Going to Pot: Why the Rush to Legalize Marijuana Is Harming America (2016)

Chapter 1

Marijuana Use Is Not Safe or Harmless. On the Contrary, It Is Dangerous.

Note to reader—I (Bill Bennett) have the privilege of hosting a national talk show and over time I have collected narratives and stories e-mailed to me by my listeners. We share some of them with you throughout the book, as we think they are narratives too many people do not hear, but that many of us will recognize as all too familiar. I begin with an e-mail from Greg in MI.

Dear Bill:

Please note when my son was 15 years old and sneaking marijuana I knew the destructive behavior and chaos that would ensue. My son is now 27 years old and a hopeless heroin addict living on the streets when he is not in prison. I have prayed and tried everything humanly possible at the cost of utter destruction of my family. Anyone that believes marijuana is harmless is like inviting your wife to have a boyfriend and believing things will be better in your marriage. Common sense is simple.

It has become nearly commonplace to say and think that marijuana is not dangerous. After all, many of today’s parents and grandparents smoked at least a little when they were younger. It is often no longer even called marijuana, but instead “medical marijuana,” giving it a gloss of safety—something therapeutic, used for health. One often hears that marijuana is safer than alcohol, a fully legal substance found in almost every home. Indeed, the President of the United States recently made that claim in exactly those words in an interview with David Remnick of the New Yorker: “I don’t think it is more dangerous than alcohol,”1 President Obama said. This statement came after he first said that marijuana is “not very different from the cigarettes that I smoked as a young person up through a big chunk of my adult life.”2

This is a sea change from just three presidential administrations ago, when President George H. W. Bush spoke directly to the nation about drug use—several times—saying such things as “Victory—victory over drugs—is our cause, a just cause. And with your help, we are going to win.”3 To our knowledge, President Obama—unlike his predecessors (both Republican and Democrat)—has given no speech on the issue of drug use and abuse during his presidency.

When the President of the United States says that marijuana is much like or less dangerous than alcohol—something most children see their parents drink—and likens it to tobacco cigarettes (which are used by 20 percent of the population), it becomes obvious that marijuana has lost its stigma. We understand why people would think it is not so bad. This motivates us to refute these claims.

Such statements about the innocence or benign nature of marijuana are not confined to Democrats such as President Obama. Republican Governor Bobby Jindal (R-LA) has come out in favor of legalizing “medical marijuana.” US Senator Rand Paul (R-KY) has spoken out in favor of decriminalizing marijuana and protecting states that adopt “medical marijuana” laws. The nation’s largest conservative conference—the Conservative Political Action Conference, or CPAC—is overwhelmingly populated by those opposed to marijuana’s prohibition. Indeed, some prominent voices in the conservative movement and Republican Party are supporters of legalization.

The Risks That Are Being Ignored

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The ancient Greeks believed that societies’ views were often shaped by the leadership of their regime. If this is true, even in part, we can see why public opinion has moved the way it has, toward de-stigmatization and legalization. Should we not be asking, is marijuana as innocent as these and other leaders say? Enter this query into a search engine: “Marijuana teen brain.” As of this writing, this is but a small sampling of what we found:

Marijuana May Hurt the Developing Teen Brain

Heavy Marijuana Use Alters Teenage Brain Structure

Marijuana: Why It’s Still a Big Deal If Your Teen Smokes Pot

Perception of Marijuana as a “Safe Drug” Is Scientifically Inaccurate

Teen Pot Use Could Hurt Brain and Memory, New Research Suggests

Marijuana Use Linked to Concerning Brain Changes in Teens

Teen Marijuana Use Linked to Lower IQ in Later Life

Study Says Smoking Marijuana Worse for Lungs Than Cigarettes

Pot Increases Heart Attack Risks

Teenagers Who Smoke Cannabis Damage Their Brains for Life

Smoking Marijuana as Teen May Have Lasting Brain Effects4

These stories come from a wide variety of sources, including NPR, Psychology Today, Science Daily, NBC, CBS, and the Daily Mail of London. A sampling of these stories’ researchers and sources? The brain imaging and neuropsychology lab at the University of Wisconsin–Milwaukee, Northwestern University Feinberg School of Medicine, the University of Montreal, New York’s Icahn School of Medicine at Mount Sinai, the National Academy of Sciences, Boston’s Beth Israel Deaconess Medical Center and Harvard Medical School, and the University of Maryland School of Medicine.

