Tomorrow, a record number of Americans will vote on legalizing marijuana in various forms. Five states, including California and Florida, could make recreational marijuana legal. And four more could approve it for medical use, which would make medical marijuana legal in nearly thirty states. A recent poll found nearly 60% of Americans now favor legalizing marijuana. But the sale or possession of marijuana remains a federal crime, even for medical use. And questions remain about the public health implications of legalizing an intoxicating drug. Diane and guests discuss changing attitudes toward legalizing marijuana and whether Election Day could be a tipping point.

Guests

  • John Hudak Deputy director, Center for Effective Public Management and a senior fellow in Governance Studies, The Brookings Institution
  • Christopher Ingraham Reporter, The Washington Post; he writes about politics, drug policy and all things data
  • Kevin Sabet Co-founder, Smart Approaches to Marijuana, an anti-legalization group that advocates for public health-based approaches to marijuana regulation. He’s also Assistant Professor of Psychiatry at the University of Florida College of Medicine, Division of Addiction; former adviser to President Obama’s drug control director (2009-2011)
  • Megan Verlee Reporter, Colorado Public Radio

Transcript

  • 11:06:53

    MS. DIANE REHMThanks for joining us. I'm Diane Rehm. On Election Day tomorrow, nine states, including California, will vote on ballot measures that would legalize various forms of marijuana. Polls show nearly 60 percent of Americans now favor making pot legal, but the sale or possession of marijuana remains a federal crime. Joining me in the studio to talk about whether tomorrow will be a tipping point for legalizing marijuana, John Hudak of The Brookings Institution and joining us from a studio in Bemidji, Minnesota, Christopher Ingraham of The Washington Post.

  • 11:07:37

    MS. DIANE REHMAnd from the NPR Bureau in New York City, Kevin Sabet of Safe Approaches to Marijuana. I'm sure many of you have thoughts on this issue. Give us a call at 800-433-8850. Send us your email to drshow@wamu.org. Follow us on Facebook or send us a tweet. And welcome to all of you.

  • 11:08:03

    MR. JOHN HUDAKThanks for having me.

  • 11:08:05

    MR. KEVIN SABETThanks for having us.

  • 11:08:05

    MR. CHRISTOPHER INGRAHAMThanks, Diane.

  • 11:08:07

    REHMJohn Hudak, I know you've just written a book about the long history of the marijuana in this country. How long have we been using this plant in the U.S.?

  • 11:08:20

    HUDAKIn the U.S., in this country, on this soil, we've been using the plant since before the founding, actually. This was a crop grown as hemp that was used in the Virginia colony in many of the original colonies. And for periods of time, it was actually required to be grown by the British crown. But over time, we moved a little bit away from hemp and people began to catch on that marijuana, cannabis also had other effects, intoxicating effects and that's what we know the plant more for today than for its uses as hemp.

  • 11:08:57

    REHMSo by the 20th century, we had this war on drugs and marijuana is included in that.

  • 11:09:08

    HUDAKMarijuana was really a central part of the war on drugs over the course of decades and that's not a surprise. It's now become the most widely used illicit drug in the country. It was one that was blamed for a lot of cultural problems, social problems, economic challenges and it was the government's desire and real effort to crack down on all drugs and especially on marijuana as part of that crusade.

  • 11:09:36

    REHMBut not alcohol.

  • 11:09:38

    HUDAKWell, alcohol, obviously, had its own period of time...

  • 11:09:41

    REHMRight.

  • 11:09:41

    HUDAK...where the federal government was cracking down, but because of a series of forces in society, prohibition was overturned, alcohol came back to licit use in the United States, but most of the nation's other drugs remained banned.

  • 11:09:59

    REHMAnd Christopher Ingraham, are we now on the verge of seeing that same kind of overturning of public opinion in regard to marijuana?

  • 11:10:15

    INGRAHAMWell, some people would say we're already there. We've got four states that they already have or are setting up commercial marijuana markets. You have a slightly different situation there in D.C. where marijuana is legal, but the sale of it isn't. And we're seeing national polls, as you mentioned at the start, showing support for legalization at 50, 60, even higher nationwide. So there's been a huge shift in public opinion over the past ten years ago and it's been surprisingly rapid. It's been like gay marriage in many ways.

  • 11:10:47

    INGRAHAMAnd so people are really looking towards what happens tomorrow, particularly with California. It's one of the nation's -- it's the nation's largest state, one of the world's largest economies and if California legalizes, a lot of observers are saying that it will no longer be possible for the federal government to kind of maintain a blind eye to what's going on in the states and it's going to have to pass some kind of legislation or otherwise address this growing gap between federal policy, which is very restrictive on marijuana, and on several state policies, which are now allowing it for recreational use.

  • 11:11:20

    REHMSo here's what I don't understand. You've had it allowed for medical use in some states, even while the federal government says you can't use it. So John Hudak, how does that conflict state laws with federal laws?

