Presented at the Illinois State Medical Society National Symposium on Psychedelic Drugs and Marihuana, Chicago, Illinois, April 11, 1968. Printed with permission of the author and Illinois State Medical Society.

 

Marihuana abuse is literally and foremost a legal problem. However you may choose to describe it—as a sociological, as a psychological or as a human problem—the fact remains that our society has decided to subject marihuana to controls through the use of criminal sanctions.

 

The prevailing philosophy in the United States, and I might add throughout the world, is based on the premise that it is better for persons to function without resorting to the abuse of a drug so dangerous as marihuana. Abuse of the drug has been considered to be a major social threat by our legislators, who have enacted and retained the anti-marihuana laws.

 

My topic today will lead me to consider with you some of the patterns of legal controls, the application of those controls, and the need to retain rather stringent Federal and State regulatory statutes.

 

Prior to the enactment of the Marihuana Tax Act of 1937 (the primary Federal control), Congress was possessed of quite a lot of information concerning the social and physiological effects of marihuana. By today's standards, perhaps the evidence against it was not as strong as it might have been. Mr. Joseph Oteri has made a special point of this in his discussion, "A Look at the Passage of the Marihuana Tax Act." 1 But, in developing programs, our lawmakers are not required to rely on only uncontroverted factual propositions. Nevertheless, the hearings, including the secondary reference material, provided ample support for the proposition that marihuana had harmful effects and that it contributed to anti-social problems.

 

Interestingly enough, medical science all over the world has long recognized the damages of marihuana. There is not a single modern, responsible medical body (to my knowledge) that supports the legalization of marihuana. The American Medical Association opposes it—and the World Health Organization opposes it. Additionally, the nations of the world have long opposed the abuse of marihuana. In fact, the Single Convention on Narcotic Drugs (1961) obligates the 65 parties to maintain special measures of control on marihuana, and to prohibit the use of marihuana for other than medical and scientific purposes within 25 years.

 

It is ridiculous to conclude that the public health officials who helped formulate the health policies all over the world did so without adequate knowledge of marihuana's dangers. To conclude, as Mr. Oteri seems ready to do, that former Commissioner Harry J. Anslinger duped all the world's scientists, legislators, and public officials and that he alone "turned off the world," is equally contrary to common sense.

 

The impression is being created that virtually nothing is known about marihuana. This is false. Also, the impression is being created that there is nothing harmful about marihuana. This is equally false. Too many people seem to think that we should not pay any attention to the old studies. Too many permissivists argue that the studies of Benabud,2 Bouquet,3 Chopra,4 Gardikas,5 Joachimoglu,6 and Wolff 7 are not valid because they were not done in America, under American standards, using American subjects, and using "American-type" marihuana. I cannot dismiss those studies so lightly, and neither should you.

 

The real damage being done in this crisis of confidence is that some scholarly men are more willing to attack the marihuana controls than to justify them; that these persons are more concerned with deriding the public officials who are charged with enforcing the laws than in helping them prevent drug abuse; and that they are more interested in rationalizing the use of marihuana than in presenting reasons for controlling it.

 

It is true that we do not possess absolute knowledge of the effects of marihuana. However, let us remember that marihuana contains a very powerful ingredient, tetrahydrocannabinol, which is capable of producing many ill effects. Various studies from the Middle East, the Near East and in the United States indicate that the mental effects are very significant. Emotional balance is disturbed—waves of euphoria are often interspersed with phases of anxiety; paranoid episodes are frequent—giving rise to disturbances of conducts; volition and initiative are impaired; sensation is changed and distorted; and even the so-called "American-type" marihuana can produce full-fledged hallucinations and delusions.

 

The formal list of reported physiological and psychological effects of the intake of marihuana is quite varied and lengthy. The 1965 report on Drug Dependence of the World Health Organization lists the following:

 

"Among the more prominent subjective effects of cannabis ... are: hilarity . . . carelessness; loquacious euphoria . . . distortion of sensation and perception .. . impairment of judgment and memory; distortion of emotional responsiveness; irritability, and confusion. Other effects, which appear after repeated administration . . . include: lowering of the sensory threshold, especially for optical and accoustical stimuli ... illusions, and delusions that predispose to antisocial behavior; anxiety and aggressiveness as a possible result of the various intellectual and sensory derangements; and sleep disturbances."

 

A problem in the United States in the field of research is the lack of a potent standard product. Significantly, about 50% of novices report that they obtained no effects whatever the first time they used marihuana.

 

They have not been the victims of a drug, but merely have been deceived with a hoax. There is so much gyping going on that it helps support the notion that marihuana is innocuous. Chemically speaking, many persons who confess on questionnaires to have been "triers" of marihuana really have done nothing more than to become partially asphyxiated from polluted air.

