Marijuana in the USA is undergoing a period of almost nationwide decriminalisation. There are numerous reasons for this recent transformation in American states’ drugs policies, including some powerful grassroots movements, but money appears to be the most important motivating factor. Prescribing medical marijuana en masse and decriminalising recreational use has created a lucrative new industry, as well as helping recession-hit state governments tap into what was previously an underground economy that deprived the taxpayer of $31.1 billion annually. Since it made history by becoming the first state to legalise recreational marijuana use and sales in 2012, it is estimated that Colorado has created over 15,000 new jobs, with annual marijuana sales of $600 million in 2014. Forget the gold rush, the green rush is on. Washington, Oregon and Alaska have already followed Colorado’s lead. And the question surrounding legalisation is no longer ‘if’ but ‘when’ in states such as Nevada and California. Investment experts are predicting that marijuana sales will reach $10.8 billion by 2019.
Interestingly, in a move that resonates with a standard neoliberal trope, pro-marijuana campaigners have helped shift the narrative of drug policy debates away from the ‘wronged pot-smoker’ towards the ‘wronged tax-payer’, who has been bearing both the excessive criminal justice costs associated with punitive marijuana policies, and the loss of substantial potential tax revenue to black market suppliers. There are certainly lots of benefits to legalisation. We know that locking people up for minor marijuana possession doesn’t make sense. There are also many proven health benefits of medical marijuana as well – for example, it reduces neuropathic pain – and the USA has been one the first countries to embrace this. Having said this, there appear to be three major problems with this new approach – especially in the long-term.
First, in the absence of free, universal access to health care, the development of a major medical marijuana industry and the decriminalisation of marijuana should not be championed as a roadmap to a healthier nation, as some have suggested. Medical marijuana prescribing goes well beyond the evidence for its benefits. There is a danger that the industry thrives in the USA precisely because people can’t access the health services and pharmaceutical medicines that they need. In this context, marijuana prescribing can be seen to be more about damage control than pioneering public health policy and America is in danger of self-medicating (at a national level) on increasingly stronger strains of cannabis.
Second, marijuana might not be the economic miracle it promises – in fact, there are already signs that the revenue generated for state governments by taxing marijuana might not cover the associated social and healthcare costs. For example, whilst not purporting to have the health benefits of marijuana, alcohol costs fifteen times as much as the revenue it creates in taxation. The potential health risks, especially related to mental illness, of heavy cannabis use are well known and the number of people admitted for treatment and into hospital with marijuana poisoning has been steadily increasing. A new American study by the Nationwide Children’s Hospital also revealed that the rate of marijuana exposure in children under six rose by 147.5% between 2006 and 2013. The long term harms of increasing use (both medicinally and recreationally) are uncertain but could easily outweigh the gains. Not least because revenue will be limited as states are forced to choose between keeping prices in line with the black market or risk losing revenue. This is already happening in Colorado where 40% of marijuana is still bought illegally. Selling at the current price may mean that the state can’t generate enough revenue to cover associated costs over time.
Third, there is growing industry involvement from companies who want a share of the profit. Smart Approaches to Marijuana, (SAM) one of the largest pressure groups lobbying for a rethink on drug policy, are warning of the rise of a “big marijuana” industry (similar to that of “big tobacco”) targeting children by promoting marijuana as cool and relatively harm-free. SAM’s concerns are not unfounded. In 2012 39% of marijuana admissions to Emergency Departments were people aged between 15 and 17 years old. While there have been no evidence of increases in teenage use of marijuana in Colorado so far (although one reason could be that state-wide studies are conducted every two years so the impact of legalisation hasn’t yet registered), young people’s perceptions of marijuana are changing there: the percentage of teenagers who think using marijuana is a risk to their health has been decreasing. Even if overall use doesn’t increase dramatically, less cautious attitudes may increase the health risks.
America’s war on drugs often did more harm than good, especially in the poorest communities, so it’s not bad news that attitudes towards marijuana are changing in the USA. Legalisation is now happening whether federal law-makers like it or not. But mass medical marijuana use is no substitute for accessible health services and evidence-based medicine. Nor is profit-driven decriminalisation a substitute for evidence-based drug policies. However, it could be a long while until anyone is getting drugs policy right. Money and media-driven panic continue to dominate for now in the US and UK.
About the authors: Adam Fletcher is a member of the Cost of Living editorial team. Ailidh Durie is a final year Sociology and Social Policy student at Cardiff University working as a summer research intern for DECIPHer. She hopes to complete a public health masters and continue with public health research.