In 1919 America stood on the threshold of a new era—the national prohibition of alcohol. Led by the forceful Carry Nation and the evangelizing Billy Sunday, Americans had been indoctrinated to believe that if alcohol were banned, "men will walk upright, women will smile, and children will laugh. Hell will be forever rent." In response to such a vocal constituency, Congress, true to its penchant for legislating against the use of drugs, made the consumption of alcoholic beverages illegal. Unfortunately this simplistic approach brought exactly the opposite results. The "speakeasy" was created, as was a billion-dollar criminal syndicate. To counter this, the government had to expand its drug-policing forces, composed of incorruptible federal agents. A new language was created: "bone-dry," "white lightning," "hijacker," "flagger," "racketeer," and "scofflaw"; all these words owed their existence to prohibition. By 1928 an estimated twenty-five million dollars a day was being spent to quench America's thirst for alcohol. In 1933 prohibition was repealed, but during its existence of thirteen years, ten months and thirteen days an established criminal syndicate was born and still exists today, as well as a general disregard for drug laws by middle-class America. Alcohol was legalized not because we found out anything new or magical about the drug, but because prohibition produced a series of social changes that were intolerable.

Unfortunately, America does not learn its drug lessons well and in 1970 we are in the middle of another drug controversy that has many parallels to the alcohol situation. This controversy, of course, is national marijuana prohibition. In the late 1930s the Federal Narcotics Bureau spearheaded an all-out attack on marijuana. It claimed the drug led to insanity, crime, violence, and moral degeneration. This position was liberally supported by the alcohol lobby, primarily for economic reasons, since users of marijuana tend to reduce their alcohol consumption. As a result marijuana was mislabeled a narcotic and very strict legal penalties were imposed on those who used or sold the drug. When the La Guardia Report, published in 1944, disproved these allegations, the battle cry became "marijuana leads to heroin." This prohibition remained in force as government agencies effectively banned almost all marijuana research so that no new information could be developed to counter previous misconceptions.

In the last five years, however, resentment against the official practice of incarceration and "think stop" has manifested itself in increasing overt rebellion even by individuals with respected positions in our society. Health, Education and Welfare Undersecretary Roger 0. Egeberg stated that penalties for marijuana possession are too strict and the drug should not be classified with "hard" substances such as heroin and LSD (Lysergic Acid Diethylamide). Dr. Stanley Yolles, Director of HEW's National Institute of Mental Health (NIMH), indicated that marijuana is the mildest of the hallucinogens and not a very dangerous drug. "Kids using the stuff" may have their sensitivity and emotional development impaired, but as far as dire catastrophe is concerned, it does not lead to addiction, it does not lead to a life of crime, and your first cigarette does not mean you are on the road to heroin.

The rebellion among the youth of our country, however, is much more direct; NIMH statistics indicate that between eight to twelve million Americans have had experience with marijuana; the major increase was among middle-class adolescents and young adults. All of these people, of course, are subject to felony convictions and incarceration of from two to ten years; the latter term has been actively supported by many conservatives in our society, including President Nixon, with his "omnibus bill" drug control legislation—although subsequently public pressure seems to have softened the administration's hard line position.

As pointed out by Erich Goode in "Marijuana and the Politics of Reality" 1 the polarization over the marijuana issue is at present primarily political rather than scientific. "Marijuana has become a symbol for a complex of positions, beliefs, and activities in which those who use the drug must also be politically radical, engage in loose sexual practices, and be unpatriotic." In other words, marijuana is a communist conspiracy; hence destructive legal penalties threatening the futures of millions of Americans are justified because they are participants in this conspiracy.

Without question, then, marijuana has served to reinforce our generation gap, for the cry among large segments of our population is "pot and peace. The hypocrisy that has gotten us involved in the war in Vietnam is the same that produced a situation in which our drug (marijuana) is illegal and your drug ( alcohol) legal."

Representative Claude Pepper (Dem.-Fla.), as Chairman of the House Select Committee on Crime, has emphasized that "the marijuana controversy has become a political rather than a scientific debate in which many contend that government is attempting to legislate morality."

To make rational decisions, however, toward resolving the political conflict and eliminating marijuana prohibition, one must be informed of the latest information on this most complex social issue. This book analyzes the most important current issues to provide the reader with the necessary information to make an informed and rational response to questions about marijuana.