Now perform one other Internet search for us: “marijuana psychosis.” Again, a modest sampling of what came up with the search engine we used:

The Cannabis-Psychosis Link

Marijuana May Both Trigger and Suppress Psychosis

How Marijuana May Drive the Brain into Psychosis

Prolonged Cannabis Use Linked to Psychosis

Marijuana Use Linked to Risk of Psychotic Symptoms

Teens Who Smoke Pot at Risk for Later Schizophrenia, Psychosis

Marijuana Use Precedes Psychosis5

Some of the sources include Psychiatric Times, Time magazine, LiveScience, Medical News Today, WebMD, and Reuters, and they are based on studies and analysis from such esteemed entities as the Department of Psychosis at King’s College London; the Queensland Brain Institute, University of Queensland, Australia; the South Limburg Mental Health Research and Teaching Network of Maastricht University Medical Centre; Children’s National Medical Center in Washington, D.C.; Harvard Medical School; the University of Wisconsin; Duke University; Northwestern University; University of Montreal; New York’s Icahn School of Medicine at Mount Sinai; Oxford University Press’s Schizophrenia Bulletin; the New England Journal of Medicine; the University of Maryland; the Journal of Neuropsychopharmacology; the Imperial College London; University College London; the Journal of Psychoactive Drugs; and the Archives of General Psychiatry, to list a sampling.

Any number of reasons have been used to justify legalization. Some people simply do not know of the current research on marijuana use or marijuana potency. But even dismissing the long-lasting and permanent serious health effects, if brain, lung, and heart function are not a worry for some, what of Governor Jerry Brown’s point: decreased motivation and ambition? Do our students today—from elementary and secondary schools to colleges and universities—have the motivation and ambition, never mind health and brain power, to establish themselves, participate, and contribute to the increasingly competitive economy? Is there a single economist or corporate leader today who looks at the next generation’s work ethic, schooling, and brainpower and sees no problem? Is this not the reason so many argue for more funding for early childhood education programs, as well as more money for our schools generally?

The science is in on this, making every dollar spent on improving our children’s education a waste when it is countered by marijuana use. To wit: “The stereotype of pot smokers as lackadaisical loafers is supported by new research: People who smoke marijuana regularly over long periods of time tend to produce less of a chemical in the brain that is linked to motivation.”6 The study, out of one of Great Britain’s finest schools of medicine, reveals what was self-evident. Nevertheless, here’s the science: “Long-term cannabis users tended to produce less dopamine, a ‘feel good’ chemical in the brain that plays an important role in motivation and reward-driven behavior.” This effect on dopamine levels will have other consequences for marijuana users as well—changing the developing brain in its pleasure reception and transmission. It is this effect that leads marijuana users to higher doses, higher concentrations of THC, and other, harder, drugs. Similarly, it leads marijuana users to an ignorance of their self-destruction. As psychiatrist Robert DuPont, the president of the Institute for Behavior and Health, has written:

The fact that marijuana does not cause a hangover the way alcohol commonly does after heavy use is not an advantage at all. Marijuana stays in the brain for a long time so that the brain is still experiencing the effects from pot smoking days after the drug use has stopped, in contrast to alcohol use…

Unlike cocaine, which often brings users to their knees, marijuana claims its victims in a slower and more cruel fashion. It robs many of them of their desire to grow and improve, often making heavy users settle for what is left over in life…

Marijuana makes its users lose their purpose and their will, as well as their memory and motivation. Marijuana smokers do not often come into treatment for their addiction simply because neither they nor those around them can differentiate their true selves from the effects of their drug use. They commonly just sink lower and lower in their performance and in their goals in life as their pot smoking continues. Their hopes and lives literally go up in marijuana smoke.7

Drug Use and Stigmatization

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We will delve more deeply into what these studies mean, but as a first question: has anyone ever alleged anything like the foregoing with tobacco use? Yet society has successfully and rightly stigmatized tobacco use for both health and cosmetic reasons. Indeed, the idea that we, as a society, cannot stop the consumption of addictive substances or, as it is often more crudely put, “win the war on drugs,” is belied by our experience with tobacco cigarettes. Since the mid-1970s, cigarette smoking in America has declined by more than half, from about 43 percent of Americans admitting to smoking (38 percent in 1983) to just under 20 percent today.8

