Exactly two weeks to the day I was born in 1979, Keith Stroup, the head of the National Organization of Marijuana Laws (NORML), told the Emory University school newspaper, The Emory Wheel, that "We are trying to get marijuana reclassified medically. If we do that, (we'll do it in at least 20 states this year for chemotherapy patients) we'll be using the issue as a red herring to give marijuana a good name."
So it is no surprise that last week, NORML -- the nation's oldest marijuana legalization organization -- published in their weekly newsletter the sweeping assertion that "medical marijuana has no discernible impact on marijuana use." NORML cited a new article in the Annals of Epidemiology (a respected publication to be sure; a similar epidemiology journal will soon release a study showing that marijuana is significantly linked with car crashes) which critiques an earlier article by Wall and colleagues showing an increase in marijuana use among states with medical marijuana. Essentially, the authors replicated the Wall study using different methods and got different results.
Certainly medical marijuana is a complex issue -- one where politics, compassion, ethics and science collide. Sixteen states and D.C. technically have laws allowing marijuana as medicine on the books, but these laws, like other drug laws, vary widely in implementation, so it is tough to even perform studies linking medical marijuana with use changes. NORML doesn't seem too bothered by that. They went on to cite a Brown University study looking at Rhode Island -- a state with a barely discernible medical marijuana program in the first place -- as further "proof" that medical marijuana doesn't impact use. And the usual folks, like Reason Online (I'm just waiting for Maia Szalavitz to get to this as well), essentially republished the NORML line without any critical analysis.
A closer look at these studies shows something a little different, and much more nuanced. First, they completely ignore the more thorough studies that in fact do show increases in use. A major study published in Drug and Alcohol Dependence by researchers at Columbia University looked at two separate datasets and found that residents of states with medical marijuana had marijuana abuse/dependence rates almost twice as high than states without such laws.
Most importantly, the studies discussed by NORML miss the mark, by failing to take into account the actual implementation of medical marijuana laws. For example, California did not have "dispensaries" until 2003, seven years after the law was enacted. And Rhode Island, the state used in the Brown study, had about 1,500 people in the entire program, so it's not a revelation that the state would not see any significant effect on teens. Time will tell, with further study and analysis, how medical marijuana is affecting attitudes and use rates in the long term.
What of course is never talked about is how medical marijuana programs in states that have gone full steam ahead actually work. Rarely mentioned is the fact that, for example, according to a 2011 study in the Journal of Drug Policy Analysis that examined 1,655 applicants in California who sought a physician's recommendation for medical marijuana, very few of those who sought a recommendation had cancer, HIV/AIDS, glaucoma, or multiple sclerosis. A study published in the Harm Reduction Journal (not exactly an anti-drug mouthpiece), analyzing over 3,000 "medical marijuana users in California, found that an overwhelming majority (87.9%) of those queried about the details of their marijuana initiation had tried it before the age of 19, and the average user was a 32-year-old white male. 74% of the Caucasians in the sample had used cocaine, and over 50% had used methamphetamine in their lifetime. Hardly any had life-threatening illnesses.
Finally, we know from other surveys like the University of Michigan Monitoring the Future study that the perceived harm for smoking marijuana occasionally or regularly has been decreasing among the 8th grade since 2007. Social disapproval for smoking marijuana once or twice, occasionally, and regularly has been decreasing among 8th graders since 2007. That has translated into a major increase in use, which is no surprise to researchers who know that attitudes effect youth use rates.
And how can we say that today's medical marijuana programs aren't having an effect on youth attitudes toward the drug? "Marijuana is medicine" has become a common slogan in America today, as people like Dr. Christian Thurstone, a Colorado doctor working with kids, recently talked about on National Public Radio.
It's time to get the legalization lobby out of the business of medical marijuana and instead focus our attention on scientists developing non-smoked marijuana-based medications for the truly ill. That would make this issue no longer the sick joke that it is today.
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