults are also mixed, though a smaller share (31%) say legalization has no impact on the use of other drugs.

Community safety

Hispanic and Asian adults also are more likely to say marijuana’s legalization makes communities less safe: 41% of Hispanic adults and 46% of Asian adults say this, compared with 34% of White adults and 24% of Black adults.

Young Americans view the legalization of marijuana for recreational use in more positive terms compared with their older counterparts.

Clear majorities of adults under 30 say it is good for local economies (71%) and that it makes the criminal justice system fairer (59%).

By comparison, a third of Americans ages 65 and older say legalizing the recreational use of marijuana is good for local economies; about as many (32%) say it makes the criminal justice system more fair.

There also are sizable differences in opinion by age about how legalizing recreational marijuana affects the use of other drugs and the safety of communities.

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9 facts about Americans and marijuana

Most americans now live in a legal marijuana state – and most have at least one dispensary in their county, americans overwhelmingly say marijuana should be legal for medical or recreational use, clear majorities of black americans favor marijuana legalization, easing of criminal penalties, concern about drug addiction has declined in u.s., even in areas where fatal overdoses have risen the most, most popular, report materials.

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• Mon 14 Feb 2022

Five benefits of legalising drugs that may change your perspective 

• By Ariana Yekrangi

Legalising drugs would make drug use safer, but the bigger impact of moving to a regulated drug market is that it would defy racism, reduce chaos and violence and make us wealthier. 

What does decriminalisation of drugs mean VS what does it mean to legalise drugs

When we talk about decriminalising all drugs, within a legal framework, we don’t necessarily refer to them being legalised. In other words, drug ownership and personal use would itself still be legally prohibited, but violations of those prohibitions are deemed to be exclusively administrative violations and are removed completely from the criminal realm. Ideally, we want the legalisation of all drugs, however, decriminalising them could also be an attractive short-term solution. Here are five arguments for legalising drugs.

1. Reducing drug violence and regulating its consumption

Will legalising drugs reduce drug trafficking.

The global market for goods, including drugs, is based on the simple principle of supply and demand. When a government reduces the supply of any particular drug without reducing its demand for it, its price goes up. However, unlike many other goods, the consumption of drugs is not particularly price-sensitive. 

As the notorious United States’ ban of alcohol during the 1920s demonstrated, public demand for the drug remained high, which in turn fueled an increase in bootleg booze and speakeasies. But that wasn’t all. It aided the emergence of various mafia gangs and other crime syndicates.

This is often known as the balloon effect, referring to the fact that when squeezing an inflated balloon, it just moves the air around, instead of completely getting rid of it. 

Legalising drugs gives us a unique opportunity to address this issue and remove much of the crime and violence associated with it. In 2018, the number of drug-related homicides in Mexico was a whopping 33,341. Imagine saving this amount of lives, just in Mexico! 

Moreover, legalising drugs further allows us to regulate its consumption. Currently, most children are easily able to buy various drugs from their friendly neighbourhood dealers, since selling drugs to children isn’t a moral code most drug cartels swear by. 

The solution is simple: let us run the drug market, not gangsters!

2. A unique chance to defy racism 

Across many nations, drug laws are not only unnecessarily strict, but also fuel systemic racism. This is not breaking news and can easily be observed if one takes the time to look at the relevant data.

In September, Simon Woolley, an ex-No 10 adviser warned Borris Johnson’s government about this very issue: “For decades, politicians from all sides have either turned a blind eye to drug policy failures or weaponised the debate to score cheap political points,” he said. “This has led to half a century of stagnation, which has landed with force on our black communities, driving up needless criminalisation and undermining relationships with the police.”

However, this is not a unique case in the UK. Across the Atlantic, in the United States, black people are several times more likely than white people to be arrested for marijuana possession; even though both groups smoke weed at similar rates. Just in 2020, people of colour made up 94% of marijuana arrests by the NYPD .

But it is not only the legal system that suffers from systematic racism; the name of a drug like Marijuana, for example, has a clear racist background.

The use of the word Marijuana increased dramatically in the US during William Randolph Hearst’s desperate campaign to create hysteria around the impact of cannabis. In fact, he decided to use a foreign-sounding name (Marijuana) to scare off Americans about an invasion of marijuana-smoking Mexican men assaulting their white women. Scary heh? 

True, legalising drugs will not, by itself, solve racism. However, numerous studies have already proven that as the general number of arrests decline, so do the racial disparities that come with them. 

3. Stopping systematic drug-related human rights abuses around the world

Capital punishment for drug trafficking is a serious offence across human right’s violating countries such as China, Indonesia, Iran, Malaysia, Saudi Arabia, Singapore and Vietnam. According to Harm Reduction International, as of 2020, thirty-five countries still retain the death penalty for drug offences.

These thirty-five nations continue to undermine the human rights and well-being of persons who use drugs and that of their families and communities. The practice is not only a blatant breach of drug user’s/traffickers human rights, but also one which is in clear violation of international law. 

In 2020, Amnesty International recorded at least 30 executions for drug-related offences carried out in only three countries (China, Iran and Saudi Arabia), a decrease of 75% from 2019. Do keep in mind though that the 75% reduction in executions is during a period when most countries are hit by the Covid pandemic and were likely to have strict quarantine and lockdown measures in place. The figure was drastically higher in the anteceding years. In 2019, 122 drug-related executions were confirmed, whereas in 2015 the number of executions was a whopping 755.

Legalising drugs will have an immense impact on the lives of hundreds who are killed as well as thousands of others across the globe who are on death row for various drug offences.