  • 11:11:43

    HUDAKI think no matter your position on this issue, this conflict between state and federal law has obviously broken public policy. It's public policy that is really dysfunctional and the way it has proceeded is the Obama administration, through an administrative directive, through a policy memo from the Department of Justice, said -- set up a system in which states could effectively legalize and say, if you legalize for medical or recreational use and you set up a regulatory system and you don't engage in other bad acts, like working with drug cartels or selling to children, then you are free to operate in your state system.

  • 11:12:22

    HUDAKIt is not the federal government saying that federal law has gone away. It's just the Obama administration choosing not to enforce the law against certain operators under certain conditions.

  • 11:12:33

    REHMAll right. So Kevin Sabet, you've heard that all this activity is going on in all these states and at the same time, medical marijuana is in use and the federal laws seem to simply overlook or bypass those states where it's legal medically. What is your thought about its being legalized for recreational use?

  • 11:13:06

    SABETWell, I think it's important to separate the medical and recreational issue and realize that, you know, today's legalization is really about a new industry, not unlike the tobacco industry that our country has fought terribly for over 100 years. And so I think there's an argument to be made that we should not jail or incarcerate or criminalize users, but that is very different than allowing the kind of legalization that's being introduced now, which is really commercial advertising and promotion.

  • 11:13:38

    SABETAnd so the edibles with gummies and these candies that have sent more kids to the ER in Colorado than before, the effect, even on adults, you know, there's some people saying now that, you know, adults that used marijuana in the '60s and '70s they have a hard time finding that kind of mellow marijuana nowadays because today's THC -- so high THC marijuana is so different than the '60s, let alone when, you know, there might have been hemp grown in the 1700s, which had basically zero THC in it at all.

  • 11:14:09

    SABETBut I think what's interesting is that unlike alcohol prohibition, the number of people who use marijuana still in this country hovers around 10 percent. During alcohol prohibition, it hovered around 60 to 75 percent as it does today and so it was impossible to prohibit something that 60 to 75 percent of people did. Whether it was good or bad for public health is a separate issue. I think that what's interesting today is that you have, you know, some 50 some percent of Americans agreeing with some kind of legalization, but that's based on about 10 percent of people using.

  • 11:14:41

    SABETAnd I think often when people say they do agree with legalization, they mean more the legalizing personal use and more the decriminalization side. I think they less mean this -- what's actually happened, which has been, you know, this massive industry selling gummies and lollipops and candies and really kid-friendly things. So I think it's going to be a constant push and pull over the next ten years, a very windy road that's not going to be resolved tomorrow or even in a few years because...

  • 11:15:10

    REHMJohn...

  • 11:15:10

    SABET...local -- this whole issue of local control is also very important.

  • 11:15:14

    REHMJohn Hudak.

  • 11:15:14

    HUDAKTo respond quickly to Kevin, I agree that part of this movement does involve industry. It involves corporatization. It involves businesses operating in these states to bring product to market and to sell it. I think one of the arguments that is often overlooked in that discussion is that there is currently a marijuana industry in place in every state in this country. It is black market. In some places, it is cartel-driven. It is unregulated and in some cases, it is unsafe. And so I think Kevin's concern oftentimes is part of what the beginning of his statement was, that this industrialization, this corporatization is like the tobacco industry.

  • 11:15:57

    HUDAKAnd I don't think anyone wants a big tobacco style corporate takeover of marijuana. But what a lot of people don't want is black market cartels running the marijuana industry in this country. And I agree with Kevin, this is going to be a push and pull between where most people want to see industry going and this plant and product going and where it currently is today.

  • 11:16:23

    REHMHow safe, John, do you believe marijuana to be?

  • 11:16:30

    HUDAKThat depends on the user, the user's level of education and what that individual chooses to do after consuming marijuana. It is not safe to consume marijuana and drive a car or operate machinery or fly a plane. That is something that should not be happening.

  • 11:16:47

    REHMBecause the effects are similar to...

  • 11:16:51

    HUDAKIt is an intoxicating effect. It's not identical to alcohol so it changes people's reaction times in different ways than alcohol, but no one wants intoxicated individuals operating cars. But the same is true for alcohol. The same is true for prescription narcotics. And so if you are consuming at certain levels in your home or in safe spaces, I think for a lot of people, they think alcohol and marijuana should be treated pretty similarly, if you are willing to make the right choices with those behaviors like our society let's people do with alcohol.

  • 11:17:26

    REHMNow, what tests have actually been done showing the intoxication level of marijuana?

  • 11:17:36

    HUDAKThis is a real challenge right now for law enforcement. There are not very accurate tests for a person's level of intoxication based on the consumption of marijuana. Those tests are getting better, but they're not quite there yet like we have for alcohol.

