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October 25, 2013 11:30 PM
By Lynn Arditi , Journal Staff Writer , This email address is being protected from spambots. You need JavaScript enabled to view it.
WARWICK — At a time when more states are legalizing marijuana for medical or recreational purposes, marijuana use among the nation’s youth is rising, a psychiatrist who specializes in addiction said at a conference Friday.
In a presentation entitled, “Not a Harmless Drug: Prevention and Treatment of Marijuana Addiction,” Kevin P. Hill, an addiction psychiatrist at McLeanHospital in Belmont, Mass., and an assistant professor of psychiatry at Harvard Medical School, described what he says is a clear correlation between marijuana legalization and its use among teenagers.
Unlike alcohol use, which society generally recognizes can be dangerous, Hill said, “Many [people] feel that marijuana is harmless, despite science that shows otherwise.”
About 16 percent of youths and 9 percent of adults who use marijuana become addicted, Hill said, “but for those people it becomes very addictive.”
The presentation was part of a conference on teens, marijuana and prescription drugs that drew about 200 people — including state health officials, mental health workers and others — to the Crowne Plaza hotel in Warwick.
The event was sponsored by the Rhode Island Student Assistance Services, a nonprofit that provides school and community-based substance abuse and intervention services.
In a brief phone interview after the presentation, Hill said his findings are supported by a 2012 national survey funded by the National Institute on Drug Abuse, a division of the National Institutes of Health, that showed “continued high use of marijuana” among 8th-, 10th- and 12th-graders, combined with a drop in perceptions about its potential harms. Marijuana use among teens has been rising since 2008, the study reported.
Hill pointed to a chart with data from the federal government’s 2009-2010 National Survey of Drug Use and Health that showed states with medical marijuana laws tended to have higher-than-average rates of marijuana use among people ages 12 to 17 and 18 to 25.
The chart was prepared by Educating Voices Inc., a nonprofit “founded to proactively support education and communication of the dangers of marijuana and other drugs,” according to its website.
But it’s unclear how the survey’s findings could be related to any changes in Rhode Island’s marijuana laws. Rhode Island has had a medical marijuana law since 2006, but the first dispensaries did not open until this year. And it wasn’t until last April that Rhode Island became the 15th state to decriminalize possession of small amounts of marijuana.
Sen. Joshua Miller, D-Cranston, who sponsored the legislation to decriminalize possession of an ounce or less of marijuana and who attended the conference, said that making marijuana illegal “has had no impact on its access.”
By making marijuana illegal, Miller told Hill after his presentation, it increases the risk that people in inner cities trying to buy marijuana are going to “get shot and put in jail.”
Craig Stenning, director of the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, said during the conference’s opening remarks that a survey of first-time marijuana use among Rhode Islanders before age 16 showed a decline to 6 percent in 2011, compared with 13 percent in 2001.
The conference also included a presentation about the rise in prescription drug abuse, particularly among painkillers or opioids. Dr. Michael A. Fiori, an adult psychiatrist at Butler Hospital, said that the common misconception about prescription drugs is that they’re “safer than illegal drugs.”
“Anyone who takes opiates long-term will develop tolerance to the desired effects and a physical dependence,” Fiori said. But their likelihood of becoming addicted, he said, depends on a variety of factors, including age, genetics and exposure to drug abuse. A family history of addiction, psychiatric disorders and sexual abuse during pre-teen years, he said, are all “risk factors” for addiction.
Though more is now known about how addiction hijacks the brain’s frontal lobe, which regulates impulses, Fiori said, long-term effects of drug abuse on adolescents is not as well researched.
Twitter: @LynnArditi
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Canadian Police Association submissions to the Senate Special Committee on Illegal Drugs
May 2001
The full text is available in English and French from HNN or at the CPA web site at http://www.cpa-acp.ca
EXECUTIVE SUMMARY
Drugs Are Illegal Because Drugs Are Dangerous
Drugs are not dangerous because they are illegal; drugs are illegal because drugs are dangerous. There is no such thing as "soft drugs" and "hard drugs", nor bona fide criteria to differentiate between these terms. People who refer to hard or soft drugs generally do not understand the truth about drugs, or are seeking to soften attitudes towards the use of certain illicit drugs. Generally, Marijuana (Cannabis) and its derivative products are described in this context to distance the drug from the recognized harm associated with other illegal drugs. This has been a successful, yet dangerous approach, and contributes to the misinformation, misunderstanding, and increasing tolerance associated with marijuana use.