The United Nations’ 2019 report “ What we have learned over the last ten years ” is a comprehensive resource on the organisation’s commitments on drug-related matters. One only needs to hope that the UN approaches its solutions with adamant hands.

4. Actually helping addicts

Would legalising drugs increase addiction.

Pretty much everything we have been taught about addiction is a fab. Most don’t get addicted because it is fun, most don’t enjoy being junkies.

During the 1970s, Bruce Alexander, a Canadian psychologist, published a number of studies known as the “rat park experiments”. The experiment essentially studied two groups of rats, both of which were pre-addicted to morphine. The first group was placed in separate cages, while the other group was added to a rat colony, with regular social access to other rats where they could play and have plenty of sex. 

Already becoming jealous? No? Just me? Moving on… 

During this period, both groups were offered a choice between water and a morphine solution. The shocking result was that the rats living together in the colony drank significantly less morphine than those living alone in isolation.

A similar conclusion resulted from a study conducted on US servicemen returning from the Vietnam war. During various military urine tests in 1971, it became clear that drug use amongst soldiers in Vietnam had reached epidemic proportions. In September 1971, a random sample of 470 soldiers, as well as another sample of 495 soldiers who had previously been tested positive for opioids, were selected and interviewed by sociologist Lee N. Robins.

All the men had been serving in Vietnam for exactly one year, so their exposure to the country’s heroin and opium resources was the same. After a closer inspection, it became known that almost half of all army men enlisted in Vietnam had tried heroin or opium and that 20% of them had developed an addiction to them. 

It may seem common knowledge that the availability of a certain drug directly correlates with its consumption. However, what surprised the research team in this particular study was that eight to 12 months after the soldiers had returned home, heroin use was uncommon, even amongst those who had previously become addicted to the drug in Vietnam. In fact, during the first year back home, only 5% of men had relapsed to addiction.

Although both experiments have their limitations when it comes to the repeatability and applications to society, they both teach us a valuable lesson: environmental factors matter and must be an undeniable aspect in prevention programmes and policies impacting drugs and crime. 

Our penal system must be rehabilitative, not vindictive. Let’s not forget that a criminal conviction relating to drugs can have devastating effects upon someone’s life. It can cause personal relationships to fall apart and limit future work opportunities and further alienate those who are in desperate need of our help. This doesn’t need to be the case. Instead of stopping drug users, let’s support them instead.

5. More tax money

Legal drugs present the possibility of tremendous benefits to economies especially as a means to recover from the pandemic induced economic downturn. 

Looking at this again, over the past few years, the sale of a drug like marijuana in states like Colorado and Washington have resulted in buoyant tax revenues. According to a report from Arcview Market Research and BDS Analytics, cannabis sales in the country were $12.2 billion in 2019 and projected to increase to $31.1 billion by 2024.

But that’s not all, we will also be able to save vast sums of money as fewer law enforcement officers would be required and fewer court cases involving drug substances would go to trial. Legalising drugs can also create more jobs and investment opportunities. 

Reform! The drug legalisation debate can be a complex one, however what is clear is that the war on drugs was an ill-advised policy that we have been pursuing for the last 80 years.

It is time we listen to experts. It is time that we understand that nations don’t live in a vacuum and global challenges require global solutions. 

Drugs can bring us joy; drugs can harm us. Legalise them and give them to doctors, pharmacists and regulated retailers, not criminals. 

Please contact us if you have any comments or would like us to write about potential arguments against legalising drugs.

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• v.109(2); Mar-Apr 2012

Legalization, Decriminalization & Medicinal Use of Cannabis: A Scientific and Public Health Perspective

Empirical and clinical studies clearly demonstrate significant adverse effects of cannabis smoking on physical and mental health as well as its interference with social and occupational functioning. These negative data far outweigh a few documented benefits for a limited set of medical indications, for which safe and effective alternative treatments are readily available. If there is any medical role for cannabinoid drugs, it lies with chemically defined compounds, not with unprocessed cannabis plant. Legalization or medical use of smoked cannabis is likely to impose significant public health risks, including an increased risk of schizophrenia, psychosis, and other forms of substance use disorders.

Introduction

In recent years, there has been a strong pressure on state legislatures across the US to legalize or decriminalize use and possession of specified amounts of cannabis and/or to pass laws that allow smoking of crude cannabis plant (also known as marijuana, weed, Mary Jane, pot, reefers, ganja, joint and grass) for prescribed medical purposes (so called “medical marijuana”). Advocacy groups claim that smoking cannabis is a safe and effective treatment for various psychological and medical conditions, ranging from stress and anxiety to Alzheimer’s dementia and Parkinson’s disease, even though cannabis is not approved for such use by the Food and Drug Administration (FDA).

Legalization of cannabis is the process of removing all legal prohibitions against it. Cannabis would then be available to the adult general population for purchase and use at will, similar to tobacco and alcohol. Decriminalization is the act of removing criminal sanctions against an act, article, or behavior. Decriminalization of cannabis means it would remain illegal, but the legal system would not prosecute a person for possession under a specified amount. Instead, the penalties would range from no penalties at all, civil fines, drug education, or drug treatment.

No state has legalized cannabis thus far. It remains a US federally-controlled substance, which makes possession and distribution illegal. However, at the time of this writing, 26 states in the US have passed either medical cannabis laws, cannabis decriminalization laws, or both. See Table 1 . A major concern of this commentary is that both the medicinal use of smoked cannabis plant and legalization/decriminalization of cannabis are being advocated in a way that circumvents the normal testing and regulatory processes by the FDA that is otherwise required for all drugs marketed for human use in the US. By circumventing this process, advocacy groups put state legislatures and/or voters in the position to decide on proposals with a certain impact on public health and medical treatment without necessarily being qualified to understand the pertinent scientific evidence.

