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INTERVIEWER
What symbolic issues?
KLEIMAN
It's taken to be symbolic of illicit drugs generally. When we argue about
marijuana, people really hear an argument about what the legal status ought to
be of the currently illicit drugs generally. That's not purely an accident. If
you look the groups in favor of changing the legal status of cannabis, most of
those organizations are now pushing for wholesale repeal of the drug laws.
So, I think there's a case to be made for treating marijuana very differently,
from the way we treat cocaine. In fact, there's no organized group, that, at
least that I know, that advocates that. Even the National Organization for the
Reform of Marijuana Laws, (NORML) is now, a general-purpose drug policy reform
organization interested in lots of things other than cannabis.
And even Marijuana Policy Project, which I think has remained more focused
publically, in private the leadership thinks we should probably legalize crack
as well.
The other set of symbolic issues is, marijuana represents the '60s. Marijuana
represents the Beatles and the anti-war movements and the Greateful Dead, and
the Civil Rights Movement and sit-ins, and unisex haircuts and free love, and
all of the things that conservatives would like the Baby Boom generation to
denounce in themselves. To the cultural conservatives, marijuana represents
laziness, disrespect for authority, irresponsibility, and the life lived
according to pleasure rather than work or reason. As long as the marijuana
debate is really about whether the '60s were a good thing or not we won't have
sensible marijuana policy.
On the other hand, lots of people who survived the `60s were left with the
impression that pot was no big deal, and what's all the fuss about . But you
shouldn't assume that just because pampered, privileged, ambitious middle-class
kids could use marijuana in college without doing much damage to themselves or
anybody else that much less well-off, much less protected, much younger kids
can use it safely. That doesn't follow.
Everybody on both sides of this debate assumes that marijuana must be good or
bad. And if it's good it's good for everybody, and if it's bad, it's bad for
everybody. Really, though, it's like anything else. It has a distribution of
risks. And the distribution of risks depends very much on the social
circumstances of the use and on the condition of the users.
Kids in very poor urban neighborhoods, smoking Phillies blunts filled up with
marijuana are not like graduate students having a joint every once in a while.
It's just not the same experience. Even then, it seems to be pretty clear that
the population you look at in the U.S., cannabis use is less associated with
violence, than alcohol use. And it's less associated with automobile accidents.
When you have marijuana-involved automobile accidents, it's usually marijuana
plus alcohol.
So in some ways, even, though marijuana use looks less benign now than it did
then, it still maybe less harmful than alcohol use,. One of the great
frustrations I have about American drug policy is that we worry about whether
the number of high school seniors who used marijuana in the last year
has gone up to 30 percent, while ignoring the fact that 35 percent of the high
school seniors report having gotten drunk more than twice in the last month.
The number of problem alcohol users among kid is much higher than the total
number of marijuana users. And yet we focus on marijuana as if it were
the problem. Now you might say, well, that's an illegal drug. But so is
alcohol, if you're underage.
And yet getting alcohol on the national drug policy agenda has been fervently
resisted by -- You guessed it! -- the alcohol industry. I was told the reason
the drug czar's charter didn't include alcohol was that the New York State
delegation, pressed by the New York State wine industry, insisted that it be
taken out.
INTERVIEWER
Returning to the 'gateway drug' issue. Is there any evidence on one side or
the other with that debate?
KLEIMAN
It's clear that kids who use marijuana are more likely to use other drugs,
than kids who don't use marijuana. There's no doubt about that. The question
is, why? Is the relationship causal? In particular, if we could reduce
marijuana use, would that reduce, the use of other drugs? About that we simply
don't know.
There any many different ways in which you could imagine marijuana being a
gateway to the use of other drugs. It might be a step toward illegal behavior,
and therefore other illegal behavior tends to follow. Well, that's one of the
arguments of people who want to legalize marijuana is that you could break that
link.
Problem: nobody wants to, or at least nobody says they want to, legalize
marijuana for kids. People talk about age restrictions, leaving it illegal for
kids. Well, wait a minute. You can't have it both ways. I actually think the
age restriction for alcohol is now a major problem. I used to be a fan of age
restrictions, I've now completely switched, views on that. And, I was, struck
by a bolt of insight on the road, not to Damascus, but the Worcester,
Massachusetts. There was a huge billboard -- black billboard, plain white
letters, that "If you're not 21, it's not Miller Time --yet."
