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Advocates of drug legalization believe that making high-quality drugs cheaply and widely available will eliminate the illegal drug market, regulate quality and price, and decrease law enforcement costs including arrest and incarceration. They predict that governments will spend less money on law enforcement, benefit from a new source of tax revenue and that drug-related crime will fall if drugs from marijuana to heroin become routinely accessible, more or less as are alcohol and tobacco.

But unless these "reforms" make all illegal drugs cheaply available to any willing buyer there will be a large and destructive illegal market in these addictive substances. In fact, by reducing the legal and other pressures that reject illegal drug use, these "reforms" all will increase the use of illegal drugs and with this increase will come the harms caused by it. Moreover, legal drugs, i.e., alcohol and nicotine, provide poor models for legalization. The tax revenues reaped from these drugs are dwarfed by their social and health costs. The same is true for marijuana and any other illegal drug.

"The greatest mortality from drugs comes from legal drugs. The moment you make a drug legal, you're going to increase the number of people who get exposed to it, and therefore you increase the negative consequences from its use. When you legalize, you create an industry whose purpose is to make money selling those drugs. And how do you sell it? Mostly by enticing people to take them and entice them to take high quantities."

- Nora D. Volkow, MD, Director, National Institute on Drug Abuse in an interview with The Boston Globe

Marijuana Legalization

In November 2012 Colorado and Washington State passed ballot initiatives legalizing marijuana, making the United States the first country in the world to legalize the commercial production, sale and use of marijuana. As of March, 2022, 18 states and the District of Columbia have legalized marijuana, adding it to alcohol and nicotine as a third drug legal for adults. Alcohol and nicotine are the leading causes of preventable illness and death in the United States.

Legal marijuana competes with illegal marijuana with a big disadvantage: legal marijuana is subjected to regulations and taxes to add to its price. Worse yet, legal marijuana has shown remarkable innovation in products beyond anything previously done by the illegal marijuana suppliers, including THC concentrates (dabs), vaping oils, and the sale of edibles. Both legal and illegal suppliers have increased the potency of their products adding to its risks.

In response to the legalization of marijuana in Massachusetts, in 2019 a consortium of clinicians and scientists released a Statement of Concern expressing their disagreement with how marijuana policy is being shaped across the state.

""To support substance use prevention and social, emotional, and mental health promotion, state and local leaders must support strategies that minimize the reach of the marijuana industry and promote healthy, drug-free norms for families and communities."

- Statement of Concern - Marijuana Policy in Massachusetts, 2019

The environmental impact

In December 2021, The Today Showinvestigation highlighted the environmental impact of illegal marijuana grows run by Mexican drug cartels in California's national forests.

"For years now, the cartels have siphoned off precious public water, poisoned wildlife, and wreaked environmental havoc, mostly unhindered."

The Community Impact

The following film Chronic State from DrugFree Idaho documents the impact of the legalization and normalization of marijuana on local communities:

What are the policy choices?

Smart Approaches to Marijuana (SAM) is leading the nation in finding smart, effective and less punitive strategies to discourage marijuana use and prevent a new Big Marijuana industry with a focus on public health. Below, SAM co-founder Kevin Sabet, PhD presents the false dichotomy of legalization and criminalization:

Ben Court, director of professional relations for an adult substance-addiction treatment hospital in Colorado, examines the impacts of a growing new marijuana industry on everything from policing and arrest rates to LGBTQ issues:

Data from the National Survey on Drug Use and Health (NSDUH) shows the discrepancy between use of legal drugs (alcohol, tobacco, and increasingly, marijuana) and illicit drugs. Among Americans 12 and older, about 51% have used alcohol in the past 30 days while about 21% have used tobacco. The percent who have used any marijuana is nearly 12%, dramatically more than those who used opioids (1%) or cocaine (0.7%).

None of the illegal drugs is less biologically attractive than alcohol or tobacco. The reason so many more Americans use these two drugs is that they are legal for adults and are widely available and promoted supported by well-established industries. Legalizing marijuana ensures that the percent of Americans using this drug will rise to the levels seen by these two legal drugs. Worse yet, it is important to note that over 58% of Americans who suffer from a substance use disorder for drugs other than alcohol have a marijuana use disorder.

There have also been substantial changes in the ways in which marijuana is used. Although overall the national rate of marijuana use for Americans age 12 and older has declined since 1979, a greater segment of marijuana users are heavy users. As shown below, from 1992 to 2014, the number of daily or near-daily marijuana uses increased 772%!

The Institute for Behavior and Health has proposed a strategy for sustained and systematic annual collection, analysis and reporting of the health, safety, and other consequences of marijuana use and marijuana legalization. IBH is calling on the US Congress to designate the National Academy of Sciences, Engineering, and Medicine (NASEM) to establish an independent Scientific Committee to Monitor the Effects of Marijuana Policy Changes. This committee would assemble, analyze and report data on the effects of marijuana use and changes in marijuana policy, and recommend priorities for research in this area. The full IBH report on this strategy can be found here.