US Cannabis Use Legislated into Law without FDA Approval

Taking advantage of the obscure legal status of cannabis (i.e., federally banned illicit drug but approved by local governments for medical and/or recreational purposes), businesses involving sales of cannabis are flourishing and even stock-market investments are available. For example, CannabisInvestments.com provides information on ways one can invest in hemp-related and medical marijuana products and companies. These business interest groups are ratcheting pressure on state legislatures to decriminalize or medicalize cannabis, counting on support of millions of addicted users and politicians looking for re-election votes and unaware of the dangers of such a legislative act.

History and Legal Status of Cannabis

Historically, cannabis has been used in various cultures and populations as indigenous therapy for a range of medical ailments (e.g., fever, insomnia, cachexia, headache, constipation, rheumatic pain) and diseases (e.g., venereal disease, malaria). Due to its presumed medical benefits, cannabis was recognized as an official, licit drug and listed in the U.S. Pharmacopoeia in 1850. Recreational use of cannabis surged in the 1930s during the Prohibition Era. In 1937, the Marijuana Tax Act effectively thwarted all cannabis use without criminalizing its possession or use. In 1970, the Controlled Substances Act classified cannabis as schedule I illicit drugs, the most restrictive category, and made possession a federal crime.

Reefer Madness is a well-known 1936 American propaganda exploitation film revolving around the melodramatic events that ensue when high school students are lured by pushers to try “marijuana” — from a hit and run accident, to manslaughter, suicide, attempted rape, and descent into madness.

The Drug Enforcement Agency (DEA), which administers the Controlled Substances Act, continues to support the Schedule I assignment (and FDA concurred) noting that cannabis meets the three criteria for such placement under 21 U.S.C. 812(b):

• high potential for abuse;
• no currently accepted medical use in the US; and
• lack of accepted safety for use under medical supervision.

A past evaluation by several Department of Health and Human Services (HHS) agencies, including FDA, Substance Abuse and Mental Health Services Administration (SAMHSA) and National Institute for Drug Abuse (NIDA), concluded that no sound scientific studies supported medical use of marijuana and no animal or human data supported the safety or efficacy of marijuana for general medical use. 1

Popular Perception of Cannabis Use

In the public debate, cannabis has been considered a relatively benign recreational drug in comparison to opiates, stimulants, even alcohol. The favorable popular perception of cannabis presumably reflects the absence of dramatic physical signs of intoxication or withdrawal. Incidentally, cessation of cannabis use does cause withdrawal, but the severity is masked by the gradual release of delta 9-tetrahydrocannabinol (THC), the major psychoactive ingredient in cannabis, from fat tissue (adipocytes) where it accumulates during chronic use. The process is not unlike the tapering of medication during detoxification.

The general public has not been adequately informed about recent scientific findings demonstrating major adverse effects of smoking cannabis on physical and especially mental health, the latter varying in range from cognitive dulling, brief psychotic experiences, to long-term addiction and chronic psychosis. 2 , 3

Epidemiology of Cannabis Use and Addiction

Cannabis (here referring to smoking of cannabis plants) is the most commonly used illicit drug in the US. Data from The National Survey on Drug Use and Health 4 , 5 indicate that 44% of males and 35% of females have used marijuana at least once in their life time. More recent studies suggest that regular use of marijuana is increasing. Data from National Survey on Drug Use and Health 6 indicate that in persons over the age of 12, the rate of past month cannabis use and the number of users in 2009 (6.6 percent or 16.7 million) were higher compared to 2008 (6.1% or 15.2 million) and 2007 (5.8% or 14.4 million).

Medicinal Use of Cannabinoids in Pill Form

Since THC was first isolated and purified 7 from the cannabis plant in 1965, more than 400 chemicals have been isolated, approximately 60 of which are cannabinoids, compounds that are the active agents of cannabis. Reflecting a rapidly growing interest in the therapeutic potential of cannabis, about 21 cannabinoids are currently under study by the US FDA. 8

More recently, two types of cannabinoid receptors have been identified: CB1 found mostly in the central nervous system and responsible for psychoactive properties of cannabis, and CB2 found mostly in the spleen, immune tissues, and peripheral blood, and responsible for immunological and anti-inflammatory effects of cannabis. 9 , 10 A group of endo-cannabinoids has been also identified, e.g., arachidonoylethanolamine or anandamide, as endogenous chemical modulators which mimic the actions of phytocannabinoids and activate cannabinoid receptors. 10 These discoveries have led to the development of numerous CB receptor agonists and antagonists and numerous studies have tested therapeutic indications for these compounds. Medications containing natural or synthetic cannabinoids currently approved or being considered for approval for medicinal use are listed below:

Dronabinol (proprietary name Marinol), a synthetic THC, is FDA approved as an antiemetic in patients undergoing cancer chemotherapy, as an appetite stimulant for weight loss/decreased food intake in AIDS patients, and less frequently to augment analgesic treatment. Dronabinol is a Schedule III medication, indicating it has some potential for psychological and physical dependence.

Nabilone (proprietary name Cesamet), is a synthetic cannabinoid. FDA approved for peroral treatment of nausea and vomiting in chemotherapy patients who have not responded to conventional antiemetics, and anorexia and weight loss in patients with AIDS. Nabilone is a Schedule II medication, with high potential for mental health side effects and addiction.

Sativex , a liquid extract from cannabis plant, is used as oral spray (“liquid marijuana”), contains THC, cannnabidiol (CBD), and other cannabinoids. Sativex has been approved for neuropathic pain, emesis, overactive bladder, and spasticity in several countries including England, Canada, and Spain. Phase III studies of Sativex are currently underway in the US, thus it does not have a schedule assigned to it.

These medications have been approved for specific indications (nausea, vomiting, cachexia) and are currently studied for a number of new indications, such as spastic syndromes, neurological disorders, neuropathic pain, and other pain syndromes, among others. Note that use of medications that have been tested and approved by the FDA is not controversial. What is objectionable is that current efforts to legalize cannabis crude plant use state legislative processes to bypass federal regulatory processes that were put in place specifically to protect the public health.

Suggested Non-FDA Approved Uses of Cannabinoids and Smoked Cannabis

Suggested but as of yet not FDA-approved indications for smoked cannabis and/or cannabinoids include spastic syndromes in neurological disorders, pain syndromes, and glaucoma. We reviewed about 70 studies of oral cannabinoids and the few available studies of smoked cannabis for a number of medical indications. As expected, prescription cannabinoids are effective antiemetics and appetite stimulants, and some studies report their effectiveness as adjunct therapy in chronic pain syndromes, spasticity, and glaucoma. Similar results are reported by the few studies of smoked cannabis plant for these same indications. As noted earlier, safe and effective alternative treatments for all these syndromes are available. Studies assessing psychological aspects of smoked cannabis and prescription cannabinoids uniformly report undesired effects: acute psychosis, poorer prognosis of chronic psychosis, or cognitive dulling in medical patients. In other words, in addition to a number of adverse medical effects (next section), psychological effects of cannabis are common and detrimental. Unfortunately, we found no long-term studies investigating whether and how frequently chronic use of small amounts of cannabis for medicinal purposes develops into cannabis abuse and/or addiction.

Adverse Medical Effects of Cannabis and THC

The extant scientific literature by and large reflects the harmful effects of inhaled cannabis smoke. In what follows we review some of these reports.

Respiratory

Many of the same mutagens and carcinogens found in tobacco smoke are found in marijuana smoke as well. 11 Marijuana smoking has been shown to decrease pulmonary function, produce chronic cough, airway inflammation and abnormal cell growth that may antecede the onset of cancer. 12 However, the International Agency for Research on Cancer found the epidemiologic data inconclusive as to the increased risk of cancer from cannabis use versus that of tobacco smokers. 13 In contrast to tobacco, marijuana-smoking lung injury is not reversed on abstinence. 14

Immunologic

In humans, an increase in mortality of HIV-positive cannabis users has been observed. 15

Cardiovascular

Direct stimulation of the cardiac pacemaker by marijuana leads to an increase in heart rate making THC unsafe in cardiac patients. 14

Daily cannabis use is a risk factor for fibrosis progression via steatogenic effects, thus, daily cannabis use in patients with liver disease is contraindicated. 16 Cannabis users metabolize and activate or inactivate drugs more slowly than normal, 17 potentiating the deleterious effects of the drugs.

Endocrine and Reproductive Systems

In preclinical studies, cannabinoids have shown inhibitory effects on pituitary luteinizing hormone, prolactin, growth hormone, and thyroid stimulating hormone with little effect on follicle-stimulating hormone. 18 , 19 Marijuana can disrupt female reproductive health. 20 Women who smoke marijuana during pregnancy are more likely to have low birth weight infants possibly from a shorter gestation. 21 The effects of maternal marijuana use on infant development have not been systematically studied. However, the lipid solubility of THC allows for rapid transit in breast milk, where it has been shown to accumulate and eventually pass to the newborn. 22

Carcinogenesis

Cannabis use increases the incidence of testicular germ cell tumors – TGCT. 23 The authors observed a 70% increased risk of TGCT associated with current marijuana use, and the risk was particularly elevated for current use that was at least weekly or that began in adolescence. These associations were independent of known TGCT risk factors.

Effects of Smoked Cannabis on Mental Health

Smoking cannabis has a number of acute and chronic pathogenic effects on human mental health. 3 , 24 Direct causal effects of chronic use are difficult to scientifically establish because the condition cannot be randomly assigned or manipulated experimentally for ethical reasons. Nevertheless, prospective population studies indicate that early cannabis use frequently serves as a prelude (or “gateway”) to other illicit drug use. Despite occasional non-confirmatory results, the “gateway sequence” is the most common pattern in the sequential progression in drug use, 25 where marijuana use often is the initial step leading towards more powerful and more harmful drugs.

The mental effects of smoked cannabis include mental slowness, “relaxation”, tiredness, euphoria, and some users report anxiety and paranoia. Acute negative effects on cognition and performance, limited to periods of intoxication, have been all well-documented. 26 , 27 Long-term effects of cannabis use on cognitive performance involve subtle and selective impairments of specific higher cognitive functions 27 , 28 including an impaired ability to focus attention and filter out irrelevant information, which is progressive with the cumulative duration of exposure to cannabis. 29 These effects of chronic use recover only partially in ex-cannabis users, but the past duration of cannabis use continued to have an adverse effect on the ability to effectively reject complex irrelevant information. 30

Remodeling of Brain Reward Circuits - Cannabis Addiction

Active ingredients in cannabis, THC in particular, affect neurophysiological and behavioral systems in ways similar to addictive drugs. 31 Cannabis use is associated with reinforcing pleasurable feelings of reward and euphoria either through direct effects on CB1 receptors expressed in N. Accumbens or through collateral circuits (including endogenous opiate receptors) with similar effects on the reward pathway in the brain. 31 In most cases, addictive drugs “reset” the threshold for stimulation of the reward pathway at a higher level, where only supraphysiological stimulation by drugs can generate the desired feeling of reward. This “hijacking” of the reward pathway reduces the motivational power of natural rewards (e.g. food, opportunity to mate, relationships, etc) and thus reshapes normal motivational priorities. With repeated stimulation of this pathway, cannabis use induces neural plasticity and alters reward-based learning, 32 all leading to phenomenological and behavioral features typical of addiction. Suggestive of its high addictiveness, cannabis is the most commonly used illicit drug in the US and rate of its use continues to rise. 4 , 5 , 6