Marijuana is a powerful drug with a variety of effects. Marijuana users are subject to a variety of adverse health consequences:
· Respiratory Damage
· Physical Coordination
· Pregnancy & Post-Natal development
· Memory & Cognition
· Psychiatric Effects
Marijuana use is associated with poor work and school performance, and learning problems for younger users. Marijuana is internationally recognized as the gateway drug for other drug use. Risk factors for marijuana dependence are similar to those for other forms of drug abuse, and much higher than those of alcohol.
Driving while intoxicated by drugs impairs judgment and motor coordination. In one study involving aircraft, ten licensed pilots were given one marijuana joint containing 19 mg of THC, a relatively small amount. Twenty-four hours after smoking the joint, they were tested in a flight simulator. All ten of the pilots made errors in landing, and one missed the runway completely.
It was the consensus of the international community to put marijuana, as well as other substances, under international control. That decision was based on evidence of its harmfulness to human health and its dependence potential.
Trends in Drug Use Among Canadians
Weakening perceptions of risk of harm in drug use, weakening moral disapproval of drug use, and increasing perceived availability of drugs have resulted in increasing rates of use among secondary students. Increased drug dependency and substance abuse problems are also being reported among young people.
Marijuana remains the most widely used illicit drug in Canada. Even though alcohol use is more common, problem use and frequent use are much less common with alcohol than with illicit drugs. Students who use drugs are more likely to use drugs repeatedly, more frequently, and rapidly make drugs a significant part of their lives. Students using drugs are far more likely to go to school intoxicated, play sports while intoxicated, or use drugs in the morning.
Drugs & Organized Crime
There is an undisputable relationship between organized crime and the illicit drug trade in Canada and abroad. Canada has earned a reputation internationally as both a consumer and leading supplier of marijuana and methamphetamine products to the United States. Increasingly potent cannabis, having a high THC content, is appearing on the illicit market.
Drug trafficking continues to increase in Canada. Besides the cannabis and cocaine smuggled into Canada out of countries such as Mexico, there was also an increase in the amount of heroin smuggled into Canada.
As Organized crime flourishes with little deterrence, members of crime gangs become more brazen and confrontational. In the province of Quebec, 150 people including an innocent child and two prison guards have been murdered by gangsters; reporter Michel Auger was shot six times in an assassination attempt; and farmers who have refused to grow marijuana and politicians who have exposed the activities have been the subject of threats. Violence and intimidation tactics have spread across Canada, including threats and acts of violence against police investigators and other justice officials.
We Are Not Losing "The War on Drugs"
The fact is that Canada is not, nor have we ever been, engaged in a "War on Drugs".
Statistics reveal that less than one drug related charge per Canadian police officer is laid per year in Canada. While enforcement efforts focus on drug production, trafficking, and importation, possession only charges are generally laid as a consequence of investigations into other crimes and complaints. Police officers and justice officials often resort, within our existing legislative framework, to alternative measures in dealing with young offenders, first time offenders and minor possession only type offenses.
The impact of the efforts by the law enforcement agencies of Canada, however, has remained limited by our judicial system. Serious offenders, such as drug traffickers, importers and manufacturers receive little or no punishment, and it has been difficult to deter them from their illicit activity.
Police resources have been subject to fiscal constraints over the past decade, and enforcement efforts have been limited as a consequence. Perceived tolerance of drug consumption by community leaders, including Members of Parliament, Senators, Editorial Writers and even some Chiefs of Police, have all contributed to the elevation of thresholds for drug investigation, arrest, prosecution, conviction and sentencing. Ultimately, the effectiveness of enforcement programs, and drug prevention strategies, will be proportionate to the level of resources and commitment.
Lessons Learned from Other Countries
The facts proving that liberalization experiments in different countries produce negative consequences are overwhelming. In many Western European Countries including Great Britain, decriminalizing possession of small quantities of cannabis for personal use has either occurred, or has been de facto implemented.
In examining these experiences we can quickly learn, however, that permissive drug policies fuel the appetite and consumption of illicit drugs. Not surprisingly, tolerance of drug use has had a proportionate impact in increasing demand and supply. The availability of drugs in Europe has increased. In many countries, the prevalence and rise of amphetamine-type stimulants is second only to that of cannabis abuse. In countries that have adopted permissive policies towards drug use, violent crime and organized criminal activity has increased proportionately to the drug trade.
Countries that have liberalized drugs have highest rate of illicit drug use and death by overdose per capita in Europe. Conversely Sweden, which has adopted a policy of social refusal and interdiction of drugs, has the lowest incidence of drug abuse in the European Union.