How did we accomplish this? We did it through a culture of education, promulgating the health risks, increasing the price of cigarettes, cracking down on sales to minors, and stigmatizing tobacco use. In fact, noting a slowing decrease of smoking rates among teenagers, a recent piece in Time magazine listed the reasons for this: “fewer anti-smoking ads,” cigars’ becoming less expensive, a lack of graphic labels on cigarette packages as in other countries, and new marketing efforts for tobacco with “enticing flavors.”9

It is clear how we got illicit drug use down in the early 1990s, and how and why we have seen it rise again since—having let up on the cultural messages, we no longer talk or teach about it; and we have abandoned fighting the nonsense about it. But why the disconnect between tobacco and marijuana? Why is one stigmatized now and the other seen as benign? People now generally understand that the best way to prevent tobacco use is to never start. The first two sentences of the Time magazine story: “The surest way to stop smoking tobacco? Never start.” One can replace “tobacco” with “marijuana” or “drugs” throughout the story and perceive why teen use of marijuana has been on the increase: “Fewer anti-smoking ads.” “Lower prices.” “Enticing flavors.” At every point there is a drug analogue. It is increasingly enigmatic to us why so many care about tobacco use, which harms the lungs, but are so blasé—or worse, even encouraging—about marijuana use, which harms the lungs and the brain, sometimes even permanently.

We simply do not now see or hear ads about marijuana the way we do tobacco. In Arizona in the 1990s, for example, a series of anti-cigarette ads ran. The message: “Cigarette Smoking: tumor-causing, teeth-staining, smelly, puking habit.” Health officials are quoted as stating that smoking rates dropped over 20 percent in the 1990s as a result of those ads.10 As one teen who saw the ad put it, “Those ads are gross and it makes me think smoking isn’t for me.”11 Today there are no messages like that regarding marijuana use. In fact, it is quite the opposite; use is encouraged. The result is that marijuana use is up. According to one recent study by Rand, marijuana use has increased more than 30 percent between 2006 and 2010, and today more teens are smoking marijuana than tobacco cigarettes, 23 percent marijuana to 18 percent tobacco.12

We have turned what was once stigmatized into so-called medicine, regarding marijuana not as something dangerous, but as actually therapeutic or helpful. Today, twenty-three states plus the District of Columbia provide for and allow “medical marijuana” use. A medical marijuana proposition was defeated in Florida in November 2014. However, in Oregon, Alaska, and the District of Columbia, voters in 2014 approved propositions legalizing recreational marijuana, as was passed in the states of Washington and Colorado in 2012. This snowball is gaining momentum as it rolls downhill: earlier in 2014, the California Democratic Party “voted to support legalizing, taxing and regulating marijuana for all uses—medicinal, recreational and industrial.”13 The largest political party in the most populous state in the country is now on record as officially in favor of legalizing marijuana.

The Cultural Message

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Beyond the politics, what of the culture? Redbook magazine recently did a story on how more and more parents are smoking marijuana: “I’m a Parent Who Smokes Pot”—“That’s the wild health confession REDBOOK heard from a surprising number of moms. They claim it’s a harmless, even helpful, habit. Are they right… or totally high?” The story opens this way:

Alice, a 37-year-old mom in Madison, WI, made a recent walk with her two daughters more fun by naming the neighborhood wildlife, starting with Squirrely Squirrelerson and his cousin, Squirrelster McSquirrelstein. “My 4-year-old cracked up, and that made my 2-year-old dissolve into giggles,” remembers Alice. “My kids demanded that I name every animal in sight, and I encouraged them to think of their own names too.” Cute story, right? Is it less cute if I tell you that Mom was a little bit stoned?14

Alice goes on to say,

… she does it for fun or to chill out, and, occasionally, to get into what she calls the “kid zone.” “If I had been perfectly sober, I would have just taken a walk, thinking about what I needed to do next,” Alice says. “I probably wouldn’t have been all that engaged with my kids. But the stoned mama that I was that day made fun out of the mundane.”15

As the story reports, more and more parents are doing this, because “marijuana can be medicinal, and some parents are using it like a quick-fix antidepressant or anti-anxiety medication.” The reporter even tells us, “Marijuana is notably less toxic and addictive than alcohol or cigarettes, but you can still get hooked.”16