Cannabis Use and Well-Being

Proponents of cannabis use argue that smoking cannabis provides relaxation and pleasure, enhances the sense of well being, contributes to stress-relief, and helps to deal with hard reality. Of course, any enhancement of well being of a mentally healthy person through use of a psychoactive substance is some sense an oxymoron. Furthermore, cannabis use decreases cortical dopamine 33 which plays a major role in higher cognitive functions, working memory, executive function, etc. Hence, the “relaxed” feeling most cannabis users report as a desirable acute effect, in all likelihood reflects cognitive dulling (“amotivational syndrome”) caused by decreases in cortical dopamine. In other words, the weight of evidence indicates that cannabis creates cognitive dulling rather than reduction in anxiety, indifference rather than relaxation, and amotivation rather than inner peace, all closer to psychopathology than to well being.

Cannabis Use and Work Performance

There is an ongoing debate whether cannabis use interferes with people’s ability to work, relate to others, and/or live a normal life. Recent research clearly shows that any work that requires cognitive involvement and decision making is affected by cannabis use. 27 , 28 , 29 , 34 In a study of young, otherwise mentally and physically healthy cannabis users, Wadsworth et al 28 report an association between cannabis use and impairment in cognitive function and mood but not with workplace errors (although there was an association with lower alertness and slower response organization). Users experienced working memory problems at the start, and psychomotor slowing and poorer episodic recall at the end of the work week. This highlights the importance of the timing of testing within the context and routine of everyday life. In a separate study of the same sample, cannabis use had a significant negative impact on safety at work (such as self-reported accidents), road traffic accidents, and minor injuries. 34 Those who had higher levels of other risk factors associated with accidents and who also used cannabis were more likely to report an accident in the previous year. Thus, it is possible that cannabis-related effects were linked to an amplification of other risk factors associated with accidents and injuries. 34

Cannabis Use and Mental Health in the General Population

According to the study 35 of 18,500 cannabis smokers published by Statistics Netherlands in October 2010, cannabis users suffer mental health problems twice as often as nonusers. The relative risk of mental problems was doubled in male and female cannabis users (20% and 28%, respectively) compared to male and female nonusers (10% and 14%, respectively). Most common mental health issues reported by cannabis users were anxiety, melancholy, sadness, and impatience. In contrast, physical health of users and nonusers barely differed. Though technically illegal, the Netherlands decriminalized the consumption and possession of less than 5 grams (0.18 ounces) of cannabis in 1976 under an official “tolerance” policy.

Taking advantage of the obscure legal status of cannabis, businesses involving sales of cannabis are flourishing and even stock-market investments are available.

For example, CannabisInvestments. com provides information on ways one can invest in hemp-related and medical marijuana products and companies.

CNS Effects of Chronic Cannabis Use

Recently, specific pathogenic effects of cannabis on human brain tissue have been documented. Using high-resolution (3-T) structural magnetic resonance imaging (MRI), Yucel et al 36 determined long-term heavy cannabis use is associated with gross anatomical abnormalities in two cannabinoid receptor–rich regions of the brain, the hippocampus and the amygdala. Subects were healthy males with long-term (more than 10 years) and heavy (more than five joints daily) cannabis use with no history of poly-drug use or neurologic/mental disorders. Cannabis users had bilaterally and significantly reduced hippocampal and amygdala volumes, with changes greater in the hippocampus. In fact, left hemisphere hippocampal volume was inversely associated with cumulative exposure to cannabis during the previous 10 years as well as with subthreshold positive psychotic symptoms. Positive psychosis symptom scores were also associated with cumulative exposure to cannabis.

Cannabis Use and the Risk of Schizophrenia, Psychosis, and Affective Disorders

Cannabis use is among the environmental factors associated with increased risk and worsened prognosis of schizophrenia and some data suggest a causal effect. 3 Cannabis use also is associated with more prevalent expressions of a wider psychosis phenotype. Isolated psychotic symptoms have reported prevalences of 5–15% among chronic cannabis users. 2 , 3 Although causality remains difficult to infer from observational studies, the weight of the evidence appears to favor a causal contribution from cannabis use for the development of Schizophrenia and psychosis. 2

Recent meta-analyses lend further support to the hypothesis that cannabis use causally contributes to the increased risk of development of schizophrenia. In a comprehensive and systematic meta-analysis, Moore et al 37 determined whether cannabis use contributes causally to the development of nonsubstance psychiatric illness, such as schizophrenia and affective disorders. The study was designed to address as much as possible two of the most important methodological problems in studying the relation between cannabis use and psychosis: 1) the potential for reverse causality (where psychosis causes cannabis use and not vice versa) and 2) the transitory intoxication effects (that is misinterpreted as psychosis as the false positive error). The results indicated that the risk of psychosis is increased by roughly 40% (pooled adjusted OR: 1.41) in cannabis users. The results were not as impressive for affective disorders. Within the users, a dose-response effect was observed with the risk more than doubled (OR =2.1) in the most frequent users. For cannabis and psychosis, there was evidence of confounding effects, but the associations persisted in almost all studies, even after adjustment for comprehensive lists of variables. The authors concluded that “there is now sufficient evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life” (page 319).