  • 11:17:51

    REHMJohn Hudak, deputy director of the Center For Effective Public Management, a senior fellow at The Brookings Institution and author of "Marijuana: A Short History."

  • 11:20:04

    REHMWelcome back, we're talking about marijuana on the ballot tomorrow in a number of states. You'll have five states, including California and Florida, voting on whether to make recreational marijuana legal. With me here in the studio, John Hudak, he is the author of a book titled "Marijuana: A Short History." With us by ISDN and Skype from a studio in Bemidji, Minnesota, Christopher Ingraham, he writes about politics, drug policy and many other things for The Washington Post, and Kevin Sabet, he is co-founder of Smart Approaches to Marijuana. That is an anti-legalization group that advocates for public health-based approaches to marijuana regulation.

  • 11:21:10

    REHMAnd Kevin Sabet, you heard John Hudak and his evaluation of the harmfulness or harmlessness of marijuana. What's your view?

  • 11:21:25

    HUDAKWell, I think a lot of people bring anecdote to this conversation rather than focusing on the science. So a lot of Americans think, well, you know, we knew a couple people that used marijuana and college, and they're fine today, and certainly we've had very smart people in our country, leading our country or leaders in various industries, that have used marijuana, and they're doing just fine. And people bring those experiences from 10, 20, 30 years ago to the conversation today.

  • 11:21:48

    HUDAKAnd I think that's unfortunate because if we listen to the American Medical Association, the World Health Organization, which just did a major review on marijuana that I invite your listeners today to read, and other scientific documents, what we see is that again, today's marijuana is stronger than it was before, it's absolutely addictive for some people, not everybody, just like no -- all drugs are addictive for some and not others.

  • 11:22:15

    HUDAKThe connection with mental health has been especially concerning in the last 10 years, the research on psychoses and long-term schizophrenia, and then finally your -- the effect on motivation, learning, IQ, self-satisfaction in life. And I think that, you know, again this is not something that I think we need to go back to "Reefer Madness" and say, oh, if you try this once, this is going to be automatically destroying your life, but I think unfortunately a lot of young people are getting the message today that this is just an innocuous plant when in reality I think we should listen to the public health community right now and at least put the -- you know, slow this train down that's going full force towards a commercialized legal market that will not only increase advertising and promotion in a big-tobacco-style network but frankly not even, I don't think, help us get rid of the black market and the things we'd like to get rid of.

  • 11:23:11

    HUDAKI mean Colorado, the underground market is thriving. Underground operators are able to undercut the legally taxed price, and I think the message to young people is we don't want to put you in prison and, again, jail you and saddle you with a criminal record, but we also want to get -- you know, want you to make smart choices. And it's difficult right now with this industry that's essentially saying it's safe.

  • 11:23:38

    REHMAll right, and Christopher Ingraham, can you tell us about any scientific studies that indicate the intoxication level of the addiction level of anything of that sort?

  • 11:23:53

    INGRAHAMSure, I mean, you know, Kevin mentions that today's marijuana is, on balance, it's a lot stronger than your parents' marijuana maybe, and that's absolutely true. And I think there's also -- there's an analogy there with alcohol, where we have certain alcohol products, like vodka or rum, that are very strong, we have others like beer that are less strong.

  • 11:24:12

    INGRAHAMSo, you know, users, people who choose to buy these products and use them, they need to be educated, and I think there's a gap in education about the effects of marijuana and how different doses affect individual people. But there's also a fair amount of evidence out there that shows that in terms of addiction, and when we're talking about the harmful effects of marijuana, that's really one of the big things we're worried about is a lot of these effects come from people who start using, and they can't stop, and they are setting themselves up at risk for the worst consequences of use.

  • 11:24:41

    INGRAHAMAddiction rates for marijuana, there haven't been a whole lot of studies of this, but the studies out there indicate that it's relatively low. You know, your odds of getting hooked on marijuana seem to be a little bit less than your odds of getting hooked on alcohol. The younger you start, of course, the higher your likelihood is. And so I think from a public health perspective, a lot of the data seems to indicate that marijuana is most risky for younger, developing minds.

  • 11:25:07

    INGRAHAMAnd there are some researchers who have been saying recently that, you know, your brain is developing up until you're about 30. So they say -- I've heard researchers who say you know what, smoke all the marijuana you want after you're 30, but before then be really careful about it. So there's -- there's a fair amount of evidence out there. It is a fairly well-studied plant.

  • 11:25:24

    REHMWhat do you think, John?

  • 11:25:27

    HUDAKI think this touches on a really important part of this discussion, this policy discussion, the way that the campaigns are rolling out, and that is most people are not taking the approach that marijuana is safe. There are certainly people who do. They are typically not taken seriously. But the idea is not that it is safe, but it is a product that has risks and what effective public policy does is manages those risks.

