This document discusses medical marijuana and its legal status. It provides an overview of marijuana usage statistics and public support for legalization. It then examines the health effects of marijuana which studies have found to be relatively safe. It outlines the history of marijuana prohibition and alternatives to the current policies, analyzing the issues from public health, ethical, economic and international perspectives. In conclusion, it evaluates criteria for different policy approaches and provides an extensive bibliography on the topic.

1. Medical Marijuana
Nick Fitz

2. Relevance
• the world’s most popular illicit drug - around
190 million users worldwide
• 41% of Americans have smoked pot - 26
million regularly use - multi-billion dollar
industry - nation’s leading cash crop
• ~750,000 people are arrested for possession
of MJ each year - half of all drug abuse
violations
• 81% of Americans support medical
legalization and 45% support general
legalization - popular
• currently on many states’ agendas

3. The Problem
• marijuana’s illegality is causing significant
problems for society

4. Aspects
• public opinion
• health
• philosophical/moral/ethical
• freedom
• crime, terrorism, and social order
• economic

5. History
• Federal Marijuana Act of 1937 - first outlawed
• Comprehensive Drug Abuse Prevention and
Control Act of 1970 - National Commission on
Marijuana - rec’d decriminalization but Nixon shot
down
• 1972, NORML petitions DEA to downgrade MJ
from class I
• 1973, Oregon enacts form of decriminalization
• 1982, NIH/NAS begin to study medicinal value
• 1984, Anti-Drug Abuse Act - severe penalties

6. History
• 1988, Judge Young concludes reclassifying MJ
to class II (physicians prescribe), but DEA
rejects
• 1996, CA passes prop. 215 - medical use -
begins federal tension and intensifies
economic cost/benefit debate
• 2005, Gonzales v. Raich - congress may ban
MJ regardless of state legislation
• now, MJ back on agenda - 10/09 Dept. of
Justice decision not to prosecute patients

7. Health
• the foundation: legitimate medical use - overwhelming
pro/neutral evidence - but enough political uncertainty to
stunt action
• MJ likely has a natural role in pain modulation, appetite,
control of movement, and memory
• average potency increased very little since 70s (~3%)
• in driving studies, MJ may actually reduce the
responsibility rate and lower crash risk
• DEA Judge, Young - “In strict medical terms MJ is far safer
than many foods we commonly consume,” in fact, “MJ in
its natural form is one of the safest therapeutically active
substances known to man.”
• “cannabis poses a much less serious public health
problem than is currently posed by alcohol and tobacco
in western societies." - strong policy implications

8. Health
• Johns Hopkins - "no significant differences in cognitive decline
between heavy users, light users, and nonusers of cannabis."
• the WHO report - "it is doubtful that cannabis use produces a
well defined amotivational syndrome."
• the majority of occasional users “will not suffer any lasting
physical or mental harm” - little evidence that effects persist after
drug use stops “or that any direct cause and effect relationships
are involved.”
• NIH - “marijuana does not have a long-term negative impact on
global intelligence.”
• Nat. Com. on MJ and WHO - careful search of the literature/
testimony of nation’s health officials has not revealed a single
human fatality in the US proven to have resulted solely from
ingestion of MJ. Experiments on monkeys conclude that the dose
required for OD death was enormous and for all practical
purposes unachievable by humans.

9. Health
• "contrary to our expectations, we found no positive
associations between MJ use and lung or UAT cancers”
• IOM on “gateway theory”- “there is no conclusive
evidence that the drug effects of MJ are causally linked to
the subsequent abuse of other illicit drugs."
• Nat. Com on MJ - “rather than inducing violent/aggressive
behavior and weakening impulse control, MJ was found to
inhibit the expression of aggressive impulses by pacifying
the user, interfering with muscular coordination, reducing
psychomotor activities and generally producing states of
drowsiness lethargy, timidity and passivity."
• “MJ’s relative potential for harm to the vast majority of
individual users and its actual impact on society does not
justify a social policy designed to seek out and firmly
punish those who use it.”

10. Philosophical
• ethical argument - response of societal
context (alcohol/tobacco)
• moral normative argument - danger (real vs
perceived) - legalization increase control -
government/collective vs individual
• ontological - personal freedom (John Mill)
vs constitutional and implicit fundamental
freedoms
• philosophical critique of decriminalization -
inappropriate, constitutionally suspect, and
functionally irrational - then legalization

11. Economic/Social Cost
• current policy - prohibition - citizens will abstain from
actions if the actions are typed as unlawful and the
prohibitions are enforced by law enforcement
• Jimmy Carter - “penalties against drug use should not be
more damaging to an individual than the use of the drug
itself. Nowhere is this more clear than in the laws against
the possession of marijuana in private for personal use." -
• more than 700,000 arrested on MJ charges last year (~5
million in past decade) - 90% of arrests are for simple
possession - and increased arrest rates are not
associated with reduced MJ use/availability/new users/
potency - waste of resources
• MJ offenders incarcerated in US jails now outnumber the
total number of prisoners in 1980 as well as the entire
EU prisoner population - massive spending on prisons as
opposed to education/health