In a meta analysis of peer-reviewed publications in English reporting age at onset of psychotic illness in substance using and non–substance using groups Large et al 38 found an association between cannabis use and earlier onset of psychosis (the effect was not seen with alcohol). The authors suggest the need for renewed warnings about the potentially harmful effects of cannabis. Similar findings are reported by other authors. 39

Genetic Moderation of Cannabis Effect on Psychosis

One of the most puzzling aspects of cannabis-associated psychosis is that schizophrenia is not rising in incidence to reflect prevalent cannabis use. The likely answer is that there is variation in individual sensitivity to the psychosis-inducing effects of cannabis. In other words, individuals who have a greater biological vulnerability to psychosis are more likely to develop psychotic experiences when exposed to cannabis. As an example, the COMT Val/Val genotype is a risk factor for schizophrenia in the general population 40 presumably by providing a pathological substrate, such as low dopamine in the frontal cortex 40 and high mesolimbic dopamine. 41 Both conditions are believed to contribute to schizophrenia symptoms. Carriers of the COMT Val/Val genotype have low cortical dopamine but do not automatically develop schizophrenia. Rather, this genotype is considered to be a matter of individual variability in the level of cortical dopamine. Hovever, carriers of this genotype, who were also chronic cannabis users as adolescents, have a dramatically (up to 10 times) higher risk of psychosis 42 compared to adult-onset cannabis users with the same genotype. Cannabis use is reported to further decrease cortical 33 and increase mesolimbic dopamine 43 possibly amplifying the preexisting, genetically created dopamine deficit. If occurring during the sensitive developmental period of adolescence, such augmentation may synergistically facilitate the onset of psychosis. Similar interactive synergism was recently described for the AKT1 gene and cannabis. 45

Finally, recent study by Welch et al 44 was the first longitudinal study to demonstrate an association between thalamic volume loss and exposure to cannabis in people currently unaffected by Schizophrenia but with increased risk for the illness due to positive family history. As Welch et al 44 conclude, this finding may be important in understanding the link between cannabis exposure and the subsequent development of Schizophrenia.

Empirical and clinical studies reviewed here clearly demonstrate pathological effects of cannabis smoking on physical and especially mental health as well as its interference with social and occupational functioning. We did not find a single methodologically sound study to suggest that the benefits of smoking cannabis outweigh the associated risks. These negative data far outweigh documented benefits for a limited set of medical indications for which safe and effective alternative treatments are readily available. However, advocacy groups are pursuing legalization or medical use of smoked cannabis, largely ignoring pills containing extracted THC and other cannabinoids. It appears therefore that it is not the benefit of active cannabis ingredients, but the route of administration, a wider set of indications, and the ritual of use that’s being advocated. Based on the empirical and clinical evidence reviewed here, it seems safe to conclude that, if there is any medical role for cannabinoid drugs, it lies with chemically modified extracts, not with unprocessed cannabis plant.

Dragan M. Svrakic, MD, PhD, and Patrick J. Lustman, PhD, practice at the Washington University School of Medicine and the Veterans Administration Medical Center in St. Louis. Ashok Mallya, MD, Taylor Andrea Lynn, PhD, and Rhonda Finney, RN, practice at the Veterans Administration Medical Center. Neda M. Svrakic, is at the University of Illinois at Urbana-Champaign.

Contact: [email protected]

None reported.

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The Pros and Cons of Legalising Recreational Drugs - TOEFL Writing Integrated Practice Test

The Pros and Cons of Legalizing Recreational Drugs - TOEFL Writing Integrated Practice Test

Updated On September 23, 2024

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The TOEFL iBT ® exam evaluates the test takers on various different abilities, specifically on their communication skills. Among all the test sections, the Writing Section is particularly significant, requiring diverse skills which candidates can practice by attempting test like 'The Pros and Cons of Legalizing Recreational Drugs'. This practice test aims to enhance your writing abilities, concentrating specifically on the Integrated Writing task of the TOEFL test. It aims to assist you in understanding task instructions, structuring responses effectively, and enhancing your performance in the TOEFL Writing segment. So, let's start your journey towards attaining your desired TOEFL score!

Writing Instructions:

• You'll read a passage and listen to a lecture on an academic topic.
• You may take notes while listening to aid comprehension.
• Then you will write a response to a question that asks you about the lecture you heard.
• Answer the question comprehensively using information from the lecture. Avoid expressing personal opinions in the response.
• There is no strict word limit. However, an effective response is considered to be within 150 to 225 words.
• Your response will be assessed based on writing quality, content accuracy, and completeness.

Reading Time: 3 minutes

The Pros and Cons of Legalising Recreational Drugs

The debate over legalizing recreational drugs has become a hot topic recently. Supporters believe that legalising these substances could bring many benefits, both economically and socially. One major advantage is the potential for large tax revenue. By regulating and taxing the sale of recreational drugs, governments can produce significant income, which can be used to fund public services like education and healthcare. For example, states like Colorado and Washington have reported millions of dollars in tax revenue from legalized marijuana sales.

Another important point is the reduction in crime rates. Legalizing recreational drugs can weaken the black market and reduce the power of drug cartels and criminal organizations. When drugs are illegal, they are often sold in unregulated and dangerous environments. This leads to violence and other criminal activities. Legalization can move the market to a regulated framework, ensuring safer transactions and reducing the load on law enforcement agencies. Also, legalization can lead to better public health outcomes. When drugs are legalised, they can be regulated for quality and safety, reducing the risk of pollution and overdose. People who use drugs recreationally can seek help without fear of legal consequences. This leads to more effective addiction treatment and harm reduction strategies. This approach can ultimately result in a healthier society with fewer drug-related health issues.