And I said to myself, "Right! If you're an adolescent, the thing you most
desperately want in the world is to be grown up," and that's why Miller
Brewing wants kids to see this billboard. The age restriction for alcohol
makes alcohol use a badge of adulthood. What could be more attractive to kids
than a badge of adulthood? So the "Let's make it legal for adults but keep it
illegal for kids" line now strikes me as just completely implausible.
Marijuana use could get people into illicit drugs simply cause it gets them to
cross the line between legal and illegal behavior. It can get them into illicit
drugs because it gets them, to know people who sell illicit drugs, who might be
prepared to sell them things other than cannabis.
It could get them into other illicit drugs because kids who smoke a lot of
marijuana wind up dealing to support their habits. And once you're dealing then
you really know people who are involved in illicit drug activities and have
both money and access.
For all of those reasons, it's not clear whether tightening marijuana policy
would actually reduce, or increase, the use of other drugs. The strong gateway
model, which is that somehow marijuana causes fundamental changes in the brain
and therefore people inevitably go on from marijuana to cocaine or heroin, is
false, as shown by the fact that most people who smoke marijuana don't. That's
easy. But of course nobody really believes the strong version.
The version that people believe, and it's not unreasonable is the tantalizer
theory. Somebody has a marijuana experience, has several marijuana experiences,
enjoyed them, is looking for something new. And somebody comes along and says,
"Well, this other drug is similar to that experience in some ways, but better
in other ways."
That seems to me a more plausible story as applied to the psychedelics than it
is about either heroin or cocaine. I can really imagining somebody saying to a
college student, "Okay, you've had marijuana, that's all right for kids. But,
you should really try mushrooms. Now that's for grown-ups. It's a comparable
experience, but it's stronger, better, nicer, higher, whatever."
That version of the gateway story seems to be quite likely to be true for some
kids. How important it is, I don't know.
On the other hand, maybe if kids learn by experience that changing their
consciousness chemically is a fun thing to do, they'll want to do it in new and
different ways. Of course, they've already learned that from caffeine and
alcohol. It's not clear how important it is to have marijuana in the mix.
The right thought-experiment to do is, imagine we could influence marijuana
consumption. Would that drive down consumption of, cocaine, heroin, inhalants,
psychedelics, whatever, target drug you have? I think we simply don't know.
And it's not that the appropriate experiment couldn't be done, but the
appropriate experiment has not been done. You'd have to do it on a regional
basis. You'd have to pick a state. Pick the state of Washington, say, and just
do a lot of stuff; enforcement, prevention, treatment, whatever, to press
marijuana use down in Washington and not do all of those things in Oregon.
Look up ten years later and see what's happened to cocaine consumption, among
kids who grew up in Washington compared to kids who grew up in Oregon. Maybe
we could do that experiment. But nobody's done it, perhaps because it might get
the "wrong" answer. In the meantime, we just don't know.
INTERVIEWER
And that's basically what you're saying, in all these points. Do the
research.
KLEIMAN
For many of these things what I say is do the research, because if we did the
research, we'd know whether cannabis was useful medically, and what it was
useful for, and to whom it was useful to.
I'm much less confident that we could do the gateway research in a way that
would yield a convincing answer. And even if we concluded at the end of the
day, that yes, if we could press marijuana use down, that really will have a
beneficial impact on cocaine use, it's not clear we know how to do that. It's
not that we've been reluctant to press down on marijuana use because people
really weren't sure it was a bad thing. We've been working hard at getting
marijuana use down. And I'm not sure we're seeing the impacts we'd like to see
either on cannabis use or on everything else.
One counter example, not of marijuana as a gateway, but of a possible gateway
to marijuana, shows how these gateways statistics can be treacherous. If you
look at kids who smoke cigarettes they're about three times as likely to use
marijuana as kids who don't smoke cigarettes. Three quarters of the cigarette
smokers, also smoke some marijuana. Only about one-quarter of the non-cigarette
smokers among kids use marijuana. And that's a pretty strong relative risk.
That would lead you to predict, if you didn't know anything else that a
collapse in cigarette smoking would lead to a collapse in marijuana use.
Yet the collapse in cigarette use among African-American teenagers during the
early 1990s - which, alas, is now being reversed - was not accompanied by any
comparable drop in the use of marijuana.
The relationships among drugs are much more complicated than a simple gateway
idea would allow for. I certainly agree that one of things we should be
worried about, in terms of marijuana use by kids or anybody else, is its effect
on use of other drugs. Note -- that can be positive or negative. Maybe
marijuana is a substitute for alcohol. There's a little bit of evidence that it
is, and some evidence the other way.