More and more parents are actually suggesting their children smoke marijuana as opposed to taking other substances (as if responsible parenting wouldn’t dictate saying no to all harmful substances). As one “mommy blog” quotes, in a post that was titled, “Pot Parents: Smoking Better Than Drinking,” more and more moms “prefer” their children choose the lesser of two evils. “Things have gotten so skewed. People look at pot like it’s the bogeyman. It’s not going to kill you; alcohol can kill you,” said Diane, one of the moms interviewed.17

Between the new parent-pot chic and the efforts to medicalize and legalize marijuana for recreational use, we can better come to understand the de-stigmatization that has taken place. We should be no less understanding of what it has led to: according to an article citing the most recent National Institutes of Health/National Institute on Drug Abuse (NIDA) report on attitudes toward marijuana, “just 39.5 percent of high school seniors view regular marijuana use as harmful. That’s down from 2012’s rate of 44.1 percent, and considerably lower than rates from the past two decades.” According to the article, the study indicates:

Young people are showing less disapproval of marijuana use and decreased perception that marijuana is dangerous… The growing perception of marijuana as a safe drug may reflect recent public discussions over medical marijuana and movements to legalize the drug for adult recreational use in some states.18

Or, as one fourteen-year veteran of the Salt Lake City Police Department more directly put it:

You talk to the kids and with everything that’s going on with it being legalized in Colorado and comments being made that it’s just not that bad for you, the kids are taking it one step further and they’re telling me, “It’s just an herb. It’s OK. In fact, it’s used for medical purposes, it’s not bad for you. It’s good for you.” And that’s the belief that our kids are getting.19

Marijuana Harms the Lungs

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So, let’s get to it: just how dangerous is marijuana? Is it less harmful than tobacco or alcohol? Can it be medicinal? Let us start with the respiratory system. According to NIDA:

Marijuana smoke is an irritant to the lungs, and frequent marijuana smokers can have many of the same respiratory problems experienced by tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, and a heightened risk of lung infections. One study found that people who smoke marijuana frequently but do not smoke tobacco have more health problems and miss more days of work than those who don’t smoke marijuana, mainly because of respiratory illnesses.20

According to the American Lung Association:

There are 33 cancer-causing chemicals contained in marijuana. Marijuana smoke also deposits tar into the lungs. In fact, when equal amounts of marijuana and tobacco are smoked, marijuana deposits four times as much tar into the lungs. This is because marijuana joints are un-filtered and often more deeply inhaled than cigarettes.

Marijuana smoke is also an irritant to the lungs, and frequent marijuana smokers can have many of the same respiratory problems experienced by people who smoke tobacco.21

It is true, however, that one can find studies stating marijuana smoking is less harmful than tobacco cigarette smoking or even that moderate marijuana smoking does not contribute to lung impairment. There is, nonetheless, a problem with those studies. As Dr. Eric Vallieres, director of thoracic surgery at the Swedish Medical Center in Seattle, has put it:

These studies, however, are limited by the fact that many marijuana smokers are also cigarette smokers, that some users mix tobacco and marijuana in their joint, and that the illegality of marijuana use may have influenced the willingness of participants to give honest answers regarding their use of marijuana, affecting the validity of the data used in these studies.22

Moreover, Dr. Vallieres writes:

Laboratory work has demonstrated the occurrence of tissue, cellular and molecular pre-cancerous changes in the airways and lungs of cannabis users that are strikingly similar to those seen in cigarette smokers. Similarly, the carcinogenic effects of cannabis smoke have been demonstrated in both human and animal models: marijuana smoke contains 50 to 70% more carcinogenic hydrocarbons than tobacco smoke. Additional factors that may contribute to the carcinogenic potential of marijuana smoke are the tendency for marijuana to burn at a higher temperature and that marijuana smoke is typically inhaled deeper and held longer than tobacco smoke (two factors that promote prolonged contact duration of potential carcinogens on the lung lining).

Some argue that one or two joints per day of exposure to these carcinogens does not even come close to the 1–2 packs per day contact a cigarette smoker experiences. While this may mathematically make sense, the fact is that we do not know of a safe level for such exposures.23

Beyond the studies showing the connection between marijuana use and lung damage, one might want to step back for one moment and ask, is it even possible that smoking and inhaling a product, a carcinogen, would not have a negative effect on the pulmonary system? It belies common sense.

