PEDIATRICS Vol. 116 No. 5 November 2005, pp. 1257 (doi:10.1542/peds.2005-1893)
Response to the American Academy of Pediatrics Report on Legalization of Marijuana: In Reply
Alain Joffe, MD, MPH, FAAP for the Committees on Substance Abuse and AdolescenceChair, Committee on Substance Abuse
Student Health and Wellness Center
Johns Hopkins University
Baltimore, MD 21218
Dr Warf states that "[w]hen one advocates against legalization, the real intent is to advocate for establishing criminal records and imprisonment for young people and adults for a common exploratory behavior." Nowhere in our statement did we advocate for such positions. As stated in the technical report, legalization of marijuana would fundamentally change its status in the United States. The legal status of alcohol and tobacco for adults permits, despite legal sanctions against sales to minors and industry protestations to the contrary, aggressive promotion and sales of these products to young people. The result is that alcohol and tobacco are the 2 drugs most commonly abused by adolescents. Dr Warf seems not to be concerned that use of marijuana by adolescents might well approach similar levels were it also to be legalized.
Implicit in Dr Warf's comments about incarceration is that many individuals wind up in jail for the sale or possession of small quantities of marijuana. We were unable to identify any data to support this position, and Dr Warf provides no data of his own. Again, to oppose legalization is not to endorse incarceration. Similarly, our technical report specifically mentioned support by the American Academy of Pediatrics for additional research into the role of cannabinoids for medical purposes.
We do agree that "tens of millions of Americans have used it [marijuana] at some point in their lives," but our concern is with adolescents, especially young adolescents. Marijuana is much more potent now than it was in the 1960s and 1970s, which is one explanation for why cannabis-use disorders in the United States have increased over the last 10 years.1 New research on brain development clearly demonstrates that the adolescent brain, which is still developing, is particularly vulnerable to the ill effects of substance abuse, including marijuana.2,3 Just as early-onset alcohol users are at greater risk for problems later in life, so too young adolescents seem to be at particular risk for numerous negative psychosocial consequences from using marijuana.4,5 In addition, several large longitudinal studies have demonstrated a link between marijuana use during adolescence and later development of mood disorders and schizophrenia.6–8 Those who advocate for legalization of marijuana must set forth how they would protect young people in such an environment.
We believe that our technical report was rational and balanced and was based on the best data available to date. Since its publication, evidence has continued to accrue that marijuana is not the harmless drug many wish it were.
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PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics
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- Response to the American Academy of Pediatrics Report on Legalization of Marijuana
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Pediatrics 2005 116: 1256-1257.[Extract] [Full Text]
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