Now play the audio.

Provide a summary on the lecture's claims and viewpoint while highlighting on the relevance stated and mentioned in the reading section.

Response Time: 20 minutes

Transcript of the Audio of the Lecture on the Pros and Cons of Legalising Recreational Drugs

Professor: While the arguments for legalizing recreational drugs might seem convincing, there are significant downsides that need to be considered. First, the idea that tax revenue from legalized drugs will be a major benefit is overly hopeful. The costs associated with increased drug use, such as healthcare expenses and addiction treatment, can be more than the tax benefits. For instance, the revenue generated might not be enough to cover the long-term societal costs of increased drug addiction.

Also, the claim that legalization will reduce crime rates is not entirely accurate. Even with legal drugs, the black market can still thrive, especially if the legal prices are high due to taxes. Criminal organizations can continue to operate by selling for less than legal prices, maintaining their influence and continuing illegal activities. Additionally, legalization might lead to an increase in drug-related offenses, such as driving under the influence, which can strain law enforcement resources.

Finally, the idea that legalization improves public health is questionable. Legalizing drugs can lead to higher rates of usage. This can result in more addiction and health problems. While regulation might ensure safer products, it does not eliminate the inherent risks associated with drug use. Increased accessibility can also normalize drug consumption, potentially leading to higher rates of abuse and long-term health consequences.

Curious about what a good TOEFL score looks like ? Check it out first, then explore the Integrated Writing sample answers!

Sample Responses for the Integrated Writing Task on the Pros and Cons of Legalising Recreational Drugs

A comprehensive analysis of various responses is provided below, enabling you to identify areas requiring improvement to achieve your target score.

High-Level Response

The lecture presents several arguments against the legalization of recreational drugs, challenging the points made in the reading passage. The reading suggests that legalizing drugs can generate significant tax revenue, which can be used to fund public services. However, the lecture counters this by arguing that the costs associated with increased drug use, such as healthcare and addiction treatment, may outweigh the tax benefits. The professor points out that the revenue generated might not be sufficient to cover these long-term societal costs.

The reading also claims that legalization can reduce crime rates by weakening the black market and reducing the power of criminal organizations. In contrast, the lecture argues that the black market can still thrive if legal prices are high due to taxes. Criminal organizations might continue to operate by selling drugs at lower prices than the legal market, maintaining their influence and illegal activities. Additionally, the professor mentions that legalization could lead to an increase in drug-related offenses, such as driving under the influence, which can strain law enforcement resources.

Lastly, the reading asserts that legalization can lead to better public health outcomes by ensuring the quality and safety of drugs and allowing users to seek help without fear of legal consequences. The lecture challenges this by stating that legalization can lead to higher rates of drug use, resulting in more addiction and health problems. While regulation might ensure safer products, it does not eliminate the inherent risks associated with drug use. Increased accessibility can also normalize drug consumption, potentially leading to higher rates of abuse and long-term health consequences.

Rater's Comment

This response effectively summarizes the main points from both the reading and the lecture, demonstrating a clear understanding of the material. The writer accurately presents the lecture's counterarguments to the reading's claims, maintaining a logical flow throughout the essay. For instance, the response clearly contrasts the reading's point about tax revenue with the lecture's argument about the costs of increased drug use. Similarly, the discussion on crime rates and public health outcomes is well-organized and coherent, highlighting the differences between the reading and the lecture.

The response is well-structured, with each paragraph focusing on a specific point of contention between the reading and the lecture. The use of transitions, such as "however" and "in contrast," helps to clearly signal the relationship between the two sources. Additionally, the writer paraphrases the information effectively, avoiding direct copying from the reading or the lecture. The language used is appropriate for a college-level essay, with strong control over grammar, sentence structure, and vocabulary. There are no significant errors that hinder understanding, and the response remains objective, focusing on summarizing the relationship between the reading and the lecture without expressing personal opinions.

Overall, this response demonstrates a high level of proficiency in summarizing and analyzing the relationship between the reading and the lecture, making it a strong example of a well-written TOEFL Integrated Writing task.

Mid Level Response

The lecture argues against the points made in the reading about legalizing recreational drugs. The reading says that legalizing drugs can bring in a lot of tax revenue, but the lecture says that the costs of increased drug use, like healthcare and addiction treatment, might be more than the tax benefits. The professor says that the revenue might not be enough to cover these long-term costs. The reading also says that legalization can reduce crime rates by weakening the black market. But the lecture argues that the black market can still exist if legal prices are high because of taxes. Criminal organizations might still sell drugs at lower prices than the legal market. The professor also mentions that legalization could lead to more drug-related offenses, like driving under the influence, which can strain law enforcement.

Lastly, the reading claims that legalization can lead to better public health outcomes by ensuring the quality and safety of drugs. The lecture challenges this by saying that legalization can lead to higher rates of drug use, resulting in more addiction and health problems. While regulation might make drugs safer, it does not remove the risks of drug use. Increased accessibility can also make drug use more normal, leading to higher rates of abuse.

This response provides a summary of the main points from both the reading and the lecture, but it lacks depth and detail in some areas. The writer presents the lecture's counterarguments to the reading's claims, but the explanations are somewhat brief and lack specific examples. For instance, the discussion on tax revenue and the costs of increased drug use could be expanded to provide a clearer understanding of the lecture's argument. The response is generally well-organized, with each paragraph focusing on a specific point of contention between the reading and the lecture. However, the transitions between ideas could be smoother to improve the overall coherence of the essay. For example, the transition between the discussion on crime rates and public health outcomes could be more clearly signaled.

