Decriminalizing Marijuana: Public Health Considerations

Boston Metro News ran a brief article this morning about a major funder of advocacy efforts for decriminalization of marijuana in Massachusetts. The decriminalization of marijuana (lessening or eliminating the penalty for marijuana use and/or possession) has been hotly debated in the US and around the globe for decades. It led me to ask, what are the public health implications for the decriminalization (for even small amounts) of marijuana?

A technical report by Alain Joffe and W. Samuel Yancy in a 2004 Pediatrics publication thoroughly reviewed literature on the legalization of marijuana and adolescent health. Joffe and Yancy report that:

1. Marijuana may reinforce dependence on other addictive drugs.

2. Impaired memory, judgement, coordination, and concentration are just a few of the adverse consequences associated with short- and long-term marijuana use.

3. Young adolescents would likely be most affected by changes in marijuana laws.

4. A 1% increase in marijuana use among adolescents would result in approximately 190,000 new users. 

A common argument by proponents of the decriminalization of marijuana is that marijuana, as compared to tobacco and alcohol, is a relatively harmless and "benign" drug. Yet as Joffe and Yancy point out, "That alcohol and tobacco cause far more harm in our society than marijuana is undeniable, but it does not follow logically that yet a third addictive psychoactive drug (marijuana) should be legalized." Looking at "lessons learned" from the tobacco industry, public health professionals would unanimously agree that millions of lives would have been saved by greater regulation and restricted distribution of tobacco products. 

In researching this topic I couldn't help but notice that marijuana use is associated with adolescents' risk factors for poor health including dating violence, lack of education/employment, greater depressive symptoms, and lower life satisfaction. While tobacco use and alcohol were also associated with the problems identified, this weakens the argument of the "benign" nature of marijuana use. Are the risks of marijuana decriminalization/legalization really worth it when considering the impact on future generations?