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Treatment community largely absent from ballot debate on legalization

October 4, 2016
by Gary A. Enos, Editor
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If opponents of easing legal restrictions on marijuana use succeed in seeing some of five recreational marijuana initiatives fail at the polls next month, they likely will do so despite a relatively underfinanced effort with minimal participation from treating professionals who address the adverse consequences of expanded access.

With only five weeks until voters in California, Arizona, Nevada, Massachusetts and Maine consider marijuana legalization initiatives, the co-founder of Project SAM (Smart Approaches to Marijuana) laments a lack of systematic assistance from the substance use treatment community.

“I have been somewhat disappointed that the treatment community has not stepped up financially,” says Kevin Sabet, though he adds that he also understands treatment organizations' concerns about the bottom line.

Given marijuana business interests' significant financial support for the latest round of recreational use initiatives, any level of organized advocacy by the treatment community could have an impact in contests that appear to be close. Sabet says all five states fall into that category, while recent media reports have suggested that the strongest chances for passage appear to be in California and Maine (while Arizona might be the least likely to see a yes vote next month).

Another four states (Florida, Arkansas, North Dakota and Montana) are placing medical marijuana ballot questions before voters this fall.

Multiple polls in California have placed support for legalization at around 60%, with support in Maine somewhat lower. Significant opposition to legalization from high-profile government leaders in Massachusetts appeared to be resonating with voters there earlier this year, but a poll released last week suggests that support for the Massachusetts recreational marijuana initiative is rising.

Early efforts among some treatment professionals in California did succeed in ensuring that the proposed measure there would specify a funding stream for treatment, which generally has not happened in other states.

Sabet says opponents of expanded access consistently have to fight the “inevitability narrative,” which suggests that public sentiment has irreversibly shifted toward supporting an approach to marijuana regulation resembling that for alcohol and tobacco. (Indeed, Gallup national surveys have indicated that public support for legalization now stands at an all-time high of 58%.)

Sabet adds that in seeking to encourage more involvement from the treatment community, advocates find that providers “don't want to get political, and these are political initiatives.” In addition, he indicates, some providers don't want to be seen as an opposing force to state officials who would become the regulators of marijuana sales and taxation if an initiative were to pass.

Stepping forward

One behavioral health leader who has no qualms about getting politically involved on the marijuana issue is Jon Daily, LCSW, CADC II, founder and clinical director of the outpatient practice Recovery Happens Counseling Services in northern California. Regardless of what the polls might say, Daily believes that as a father of five who also sees all of the negative effects that today's stronger marijuana can have on young people, this is a fight worth fighting.

“I want to be able to hang my hat on, 'Here's what I did to help this cause,'” says Daily, who today will accept the invitation to attend a rally against the California initiative.

Daily speaks proudly of his recent participation in the Sacramento Bee editorial board's examination of the initiative, in meetings with stakeholders that culminated in a newspaper editorial against legalization. He says the public's normalization of marijuana use makes it particularly difficult for clinicians to break through with patients whose use has led to problems.

“A person doesn't hit bottom until society hits bottom,” says Daily, such as in the public's harsher reaction toward use of drugs such as methamphetamine and heroin.

He believes that many treatment professionals don't get involved in the advocacy effort because they don't have firsthand experience observing the effects of highly potent marijuana on the developing brain. The risk of greater exposure to the drug among young people tends to be atop the list of legalization opponents' concerns.

“We see the psychosis, the anxiety attacks,” says Daily, whose organization has treatment locations in the Bay Area and greater Sacramento. “It's just a different drug today.”

For Daily, the only upside to the legalization initiative that he can identify lies in tax revenue, while the downsides are many. As another example, “You see the cartel thing in the other states [with legalization],” he says. “The criminal element hasn't slowed down at all.”