Lieberman is The Constance and Stephen Lieber Professor of Psychiatry at Columbia University Vagelos College of Physicians and Surgeons, and President of the ARETE INSTITUTE for Health, Well-Being and Human Potential. He is also the author of SHRINKS: The Untold Story of Psychiatry (Little Brown, 2015) and MALADY OF THE MIND: Schizophrenia and the Path to Prevention (Scribner-Simon and Schuster, 2023)
In a dramatic example of government yielding to public opinion the Senate has introduced legislation to legalize cannabis on the federal level. Though passage before the November election is unlikely, this long overdue legislative action seeks to update a statute stemming [pun intended] from marijuana’s demonized image as depicted in the 1936 documentary film “Reefer Madness” and better reflect public opinion and liberal social trends. Currently, under the Federal Controlled Substances Act (CSA) of 1970, cannabis is considered to have “no accepted medical use” and a high potential for abuse and physical or psychological dependence. This Federal statute contrasts with the claims of therapeutic benefits of cannabis’ biochemical constituents such as cannabidiol and THC (tetra-hydro-cannabinol) when the sole FDA indication for their use is a rare childhood (Lennox-Gasteau) seizure disorder.
While the scientific information to officially endorse cannabis products as having therapeutic benefits is lacking, a recent Pew Research Center Survey found that 88 percent of Americans felt that marijuana should be legal for medical or recreational use. This wave of popular opinion has led to marijuana’s approval in 38 states for medical use, in 24 states for recreational use and decriminalization in an additional seven states.
Who could have anticipated that in less than two decades, a naturally grown recreational intoxicant, cannabis sativa, would go from demonization (as) to mainstream, and begat a tsunami of popular demand for legalization and a gold-rush of commercialization fueled by $61 billion of investment. Some may see this as an impressive demonstration of social progress, while others consider it the result of reckless and ill-conceived policies that have created a tangled matrix of laws and conflicting incentives based on confused logic and incomplete knowledge.
Americans now have access to a recreational intoxicant that is arguably no more dangerous than alcohol or tobacco without fear of the disproportionately severe punishments previously meted out to those apprehended for possession and use. But at the same time, there are numerous inconsistencies and cross-purposes integral to the legalization and commercialization of cannabis products. The most obvious of these is the fact that Federal law considers the use, sale, and possession of cannabis illegal.
Read More: What Marijuana Reclassification Means for the United States
The consequence of the latter was not just that the exaggerated therapeutic claims were not born out by scientific research, but that it served as a “Trojan Horse” to galvanize public opinion and advance cannabis advocates ultimate goal of unfettered access. This came to fruition when the state legislatures of Colorado and Washington voted to legalize the commercial production and sale of cannabis products in 2012. This triggered a stunning demonstration of states’ rights in which a majority of states followed suit by liberalizing their cannabis laws despite Federal prohibitions.
The legislative conflict between Federal and state laws is not ideal, but not a grievous problem in large part because the conflict is tolerated and not enforced. More onerous is the conflict between legislative reform and public health that has emerged. By acceding to public opinion and false claims of salutary effects, state governments are exposing their constituents to health hazards. Compounding this misguided policy is the fact that state governments are incentivized by the prospect of increased tax revenues.
In a glaring recent example of governmental missteps, on March 17, Gov. Kathy Hochul declared New York State’s commercialized cannabis licensing and distribution system “a disaster” and announced “a top-to-bottom review of the NYS Cannabis Control Board and its system for regulating legalized cannabis products.” The main purpose of the review was to process applications faster and enable more cannabis vendors to open. Just weeks before Hochul’s executive order which was intended to give New Yorkers greater access to cannabis, the American Heart Association had issued a warning on the higher risks of cardiovascular events associated with heavy cannabis use. This was based on a National Institutes of Health (NIH)-funded study of nearly 435,000 American adults reported last November which found that “Daily use of cannabis –– was associated with a 25% increased likelihood of heart attack and a 42% increased likelihood of stroke when compared to non-use of the drug.”
Prior to that, the NIH issued the following warning: “Regular recreational marijuana users had psychotic disorders at a greater rate than any other recreational drug. More than cocaine, methamphetamine, amphetamine, LSD, PCP, or alcohol. The risk of negative mental health effects is increased about five times by regular use of high potency marijuana.” High potency refers to the fact that the commercialized pot sold legally today is not the same naturally grown weed smoked by constituents of the counterculture.