Marijuana’s Negative Impact on the Adolescent Brain

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We highlighted a series of stories about marijuana and the brain earlier. Now let us be more specific. Here is how marijuana works on the teen and young adult brain. The brain is in development through a person’s early to mid-twenties. Introducing marijuana into the brain during this time can actually change its normal and natural development. As Joe Califano of the National Center on Addiction and Substance Abuse at Columbia University puts it in his book How to Raise a Drug-Free Kid, “Whatever the substance, brains of repeat drug users are ‘rewired,’ becoming predisposed to cravings… As a result, to increase dopamine levels and experience resulting pleasure, the addict needs to use drugs. And the more frequently and longer an addict uses drugs, the more drugs he or she needs to create the high.”24 This is the definition of a vicious cycle.

Put another way, marijuana affects receptors in the brain that are responsible for everything from memory to pleasure response. As noted on Science Daily, the Society of Nuclear Medicine and Molecular Imaging found, “abuse of the drug led to a decreased number of cannabinoid CB1 receptors, which are involved in not just pleasure, appetite and pain tolerance but a host of other psychological and physiological functions of the body.”25

Consider the teen brain and what marijuana, the drug most commonly abused by teens, does. As a Psychology Today article points out, based on a recent study:

Teenagers who use marijuana regularly are at greater risk for long-term brain damage and declines in both IQ and cognitive functioning years later. Daily cannabis use is on the rise among adolescents who are now smoking marijuana at younger ages than ever before, many of them on a daily basis. This rise in marijuana use is caused in part because most teenagers do not believe that smoking marijuana is harmful to their health.26

Why is this? In part, to quote from a study from the Massachusetts Chapter of the American Academy of Pediatrics:

During the first decade of life, brain growth occurs mainly in the gray matter (neurons and dendrites) and during the second and third decades, it occurs primarily in the white matter (connectivity). Exposure to neurotoxins during the brain’s developmental period can permanently alter the brain’s structure and function.27

That is what marijuana does to the teen brain: it alters the structure and function. Because of a vicious cycle that numbs the reward and pleasure responses in the brain, more and more is required to obtain such pleasure—or such a high. This is but one reason marijuana users are much more likely to try harder drugs than those who never initiate marijuana use. With all the challenges our adolescents face today, negatively altering their brain structures and functions is destructive to both individuals and society.

The Increased Risk Posed by Today’s Turbo Marijuana

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Why do so many parents and grandparents, who may not be familiar with this new research and literature, still think marijuana is not worse than cigarettes or is mostly harmless? We believe they are unaware of the prevalence and the strength of marijuana today. There is much more marijuana use now than there was a generation or two ago, and, what’s worse, the substance itself is far more powerful than the marijuana society got used to in the late 1960s and throughout the 1970s. What about that seemingly innocent pot that we see being smoked in historical footage from Woodstock? It is no longer innocent: marijuana is more potent than at any time since scientific analysis of the drug began in the 1970s. The average amount of THC in marijuana today, the primary psychoactive ingredient in the drug, is about 9.6 to 13 percent, more than double the potency of marijuana in 1983, which was more than double what it was the decade before. We also are seeing THC levels skyrocket in some samples being marketed and used. The Cannabis Cup (an annual competition sponsored by High Times magazine) boasts strains containing 25 percent THC, and the Marijuana Potency Project at the University of Mississippi has found levels of THC as high as 37 percent. That is a growth of a psychoactive ingredient from 3 and 4 percent a few decades ago to close to 40 percent.28 The full effects of these strains on the brain are yet unknown, even as they are becoming more and more popular. But we do know the effects are not salutary; in fact, we know they are dangerous.

Dear Bill:

My husband and I are 67 and 69. Last year we went to a Steely Dan concert and our neighbor (36 yrs old) gave us some marijuana and with a smile said “be careful.” We hadn’t smoked pot for 30 or more years and we thought “why not?” and we blew off his warning saying, “We know, we’ve smoked pot before.” Off we went and with true teenage abandon we took two puffs each in our car in a casino parking garage. We looked at each other and agreed… we didn’t feel anything. A few minutes later we attempted to step out of our SUV and almost fell. It came on so fast and so strong. We had to navigate an elevator, walk through the casino, out to the street and two blocks to where the concert was being held. We were having to focus 100% on the act of walking. The doors to the venue weren’t open and we stood up against the building, away from people just waiting to be able to get to our seats and ride it out. My husband wanted to slide down the wall and sit on the sidewalk but he was afraid he wouldn’t be able to get up… Everything visual and auditory was exaggerated and distorted. This new marijuana is waaaaaaay beyond simple medical use for pain. It lasted about six hours with the first three hours being at its strongest. There is no way we could have or would have driven the first three hours. Sit in a classroom and learn, impossible. Sit at the dinner table with your family and enjoy a conversation, impossible. This is not a couple of beers. This is not a couple of martinis. This is being drugged.