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Drug Legalization | Institute for Behavior and Health

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Advocates of drug legalization believe that making high-quality drugs cheaply and widely available will eliminate the illegal drug market, regulate quality and price, and decrease law enforcement costs including arrest and incarceration.

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Government at all levels spends about $100 billion a year on law enforcement and criminal justice programs to combat the drug problem, and about $35 billion is directly related to drug law enforcement. About $50 billion a year could be saved if drugs were legalized, and this figure could go as high as $150 billion a year if one considers the resources spent on ineffective drug suppression activities. Drug legalization could increase property values in cities but would not solve the problem of inner city decay and disintegration. If the illicit drug business no longer existed in cities, streets and schools would become safer. About one-third of inmates would not be in prison if it were no longer a crime to possess or traffic in illicit drugs. Further, if drugs were legalized, dangers to public health from using heroin, cocaine, and marijuana would be greatly reduced since legalizing drugs would probably reduce the use of harmful drugs. The main risk of drug legalization concerns the potential for increased drug consumption. Because the drug market is already saturated with a combination of legal and illegal drugs, however, virtually everyone who wants to get "high" already does so. The authors conclude that, considering all benefits and costs, the case for drug legalization is overwhelming. 39 notes

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Legalizing Drugs Would Benefit the United States (From Legalizing Drugs, P 32-48, 1996, Karin L. Swisher, ed. -- See NCJ-160030)

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Government at all levels spends about $100 billion a year on law enforcement and criminal justice programs to combat the drug problem, and about $35 billion is directly related to drug law enforcement.

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Drug Legalization?: Time for a real debate | Brookings

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Drug Policy In The United States

Drugs & drug policy evoke strong opinions. At stake is a mix of issues of personal freedom, public health, racial equality, public safety, costs, & large financial profits.

There are many vested interests and pressures on policy makers. Ultimately in a civilized society, good policy preserves individual freedoms, while respecting the rights of others likely to be affected.

In the case of psychoactive drugs, such as marijuana, there is an added layer because while people make a free choice to use a drug initially, a proportion of users suffer from a radically impaired ability to continue to make that rational choice- they become addicted (about 9% of marijuana users will develop a substance use disorder), and are at elevated risk for also suffering from additional mental illness, such as depression, triggered by drug usage. Substance use disorder then dramatically impairs quality of life, and with some drugs such as alcohol and opioids, can foreshorten the human lifespan by decades.

BELOW, FIND BRIEF OUTLINES OF THE SPECTRUM OF DIFFERENT DRUG POLICY POSITIONS RANGING FROM THE MOST, TO THE LEAST, RESTRICTIVE.

PROHIBITION

Most of us have heard the term "prohibition," often associated with "alcohol prohibition." Alcohol prohibition was enacted with the passing of the 18 th amendment to the US Constitution and lasted for about fourteen years. The Volstead Act on which the initial amendment was based, banned the manufacture, sale, and distribution of all alcoholic beverages. Prohibition legislation was eventually repealed with the passing of the 21 st amendment in 1933. This meant that alcohol was again legal. In most countries and the US, prohibition generally remains the primary policy position for psychoactive drugs that have the potential to be misused, cause intoxication, addiction, and induce harms.

PROs: Decreases accessibility to the drug

CONs: Increases criminality, incarceration, & black markets

DECRIMINALIZATION

Decriminalization is often confused with legalization. They are very different. Decriminalization means that if you are caught in possession of small amounts of a drug for personal use, you do not incur a criminal penalty. It is still illegal to use the drug. The penalty, however, is typically nothing more than a modest fine, such as $100. Multiple states have now passed laws decriminalizing the possession and use of marijuana.

PROs: Decreases criminality, incarceration, & black markets

CONs: Does not eliminate the cartels and criminal activity associated with the drug's manufacture, distribution, and sales.

DE FACTO DECRIMINALIZATION

Often prior to passing decriminalization legislation, many states go through a period of "de facto decriminalization," whereby no actual decriminalization law has been officially passed, but the existing criminal law prohibiting use is no longer enforced. It is an implicit recognition that decriminalization might be a potentially useful policy position, even if sufficient social and political will to enact it is currently absent.

PROs: Reduces criminality, incarceration, & black markets

CONs: Does not eliminate the cartels and criminal activity associated with the drug's manufacture, distribution, and sales.

MEDICALIZATION

Medicalization is a policy position taken for some psychoactive drugs. Notably, in the case of marijuana, its use for medical purposes has now become law in the majority of US states. Medicalization of marijuana is unusual in this regard because it is medically "recommended" rather than actually "prescribed," due to a limited availability of rigorous empirical evidence on health benefits.