  • 11:25:51

    HUDAKFor some products we ban it because the risks are too high for proper use or socially acceptable use, and that's where we have been with marijuana for about a century. But increasingly people are looking at this plant and saying that the risks are not so severe that banning it is necessary, but risks still exist in society, and the best way for society to get a handle on those and to deal with these problems is to regulate it and not to allow a thriving black market to make those choices for you.

  • 11:26:27

    REHMKevin?

  • 11:26:28

    SABETWell, I think the main reason why alcohol and tobacco, one of the biggest reasons, and this is what the head of (unintelligible) and other say, one of the biggest reasons alcohol and tobacco are so harmful is actually because they're legal, because you're advertised and normalized and commercialized, and they come in all shapes and sizes. They -- I mean, look, with tobacco we were, you know, fighting that war for, again, over 100 years, until we finally listened to the science 80 years after the first scientific study connecting lung cancer with tobacco.

  • 11:26:56

    SABETAnd so, you know, I think the idea is yes, obviously it's not as risky as something like heroin or methamphetamine or cocaine, but the issue is we have our hands full. I mean, we have our hands full with alcohol and tobacco, they're not legal because they're safe, they're legal because -- or even necessarily safer than heroin. I mean, tobacco is, actually if you look at addiction, and Chris mentioned let's look at the addiction rate, tobacco is more addictive than heroin.

  • 11:27:20

    SABETThat's not an argument to make heroin legal. It's an argument to say what happens when we make drugs more available and legal is that more people use them. That's why so many more people drink or smoke cigarettes than they do use marijuana or other illegal drugs. So I think I would just say let's at least be cautious. Right now the way this is unveiling is an industry sees money, they see profits, and in an addictive industry, whether it's alcohol, tobacco, gambling, prescription drugs, which opiates are legal, and we're having such a hard time with them. President Obama made that point I think very astutely two days ago on the Bill Maher show about we have our -- sort of we're dealing with opiates right now, and that's legal, and we're not dealing with them particularly well.

  • 11:28:02

    SABETI think when they are legalized and normalized, it's much harder to deal with because you have an addiction -- I would call addiction-for-profit kind of scheme, where these businesses rely on -- John, Chris and I would all agree that heavy users probably of any drug are responsible for the majority of the problems. And the issue is these operators, these legal operators, they rely on addiction for profit. They have to have heavy, irresponsible users.

  • 11:28:31

    SABETI mean, the alcohol industry relies on the 10 percent of Americans that drink 15 drinks a day. It's not that the majority of Americans drink irresponsibly, they don't, they actually drink responsibly, but the small number of them, the 10 percent, are responsible for 80 percent 70 to 80 percent of the total revenue. That means if you're in the business, you have to promote irresponsible, dangerous, early, reckless use, and as Chris said, you don't start -- you know, your brain is developing until age 30, and you have to go after those young customers in order to make money.

  • 11:29:01

    REHMAll right.

  • 11:29:02

    HUDAKOtherwise you can't get into this business, and that's what I worry about.

  • 11:29:05

    REHMChristopher Ingraham, you've got these ballot measures across the country. If they do pass, what then does federal law do? Will Congress be under some pressure to change its own federal laws?

  • 11:29:29

    INGRAHAMI think that's absolutely right. I mean, look, if all five states legalize marijuana where it's on the ballot tomorrow, then you'll have something like a quarter of the country living in areas where they have open access to a commercial, regulated marijuana market. So there is going to be pressure on legislators to change things federally. But as we've seen over the past 10 years, there is basically nothing that congressmen want to do less than to tackle marijuana reform.

  • 11:29:55

    INGRAHAMThey've been trying to avoid it for as long as possible. So I think what you might see, there will be some more pressure on Congress to change things, but I think you're going to try to see them tackle the issue in the most minimalist way possible, and, you know, the one kind of plausible route I see them taking going forward is not necessarily making marijuana legal at the federal level of taking it out of the Controlled Substances Act completely but maybe creating some sort of special carve-out where they say in states that have passed either medial or recreational marijuana, the Controlled Substances Act provisions do not apply to marijuana.

  • 11:30:32

    INGRAHAMI can see them taking some kind of minimalist approach and moving very slowly on this, as they have been over the past 10 years.

  • 11:30:36

    REHMJohn?

  • 11:30:37

    HUDAKI agree with Chris on this quite a bit. I think there will be added pressure. I think Kevin's points on the growth of industry are absolutely right. And we know that as an industry grows in size and economic power that it has lobbying power coming along with that. But I don't think any congressman is going to wake up Wednesday morning and say if there was a clean sweep, and all of these states legalized, no one is going to say, wow, now I have to get back to Washington and fix this marijuana problem.

  • 11:31:08

    HUDAKI think if there was this critical mass or this tipping point, we would've already seen significant reform on medical marijuana where 25 states and D.C. have legalized, and about 200 million Americans live in states with medical marijuana systems. Like Chris said, Congress doesn't want to touch this, but the longer they go without addressing some of these issues the more this broken policy has secondary and tertiary consequences across the country.