Nancy in NV

Odd to us is the idea that when other legal products have their addictive or psychoactive ingredient jacked up—think high-alcohol malt beer or higher nicotine contents in cigarettes—the culture usually pushes back. The tobacco companies now actually try to market lower-nicotine cigarettes or “lights.” However, when it comes to marijuana, the rules are different. The ingredient most active on the brain, THC—which has far worse consequences to the brain than tobacco or nicotine—is increasing year after year, and yet there are “cups” or awards given to those manufacturers who produce the new strains. The move by the culture, as with public opinion, is to continue on the path toward more legalization and availability, and higher THC rates.

Not Just Adolescent Brains Are Injured

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Although research regarding the impact of the higher levels of THC on the brain is ongoing, we have some evidence already:

“There’s an increase in psych admissions,” says Dr. Stuart Gitlow, a psychiatrist who estimates that upwards of 1 in 100 people using high-THC marijuana experience psychotic symptoms. As president of the American Society of Addiction Medicine, Gitlow also worries about the long-term impact.

“If you look at marijuana, the intensity has changed. So I would expect it to have a somewhat higher addictive potential.”

Dr. Christian Thurstone, who runs an addiction treatment center in Denver, agrees that there is a trend toward heavier use. He’s seen steadily higher levels of THC metabolites in clients’ urine tests when they enter his program. “It’s more difficult to get kids clean,” Thurstone says, “because they come in less motivated for treatment, and more addicted.”29

There is a concern that the drive for more legalization and availability will “dumb down” America and Americans. The science on marijuana use and its effects on intelligence supports this. Take this headline from WebMD last year: “Cannabis Use in Teens Linked to Irreparable Drop in IQ.”30 Or this headline from the New York Times: “Early Marijuana Use Linked to IQ Loss.”31 Now take the opening line from the first story: “Cannabis users who start smoking the drug as adolescents show an irreparable decline in IQ, with more persistent use linked to a greater decline, new research shows.” The last line of the story should frighten: “Cessation of cannabis did not restore IQ among teen-onset cannabis users.” Even tobacco smokers can restore lung function years after cessation of smoking. The brain, though, is not the lungs, and marijuana brain damage can be permanent. It can also lead to all manner of academic problems—including dropping out of school entirely—and job prospect limitations. After all, an eight-point drop in IQ can mean the difference between someone being “very gifted” and “gifted,” or “gifted” and “superior,” or “superior” and “high average,” or “high average” and “average,” or “average” and “low average,” or “low average” and “borderline impaired,” or “borderline impaired” and worse.32

While the study on marijuana and IQ—from Duke University—has been subjected to criticism and challenges, as is typical of almost every study on every issue, the authors have defended it. Dr. Nora Volkow, the director of NIDA, has said of the study:

The message inherent in these and in multiple supporting studies is clear. Regular marijuana use in adolescence is known to be part of a cluster of behaviors that can produce enduring detrimental effects and alter the trajectory of a young person’s life—thwarting his or her potential. Beyond potentially lowering IQ, teen marijuana use is linked to school dropout, other drug use, mental health problems, etc.… regular marijuana use stands to jeopardize a young person’s chances of success—in school and in life.33

So the question now presents itself, what are the chances these studies are right? One hundred percent? Fifty percent? Twenty-five percent? Let us hypothesize severe skepticism and say, for argument’s sake, all these studies have a 5 percent chance of being right—a 5 percent chance of showing that teen marijuana use can lead to lower IQ, a 5 percent chance that teen marijuana use may lead to psychosis in some users, a 5 percent chance that teen marijuana use could lead to other mental health problems. Now ask yourself this: if a doctor prescribed you a medicine and said, “There’s a small risk, maybe five percent, that this drug can lead to a lower IQ or psychosis,” would you ever even consider taking it or giving it to your teenager? Such a drug certainly would not pass FDA muster and the manufacturer of such a drug would be subject to the kind of lawsuit that would put it out of business.