PROs: If properly regulated and supported by clinical science for specific medical conditions, medicalization of a drug can help destigmatize use, and decrease pain and suffering related to those specific conditions.

CONs: Because of safety concerns (e.g., in utero effects in pregnancy, drug-drug interactions, other medical contraindications), medicalization typically requires extensive testing to ensure users of the prescribed medication are not harmed by its use, and side-effects are minimized.

So, you have prohibition, de facto decriminalization, decriminalization & medicalization. Then there's legalization, & that's the end right?

LEGALIZATION

(IN ITS MANY FORMS)

While you might think legalization is simply a yes or no dichotomy, it is important to recognize that there are actually several forms that legalization can take, each accompanied by its own set of pros and cons.

LEGALIZATION WITHOUT COMMERCIALIZATION

One way drugs can be made legal for recreational use (e.g., marijuana), is to allow production, distribution, and sale, but forbid commercialization. This form of legalization bans product branding and advertising that are designed by industries to proactively increase sales, consumption, and profits. This is what happens currently with alcohol and did for a long time unabated for tobacco.

An alternative is to have local, state, or federal control over the production and sale of the drug. This would still make the drug completely legal, available, and accessible, and retain better control of quality and labeling of the drug's psychoactive potency and ingredients.

Legalization without commercialization may be a sweet spot in terms of reducing both the negatives of prohibition, while also minimizing the public health and safety harms that come at a population level with the increased availability, accessibility, and reduced price. This allows people who want to buy and use the drug to do so without the drug being "pushed" on the population through advertising and branding.

PROs: On the plus side of the legalization without commercialization position, people who wanted to use the drug recreationally could do so by obtaining and using it without fear of recrimination, which would eradicate criminality, incarceration, and black markets. It would also lessen the stigmatization of addicted users, lessening a known barrier to seeking treatment.

CONs: On the downside, because psychoactive drugs, including marijuana, do cause acute psychological impairments when people use the drug, as well as addiction (about 9% of marijuana users), the increased accessibility, de-stigmatization, and decreased price that comes with legalization, would result in more users and therefore more potential hazards and harms in the population (e.g., drugged driving) as well as addiction cases.

LEGALIZATION WITH LIMITS ON COMMERCIALIZATION

Alternatively, one could legalize the drug(s) but allow at least some modicum of commercialization. For instance, restrictions could be placed on how much and to whom the newly legalized products are advertised. A drug like marijuana for example, could be made legal for recreational use, but its commercial advertising in certain venues and at certain times when children and adolescents are likely to be exposed to the advertisements, is restricted. Other restrictions could also be put in place while still legalizing the drug. These could include such things as having a minimum age for use (e.g. being at least age 21), ensuring quality control in production, and listing of ingredients including the nature and potency of its psychoactive content; limiting the number of licensed sales outlets in a given area; prohibiting use under certain conditions, such as when driving a car; and having a minimum price per unit at which the drug could be sold. Many such restrictions are placed on the sale of alcohol, for example.

PROs: Increased accessibility to drug for targeted populations.

CONs: Likely to substantially increase drug sales and consumption, as well as public health and safety harms in the population as more people use it. It should be noted that just because there are laws in place to limit potential public health and safety harms from an uptick in use, it does not mean necessarily that such laws will be adequately enforced once a drug is legalized.

LEGALIZATION WITH FULL COMMERCIALIZATION

At the other end of the spectrum from prohibition, and at the far end of the legalization continuum, one can have unmitigated free market commercialization. This allows free reign for industry to brand and advertise as much as they want and for it to be sold with few, if any, restrictions. To think about how valuable advertising and branding is, think about buying cigarettes sold in a plain white box with nothing on the outside; or buying wine, beer, or liquor, in ordinary transparent glass containers with just a simple white label on the outside stating, "Wine" or "Vodka." Not quite the same allure. Industry goes to great expense to attractively shape, tint, color, and even emboss the glass, create gilt-edged high-color labels, gold foil wrappings, and launch multi-million-dollar professional advertising campaigns in an attempt to create an image that attracts, seduces, and increases sales and profits.

PROs: Eliminate the criminal activity and increase associated industry jobs and tax revenues.

CONs: Likely to substantially increase drug sales and consumption, as well as public health and safety harms in the population as more people use it. Thus, any potential tax revenue gains from sales can be offset by economic losses related to lowered workforce productivity (e.g., more people take days off work to recover from the effects of use) as well as health care costs. It should also be noted that despite being legal, economic costs due to law enforcement and criminal justice could still also contribute to economic burden due to violations of the laws accompanying legalization (e.g., drugged driving convictions; sales to minors).

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