Marijuana debate isn’t just legalization vs. incarceration Project SAM directors Patrick Kennedy and Kevin Sabet wrote this column, published Jan. 12, 2013 in The Denver Post. Colorado residents are holding their breath for President Obama’s announcement regarding recently passed measures legalizing marijuana. Whatever the decision is, it is sure not to end the debate about marijuana, especially since some Colorado counties are banning marijuana operations already. And marijuana use and sales remain illegal under federal law. Sadly, this debate has been mainly confined to two very simplistic notions of policy: incarceration and legalization. These words have dominated the marijuana policy discussion over the past decade. And they are both wrong. They represent a false dichotomy that overlooks more complex and promising solutions in favor of simplistic and risky ones. Though touted by legalization advocates as a cure to ailing state budgets and a crippling of drug cartels, it is clear that marijuana is good for neither. Legal alcohol and tobacco provide examples: For every dollar the government brings in from taxation, it spends $10 on social costs. We know that the costs of today’s highly potent marijuana include 400,000 emergency room visits, increased incidence of mental illness, car crashes, and learning problems for kids. These costs will only increase as more people use easily obtainable, heavily promoted, cheap marijuana in such a permissive environment. And we are confident marijuana will be promoted widely. Already, talk of creating the Starbucks equivalent of marijuana and pop-star promotion of the drug has begun. But we also know one more segment of private industry might be interested in cashing in: big tobacco. A consultant’s report to Brown and Williamson uncovered in court read: “The use of marijuana … has important implications for the tobacco industry in terms of an alternative product line. [We] have the land to grow it, the machines to roll it and package it, the distribution to market it.” Big tobacco lied to America for 80 years about the dangers of smoking. They deliberately targeted kids. Why would we think it would be any different for marijuana? That we are uneasy about legalization should not be construed as acceptance of the status quo. Though people are not imprisoned for using small amounts of marijuana, people still get arrested for possessing the drug, resulting in a blemish on their records. They have a hard time getting a job or accessing social benefits — and this can incentivize reintroduction into the illicit economy. The answer is not to simply legalize; we must instead offer health interventions and other assistance to those who are caught with the drug, based on their particular situation. Finally, studies show that the average “medical” marijuana user is a 32year-old with no life-threatening illness. Less than 5 percent have cancer, HIV or a terminal illness. But that doesn’t mean components of marijuana are not medicine. There are ways to deliver its medicinal potential without compromising public health. A pill containing marijuana’s most active ingredient is available at pharmacies. We need more research into marijuana’s other components, since many have begun to show promise. (One such medicine, an oral spray that does not get you high, is available in 22 countries already.) And until such research produces those medicines, we could also enroll the seriously ill into a research program giving them responsible access to non-inhaled components of marijuana. Just like we don’t smoke opium to reap the benefits of morphine, however, we need not smoke marijuana to get its therapeutic properties. So if neither legalization nor prohibition, then what? Science-based drug education for parents and kids needs to become a top national priority. Community coalitions that engage in multiple community sectors, and drug courts that leverage the criminal justice system with treatment must be brought to scale. Strategies that implement job and stable housing programs should also be more widespread. While “lock ‘em up” or “legalize” may both fit neatly on a bumper sticker, they are not thoughtful ways to implement drug policy. As cities and towns ban retail sales on their own in Colorado, we should not think full legalization is a foregone conclusion here. It is not too late to have a responsible conversation about marijuana. Patrick J. Kennedy is a former Rhode Island congressman and Kevin A. Sabet is a former senior drug policy adviser in the Obama administration. Both are founders of Project SAM (Smart Approaches to Marijuana).