12. Economic/Social Cost
• MJ arrests disproportionately impact young males
• state costs for MJ arrests are ~$7.6 billion/year - police
costs $3.7 billion, judicial/legal costs $853 million, and
correctional costs $3.1 billion. In CA/NY, state costs for
MJ law enforcement are over $1 billion/year each
• the US prohibition effort is currently a $30 billion
campaign - only includes direct enforcement
expenditures - significantly more with addition of
economic impact of holding 400,000 prisoners on
prohibition violations
• CA has a landmark bill to tax and regulate marijuana like
alcohol - estimated $1.4 billion/year revenue from fees/
sales/excise taxes
• estimates hold that MJ legalization would yield tax
revenue of $2.4 billion/year if taxed like all other goods
and $6.2 billion/year if taxed at alcohol/tobacco rates

13. International Cost
• former undercover DEA agent Michael Levine explained
his work with Colombian cartel: “I learned that not only
did they not fear our war on drugs, they counted on it to
increase the market price and to weed out the smaller,
inefficient drug dealers. They found U.S. interdiction
efforts laughable. The only U.S. action they feared was an
effective demand reduction program. Top cartel chief,
Jorge Roman, expressed his gratitude for the drug war,
calling it “a sham put on for the American taxpayer” that
was actually “good for business”
• current system of criminalization provides powerful
incentive for political/enforcement corruption
• “bad neighbor policy” - Latin American countries criticize
US prohibition for providing the massive market that

14. Alternatives
• business-as-usual / do nothing (prohibitionism)
• philosopher Husak explains “current drug policies lead to
immense personal suffering, as well as police corruption,
organized crime, and make drugs more dangerous b/c not
subject to proper controls” - “it is now beyond
reasonable doubt that applying criminal sanctions for
minor cannabis offenses is not in the best interests of the
community."
• decriminalization - abolition of criminal penalties,
retroactively, though fines may still apply - solves much of
issue, but is logically incongruous, without major benefit
• legalization - removing a legal prohibition - would open
up new, massive, regulated markets.

15. Criteria
• economic efficiency (cost/benefit analysis)
• political acceptability
• strength and improvability
• process values - transparency, citizen
access/voice, rationality
• freedom/equality
• legal implementation and efficacy

16. Bibliography
• Armentano, Paul. Marijuana is safer so why are we driving people to drink? White River Junction,VT:
Chelsea Green Pub. Company, 2009. Print.
• Carpenter, Ted Galen. Bad Neighbor Policy Washington's Futile War on Drugs in Latin America. New
York: Palgrave Macmillan, 2003. Print.
• Earleywine, Mitch. Understanding Marijuana A New Look at the Scientific Evidence. New York: Oxford
UP, USA, 2002. Print.
• Finkel, Madelon. Truth, Lies, and Public Health How We Are Affected When Science and Politics
Collide. New York: Praeger, 2007. Print.
• Fish, Jefferson M. Drugs and Society U.S. Public Policy. New York: Rowman & Littlefield,, 2005. Print.
• Fish, Jefferson M., ed. How to legalize drugs. Northvale, N.J: Jason Aronson, 1998. Print.
• Gray, James P. Why Our Drug Laws Have Failed and What We Can Do About It: A Judicial Indictment
of the War on Drugs. Philadelphia: Temple UP, 2001. Print.
• Grinspoon, Lester. Marihuana, the forbidden medicine. New Haven:Yale UP, 1993. Print.
• Grotenhermen, Franjo, and Ethan Russo, eds. Cannabis and Cannabinoids Pharmacology, Toxicology,
and Therapeutic Potential. New York: Haworth, 2002. Print.
• Hall, Wayne, and Rosalie Liccardo Pacula. Cannabis Use and Dependence: A Public Health Perspective.
Port Melbourne: Cambridge UP, 2003. Print.
• Himmelstein, Jerome L. Strange career of marihuana politics and ideology of drug control in America.
Westport, Conn: Greenwood, 1983. Print.

17. Bibliography
• Husak, Douglas N. Legalize This! The Case for Decriminalizing Drugs (Practical Ethics
Series). New York: Verso, 2002. Print.
• Iversen, Leslie. The Science of Marijuana. New York: Oxford UP, USA, 2000. Print
• Jones, Helen C., and Paul W. Lovinger. The Marijuana Question: and Science's Search for an
Answer.New York: Dodd, Mead & Company, 1985. Print.
• Kleiman, Mark. Marijuana costs of abuse, costs of control. New York: Greenwood, 1989.
Print.
• MacCoun, Robert J., and Peter Reuter. Drug War Heresis: Learning from Other Vices, Times,
& Places. New York: Cambridge UP, 2001. Print.
• Mack, Alison, and Janet E. Joy. Marijuana as Medicine The Science Beyond the Controversy.
New York: National Academy, 2001. Print.
• Medicine, Institute Of. Marijuana and Medicine Assessing the Science Base. New York:
National Academies, 1999. Print.
• Musto, David. Drugs in America A Documentary History. New York: NYU, 2002. Print.
• White, Bruce D. Drugs, Ethics, and Quality of Life Cases and Materials on Ethical, Legal, and
Public
Policy Dilemmas in Medicine and Pharmacy Practice. New York: Pharmaceutical
Products, 2007. Print