There are a few grammatical and punctuation errors that affect the clarity of the response. For instance, the sentence "The professor says that the revenue might not be enough to cover these long-term costs" could be rephrased for better clarity. Additionally, the sentence "Criminal organizations might still sell drugs at lower prices than the legal market" could benefit from a clearer explanation of how this undermines the reading's argument.

Overall, this response demonstrates a basic understanding of the relationship between the reading and the lecture, but it could be improved with more detailed explanations and smoother transitions. The grammatical and punctuation errors also detract from the overall quality of the essay.

Strategies for Taking the Integrated Writing Task on the Pros and Cons of Legalizing Recreational Drugs

Here are the strategies for taking the Integrated Writing Task.

• Read the passage carefully, taking concise notes on key points.
• Listen actively to the lecture, noting its relationship to the reading.
• Begin your response by clearly stating how the lecture relates to the reading.
• Explain any contradictions or connections between the reading and lecture.
• Integrate information from both sources throughout your essay.
• Use clear transitions and attributions for information from each source.

Prepared to enhance your TOEFL writing skills? Our collection of example responses and professional tips is here to support you in your journey. It's time to put your abilities to the test with some hands-on practice!

Additional Reads:

• TOEFL Integrated: Gain the Ability to Comprehend Information and Express Thoughts in Writing
• Chevalier de Seingalt - TOEFL Writing Integrated Test
• Economic Growth and Environment - TOEFL Writing Academic Discussion Test
• Targeted Advertising - TOEFL Writing Academic Discussion Test
• Grading Students - TOEFL Academic Discussion Writing Practice Test with Answers
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Q&a on question 4: whether or not to legalize psychedelics for therapeutic use.

Psychedelic plants such as holy basil, coleus and lemongrass are growing in the greenhouse for research at Massachusetts General Hospital. Jesse Costa/WBUR photo

Voters will soon decide whether to legalize plant-based psychedelic drugs in Massachusetts. A majority “yes” vote on Question 4 on the November ballot would approve the use of natural psychedelic substances, like psilocybin mushrooms, for people 21 and older at licensed therapy centers.

Massachusetts would then be the third state, following Oregon and Colorado, to legalize certain psychedelics, with state law creating a regulatory framework for their therapeutic use. But like cannabis, substances like psilocybin and mescaline would remain illegal at the federal level.

What exactly would Q. 4 do if passed? – The law would create a five-member “natural psychedelic substances commission” to oversee the new psychedelics industry. Similar in structure to the state cannabis control commission, the members would be chosen by the governor, attorney general, and treasurer.

What your vote will mean – A “yes vote” would allow persons over age 21 to use certain natural psychedelic substances under licensed supervision and to grow and possess limited quantities of those substances in their home. It would also create a commission to regulate those substances. A “no vote” would make no change in the law regarding psychedelic substances.

The commission would license “psychedelic therapy centers,” where people 21 and older could take certain drugs under the supervision of a licensed facilitator. The law would allow for the cultivation and sale of five types of substances: dimethyltryptamine (DMT), mescaline, ibogaine, psilocybin, and psilocyn. The commission would be tasked with defining who is allowed to administer the drugs. The first centers would not open until at least 2026.

People would not be able to buy psychedelics at retail shops, like marijuana dispensaries. However, the law would decriminalize possession and the limited growth of the drugs at home for personal use.

What do supporters argue? – Proponents argue that limited legalization would be another important step in reversing the government’s decades-long war on drugs. They also point to studies showing psychedelics’ potential as a treatment for people with depression or those struggling with addiction.

Today, Boston is a hub for research into psychedelics and mental health. The Center for the Neuroscience of Psychedelics at Massachusetts General Hospital is looking into a possible treatment that combines psychedelics and MDMA with psychotherapy to treat post-traumatic stress disorder (PTSD) in veterans, among other related studies.

Meanwhile, Dana Farber is investigating whether psilocybin eases depression in patients with cancer. Advocates say residents deserve access to potentially revolutionary therapies.

“Voting yes on Question 4 will give veterans, patients with end-of-life distress, and people who are suffering access to this life-saving mental health tool,” said Jennifer Manley, a spokesperson for Massachusetts for Mental Health Options, which has been the driving force behind the campaign. «Psychedelic medicine can provide healing and hope where other mental health treatments have failed.»

Massachusetts for Mental Health Options is funded by the Washington, D.C.-based New Approach PAC, which also led the legalization efforts in Oregon and Colorado. The committee has received more than $4 million in donations and in-kind contributions since its launch in the summer of 2023, primarily from wealthy donors like TOMS Shoes founder Blake Mycoskie, actress Eliza Dushku, who is best known for her role in “Buffy the Vampire Slayer,” and All One God Faith Inc., the company behind Dr. Bronner’s soaps.

What do opponents argue? – Opponents worry about a proliferation of drugs that will remain federally illegal. The law would allow people to grow their own psychedelic plants in a space no larger than 144 square feet, as long as they’re secured from anyone under 21. The Colorado psychedelics law also allows for limited home growth, while Oregon does not.

“A black market is inevitable with this amount of home growth,” said Chris Keohan, a spokesperson for the Coalition for Safe Communities, a committee formed to oppose the ballot question.

Detractors also point to issues of cost and access. Early evidence from Oregon shows psychedelic treatment can cost people from $800 to $2,500 out of pocket.

“This measure prioritizes for-profit corporate interests over public health and dangerously and unnecessarily decriminalizes psychedelics for recreational use and distribution statewide,” Keohan said.

This article was published by WBUR on Sept.20. The Reporter and WBUR share content through a media partnership.

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