Having unsuccessfully experimented with permissive drug policies of varying kinds in the 1960s and 1970s, Sweden subsequently concluded that Drug abuse is dependent on supply and demand. According to Swedish authorities, if drugs are readily available and society takes a permissive attitude, the number of persons trying drugs will increase. If drugs are very difficult to come by and there is a danger of being arrested, the number of people trying drugs will be reduced.
Alaska is also an example of failed drug liberalization. From 1980 to 1990 hashish consumption and possession was not a criminal offence there. During this time hashish abuse, especially among adolescents, increased drastically. In 1988 the proportion of adolescent hashish smokers in Alaska was double that of all other states in the USA. As a consequence, a public vote in 1990 repealed the decriminalization measure.
"Harm Reduction" has become the focus of drug strategies in Western Europe with spill over into other countries. Unbeknown to most Canadians, Canada has also shifted from the goal of a drug free approach towards the "harm reduction" approach. This shift in policy has occurred quietly over time, with little if any input from the majority of Canadians. Of serious concern to the CPA are the confusing and often conflicting messages that are being delivered to young people, who are the primary target of the illicit drug trade.
Prevention - Reducing Demand
Governments fulfill a legitimate and critical role in establishing laws and policies that define behavioural standards and societal values. Legislation and enforcement are required proactive strategies to deter behaviour that places individuals at risk.
The success of seatbelt legislation suggests that legislative strategies are effective in supporting behavioural change. Prior to seatbelt legislation in Canada, only an estimated 15% to 30% of Canadians wore seatbelts. Today it is estimated that more than 90% of drivers wear seatbelts. These results reflect the influence that legislative action outside of the health sector can have on the health of Canadians.
Risk of apprehension and meaningful consequences have also been integral components of successful strategies to reduce impaired driving in Canada. While the fight to eliminate Impaired Driving may never be won, there is no disputing the fact that strategies have been effective in changing behaviour and reducing risk.
Examples of similar initiatives to increase public safety include bicycle and motorcycle helmet laws, school bus stopping laws, and boat safety. Success is determined by level of sustained commitment to programs that combine Public Awareness, Education, Legislation, and Enforcement.
The Costs of Legalization Will Be Astronomical
Canadian statistics clearly demonstrate that the costs of Canada's alcohol and tobacco are more than thirteen times those of illicit drugs. Enforcement for alcohol related crime costs more than three times that of illicit drugs. Direct Health Care Costs for alcohol and cigarettes are nearly 50 times greater than those for illicit drugs. Law enforcement costs for illicit drugs, including courts, corrections and border protection, represent only 2 percent of the total costs to Canadians of alcohol, tobacco and illicit drugs in Canada.
The primary reason costs are lower is simply lower usage. As legalization and permissiveness will increase drug use and abuse substantially, the costs of health care, prevention, productivity loss and enforcement will increase proportionately.
While a balanced drug strategy will not completely eradicate drug use; it is cost-effective and beneficial to society to deter drug use, and focus available resources for prevention, treatment and rehabilitation on the small percentage of the population who have the greatest need.
The Canadian Police Association Opposes Legalization or "Decriminalization"
There is abundant proof that proponents of drug legalization seek to "normalize" illicit drug use, through the promotion of programs such as "Harm Reduction" over strategies to reduce demand and supply. Yet, Canada's balanced approach to drug use continues to have a significant positive effect. We should not lose sight of the fact that the overwhelming majority of Canadians have not used illicit drugs in their lifetime.
Unfortunately, it is our youngest and most vulnerable members of society who are at greatest risk. Organized criminals continue target young Canadians as the primary market for the sale of illegal drugs in Canada.
The United Nations Office for Drug Control and Crime Prevention, in a February 2000 presentation to the International Drug Control Summit concerning Amphetamine Type Stimulants, suggested a five-prong approach to prevent drug use:
· Raise Awareness
· Reduce Demand
· Provide Accurate Information
· Limit Supply
· Strengthen Controls
Prevention is at the core of demand reduction. Sending a message to our young people that cannabis use is not harmful or can be used safely, when there is an abundance of scientific proof to the contrary, is not consistent with any of these approaches. Treatment and rehabilitation should be available to those who have drug dependencies.
The CPA will actively oppose efforts to decriminalize the possession of illegal drugs, except in those approved instances where drugs are legally prescribed for bona fide medical purposes.
The time has arrived for leaders to enter into the debate, persons of stature in the community who will present positive role models for our young people, raise public awareness about the harms associated with illicit drug use, and put an end to the erosion of public opinion through misinformation and self interest. We need to reinforce a balanced approach that instills meaningful and proportionate consequences for serious crime, combined with measures to reinforce desired behaviour with our young people.