  • 11:31:36

    REHMSo as you see this unfolding, do you believe that Congress will want to deal with this anytime soon, or do you believe that there will be enough pressure, say from the alcohol industry, to quash these measures in the states where they're voting tomorrow?

  • 11:32:04

    HUDAKI think there's going to be interest, as Chris said, from Congress to address a few issues piecemeal. Banking access might be one. Issues of tax relief for the cannabis industry might be another, real economic forces. Another area that Congress may get engaged on this is one that we haven't touched on yet. We've talked a lot about the harms of marijuana, focusing on addiction and use, but what we're not talking about is the harms of marijuana enforcement and the effects that that has had on communities of color in the United States.

  • 11:32:36

    HUDAKThis is a real problem, and Kevin has talked about this. We don't want to lock everyone up. But the reality is we are imprisoning people, we are fining them, and we are putting on their record things that can disqualify them from jobs and other economic advancement in our society.

  • 11:32:53

    REHMAnd now President Obama is attempting to undo many of those convictions.

  • 11:32:58

    HUDAKExactly, and I think you feel this in Cong, too, people concerned with criminal justice reform, and I think marijuana gets folded into that conversation. Congress might not legalize it, but they might deal with some of these other issues that are facing this policy nationwide.

  • 11:33:14

    REHMJohn Hudak, he is the author of "Marijuana: A Short History." And you're listening to the Diane Rehm Show. And joining us now is Megan Verlee. She is a reporter for Colorado Public Radio in Denver, Colorado. Megan, thanks for being with us.

  • 11:33:40

    MS. MEGAN VERLEEOh, it's great to be here.

  • 11:33:43

    REHMI know Colorado was one of the first states to legalize marijuana back in 2012. Tell us how this is playing out in your state so far.

  • 11:33:56

    VERLEEWell, I'd say that legalization has been more controversial than the proponents projected but probably less than many opponents feared it would be. There are still a lot of questions in the state about the long-term impact of having legal marijuana, around whether it will raised youth use, whether -- what to do about public consumption, which our law does not allow but which certainly occurs in a lot of places, whether to limit potency and what to do about people driving while impaired, just a lot, a lot of question that, you know, a couple years of legal sales have not answered yet.

  • 11:34:31

    VERLEEBut the conversation around whether legalizing marijuana has been good or bad for Colorado is happening in the state just booming overall, and we have, you know, a ton of millennials moving here, property values going through the roof and a lot of tourism. And so it's very hard right now to judge whether or if legal marijuana is affecting that, but the conversation around legal marijuana happening in the state at this moment is probably more positive simply because the state is doing so well overall.

  • 11:35:03

    REHMSo economically I gather the sales of marijuana brought in an extra $135 million in tax revenues?

  • 11:35:17

    VERLEEIt's such an interesting thing on the tax revenue because that is a very large number, but it's actually a very small portion of the state's overall budget, you know, just a couple of percentage points. And what we've started to hear from folks who want to increase the state budget, either by asking voters for higher taxes locally or statewide, or through other measures, is that they're running into residents who think that all of our budget problems have been solved by marijuana tax revenue, and that is absolutely not the case.

  • 11:35:44

    VERLEEYou have individual, little -- very little towns that have a lot of marijuana retail, where they're, you know, literally paving all their streets with marijuana money, but statewide, the effect is actually pretty negligible.

  • 11:35:58

    REHMTell me how regulated marijuana is under the new state law.

  • 11:36:03

    VERLEEI would say it's fairly heavily regulated. There are limits on where marijuana stores and grows can open, what hours they can be open, and these regulations are both at the state and local level. Public consumption is outlawed, like I say, that's sort of a hot point on it, and then there's a lot of regulation happening around making marijuana as safe as possible for its consumers.

  • 11:36:27

    VERLEESo there's been a lot of discussion around edibles, making sure that edibles are marked in ways that children can't accidentally consume them. They now are going to start having to actually have a mark on the food product.

  • 11:36:40

    REHMAnd what about increased accidents or hospitalizations related to marijuana?

  • 11:36:49

    VERLEEThere have been some very high-profile cases. There was a college student who consumed a cookie that was far too potent for one person to eat and jumped out of a window. There was a husband who shot his wife after eating some marijuana candies. But these are very anecdotal. And I think the main conclusion right now is there is just not enough data to know what the widespread effects are.

  • 11:37:11

    VERLEEThat said, there do seem to be -- there does seem to be some increase in ER visits from children accidentally exposed to marijuana edibles, but, you know, it's probably going to take years of research to know really what the impact is.

  • 11:37:24

    REHMAll right, Megan Verlee, a reporter for Colorado Public Radio in Denver. Thanks so much for joining us.