To begin such a discussion we must understand the nature of the drug we are talking about. Is it a narcotic, a hallucinogen, or a sedative? All of these classifications have been advanced and vigorously defended in modern times, and yet the drug marijuana ( derived from the flowering tops of the female Cannabis sativa plant) has been associated with civilized man for more than 4,000 years; the first written account occurred in Chinese literature around 2700 B.C.

Part One of The New Social Drug deals with the issue of marijuana pharmacology and classification. Although at present no sound medical opinion would classify marijuana as a narcotic similar to the opiates, experts are divided as to its correct classification. Dr. William McGlothlin, among others, has described marijuana as a mild psychedelic and pointed out its close similarity to drugs such as LSD, with the primary difference being only in intensity of effect? Dr. Frederick Meyers, however, feels that marijuana should be classified as a sedative-hypnotic-anesthetic and that its high dose perceptual effects are consistent with such anesthetics as laughing gas or nitrous oxide.3 Dr. Leo Hollister feels that marijuana lies halfway between alcohol ( a sedative-hypnotic) and LSD ( a psychedelic ), "combining the best of both worlds." 4 Goodman and Gilman, the prime pharmacological reference, hedges the issue by listing Cannabis in a "miscellaneous" drug classification!'

Certainly a great deal of the controversy in properly classifying marijuana arises from the difficulty in isolating and studying its active ingredients. Currently it is felt that tetrahydrocannabinal ( THC) is the primary psychoactive agent in Cannabis. Isolation and synthesis of THC is a relatively recent phenomenon; it permits investigators to standardize dosage and administer THC under controlled circumstances to produce valuable information as to the pharmacological nature of marijuana.

THC has taken on greater social significance since large quantities of various drugs labeled "THC" have been sold on the black market. Some newspapers have even described THC as "synthetic pot"; this has increased the extreme anxiety of parents and legislators alike. Although dozens of supposed THC samples have been analyzed, to date none has contained the chemical. Because of cost and difficulty in synthesis it is unlikely that THC will become a psychochemical of major social use. What we will see instead is black market advertising of drugs such as Benactazine ("Hog") and P.C.P. ("peace pill") sold as synthetic pot. At present the editor would agree with Dr. Meyers that marijuana should be considered primarily a sedative-hypnotic anesthetic, and that its desired effects ( anxiety relief and euphoric intoxication) and adverse effects (nausea and high dose perceptual alteration) are closely related.

Part Two deals with marijuana abuse. Any acute or chronic drug response is dependent not only on the properties of the drug itself but also on the personality of the drug user and the social and cultural factors surrounding and influencing his drug use. Marijuana, like all drugs, has a certain abuse potential. Uncritical liberals, nevertheless, have stated publicly that marijuana as used in America is harmless in all cases. Inexperienced biased conservatives, on the other hand, have been quite vocal in proclaiming frequent acute'psychotic episodes or "instant heroin addiction" as a consequence of smoking marijuana. Both positions are invalid.

San Francisco and the surrounding bay area has a very high incidence of occasional or regular marijuana use. This ranges from virtually 100 percent use in the Haight-Ashbury district of San Francisco to 30 percent use in many bay area high schools. As a result of this high density use, the editor, as consultant on drug abuse at the San Francisco General Hospital and as medical director of the HaightAshbury Medical Clinic, has had the opportunity to observe many nonabusing marijuana users and to treat in certain patients the problems resulting from acute and chronic marijuana toxicity. Case examples of acute and chronic toxicity will be presented in an attempt to define properly the abuse potential of marijuana; the examples will be followed by a detailed analysis of the use and abuse of marijuana in Haight-Ashbury. It is apparent from this work that a higher incidence of acute toxic reactions occurs with inexperienced users or individuals with rigid or disturbed personalities. It is also apparent that an individual who abuses one drug tends to abuse another (the multiple drug abuse theory), and that any association between marijuana and other drugs is due to the influence of personality and group factors. There is nothing in marijuana that leads one to heroin—current mythology to the contrary.

Part Three attempts to place use of the drug in proper perspective by discussing marijuana as a social issue. During the 1960's we have seen major segments of America's younger generation turn from enthusiasm for to alienated rejection of our country's dominant value system. This alienation has reached its peak in such areas as HaightAshbury, where thousands of young people have massed to form an environment based on the philosophy "drop out, turn on, tune in."

However, in analyzing the various youth protest movements—whether political activists and the Peace and Freedom Party, centered in Berkeley, or the Bohemians in Haight-Ashbury—one finds a number of common slogans: "end the war in Vietnam, eliminate racism, and legalize marijuana." A very definite drug culture involving young people in various states of rebellion has developed in the United States. One group of young marijuana smokers told me, "We smoke pot as a bond of trust in our battle against the establishment. Oppression by the straights solidifies our group."

This cultural conflict is going to intensify and very soon. Large numbers of American soldiers have been "turned on" to "grass" for the first time while in Vietnam. Reliable estimates have confirmed that more than half the U.S. soldiers in Vietnam have smoked marijuana; many antiwar protestors have stated that the only good result of this tragic war will be that a whole new segment of American society will henceforth prefer "grass" to alcohol. It is interesting that the politicians who are most vigorously supporting the war effort are also the most vocal in their attacks on marijuana and "its associated evils such as the hippies." It is ironic that the war of these politicians is serving as one of the major forces in strengthening marijuana's acceptance by American society.

In Part Three Dr. Gilbert Geis reviews the social and epidemiological aspects of marijuana use;6 Dr. James Carey completes this part with a description of marijuana use among the new bohemians.7
Marijuana, then, has contributed to widening the generation gap in America. Alcohol is the social drug of this generation and pot is the social drug of the next generation. Many youthful protestors cannot vote. The youth say, "You start immoral wars and then draft us to fight your wars before we can even vote on the issue. You outlaw our drug, but keep your own personal vices, and all of it's part of the hypocrisy of the dominant culture . . . but all that's going to change!" It is apparent that drug laws will change, but in what direction is still not clear.

President Nixon's "omnibus bill" legislative attack on drug abuse lumped marijuana together with all other agents of abuse (including heroin and LSD) and called for increased possession penalties and reduction of illegal supply to push the price of the drug so high that students will not be able to afford it. He placed little emphasis on the education and treatment approach. Of even greater significance is the fact that the Nixon proposal could serve as a prelude to organized crime's assuming control of the marijuana market in a manner similar to the way it now controls the sale of heroin. A defense of this conservative and punitive approach to marijuana was well presented by Judge G. Joseph Tauro, chief justice of the Massachusetts Superior Court, who presided over the famous 1967 Commonwealth vs. Leis case (the most exhaustive court presentation on the validity of current marijuana legislation) in his presentation on "marijuana and relevant problems." 8

Judge Tauro listed the following nine "areas of agreement," although he was vague about who agreed to these points:

There are certain important areas on which there is no substantial controversy among reputable and informed authorities.

First, marijuana is universally recognized as a mind-altering drug which in varying degrees and with unpredictable effect produces a state of intoxication sometimes referred to as "euphoric."

Second, in the United States marijuana is customarily used for the explicit purpose of inducing this state of intoxication.

Third, in varying degrees this state of intoxication can cause a lessening of psychomotor coordination and a distortion of the ability to perceive time, distance, and space. However, there is usually no interrelated diminution of muscular strength.

Fourth, the habitual use of marijuana is particularly prevalent among individuals with marginal personalities exhibiting feelings of inadequacy, anxiety, disaffiliation, alienation, and frustration or suffering from neuroses, psychoses, or other mental disorders. Such persons constitute a significant percent of our population, and it is precisely among this type of individual that marijuana may cause psychological dependence.

Fifth, marijuana may have a disinhibiting effect upon the user which tends to aggravate or exaggerate his pre-existing mental state or disposition. Thus its effects can vary with individuals and can vary during different occasions of use by the same individual.

Sixth, marijuana has no accepted medical use in modern medicine and serves no useful purpose in any other way.

Seventh, the use of marijuana is not part of the dogma of any recognized Western religion.

Eighth, marijuana has had a growing attraction for the young and the adolescent.

Last, but probably most significant, no one can guarantee with any degree of certainty that continued use of marijuana will not eventually cause permanent physical injury.

Tauro concluded that on the basis of these points marijuana "is a dangerous drug possessing a potential of harm both to the user and to society." He further indicated that because marijuana is harmful, the current system of punitive drug regulation is valid, and that anyone criticizing this system is both unscientific and irresponsible. He further concluded that "no foreign enemy poses a greater danger to our nation than a self-imposed danger of permitting drug use to become part of our culture, and no outside force would be more destructive."

The major errors in Judge Tauro's "areas of agreement" and conclusions reflect the confusion in the defense of current marijuana regulation. An excellent study by D. I. Manheimer, et al.9 indicated that psychoactive drugs are already a major part of our culture and that millions of Americans regularly ingest a variety of stimulants, sedatives, and tranquilizers. In fact Americans are the greatest drug takers in the history of mankind and must look to doctors, drug advertising, and affluency to discover the real cause of their orientation to drug use. The desire to blame a foreign conspiracy is actually an attempt to shift the blame from the real culprit—ourselves.

The judge's nine points could also be applied in many cases to a widely accepted legal intoxicant, alcohol. Basically the question revolves around not whether we use drugs, but what drugs we do use. It is now impossible in an age of mass communications for a father to come home "roaring drunk" on Friday night and preach the dangers of marijuana on Saturday morning to his credulous son. All drugs have an abuse potential, and they should be regulated in proportion to it. Whether an individual uses a drug destructively depends more on his personality than on the agent itself. For example, individuals that have a history of alcohol abuse may, when they start using marijuana, decrease their alcohol consumption but then smoke marijuana to excess. Conversely, if we were to legalize marijuana, we would not increase the net amount of drug abuse, but rather just produce a shift in the agent of abuse. Without question current marijuana legislation is designed to punish the users of one particular intoxicant and to imprison rather than rehabilitate the abusers of that agent; the latter position is particularly repugnant to a physician.

Many people advocate making regulations on the use of marijuana exactly like those regulating alcohol consumption. Certain influential groups—some motivated by profit, such as the liquor lobby, and others by power, such as the Federal Bureau of Narcotics—would fight such a proposal. Beyond these questionable considerations of profit and preservation of bureaucratic prerogatives, however, making marijuana laws like alcohol laws seems a dubious objective to the editor.

Alcohol abuse is the major drug problem in the United States; 80 percent of the adult population uses alcohol ( alcohol is highly caloric and is used as a food substituent as well as an intoxicant) and one in twenty abuse it. In addition, alcohol is a factor in close to 50 percent of the nation's major auto accidents. How can we regulate marijuana so that the statutes are consistent with the abuse potential of the drug, so that the constitutional rights of the individual are not violated ( as is the present case), yet not reproduce the errors made with current alcohol regulation? This is the concern of Part Four.

In Part Four, Roger C. Smith, criminologist, reviews the history of marijuana regulation in the United States."' Michael A. Town, a member of the California Bar, discusses privacy and the marijuana laws." Dr. William McGlothlin proposes a rational view of marijuana regulation." Dr. McGlothlin feels we must consider protection of the young, who are often too immature to properly handle psychoactive drugs, and the compulsive drug abuser, who seems unable to handle any drug no matter what his age. This must be done without compromising the rights of those who do not fall into either of these categories.

The book closes with Part Five, which discusses marijuana as a political issue, with articles by Dr. Mark Messer on the psychedelic revolution" and Dr. Erich Goode on marijuana and the politics of reality." The articles defend the thesis that opposition to a rational approach to the marijuana question—an approach that includes such proposals, as the removal of Cannabis from the narcotic classification and the elimination of marijuana from the felony category ( a provision that threatens the futures of millions of American youth)—is primarily political in nature. Unfortunately, it does not appear that this political irrationality will be modified in this generation; but if the editor may venture a prediction, when the old generation passes on, marijuana will be placed in proper perspective, for as Victor Hugo said, "Stronger than all the armies is an idea whose time has come."

1 See below, pp. 168-86.

2 See below, pp. 147-58.

3 See below, pp. 35-39.

4 L. E. Hollister; R. K. Richards; and H. K. Gillespie, "Comparison of Tetrahydrocannabinol and Synhexyl in Man," Clinical Pharmacology and Therapeutics 9 (1969 ): 783-91.

5 Goodman and Gilman, The Pharmacological Basis of Therapeutics (New York: Macmillan, 1960) : 170-75.

6 See below, pp. 78-90.

7 See below, pp. 91-104.

8 Judge G. Joseph Tauro, "Marijuana and Relevant Problems," remarks before the Commonwealth of Massachusetts Drug Dependency Conference, March 12, 1969.

9 D. I. Manheimer; G. D. Mellinger; and M. B. Malter, "The Use of Psychotherapeutic Drugs among Normal Adults," Family Research Center, Langley Porter Neuropsychiatric Unit, San Francisco Medical Center, 1969.

10 See below, pp. 105-17. 

11 See below, pp. 118-46. 

12 See below, pp. 147-56. 

13 See below, pp. 157-67.

14 See below, pp. 168-86.