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May 13 - July 14, 2019
Other reformers suggest additional regulations, including licensing users and limiting the amount they may purchase. This approach would provide a specified supply of marijuana to licensed users, perhaps through mail-order or state-run stores (Kleiman, 1992; Nadelmann, 1992). This strategy has the advantages of other legalization proposals.
Most consumers would prefer legal cannabis with competitive pricing, detailed labeling, and assurance of quality, to the underground market’s product.
Smaller quantities may not only decrease the probability of problem use but also may keep the underground market alive.
Yet licensing users and limiting purchases could minimize negative consequences of the drug, even if more people decided to consume it.
These proposals may confuse licensing use during free time with intoxication during work hours. Just as millions of workers who purchase alcohol legally do not attend their jobs drunk, a licensed marijuana user need not report to work high.
Few data address the efficiency of marijuana smokers at their jobs.
Any residual effects from marijuana consumption off-duty appear slight to nonexistent (Normand, Lempert, & O’Brien, 1994).
Marijuana appears to have no impact on health benefits, either. A study of a large group of HMO patients in California’s Kaiser Permanente program compared medical costs of users and nonusers and found no differences (Polen, 1993).
Drinking huge amounts of water likely lowers the concentration of metabolites in the urine.
This chapter is not a substitute for substance abuse treatment but may serve as a guide to the approaches available for limiting marijuana-induced harm.
Estimates suggest that 9% to 15% of cannabis users develop some problems with the drug (NIDA, 1991; Weller & Halikas, 1980).
Many abstinent people report a critical incident that inspired them to quit.
In addition to those who quit on their own or never quit, some people turn to professionals for help.
They showed no difficulties with drugs other than cannabis. Their concerns included trouble decreasing their use, negative feelings about smoking marijuana, procrastination, decreased self-confidence, memory loss, and withdrawal symptoms. Many also reported experiencing financial difficulties and complaints from their loved ones (Stephens, Roffman, & Simpson, 1993). This sample clearly qualified as heavy users experiencing adverse effects.
The idea that almost two-thirds of those in treatment could not eliminate their marijuana problems and over 85% continued to use the drug might seem unimpressive. These numbers look particularly discouraging in light of the 45 people who did not complete the outcome measures. Nevertheless, these data do suggest that problem users are not doomed to a lifetime of negative consequences.
Although no data address the issue of group versus individual treatment for marijuana problems, a study of cocaine abusers actually found some advantages for group treatment (Schmitz et al., 1997). This study revealed fewer cocaine-related problems for participants in group therapy compared to those in individual. Perhaps group treatments provide social support that enhances outcome.
Medications with fewer side effects and negative consequences might help these people leave marijuana behind.
Psychological treatments that focus on these symptoms might also help people reduce their marijuana smoking. For example, cognitive-behavioral treatments can decrease depressive symptoms and eliminate cannabis that may have been used as an antidepressant.
At least three different approaches have shown considerable promise in minimizing the negative consequences of drugs. These include cognitive-behavioral therapy, twelve-step facilitation, and motivational interviewing.
An enormous project that contrasted the outcome of these three treatments for alcohol-dependent people found that all three were comparably effective (Project MATCH, 1998). The treatments share several factors, which may help explain their similar outcomes. All emphasize the client’s responsibility for change.
A few points about marijuana remain unarguable. The plant is at least 10,000 years old. Its medicinal applications began at least 4,500 years ago. Recreational use has also been around for thousands of years. Cannabis is the most popular illicit drug in the world. Hundreds of millions of people have tried it. Only a small fraction of them develop problems with other illicit drugs. Less than one-tenth of the people who ever try marijuana end up using it regularly. Fewer still develop troubles with it. Some fix the problems on their own. Many respond well to therapy. Current treatments are
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A few facts about marijuana intoxication also seem clear. The experience is difficult to depict and varies dramatically from person to person and across situations. Some people feel more relaxed, happy, and alive. Others feel paranoid and anxious. After smoking marijuana, people experience time, space, and emotions differently. They eat more and crave sweets. Intoxicated people do not learn new material well. They cannot solve complex problems quickly, and their brain waves change. They can drive a car as well as the unintoxicated, but these consistent results are so counterintuitive that most
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Compared to alcohol, cigarettes, and over-the-counter medications, occasional marijuana use causes little harm.
A few chemicals that alter consciousness also remain accepted. Caffeine, nicotine, and alcohol have established effects on thoughts and moods. Their toxicity is much higher than marijuana’s.
Citizens seem to trust adults enough to let them attempt to use this drug in a way that will not cause problems. Can we extend this trust to people who use marijuana?