  • 11:37:33

    VERLEEThank you.

  • 11:37:34

    REHMShort break, we'll be right back.

  • 11:40:01

    REHMAnd welcome back. We're talking about ballots on various states that will, if it passes, vote to legalize marijuana use. Here's an email from someone who says, "For many Americans with anxiety, depression and other mental issues, marijuana is the only treatment that gives release -- relief. We deserve the right to choose an effective treatment without fear of legal reprisal." Chris Ingraham, has marijuana research shown that to be true?

  • 11:40:49

    INGRAHAMThere's been a fair amount of research into the medical effects of marijuana. One of the big things that we know that it is -- does seem to be pretty good at is treating pain and treating chronic pain. And that's potentially a big development. Because, as we know, a lot of the drug-related deaths in this country are due to overdoses on opiates and narcotic painkillers.

  • 11:41:09

    INGRAHAMI think the actual clinical evidence for a lot of other symptoms and conditions is more mixed. But you have a lot of people like your reader saying, look, you know, I feel bad. I smoke marijuana. It makes me feel better and I'm able to go on about my day. And there's -- there are a lot of stories like that online. And those are really powerful for a lot of people. I think the tricky thing is, from a medical standpoint and from people who are trying to get the FDA, say, to recognize the medical potential of marijuana, the FDA doesn't typically recognize whole plants as a treatment for anything. Right?

  • 11:41:46

    INGRAHAMThink of penicillin, the FDA approves of penicillin for treating infections. But it doesn't approve of, say, mold. So there's kind of a real disconnect between the way people use marijuana to treat their conditions and the way the federal bureaucracy is set up to regulate the use of those kind of medicines. And it's almost like marijuana is such a unique substance, such a strange drug that it kind of breaks that normal binary between lawful and unlawful drugs that federal policy has relied on for 40 years or so.

  • 11:42:18

    REHMAnd John Hudak, just think of the Native Americans who were here in this country before we got here, using every plant possible.

  • 11:42:30

    HUDAKI think that's one of the concerns that exists in this space, is that it is an old plant. It is something that has been used in many cultures throughout the world for quite some time. But, you know, leeches and blood-letting were also medical treatments that were used…

  • 11:42:46

    REHMAnd in some areas of the world still used.

  • 11:42:49

    HUDAKAnd still is. It's not accepted here in the United States or in most Western cultures. And so I think the history of it is not necessarily license for its medical value. And as Chris said, there is evidence about pain relief and there's evidence in its treatment for epilepsy, but with others there's more anecdotal or more mixed evidence. And so I think some people will swear by its medical value. And perhaps for them individually it does help them for whatever ailment they have.

  • 11:43:19

    HUDAKBut that is not the standard that the medical community requires to show medical value. And in this conversation, it becomes very frustrating for the medical community, who struggles to get that point across, and for patients who struggle to understand what that threshold is.

  • 11:43:36

    REHMAll right. Let's open the phones. Going to Jeremy in Omak, Wash. You're on the air.

  • 11:43:45

    JEREMYHi, Diane.

  • 11:43:46

    REHMHi.

  • 11:43:47

    JEREMYI think a part that has been widely overlooked is the environmental impact that growing marijuana has had. Dr. Evan Mills, who works for the National Labs in Berkeley, did some independent research in 2011 and found that one percent of the nation's power is being used to grow marijuana. And now in legalization we just saw Hawaii say no to growing marijuana under the sun sustainably. So in the black market and in the legal market we see a trend towards the continuing the practice of high-energy use, high-carbon footprint.

  • 11:44:23

    JEREMYIt seems to me that the politicians could put aside the social issues and see an opportunity here to really improve the environment by saying, let's not do this under lights in the basement. It's now legal. Take it out and grow it sustainably.

  • 11:44:39

    REHMChristopher Ingraham?

  • 11:44:43

    INGRAHAMYeah, environmental impact has definitely been a concern. Particularly in some places like California, where you hear stories of illegal grows in the national forest, diverting entire streams and small rivers for marijuana plants. So it's -- it definitely -- it can be a resource-intensive crop, but, you know, at the end of the day it's a crop kind of just like any other.

  • 11:45:01

    INGRAHAMThere's a reason they call it weed. It grows everywhere. It can be grown just about anywhere. And I think there are some good arguments in place that if you're concerned about the environmental impact of marijuana, the best way to deal with that would be to regulate it, to bring it out into the open and so you can put laws in place for these growers that say you're only allowed to use so much water or so much electricity. And to put some kind of just commonsense regulations around that.

  • 11:45:25

    INGRAHAMRight now in many states it's just completely unregulated how these grows happen. And even in states where you have, you know, something of an existing medical marijuana market, like California, medical marijuana there is legal, but the growing and the production of marijuana there, it really kind of operates in this uncomfortable gray area. And so a lot of people say one of the benefits of legalization would be taking those practices out into the light and putting some better standards in place for them.