Think about the drug Vioxx for a moment. It was known as a “blockbuster” pain and arthritis medication. However, in 2004 it was pulled off the shelves and its manufacturer was subject to all manner of litigation when it was discovered 3.5 percent of its users suffered heart attacks as opposed to 1.9 percent taking a placebo.34 Those a little older may remember the drug thalidomide. Some called it a “miracle drug” because of its sedative and anti-nausea properties. Thalidomide was banned in America in the early 1960s (it is now being used again for populations not at risk) after it was noted that some ten thousand babies born worldwide had suffered birth defects from it, about 10 percent of the thalidomide-using population.35 The point is this: when there is a risk—3 percent, higher, lower—of a drug or substance negatively affecting our or our children’s health, we as a society have been rigorous about reducing the risk or pulling that product from the market. We have banned the use of drugs with far lower chances of damage than we see in all the studies coming out about the dangerous side effects of marijuana.

With marijuana we have inexplicably suspended all the normal rules of reasoning and knowledge.

The Marijuana Paradox

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It is perplexing that we are so in favor of marijuana when there are ever-growing public policy debates about mandating earlier education for our youth, for example, mandatory federally subsidized preschool. The goal is to give our children a better head start and increase their chances of success in life with better education and effective brain power. We have health care policy debates—especially about funding and reach—to ensure the health of our youth. Indeed, a large part of the Affordable Care Act was its mandate of health care coverage not only for children, but also for teens and young adults. This country rightly cares about and spends a lot of money on child health and education. Introducing a once-illegal substance into the sphere (brains and lungs) of our youth is not only societal cognitive dissonance, it is public policy malpractice. In 2014 Elliott Kaye was President Obama’s nominee to chair the Consumer Product Safety Commission.36 He had served as its executive director until his nomination to that role. Up to his nomination, his best-known efforts had been to ensure better safety standards for football helmets, from the NFL down to young players in amateur sports. Mr. Kaye won bipartisan praise for these efforts and said that, if confirmed, “brain safety” will be his top priority. The hearing on his confirmation was lauded in the press as one of refreshing bipartisan agreement.37

Here is the disconnect. From early childhood to the NFL (where players are actually adults and know the risks), there are multiple efforts to protect brains. We endeavor to help develop and enrich them at as early an age as possible; other efforts are geared toward protecting them physically, in everything from car safety to football safety. Yet here we have a drug, legalized by four states, called medicine in many others, and being propagated as harmless (at worst) and therapeutic (at best), when every serious study of the effects of marijuana on the teen brain says there is at least some cause for concern.

Why do we focus on the teen brain? For a very simple reason—most drug users, over 90 percent of them, including marijuana users, started using drugs in their adolescent years. In fact, if one abstains from substance abuse up until the age of twenty-one, the chances one will ever have a substance abuse problem are next to zero. As we will show in the next chapter, efforts to medicalize and legalize marijuana for adults, that is, to make marijuana available for people only over the age of eighteen or twenty-one, have failed. How many of you know or know of someone under the age of twenty-one who has been able to drink alcohol, how many under the age of eighteen who has been able to buy cigarettes? Those legal products are, after all, banned from being sold to people under twenty-one and eighteen, respectively. Yet teen use of alcohol and tobacco is through the roof. Nearly ten million underage people currently use alcohol, and nearly six million of them are binge drinkers.38 Nearly 25 percent of high school students use tobacco products today.39

Substance abuse and addiction generally begin before age twenty-one. As Dr. Nora Volkow from NIDA puts it, “There is no question that marijuana can be addictive; that argument is over. The most important thing right now is to understand the vulnerability of young developing brains to these increased concentrations of cannabis.”40

Earlier we asked you to perform an Internet search for “marijuana” and “psychosis,” and provided a sampling of headlines. Here are a few more:

Cannabis May Increase Stroke Risk

Legalizing of Marijuana Raises Health Concerns

Scientists Warn of Cannabis Link to Heart Attacks

Wake-up Call for Teen Pot Smokers; Study Links Cannabis Use with Psychosis

Marijuana Use Linked to Psychotic Symptoms in Teenagers

A Risk Gene for Cannabis Psychosis

The Cannabis-Psychosis Link

Marijuana Linked to Psychosis in Teens

Doctors: Marijuana Triggers Psychosis

You get the point. Summarizing her work, Dr. Sion Kim Harris, director of the Survey Research Methods Core of the Clinical Research Program of the Boston Children’s Hospital, puts it this way: “Besides the evidence showing that marijuana affects memory and cognitive performance, there is a growing body of evidence suggesting that marijuana may increase risk for mental illness.”41 To wit: “Regular marijuana use during adolescence [has been] found to increase risk 2 to 5 times of developing psychosis, schizophrenia, anxiety, and depression in adulthood.”42 A recent report by the Northwestern University School of Medicine demonstrated that if someone has a family history of schizophrenia, that person increases his or her risk of developing schizophrenia by regularly using marijuana.43