 

There is a wide variance in the potency of black market marihuana. Although hashish is readily available in many parts of the United States, the majority of the marihuana is of the less potent variety. Also, we know that marihuana varies according to where it is grown, when and how it is harvested, and its age. Nevertheless, there is little doubt that marihuana contains a very powerful hallucinogen, and when potent substances are consumed, or the dosage of a weaker substance is increased, mental and physical reactions are intensified. The results of using the natural occurring tetrahydrocannabinol of marihuana seem to be conclusive. Dr. Harris Isbell concludes that in sufficient dosage, the properties of marihuana "can cause psychotic reaction in almost any individual." 8

 

The isolation of the tetrahydrocannabinols and the promise of increasing availability of synthetic substances makes it possible for us finally to perform the vitally needed pharmacologic, biochemical, genetic and behavioral research necessary to answer the questions about the long-range effects of marihuana. More likely than not, the earlier failures in finding such effects in this country resulted from the unavailability of chronic users of high quality marihuana. Even the clinical studies in the highly regarded "LaGuardia Report," 9 must be reviewed with the knowledge that marihuana of unknown potency was smoked, and that much of the research involved oral administration of a marihuana concentrate.

 

Hence, we find very adequate reasons for proscriptions against marihuana. Even if we were to accept the snobbish proposition that the children of our colleges today possess a superior sense of moral intelligence and are better able to deal sensibly with drugs, and even if we were to conclude that marihuana affects only the weak and the vulnerable, since when has our society stopped being concerned about a minority? The very purpose of many of our health laws is the protection of minorities. I am not impressed that a law student with a high IQ does not obtain a reaction from taking two or three puffs on a marihuana cigarette. I am concerned over the consequences of making the drug readily available in a society containing millions of persons predisposed to impulsive and aggressive behavior.

 

I believe that most of us here today would oppose complete legalization of marihuana. The real issue seems to be the extent to which we should control it. The Marihuana Tax Act of 1937 1° is a system of registration, occupational tax, transfer tax, and transfer forms. The law is designed to permit marihuana to be produced and used for industrial, scientific and medical purposes only. In determining which persons may become registered, and thereby sell or acquire marihuana, the regulatory scheme requires as a condition precedent that the applicant be qualified to engage in the activity according to the applicable State provisions. A typical "street peddler" could not become registered, because such a person is disqualified by State law. Lawyers will continue to argue that the Federal Government has no right to rely on such controls. Indeed, great stress has been put on certain aspects of such laws in recent Supreme Court decisions.11 However, I take it that the major concern of this symposium is in the area of penalties. So, I will try to ventilate the fog of misunderstanding in that area.

 

It is true that the Federal law does have rather substantial sentencing provisions. The penalties provide not less than 2 years or more than 10 years for a possession offense, and not less than 5 years or more than 20 years for a sale offense. Perhaps, if the law had been designed for and applied against minor traffickers and so-called "users," there might be a need for adjustment of the penalties to fit the gravity of the offense. However, this is not the case. The mandate from Congress and the Executive policy makers is to concentrate our efforts on the larger international and interstate traffickers. Even if we were to obtain evidence against a mere possessor of marihuana for his own use, there are certain latitudes, such as charging the person as a "juvenile delinquent" or handling him under the Federal Youth Corrections Act rather than sentencing him under the regular penalty provisions. I can recall no case where a student was prosecuted in Federal court based on mere evidence of possession of marihuana for his own use. It is interesting to note that Congress has looked at these penalty provisions on several occasions, and has not found a need to reduce them.

 

Why make possession a violation of law? Law professors will claim that in order for a law to be an effective prevention, its operation must be prompt, certain, efficient, and its threats must not be bluff—its club must not be stuffed with highly selective enforcement and frequent evasions. On the surface, this would not be true with the Marihuana Tax Act of 1937 in view of the manner in which the laws are administered. Nevertheless, it is reasonable to assume that the fear of suffering the consequences of the law does deter countless reasonable and responsible persons. Avoidance of punishment and disgrace is a very decisive reaction of normal people. It can be assumed that the vast majority of the people who have lived with the social contrivance of punishment, in the home, in the schools, at play and at work, will avoid certain courses of action which are potentially injurious. The big red apple on the tree in the field where the bull grazes may be enticing, but most of us are afraid to go over the fence after it.

 

This, consequently, sets up a barrier, not only to unauthorized use, but more importantly against proselytizing. We can make one generalization: marihuana abuse spreads from person to person—the users who possess it are the ones who breed new users. To condone possession is to condone a ready source of marihuana for proselytizing. The result of "legalizing" possession can only be a more permissive attitude.

I believe a case has been made against marihuana. It is a harfnful and dangerous substance which must be controlled. Further scientific studies are needed, and the National Institute of Mental Health is presently carrying on a complete plan of research, covering all aspects of marihuana use. The Bureau of Narcotics has been working with N.I.M.H. to develop procedures to facilitate research, and to obtain sufficient quantities of marihuana and tetrahydrocannabinol for the research. We are hoping that continual funds will be available for the next several years in order that we will be able to find the answers to the basic research questions which are being asked.

 

In the meantime, pending the results of the new studies, we should not make any off-the-cuff decisions. We should not take any action which will be seized upon as approval to use a debilitating drug. We now have more than 62,000 reported active addicts, we have untold thousands of amphetamine and barbiturate abusers, and we have millions of persons who drink too much alcohol. That seems to be quite enough.