INTERVIEWER
What about DARE?
KLEIMAN
Dare is a wonderful tool for police-community relations, especially in poor
neighborhoods. Getting poor kids to meet a police officer, and getting a police
officer to meet poor kids, on a civil, friendly basis, is a wonderful thing to
do. Police officers love it, and police departments love it, and neighborhoods
love it, and kids love it, and parents love it, and everybody loves it.
What DARE is not is a complete drug prevention program. And, in fact, the
evaluations have been pretty uniformly discouraging. It' s very hard to see any
evidence that kids who go through DARE are better off in terms of their
marijuana use, alcohol use, nicotine use, in middle school, than the non-DARE
kids. One study just came out suggesting there may be some delayed sleeper
effect of DARE in reducing the use of harder drugs, of cocaine, heroin,
inhalants in high school. Everyone is waiting to see if that can be
replicated.
So I think DARE is a fine thing to do. I don't think DARE's an adequate thing
to do in place of doing real drug education. There's a good argument for
focusing less on drugs and doing more education, at younger ages. You don't
want to talk to second graders about drugs. But you can talk to second graders
about the problem of impulsiveness. You can talk to second graders about their
health as something that they want to maintain, and about a class of
health-risk behaviors that threaten it.
So if you can get them in the mind-set of being good stewards of their own
bodies, then, later, you can start talking about the details, about illicit
drugs, about alcohol, about nicotine, about sex, about inadequate exercise,
about bad eating habits, about all of the other things that are bad for you .
But I think, given the lack of evidence that we really know how to deliver
effective drug education, I think we need to start delivering a broader
health-promotion message, younger, and see if that works.
There are good pilot-program data that suggest that there are training programs
you could do for grade-school teachers: intervening, not around drug use, but
around problem behavior, on kids who act out in class. Kids whose teachers have
had that training, are much less likely to start smoking when they hit the
sixth grade than kids whose teacher's haven't had that training.
Now if that's true, if you can replicate that experimentally, and, what's
always the harder problem, if you can replicate it at scale, getting it done by
ordinary by first-grade teachers around the country, then you can maybe have a
big impact.
We need to make drug education less an ideological effort and more a practical
effort. Right now, any drug education program that delivers strong anti-drug
messages is perfectly satisfactory to people who insist on anti-drug education,
whether or not it changes the actual behavior of the kids.
And in fact, what you find about the mass-media anti-drug ads is that they
have very little impact on the behavior of drug users. They strengthen the
anti-drug attitudes of non-users. Well, if you think about it, who designs
them? Who gets them on TV? Who pays for them? Who evaluates them? People who
have strong anti-drug attitudes. And so you can have a phenomenon of
preaching very successfully to the choir, and missing the sinners entirely.
INTERVIEWER
So, in short, we don't really know the effect of driving the price up of
marijuana?
KLEIMAN
In short we don't know much about the effect of driving up the price. We also
don't know very much about how much additional enforcement we require to drive
up the price even more, or how much the price would fall if we did a little
less enforcement. I have to admit, I was wrong. I very much underestimated the
impact of the big marijuana enforcement increase of the '8Os on marijuana
prices. We were very successful in pushing price up.
But even at its peak price, marijuana remained a very cheap intoxicant compared
to beer. It's not clear that you can price kids out of this market, even at
current prices, which tend to be about 10 dollars a gram, an enormous sum
historical standards. Part of what's happened is that as cannabis has gotten
somewhat more potent the size of a marijuana cigarette has fallen to about a
quarter of a gram.. That means that a joint is about two and a half dollars'
worth of marijuana. And with the more potent stuff, two or even three people
can share that joint, and get as high as they want to be. That means that the
price of getting stoned is about a dollar. You can't do nearly that well on
beer.
The limit on the effectiveness on marijuana enforcement is that it's so easy to
produce. That makes it hard to make it very expensive.
INTERVIEWER
So where do you see us going? I mean in terms of national policy on marijuana?
You really think there's hope of staking out a middle ground here?
KLEIMAN
The best hope is to focus the attention of the country on the drugs that are
doing most of the damage. Cocaine, heroin, methamphetamine, alcohol,
nicotine.
I think marijuana deserves a relatively low priority on the list of drug policy
targets. And I think if it weren't so tied up with other, symbolic issues, it
might get the obscurity it deserves.
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