NCADA supports policies which reduce the availability of marijuana to youth. Even while this drug remains illegal, we are seeing increasing use and addiction in adults and youth. Any policy that creates a commercial, legal market, in which it becomes easier for minors to access marijuana, is not the solution. While continued prohibition is not effective, the commercialization of a third legal, addictive substance is not a good public health alternative. We believe it is not a simple binary choice between continued prohibition and commercialization, and we believe such middle ground should be considered.

Legalization of Marijuana

Drug and alcohol misuse—especially among young people—is a major public health problem. Teenage marijuana use is strongly correlated with declines in academic performance, motivation, memory and cognition; and the long-term effects of today’s marijuana—genetically modified and bred for high concentrations of THC—are largely unknown.

As the country debates new policies on marijuana—medicalization, decriminalization and legalization—NCADA keeps the health and well-being of young people as its preeminent concern. Consequently, NCADA is opposed to marijuana reforms that would likely increase use among teenagers.

During the last decade, as more and more states have liberalized their laws, the number of people who report trying marijuana has barely increased. However the number of heavy (daily or near-daily) users has soared.

NCADA recognizes that the status quo is changing and we recognize that, in some respects, it needs to change. We do not believe that any drug use should be treated as primarily a law enforcement issue, but rather a public health issue. Because the consequences of arrest and a criminal record are generally far more serious than the consequences of marijuana use itself, there needs to be reform.

NCADA is therefore less concerned about the legalization of marijuana than with its commercialization. In other words, creating a market-driven marijuana industry in which sellers profit most from those who use the most marijuana is a model fraught with unintended negative consequences.

This country has paid a high price—in social, economic, and health-care costs—from the commercialization of its other two addictive drugs: alcohol and tobacco. Commercializing a third addictive drug is likely to create a different and nontrivial set of problems.

Like alcohol, marijuana is “no ordinary commodity,” and for that reason, NCADA believes that lifting prohibition should be accompanied by protections for the minority of consumers who will become addicted.

Therefore, NCADA believes that the legal status of the cannabis plant should not create opportunities for corporate profit and increased state tax revenue. Though forgoing tax revenue is politically unpopular, we believe that selling and taxing marijuana the way we’ve done with alcohol and tobacco is likely to normalize its use, increase its availability, and lead to increased negative health outcomes, especially among young users.

NCADA urges caution, and reminds everyone that there need not be a binary choice between full prohibition and full commercialization. Other countries and other U.S. jurisdictions have implemented not-for-profit cooperatives; “grow and share” programs, and other initiatives that eliminate criminal penalties while not generating a significant profit/revenue motive.

We will closely monitor legalization as it continues to unfold in eight states and the District of Columbia, and evaluate the impact on the health of our kids. We will push for more, and more effective prevention programs. We will equip parents with the information they need on the very real health risks of early use and help them have factual, frank conversations with their kids in this changing landscape.

(link to PDF version)

Medical Marijuana

Cannabis is a raw botanical thought to have medicinal properties. However today’s physicians no longer rely on raw botanicals to treat illnesses.

Herbs and botanicals are still in use, but now largely as folk remedies—alternatives to modern, Western medicine. Unlike FDA approved drugs, they are neither standardized nor tested for effectiveness. As a result, their quality, concentrations, and efficacy vary widely. Their therapeutic claims are not substantiated by scientific rigor and, unlike modern medicines, they are not subject to the same kind of regulation or approval. Instead, as science came to better understand the body’s internal regulatory systems, researchers developed and purified specialized drugs to affect those systems in faster and better ways.

Advocates tend to talk about cannabis as if it’s an established medicine, while simultaneously describing it as an alternative to modern medicine, in other words: a folk remedy. This engenders confusion.

Marijuana likely has potential as an effective medicine for a number of conditions. But to elevate marijuana from folk remedy to valued entry in the United States Pharmacopoeia (USP) it should meet the same standard as other medicines.

While NCADA is not supportive of folk remedy marijuana, we would very much support real medical marijuana. In other words: NCADA believes the active ingredients in marijuana (primarily THC and the non-psychoactive, CBD) should be turned into FDA-approved medicines. We believe that marijuana should move to FDA Schedule II and be researched for potential benefits. To date, the preponderance of research into marijuana has been about its harms; it’s certainly time to fast-track research into its benefits, and to finally approve cannabis-based pharmaceuticals, like Sativex and Epidiolex.

In the meantime, NCADA believes that anyone with a serious illness that has not responded to conventional therapies should be able to try marijuana if a licensed physician has good reason to believe it could offer relief from infirmity. Though the use of marijuana clearly has risks, the key for medical decision-making is not eliminating risk—no treatment is without it—but by examining the balance between risks and benefits. This calculus should take precedence over political expediency and should be determined by doctors and medical ethicists, not by advisory panels populated with laypeople advocating either for or against legalization.

However, before permitting marijuana to be legalized as medicine, it is imperative to be mindful of the risks (most especially addiction, misuse, diversion) and to take steps to minimize them. To these ends, we believe patients should receive dosing instructions from licensed health professionals, and any ongoing or chronic use should be carefully supervised, again by a licensed physician.

The implementation of medical marijuana programs should be flexible in order to address unintended consequences in a timely matter. Passage of medical marijuana legislation via constitutional amendments does not allow for this flexibility or responsiveness.

Those seeking relief from chronic, debilitating medical conditions should not be penalized by excise taxes, which are often promoted as convenient mechanisms to fill budget gaps or generate revenue.

Finally, in this country medicine is not defined by prevailing political positions.

(link to PDF version)


Alcohol | Marijuana | Opioids/Heroin | Prevention | Substance Use Disorder Treatment | Tobacco/Nicotine

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