  • 11:45:53

    REHMAnd here's a question from Margaret on that gray area. She says, "I live in Florida, where we're voting on an amendment to legalize medical marijuana. My question is why are we voting for this? Don't we have a process through the FDA to examine and recommend medical practices? We did not vote to make marijuana illegal. We have not had the opportunity to vote on aspirin or antibiotics or morphine. Why is the general public deciding what experts should determine?" John Hudak?

  • 11:46:40

    HUDAKThat's a great question. And it's something that a lot of people worry about or are concerned about. This is something that is abnormal in the process. Typically, medicines in this country come to market through a rigorous, long-term FDA approval process. What has happened in the states right now, however, is that there are institutional barriers to doing the type of research on marijuana that can answer those questions and allow FDA to play that out, play that process out.

  • 11:47:12

    HUDAKIt is not impossible. Marijuana is studies in those contexts, but there are tremendous barriers to getting that work done. And so what individuals have done, what interest groups and advocacy organizations have done -- have taken that decision in to their own hands and began to let Americans decide whether they think there's medical value.

  • 11:47:34

    REHMBut where are the barriers coming from?

  • 11:47:38

    HUDAKThe barriers come from marijuana's schedule 1 status, which makes it the most-highly controlled drug in our society. It means that to do conduct -- to conduct research on this substance is very expensive, it's time consuming, it is risky. Some universities don't want to participate in that practice. And there's only a single producer of research grade marijuana in the United States. That's a farm at the University of Mississippi.

  • 11:48:05

    HUDAKAnd all of this means that scientists who want to do this research, they're not waiting six months or a year to get approval and to be able to do this. Some of them are waiting a decade. And that's a real problem in our science. And it's a real problem in our bureaucracy.

  • 11:48:20

    REHMAll right. Let's go to Rick in Gilbert, Ariz. You're on the air, Rick.

  • 11:48:27

    RICKHello, thank you for taking my call.

  • 11:48:28

    REHMSure.

  • 11:48:28

    RICKLong-time listener, first-time caller.

  • 11:48:30

    REHMThanks.

  • 11:48:32

    RICKI want to put the focus a little bit on law enforcement and share the fact that when I was very young -- I'm 58 now. But when I was young and first was exposed to marijuana, immediately I thought to myself, well, gee whiz, you know, this puts people in prison. And I had known some people at that time that had been sent to prison for marijuana and marijuana, you know, use, small quantities of marijuana.

  • 11:48:57

    RICKAnd I thought, you know, that's an awful strict result of something that to me seemed somewhat benign. I mean, granted you do get euphoria from it and stuff like that. But I all but rather drive on a freeway with pot smokers than I would with people with their cell phones. So, you know, I want to…

  • 11:49:12

    REHMAll right. Kevin Sabet, what's your reaction on the issue of criminalization and jailing and so on?

  • 11:49:23

    SABETWell, look, luckily it's very rare to be imprisoned for low-level marijuana use anymore. I mean, several states decriminalized marijuana as early as the '70s. I mean, in California, where they're voting tomorrow on legalization, that there's not one person behind bars for smoking a joint. That said, people get criminal records, with arrests and I think there are ways to mitigate that. What's ironic I think with legalization in a state like Colorado, for example, what wasn't said earlier, but I think it's very salient, is that arrests for young black and Hispanic kids have actually gone up for marijuana after legalization versus before.

  • 11:50:01

    SABETAnd that's because there are still laws you're enforcing. So the public use, bringing it to school and often kids will think, you know, if it's legal for adults, it's legal for me, too, and we're not gonna get in trouble. And so what's troubling, I think, is that you have, you know, these rules in Colorado, they've tried to put up, for example, on the environment, like we heard before, or on public use or on driving or, for example, bringing it to school.

  • 11:50:27

    SABETAnd yet, in almost all of those categories violations are going up since legalization. So I think it's very complex and very, you know, to this connection. And I think way too simplistic to think that if we legalize something we're gonna have fewer arrests and fewer criminal justice entrants. After all, alcohol is the number one arrestable offense of any drug by far because of DUI and public use and selling to minors.

  • 11:50:51

    REHMRight, right. Chris Ingraham, do you want to comment?

  • 11:50:56

    INGRAHAMYeah, I think, you know, the whole conversation brings an interesting fact to light, is that we've been talking a lot about the risks associated with legalizing marijuana. We already have a lot of risks that are currently in place just from our current punitive system for dealing with marijuana. Kevin mentioned that, you know, there aren't a lot of people in prison for using marijuana. There still are some people in prison for that.

