DECRIMINALIZE MARIJUANA: IT'S FAR LESS HARMFUL THAN ALCOHOL

The California Medical Association in October declared the
criminalization of marijuana to be a failed public health policy. Its
assessment is appropriate.

Marijuana prohibition is a classic case of the so-called cure
(criminalization) being worse than the disease (the private
recreational use of marijuana).

Consider the questionable efficacy of our present policy. Forty-three
percent of Americans over the age of 12 admit to having used
marijuana, and nearly one in 10 Californians use it now. At an
estimated $15 billion, marijuana is California's largest cash crop.

Now let's consider the costs of prohibition. In the Golden State,
taxpayers spend $300 million annually to arrest and prosecute 60,000
people -- largely Latinos and African-Americans -- for possessing
minor, recreational amounts of marijuana. Prohibition is also
empowering drug cartels, particularly criminal enterprises in Mexico,
which now reap between 60 percent and 70 percent of their total
revenue from the exportation of marijuana to America and threaten to
turn Mexico into a "narco" state.

So what's the alternative? In my opinion, it is the passage of
Proposition 19, which would legalize, regulate and tax the adult
possession, use, production and distribution of marijuana in a manner
similar to alcohol.

I do not come to this position cavalierly. I am a board-certified,
career emergency physician who witnesses the adverse health effects
of licit and illicit drugs daily. Yet the recent RAND report on the
financial impact of Proposition 19 reaffirmed my belief that the
legalization and regulation of marijuana would make our communities
safer and more just.

According to RAND, fewer than 200 total patients were admitted to
California hospitals in 2008 for "marijuana abuse or dependence."
This relatively low number did not surprise me. In my 35-plus years
as an emergency physician in busy ERs in Northern California, I have
never needed to admit a patient due to an adverse reaction or medical
problem caused by marijuana.

Personally, I have taken care of fewer than 10 patients during my
entire professional career whose chief complaint was related to
marijuana. Mostly these were parents who were cajoled to smoke by
their teenage kids and then experienced an anxious reaction. One
hysterical woman called 911 because her dog had eaten a baggie of
marijuana. Both the patient and the dog ended up fine.

Comparing the health care consequences of marijuana to the health
care consequences of alcohol is startling. In 2006, there were 72,771
hospitalizations in California related to the use of alcohol. Of
these, 34,292 hospitalizations were due to illnesses or chronic
conditions caused by alcohol consumption. This total is roughly 200
times the number of hospital admissions associated with marijuana.

From a physician's perspective, marijuana is a minor ailment. The
supposed cure, criminalization, is like the IV administration of a
toxic, expensive antibiotic to treat a cold. An adverse effect of the
inappropriate and ineffective use of antibiotics is the growth of
drug-resistant bacteria. The adverse effect of criminalization of
cannabis is that is stigmatizes 60,000 people a year as criminals.

As emergency physicians, we are the ultimate realists. We know that
the prohibition of marijuana is a failed public health policy.
California's nearly 100-year-old war on marijuana is an expensive
failure. Let's get real: Legalize, regulate, control and tax
marijuana. As physicians we know the best way to deal with marijuana
dependency is by education and treatment, not by criminalization.