(EDITOR'S NOTE: Four leaders who in recent months have been active in the effort to oppose marijuana legalization initiatives have co-authored a call to action for the treatment and recovery community. We present this article in sections authored by former U.S. Rep. Patrick Kennedy; Project SAM co-founder Kevin Sabet, PhD; CeDAR executive director Steven Millette, and CeDAR business development manager Ben Cort.)
A treatment center steps up
Two of us are affiliated with CeDAR—The Center for Dependency, Addiction and Rehabilitation at the University of Colorado Hospital on the Anschutz Medical Campus, a major academic medical center. We find it important both to have a position on the legalization of marijuana and to understand the impact legalization will have on our center, our hospital, our community and our state. I find the latter must inform the former.
Our position as a healthcare organization must be based on the science that tells us what we could and should expect to be the impact of the legalization of marijuana. There is a lot at stake relative to the health and welfare of our patients, families, community and society, especially our youth and other vulnerable populations such as those in or seeking recovery from substance use and mental health disorders. While the politics and policy issues are complex, the impact of marijuana on our constituencies is fairly clear. Increased access to marijuana will harm our society in the form of increased addiction and mental health problems, as well as a significant increase in associated morbidity and mortality.
CeDAR enjoys a unique position in the field as a nationally recognized treatment program embedded in a major academic medical center. In this position, we see the opportunity to provide exceptional, state-of-the-science care while pursuing other elements of our mission: learning and discovery. We understand that our behavioral health program assumes a position within the larger healthcare system and we work to optimize integration within this system in order to maximize our ability to fulfill our mission.
We understand that addiction and mental health disorders manifest along a continuum. Many people experience problems with alcohol or other drugs in varying levels of severity. Many experience problems with substances in transient or intermittent forms such as college binge drinking, but for many the problems manifest as chronic, persistent and very severe conditions. We operate from the premise that these chronic conditions are best addressed in a coordinated, interdisciplinary, recovery-oriented system of care. We also know that substance use and mental health conditions manifest in less severe or non-chronic forms and that education, early detection and early intervention work to reduce the likelihood that the disorder will develop to more severe levels. This is the context from which we articulate and define our position against the legalization of marijuana and align with the position put forth by the organization SAM.
SAM applies a science-based approach that supports reasonable approaches to addressing the problems inherent in the criminalization of substance use, while informing the dialogue around broader public policy issues.
It is CeDAR’s position that smoked marijuana is not medicine and that the use of cannabis for recreational use is harmful.
The data tell us that in this country the use of marijuana is trending up. When drug use for adolescents and young adults goes up, so does the relative level of harm caused by its use, including addiction, adverse developmental effects, mental illness, lower academic performance, associated physical problems, driving under the influence, lower quality-of-life outcomes and poor job performance. Additionally, there are many issues that should be considered when it comes to pursuing more effective policies related to cannabis use, possession, sale and cultivation. Here is a sample of some issues that should be factored into any debate and should inform public education regarding the decision to legalize or not:1
• In 1979, after 11 states decriminalized marijuana, the United States saw the highest rates of marijuana use in history by teenagers: more than 51% by high school seniors that year.
• Among youths ages 12 to 17, marijuana usage rates are higher in states with medical marijuana laws (8.6%) than in states without such laws (6.9%).
• Residents of states with medical marijuana laws have marijuana abuse/dependence rates almost twice as high as states without such laws.
• Increased use rates lead to higher addiction rates. Marijuana addiction is real and affects about one in nine people who ever start using the drug (a number similar to alcohol). If one starts using marijuana in adolescence, addiction rates jump to one in six users.