  • 11:51:18

    INGRAHAMBut there are still -- each year there are about 650,000 arrests in the United States for marijuana possession alone. And those arrests can be incredibly disruptive. It can mean, you know, missing out on a job interview or losing a day of work, losing your job. And so those arrests are a huge problem. They're incredibly impactful. And as John mentioned earlier, they tend to affect minority communities much more so than other communities.

  • 11:51:45

    INGRAHAMSo, you know, a lot of the conversation is focused on these risks and, you know, the kind of -- the great unknown of what will happen if we legalize marijuana. On the other hand, we also know already, and we've experienced over the past 40 years, there are many incredibly damaging aspects of the way we enforce the marijuana laws in place right now.

  • 11:52:05

    REHMAll right. To Louisville, Ky. And John, go right ahead.

  • 11:52:10

    JOHNHi, Diane. Good morning.

  • 11:52:12

    REHMHi.

  • 11:52:12

    JOHNThanks for taking the call.

  • 11:52:14

    REHMSure.

  • 11:52:14

    JOHNI was formally a docent at Farmington, an historic plantation here in Louisville, where we are now growing an experimental crop of hemp. It was a big crop for the farm back in the 1800s. And in fact, Kentucky was the leading producer of hemp in the country for a long, long time, up until probably close to 1900. The first comment that was made by John when the show opened, about the low level of THC and all of this stuff, he made a, to me, a crucial error in his commenting because he was lumping together marijuana and hemp.

  • 11:53:04

    JOHNThey are not the same. The level of THC is insignificant when it comes to an inebriation. The people that were promoting the growth, the crown law he was referring to, was because hemp was used in production of rope for the British Navy. It was not to get little kids high in London.

  • 11:53:24

    REHMAll right. And you're listening to "The Diane Rehm Show." John Hudak, do you want to comment?

  • 11:53:34

    HUDAKSure. I will comment on that. I think John misinterpreted what I was saying. It is clear that hemp was used as a cash crop, not to "get little kids high," but because of its value to the British economy, which I had mentioned. And I think while there is a significant hemp movement in this country that is held back by the criminalization of the cannabis plant, there are moves at the federal level to relax those rules around hemp production, so long as that plant does not mature and become a crop used to produce marijuana, the intoxicating effect.

  • 11:54:16

    HUDAKIt does have a lot of uses for food, for fuel, for linen, for rope, for a variety of purposes that have since been replace by many other crops and many other processes. But at the end of the day, there's still that movement here in this country to get back to those roots in Kentucky and Tennessee. In other parts of the country that have struggled mightily with economic transformation, some see hemp as maybe a saving grace. And the rules around our drug policy is what is holding hemp back.

  • 11:54:46

    REHMAll right. And one last question from George in Baltimore, Md. Please be brief, sir.

  • 11:54:55

    GEORGEThank you. My question's for Christopher. Yeah, in my early 20s I became a marijuana addict. I'm almost 70 now and I had a mental breakdown and struggled over 45 years with mental illness. Now, actually there's a lot of stuff on the internet about that. You see groups like Moms Strong, Parents Against Pot. These are parents talking about their kids who have suffered because of marijuana abuse. You know, it's actually a thing that's happening. This isn't any intellectualization. Now, knowing this, do you not agree that the information about marijuana's dangers needs to be widely disseminated to the public by the media and other means?

  • 11:55:37

    REHMOkay. Thanks for calling. Chris?

  • 11:55:41

    INGRAHAMYeah, I think absolutely. I think it takes us back to the point we talked about at the beginning of the hour, that, you know, marijuana is not safe full stop. It is not without risks. And to those specific issues, there's been a lot of research done on potential links. And there are a lot of questions about the links between marijuana use and the development of later mental health issues. And that is one of the big concerns for younger users.

  • 11:56:04

    INGRAHAMOn the other hand, a lot of the research on those questions, it's not necessarily -- it doesn't establish a causal link. It's not necessarily indicating that marijuana use by itself causes a later breakdown. There are a whole lot of other factors that come into play with these issues, from family environments to, you know, personal, you know, your- just your mental state. So there are a lot questions there. And unfortunately, a lot of research that would kind of help us answer those questions and really tease out cause from effect there, it's just so incredibly hard to do these days with our current marijuana policies in place.

  • 11:56:37

    REHMAll right. All right. And we'll have to leave it at that. Christopher Ingraham of The Washington Post, John Hudak of The Brookings Institution, author of "Marijuana: A Short History," and Kevin Sabet, co-founder of Smart Approaches To Marijuana. Thank you all so much.

  • 11:57:04

    SABETThanks for having us.

  • 11:57:05

    INGRAHAMThanks, Diane.

  • 11:57:06

    HUDAKThanks.

  • 11:57:06

    REHMAnd I hope you all will take the time to vote tomorrow. NPR and reporters from stations across the country will be live on election night and the morning after, breaking down national and local results. You can listen live right here and follow the races important to you at NPR.org. Please vote. Thanks for listening. I'm Diane Rehm.

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