Rarely a day goes by where we do not encounter political, legal or medical news and arguments asking or declaring how we should handle marijuana. As an addiction medicine physician, I too encounter these questions almost daily. My own research and attempt at crystallizing an opinion is frustrated by many paradoxes. Several questions are really being asked about marijuana, but they are disguised or misrepresented as a single question: “Yes or No” concerning marijuana? This is an extreme oversimplification when asked this way, but it avoids and dodges potholes (sic).
Proponents of the use of marijuana for medical reasons cite growing evidence of proven medical benefits. Legalization arguments are convincing too. A purported failure of prohibition and the enormous economic and societal costs of attempts at enforcement burden us all. Perhaps the loudest chorus for making marijuana legal and medically available comes from those whose real goal is recreational use with a cultural refrain written with Cheech and Chong asking “hey man, am I driving OK…I think we’re parked man…”
The argument of what to do with marijuana can and should be discussed as three separate issues, all related, but all with specific considerations. 1) medical use, 2) legalization, and 3) recreational use. More often what we find in reported stories, quotes and political questions about marijuana is an argument covering only one of these issues, and it is used to answer all three questions. This creates confusion and obfuscation inherent in finding “the answer” for marijuana. We listen to Sanjay Gupta on CNN “doubling down” for the medical uses of marijuana. Our Justice Department describes the inequities of prosecution leaving a disproportionate number of Blacks and Hispanics serving time for “minor marijuana offenses”. Our own President in an interview in the New Yorker a few months ago has made statements supportive of marijuana comparing it to alcohol while the government he represents bans it. He explicitly states that he tried marijuana when he was younger, while implicitly seeming to say “I turned out all right, how bad could it be”. Each of these points of view are then used to support any and all use of marijuana by zealous proponents. Some more specifics: