Canada and Marijuana

Eight years ago when I announced to my colleagues in a departmental meeting that I was going to move to British Columbia, one of my colleagues who had taken his residency training there smirkingly responded, "Everybody there is on drugs!" Of course, that is not true, and I did not believe him, but neither have I forgotten his reply. The statement does reflect perhaps a more permissive attitude towards the use of "drugs" in BC then elsewhere in Canada. Some would relate this to its proximity to California, which has often been seen as the beginning of many things culture-cultural, referring to DC as "California North close. Now, of course, states even nearer the sea such as Washington, and Colorado, seem to be moving in an even more liberalizing direction than California when it comes to the use of marijuana.

I have never "used drugs." Some of the background of that would be my religious faith, which would be against it. As a Christian, I regard my body as, as Scripture puts it, "the temple of the Holy Spirit", and as such, do not believe that I need to inhale, ingest or inject anything to alter my experience, my sensory awareness. Some of this would also simply be the fact that I have been blessed with a good life and generally feel that my mental health is good so far, so I am not tempted in this direction either. Now, when I say good life, it does not mean that it has been all ‘smooth sailing.’ I have experienced significant losses and struggles in my life, but again, I believe it is my faith and the support of family, church and friends (probably in that order for me) that has helped me process and overcome these issues without becoming negative or depressed. However, that is another story.

At the same time, I think all of this, for me, let's me be more open to the possibilities of benefit of "drug use" for those who are not as fortunate as myself. Who am I to judge? It is a bit like the ex-smoker being harder on remaining smokers than those of us who have never smoked. The new convert is often more zealous than someone who has grown up in a faith or whatever area we are talking about. Don't get me wrong, I am not pro-drug use of any kind except the medical. I even have my reservations of their, which in some ways have increased the longer I am in the medical profession. For most of my life I have even almost been a teetotaler.  I have never been a smoker (I tried a cigarette once, and did somewhat enjoy a cigar on 3 occasions when friends had a birth in their family). But since when do we foist these views on everybody else in society. Even if I come as a Christian, believe that we can do without these substances and perhaps should do, not everyone in our world is a Christian, so I cannot tell them what to do.

Really too, what is it in our culture or history that has led us to focus on marijuana versus alcohol or tobacco? One thing that the lay public often sees as being wrong with marijuana is that it is believed to cause people to lose initiative and motivation. There is some research that counters this, suggesting that those manifestations are more the sign of the underlying problems, such as depression, that have led to the substance use as a form of self-medication, rather than coming from the substance use itself. The other perception of marijuana users that the non-using public also of course has is that of the "stoners," those who are so "high" or intoxicated that they are somewhat non-functional. Now, is that any worse than individuals who are intoxicated on alcohol? Again, both substances also are known to cause problems with cognitive function, perception and physical attributes of his reaction time when it comes to things such as driving motor vehicles. However, again, this is when one is "intoxicated" or under the influence. Some of these things did lead to movements in the past to prohibit alcohol, but our Western societies long ago gave up on that. Interestingly, almost euphemistically, some of that was referred to as a Temperance Movement.

What many do not know, which I know from the medical vantage point, is that marijuana can cause symptoms such as even panic attacks, suggestive of increasing anxiety. That would be an argument against its use, but it does not happen to nearly everybody. The chief complaint against marijuana is that it is often linked in young people with the development of psychosis. That is a serious issue. However, again, it does not happen to everybody. Indeed, again, there is research indicating who is more at risk of this, and these factors do not apply to every user.

However, we all know that alcohol is not without its problems either. When it comes to intoxication, I sometimes like to put it, perhaps somewhat facetiously, that individuals under the influence of marijuana seldom if ever say to someone they encounter, "Let's take it outside", in other words, let's settle something with a fight. That scenario is all too common with alcohol. We have already mentioned the area of cognitive and perceptual impairment that can lead to disastrous consequences with things like motor vehicle accidents, which can cause injuries and death. Many of us also know that perhaps 10 to 15% of those who drink alcohol develop dependency, become alcoholics. We know that people using marijuana can also apparently become dependent on it. However, because it is an illicit substance, we don't really have a good research-based to know what percentage of users that might be. For the same reason, we really don't know how many people develop anxiety or psychosis related to marijuana use. With respect to the latter, there is continued to be too though as to the chicken-end-egg nature of this issue. With these individuals have developed psychosis without marijuana use? One can well understand that one could never do research that would answer that question. You are not going to very likely receive ethical support for a study that requires a certain group to go on marijuana from a certain age for a long-term compared to a control group that does not, to see who'd become psychotic. So what do we do with that question?

We know that there are also a certain number of people who abuse alcohol who develop problems of our psychotic nature, particularly as they get older and even developed an alcohol-related dementia. Then, there are also the chronic and heavier users of alcohol to the belt things like stomach ulcers and cirrhosis of the liver, the latter of which can even be fatal. Alcohol use is also a risk factor for other problems like heart disease. So, as we know, alcohol is by no means benign, but we still have it, legally, and at least as regards its manufacture, distribution and sales, largely controlled.

Given that comparison of alcohol and marijuana, I do not think we really have a good basis for refusing to decriminalize or even legalize marijuana and allow it to be used in our society in the way that alcohol is. How many of us do not enjoy a beer or wine as part of our normal social life? Who are we to hold on to that but deny those who use marijuana the same pleasure with using it as part of their social life?

Those of us old enough to remember, or who have studied history enough, about the criminal element that prospered during the period of alcohol prohibition in North America. Well, we have been experiencing that for decades with respect to marijuana prohibition. Frankly, I think it is a drastic waste of resources to direct so much energy of our law-enforcement agencies into fighting the distribution and use of marijuana. Indeed, there are an increasing number of politicians, health experts and even those in law-enforcement agencies, and even more so those who have retired from these positions and they'll feel free to speak out, who are beginning to realize this and lobby for changes with respect to our legislation about marijuana.

Interestingly, in both our country and the US, it is the federal government that seems more in opposition to this direction then state and provincial bodies. Some of that in Canada has to do with our desire not to upset our southern neighbors by making our laws more relaxed when they are still carrying on such a large campaign against drugs. There are concerns about what it would do to our border exchanges. In the US, a lot of their effort is focused on trying to stem the production and flow of drugs into their country from Latin America and Canada. How would this be different if the laws were changed? It would probably make relations between these countries better in some respects.

An argument that has long been used against the use of marijuana is that it is a gateway drug, one that is first used on the path to use of "harder drugs" such as cocaine and the opiates. However, I do not think that this is something that the science and population epidemiology really supports. Given the degree of marijuana usage in our societies, I am not sure that there is a real concern about its use significantly escalating, if at all, if the laws were relaxed. Indeed, for some, the rebellious aspect now currently associated with it might make it less desirable.

We in BC are all too familiar with the regular news reports of gang-related activities, the shootings, the death of innocent bystanders, because of those involved in the illicit behaviors around the use of these currently illicit substances. Marijuana is by far the most commonly used up all of the substances, so taking that out of the domain of those involved with it illegally, would create a significant drop in criminal activity. That would still be there to a certain extent with respect to the use of other drugs such as the opiates and cocaine, NDMA or "ecstasy," methamphetamine and a host of other substances and drugs that people misuse. However, again, this argument has not been used again since the 1920s and 30s to try and eliminate alcohol from our society, so why continue it against marijuana? We know that some of these substances have valid uses, e.g. opiates for pain control, but that they also have misuses. Removing the restrictions on marijuana use might even lesson the attraction of some of these other substances. Many of these substances are used to self-medicate against everything from physical symptoms such as the pain and nausea associated with cancer to psychological symptoms such as anxiety and depression. There appears to be evidence that certain strains of marijuana, with different ratios of the active substances, can be purified to be more specifically effective against everything from insomnia to anxiety and depression. If this could be pursued legally and scientifically, marijuana and its derivatives might be effectively used for many of the conditions to which people are now turning desperately to all kinds of more potentially harmful substances.

Is it not really time to look at changes with respect to our marijuana laws? To be sure, our government has seemingly lowered its guard somewhat with respect to the whole area of the use of medical marijuana, but that is a morass in itself, which is worth devoting another essay to.

2013-8-2