Marijuana’s Short-Term Impact on Judgment, Coordination, and Motor Skills

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Beyond what marijuana can do to the brain in the long run—as with cigarette smoking and lung cancer or COPD—there is new evidence on driving impairment: “Recent national statistics show that, among fatally injured drivers who were randomly selected for drug testing (excluding tobacco, alcohol, and medications administered after the crash), more and more are testing positive for marijuana. In 2009, the rate of positive tests had increased to one in three. Among positive tests, marijuana was the most common drug found.”44 Dennis Prager has analyzed this point best, distinguishing between the effects of marijuana and cigarettes on the brain: would you rather get in an airplane where the pilot had just smoked a cigarette or a joint? Or just keep it to driving cars: as Dr. Marilyn A. Huestis of NIDA has found, “several researchers, working independently of one another, have come up with the same estimate: a twofold increase in the risk of an [automobile] accident if there is any measurable amount of THC in the bloodstream.”45 Does any parent in America think it a good idea to give car keys to a sixteen-year-old who uses a product that increases twofold the chance of an automobile accident?

Negative Consequences for the Heart

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Most of this chapter has discussed current studies detailing marijuana’s effects on the brain and lungs. But what of the heart? We know the following:

Marijuana also raises heart rate by 20–100 percent shortly after smoking; this effect can last up to 3 hours. In one study, it was estimated that marijuana users have a 4.8-fold increase in the risk of heart attack in the first hour after smoking the drug.46

It seems that almost every couple of months, another study comes out on the dangers of marijuana. No studies conclude that it is benign. This recent headline from the Los Angeles Times is illustrative: “Potential for heart attack, stroke risk seen with marijuana use.” Here is a précis of that article:

Over a five-year period, a government-mandated tracking system in France showed that physicians in that country treated 1,979 patients for serious health problems associated with the use of marijuana, and nearly 2% of those encounters were with patients suffering from cardiovascular problems, including heart attack, cardiac arrhythmia and stroke, and circulation problems in the arms and legs. In roughly a quarter of those cases, the study found, the patient died.

In the United States, when young and otherwise healthy patients show up in emergency departments with symptoms of heart attack, stroke, cardiomyopathy and cardiac arrhythmia, physicians have frequently noted in case reports that these unusual patients are regular marijuana users…

“There is now compelling evidence on the growing risk of marijuana-associated adverse cardiovascular effects, especially in young people,” said Emilie Jouanjus, lead author of the French study, which was also published in the Journal of the American Heart Assn. That evidence, Jouanjus added, should prompt cardiologists to consider marijuana use a potential cause of cardiovascular disease in patients they see.47

Another major study on the dangers of marijuana was released in October 2014 by Dr. Wayne Hall of the University of Queensland, published in the journal Addiction. The study was described in the media as “a sweeping new review of 20 years of research into the recreational use of marijuana.”48 Here are some of the major findings from the study’s abstract: “Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence. Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood.” The abstract’s conclusion: “The epidemiological literature in the past 20 years shows that cannabis use increases the risk of accidents and can produce dependence, and that there are consistent associations between regular cannabis use and poor psychosocial outcomes and mental health in adulthood.”49

Can all these studies be wrong? What is the Pascal’s wager here? Assume we are wrong and marijuana is harmless (a big assumption given all the scientific research that is coming in). Do we need it? Is there any anecdotal evidence at all that it is good for our teens? Turning the wager around: what if all or most or even just some of these studies are right? Are we not about to unleash a new flood of health problems on society with the growing effort to normalize and legalize marijuana?

The culture has convinced itself marijuana is harmless or that the risks to health are worth taking for the benefit of the therapy… or the high. As more and more evidence mounts that marijuana is dangerous, especially for the young, it is a shame so many are trying to make it widely available and legal. It is an assault on our youth and their brains. It is a foolish idea that, should it win the day, will reduce IQs and ambition, and make Americans mentally and physically sicker.