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Legal marijuana will generate heavy costs

November 24, 2014
by David Macmaster, CSAC, PTTS
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Alcohol and tobacco products are legal for those old enough to buy them. Alcohol and tobacco products generate wealth, business opportunities and employment. Alcohol and tobacco produce significant tax revenues for states and the federal government. Legal marijuana ultimately would do the same. So, the argument often goes, why not legalize marijuana and enjoy the economic benefits it will produce, despite the health, safety and social costs legal marijuana will create?

But what will legal marijuana cost the community, based on reported burdens from tobacco and excessive drinking? These are some of the tobacco and alcohol costs that already affect the community. These problems can be projected to increase with the legalization of recreational marijuana:

  • Increased health care costs.

  • Increased law enforcement, court and corrections costs as increased marijuana use leads to increased intervention, treatment and recovery expenses.

  • Lost productivity as reported in alcohol and tobacco studies.

  • Increased social and human services expenses.

  • Mortality—500,000 annual deaths, with millions in the pipeline (some increase from greater marijuana use can be expected, but the degree is unknown because we do not have much data on marijuana-related mortality in countries where recreational marijuana is available).

Increased costs to the community can be expected from legal marijuana, but precise projections are difficult without the research to determine the extent of it.

Data from Wisconsin

Wisconsin and other states have concluded that the financial benefits from legal tobacco and alcohol are more desirable than the health, public safety and social downsides they create. This claim can be supported by the following facts that Wisconsin (as one example) is living with and not challenging with any public discussion. Nor are these numbers a political issue being discussed in our legislature as part of the marijuana legalization debate. These figures are from University of Wisconsin reports on the burden of tobacco and excessive alcohol use, released in 2010 and 2014, respectively:

  • 15,000 deaths a decade from alcohol, with 60,000 grieving family members.

  • 77,000 deaths a decade from tobacco, with more than 308,000 grieving family members.

  • A $6.8 billion annual burden from excessive drinking in Wisconsin.

  • A $4.5 billion annual burden from tobacco in Wisconsin.

  • $58 million a year in tax revenues from alcohol sales.

  • $640 million a year in tax revenues from tobacco sales (more than 10 times higher than the amount in sales taxes from alcohol, when only 20% of Wisconsin residents smoke compared with 66% who drink alcohol—really?).

  • The Wisconsin government’s General Revenue Funds investment in alcohol and other drug abuse prevention, treatment and recovery services—$3.5 million a year.

  • The Wisconsin government’s General Revenue Funds investment in tobacco prevention and control program services—$5.3 million a year.

Just as Wisconsin’s alcohol industry and the Wisconsin Tavern League lobby to keep alcohol taxes low, the tobacco-growing and -producing states work to ensure that tobacco taxes in those states remain lower than the national average.

What kind of a deal is this for the people of Wisconsin and other states? Yes, we want the freedom to use legal products if we are old enough and can pay for them. But do we really understand the tradeoffs?

In Wisconsin, we are investing a pittance from the massive tax revenues we collect to reduce harm from the sale of these two legal products. Our state’s budgets that are designed to provide prevention, treatment, recovery and control policies remain woefully inadequate. We seem not to mind looking the other way, while this annual imbalance is as predictable as the sunrise.

If this is true for alcohol and tobacco, will it be any different when marijuana becomes legal? Now that voters in two other states in 2014 joined Colorado and Washington in legalizing recreational marijuana use, do we really think this will not happen in other states? Those supporting legalization of marijuana have made considerable progress. It started with medical marijuana, but now is including recreational pot as revenue-strapped governments consider the funds that can be obtained from taxing legal marijuana sales.

Will powerful business interests such as the tobacco and alcohol industries miss out on the pending billions in profits from legal marijuana? We know their histories. Who will buy up the small marijuana entrepreneurs pioneering this new product line? Bigger companies already are doing it. Who already has the fully established distribution systems ready to add legal marijuana?

Seeking to prohibit marijuana, as we once tried with alcohol, stands little chance of success in Wisconsin or anywhere else in the country. Personal freedom is too powerful a principle to be challenged in our current political reality.

What should we do?

If we choose to allow the freedom to market and use alcohol and tobacco as the legal products they are, we need to change the funding formula we apply to the known and documented downsides from these products. We need to fund the evidence-based public health and control practices that reduce the damage from these products at levels recommended by our best minds in public health and safety.

Wisconsin gets an “F” grade from the American Lung Association when it comes to its tobacco prevention and control services. Most other states do no better. We deserve to get an A, not an F. We collect enough sales taxes to fund appropriate tobacco and alcohol services to achieve better results.




David's analysis is spot on and the recommendations are appropriate, but the likelihood that a public health policy approach to marijuana legalization will emerge is unlikely.

The public's interest in legalizing cannabis is partly the result of our historic overreaction to potential harms and a national policy that placed the drug on a par with much more dangerous substances.

In his seminal work The American Disease, David Musto chronicled our historic tendency to swing like a pendulum to the extremes of liberalization versus prohibition. It's happening again.

If as true public health professionals we had taken a more measured, reasoned and evidence-based approach to cannabis historically, we would not find ourselves in this position.

With the cannabis legalization movement the treatment community has the choice, as Musto recommended, of partnering with other institutions to find the middle course of sound but reasonable regulation and control. Or, once again we can beat the drug war drum, to which the public will not march.