Reprint of undated pamphlet issued by the Federal Bureau of Narcotics

 

Recently, within the United States, we have witnessed an increasing abuse of marihuana as well as other hallucinogenic or "mind-changing" drugs. Regrettably this trend has been encouraged by a small number of misguided but highly articulate spokesmen, who have attempted either to justify or to excuse the use of such drugs. As a consequence of promotional activities by these spokesmen, many impressionable young persons have been led to experiment with marihuana. It is therefore wise for every citizen to acquaint himself with the basic medical and sociological facts concerning marihuana.

 

WHAT IS MARIHUANA?

 

The technical name of the plant from which all marihuana preparations are derived is cannabis sativa (L.), sometimes called cannabis indica, Indian hemp, or simply hemp. The cannabis plant is native to large areas of the world and its fibers have been used for the manufacture of twine, rope, bags, clothing, and paper. The sterilized seeds are occasionally used in various feed mixtures and particularly for bird seed. Marihuana has also been used in the treatment of a variety of clinical disorders as an analgesic, a poultice for corns and in other ways. All of these medical uses were found to be either unsound, inefficient, or without predictable effect. Hence, the drug has been removed from the U.S. Pharmacopeia as well as the official drug lists of nearly all other countries. However, legitimate medical research into marihuana's possible utilization in a range of useful therapeutic functions continues. Such research has never been prohibited by Federal laws.

 

Under the Federal law, "marihuana" is defined to mean all parts of the cannabis plant except for the stalks and sterilized seeds. All other preparations of the plant, whether of leaves, flowers, resins, or chemical extracts, are various forms of marihuana. The best known of these is hashish, a concentrated preparation of marihuana. In this country, the term "marihuana" usually refers to a preparation of pulverized leaves, resins, flowers, or combination of these, also called "pot," or "grass," for smoking in pipes or homemade cigarettes (called "reefers," "sticks," or "joints"). We now know that marihuana contains a number of potent compounds called tetiahydrocannabinols which affect the mind and body in various ways.

 

The'strength of any given preparation of marihuana depends upon the amount of tetrahydrocannabinol which is contained in it. The strongest preparations, such as hashish, are made in certain areas of the world, particularly India and the Near East. A substantial quantity of hashish finds its way into this country's illicit traffic; however, most marihuana users customarily must settle for more adulterated forms. This is primarily due to state and Federal policing activity plus the general air of social condemnation, all of which results in making it difficult, expensive, and dangerous to acquire and possess marihuana. Thus, American users accept whatever grade of marihuana they can get at whatever price it is offered and whenever it is available.

 

EFFECTS ON THE MIND AND BODY

 

The consumption of marihuana produces a variety of immediate mental and physical effects which become more pronounced with chronic use. The 1965 report on Drug Dependence for the World Health Organization describes the nature of the intoxication as follows:

 

"Among the more prominent subjective effects of cannabis . . . are: hilarity ... carelessness; loquacious euphoria ... distortion of sensation and perception ... impairment of judgement 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 acoustical stimuli ... illusions, and delusions that predispose to antisocial behavior; anxiety and aggressiveness as a possible result of various intellectual and sensory derangements; and sleep disturbances."

 

The effects of the drug on the nervous system and brain are undoubtedly the most profound and constitute the greatest problem for the user and the persons around him. These include the precipitation of psychotic episodes during which the user becomes mentally unbalanced for varying periods of time. A recent study which described the effect of the most active of the tetrahydrocannabinols (abbreviated as THC) reports the following:

 

"It has long been known that marihuana and hashish can cause psychotic reactions, but usually such reactions are ascribed to individual idiosyncrasies rather than being usual or common reactions to the drug. The data in these experiments, however, definitely indicate that the psychotomimetic effects of L"—THC are dependent on dosage and -that sufficiently high doses can cause psychotic reactions in almost any individual. Psychotic reactions after smoking marihuana under the usual conditions in the United States appear to be rare but the low incidence of such psychotic breaks may reflect nothing more than the low tetrahydrocannabinol content of most of the marihuana available in the United States." 2

 

Those who have studied users of marihuana have found that:

 

"Excessive indulgence in cannabis is apt to produce in healthy individuals and more so in susceptible individuals, mental confusion which may lead to delusions with restlessness and disordered movements. Intellectual impairment as well as disorientation may show itself in various ways." 3

 

Prior to the studies showing that tetrahydrocannabinols in appropriate concentration cause psychotic reactions, there had been considerable controversy over the connections between marihuana use and criminality.

 

A recent report of the New York County Medical Society noted that habitual use of hashish is definitely associated with criminality, violence, and insanity.'

 

A sufficient dose of marihuana is capable of producing all of the effects of hashish and even of LSD,5 which is conceded to be one of the most powerful drugs known to man. To resolve the dispute, it is enough to say that for certain individuals, a small dose, and for all individuals, a large dose of marihuana's active ingredients causes temporary insanity. What each individual does while in a psychotic state will vary with the individual and his circumstances at the time of the psychosis. The important question for society is no longer in what manner marihuana use causes crime, but rather how many crimes would not be committed but for the addition of this drug to the social environment.

 

MARIHUANA VS. ALCOHOL

 

Some marihuana users have tried to excuse their indulgence by claiming that it is no worse than consuming alcohol. While alcoholism constitutes a major social problem, surely it is not valid to justify the adoption of a new abuse by trying to show that it is no worse than a presently existing one. The result could only be added social damage from a new source. Moreover, marihuana, unlike alcohol, is nearly always consumed by its users for the express purpose of attaining a "high," a disorientating intoxication. Evidence of studies of chronic marihuana users also indicates that a more dangerous psychosis may result.

