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Sheldon Miller, M.D., is quoted in the May 1 issue stating that a new study by Crowley et al. about teen marijuana use "tends to add weight to arguments against legalization of marijuana." However, the study's conclusions are neutral as to how best to regulate marijuana. In fact, they could just as easily be used to argue for effective, legal regulation of marijuana as for the current policy of harsh prohibition. This is an example of how the politics of the Drug War, which emphasizes harsh criminal sanctions against users, have become intertwined with the scientific process, thus distorting it.
Dr. Miller concludes that because harmful marijuana use occurs among conduct-disordered teens, current drug policies should be continued. He uses the word "legalization" as though its meaning is clear. In fact, there are many alternatives to current policies, some of which involve a more effective, pragmatic, and humane prohibition, and some of which include decriminalization and regulation of marijuana for adult use. His comment is an attempt to preempt discussion of alternatives by lumping them into the category of "legalization," then totally dismissing them.
Most serious proposals for alternatives to the Drug War include provisions for minimizing use among children and teens. Despite current policies, marijuana is widely available, especially to teens. In many cities and schools, marijuana is as easy for teens to get as is alcohol, which is legal for adults and regulated. Effective legal regulation of marijuana could conceivably lead to a reduction in teen use and in the harms associated with teen use. New proposals generally call for policies that are more nuanced than current ones and that result in the least overall harm to users and to society.
Addiction psychiatrists understandably are very concerned about any increase in drug abuse that might occur with the liberalization of drug policy. We must be vocal in conveying that concern and the pressing need for more treatment and research. We are mistaken, however, if we think that Drug War advocates are friends of either drug users or of treatment. Their policies stigmatize and punish drug users in increasingly inhumane ways, while placing barriers in the way to recovery. Prisons fill while treatment programs close. Furthermore, abuses of basic civil rights, such as civil forfeiture of assets and random workplace drug testing, threaten us all. There is no body of evidence that supports the Drug War, which is based in ideology, not science. Most drug policy experts agree that current policies are ineffective and expensive, and there is an emerging consensus about reasonable steps that could be taken toward a more effective and humane policy. A widely debated critical examination of the merits of various policies toward marijuana and other drugs is badly needed. As professionals, we should be supporting such a debate rather than drawing political conclusions from clinical studies.
Mark L. Willenbring, M.D.
Minneapolis, Minn.