 

Another significant difference between alcohol and marihuana which has been given considerable attention is that alcohol more rapidly impairs motor coordination, thus disabling the inebriate. Marihuana intoxication, on the other hand, does not result in such rapid motor incoordination. This difference becomes very important when the marihuana user operates a car, for cannabinol distorts time and space concepts very radically.6

 

MARIHUANA AND ADDICTION

 

The question regarding the addiction liability of marihuana has been the subject of considerable debate among scientists, and research in the area still continues. Chopra found that, "Repetition of the dose developed into craving for the drug, and gradually there developed in such individuals habitual use and increasing tolerance which led to increase of dosage." However, he pointed out that this was in no way as significant as in the case of morphine-type drugs. Recent studies in England also uncovered a suggestion of tolerance and progressive dosage. Nevertheless, all agree that marihuana does not produce a dependence of the morphine type, and abstention does not result in the classic withdrawal symptoms which invariably accompany abstention from narcotic drugs. The World Health Organization has recently chosen to discontinue the use of the terms "addiction" and "habituation" and substitute the single term "dependence." Thus, one may speak of "marihuana dependence" or "morphine-type dependence" without confusion.

 

From a medical standpoint, this distinction cannot be overlooked, but it assumes less importance when considering the practical social dangers of the drug. Dr. David P. Ausubel, in his book, Drug Addiction, noted that chronic users of marihuana will go to great lengths to insure that they will not be without the drug. Deprivation, he says, may result in "anxiety, restlessness, irritability, or even a state of depression with suicidal fantasies, sometimes self-mutilating actions, or actual suicidal attempts." Other researchers have also observed that, from a psychiatric point of view, marihuana dependence is but little different from narcotic addiction.?

 

Another dangerous aspect of habitual marihuana use is the pattern of graduation to narcotic addiction. Of course, not all persons who use marihuana go on to use heroin, but actual experience leaves little doubt that a large majority of narcotic addicts began their drug-taking with marihuana. Intensive research conducted at the Public Health Service Hospital in Lexington, reported in 1967 by Dr. John C. Ball, disclosed that of 2,213 addicts examined, 70.4 percent had used marihuana prior to their addiction. This sample included addicts from all classes and professions, representing 46 states. Moreover, in those states classified as areas in which marihuana is often available, it was found that of 1,759 addicts, 80 percent had first used marihuana.

 

As a result of intensive psychiatric evaluation of 80 subjects, Dr. P. A. L. Chapple concluded that the connection between marihuana abuse and heroin addiction could not be accounted for simply on the basis that both drugs are often available from the same illicit source. The evidence is strong that the use of marihuana develops a taste for drug intoxication which, in turn, leads many people to the use of more potent drugs—even heroin.

 

CONTROL AND ABUSE IN THE UNITED STATES TODAY

 

Marihuana is the subject of worldwide prohibition as expressed in the 1961 Single Convention on Narcotic Drugs. On the advice of the Expert Committee on Dependence-Producing Drugs of the World Health Organization, it was placed in a special category with heroin as being a drug "particularly liable to abuse and to produce ill effects." The United States, which acceded to the Single Convention in the spring of 1967, has controlled marihuana since, the passage of the Marihuana Tax Act of 1937. Under this Act, the use of marihuana preparations is confined to bona fide medical research and industrial needs and all other uses are prohibited. A person found guilty of the illegal sale or transfer of marihuana may be sentenced to not less than 5 nor more than 20 years imprisonment for the first offense. A person found guilty of illegal possession of marihuana may be sentenced to a probationary term or not less than 2 nor more than 10 years imprisonment for the first offense.

 

The efficiency of Federal, state and local law enforcement agencies in coping with the illicit marihuana traffic has succeeded in preventing this abuse from becoming the major problem it is in some other countries.

 

This success has also, unfortunately, resulted in concealing from many observers the full dangers involved. The low potency of the marihuana which is available and the arrest of those who traffic in it have resulted in partially disguising its consumption as a causative factor in crime and psychosis; a connection which is more apparent in those countries where use has been widespread and has been effectively deterred.

 

In contrast to the social and scientific realities, the prophets of the drug experience make fantastic claims for the virtues of marihuana. They would have it regarded as a "benevolent herb" which may lead its users to profound philosophic truths, greater social intimacy and keener artistic expression. These claims are often accompanied by otherwise valid criticisms of society's ills and hypocrisies. Such observations are designed to enlist the individual's sympathies and thus to convince him that the claims are as justified as the criticisms. However, it takes little philosophic sophistication to recognize that such virtues do not reside in drugs but in men. They are the products of conscious labor, and cannot be attained on the peddler's prescription. At best, drugs provide only mechanisms to escape from problems and hence to escape from the character development which would ultimately permit their solution.

 

The spread of marihuana abuse can only add to the difficulties which already plague our society, not solve them.

 

The Committee on Alcoholism and Drug Dependence of the Council on Mental Health of the American Medical Association in a recent article on dependence on cannabis stated: "Only an aroused and concerned public can create, mobilize and implement resources to deal adequately with as serious a problem as drug dependence in all its forms. .. . Frank and forceful public discussions, focusing on the futility and inherent dangers in experimentation with drugs such as marihuana and the consequences of any subsequent psychological dependence, can act as deterrents," and finally: "Marihuana is centuries old, but it represents a constant danger. The responsibilities of the citizen, including the physician, are clearly defined. The time to begin is now." 8

 

7 Chapple, P. A. L.: Cannabis, a Toxic and Dangerous Substance—A Study of 80 Takers, Brit. J. of Addiction 61:269, 1966.

8 J.A.M.A. 201: 368, August 7, 1967.