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Debate:Marijuana for Medical Purposes

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Should marijuana be made legal for medical purposes?

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Background and Context of Debate:

Marijuana or cannabis is one of the most widely used drugs in the world. It causes hallucinations, disorientations and also feelings of exhilaration and anxiety. The same drug has been found to relieve symptoms of many serious diseases, including asthma, glaucoma and muscle spasms, as well as loss of appetite and nausea due to AIDS wasting syndrome and chemotherapy treatment. Many distinguished professional medical bodies, including the American Medical Association, the American Public Health Association and the New England Journal of Medicine have publicly supported prescriptive access to marijuana. Governments, however, are still opposing the legalization of marijuana for medical use. They continue to list marijuana as a Schedule I drug: "unsafe, highly subject to abuse, and possessing no medical value." As of July 9, Canada became the first country to adopt a system regulating the medicinal use of marijuana in July 2001. 582 Canadians were authorized to possess marijuana for medical reasons, most of whom were also licensed to cultivate the drug.

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Treatment: Is marijuana important in treating illnesses/diseases?

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Yes

  • Marijuana helps treat the symptoms of many illnesses -- Joycelyn Elders, M.D., Former U.S. Surgeon General. Editorial, Providence Journal. March 26, 2004 - "The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS -- or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day."[1]
  • Marijuana might have some toxicity, but so do other drugs.
  • The health risks of smoking marijuana are relatively minor. Lester Grinspoon, M.D., Emeritus Professor of Psychiatry, Harvard Medical School. "Puffing Is the Best Medicine," Los Angeles Times. May 5, 2006. - "[T]here is very little evidence that smoking marijuana as a means of taking it represents a significant health risk. Although cannabis has been smoked widely in Western countries for more than four decades, there have been no reported cases of lung cancer or emphysema attributed to marijuana. I suspect that a day's breathing in any city with poor air quality poses more of a threat than inhaling a day's dose -- which for many ailments is just a portion of a joint -- of marijuana."[2]
  • Marijuana is only unhealthy or risky when abused The problem with illegalizing marijuana is that it lumps the most moderate of uses of marijuana in with the worst of abuses. Just like with alcohol, there are scales of use that fall within responsible to irresponsible to abusive categories. The responsible use of marijuana might involve the recreational use of the drug a couple of times a year and in very small doses, such as, a single toke. Does it make sense for such innocuous levels of consumption to be illegal? No. And, yet, in states where marijuana is illegal, such levels of consumption are illegal. Instead of this system, marijuana should be legally regulated like alcohol on the basis of abuse in circumstances where it has the potential to threaten other citizens, such as before driving or operating machinery.


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No

  • Marijuana has too many negative effects overall. John Walters, Director, Office of National Drug Control Policy. March, 2002 - "Smoked marijuana damages the brain, heart, lungs, and immune system. It impairs learning and interferes with memory, perception, and judgment. Smoked marijuana contains cancer-causing compounds and has been implicated in a high percentage of automobile crashes and workplace accidents."[3]
    • Marijuana smoke is highly damaging to the lungs British Lung Foundation. "Smoking Gun: The Impact of Cannabis Smoking on Respiratory Health," a publicly disseminated report November, 2002 - "3-4 Cannabis cigarettes a day are associated with the same evidence of acute and chronic bronchitis and the same degree of damage to the bronchial mucosa as 20 or more tobacco cigarettes a day."
    • Smoking marijuana impairs the immune system - British Lung Foundation. "Smoking Gun: The Impact of Cannabis Smoking on Respiratory Health," a publicly disseminated report. November, 2002 - "Cannabis smoking is likely to weaken the immune system. Infections of the lung are due to a combination of smoking-related damage to the cells lining the bronchial passage and impairment of the principal immune cells in the small air sacs caused by cannabis."[4]


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Pain control: Is marijuana an effective medicine for reducing pain?

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Yes

  • Legalizing marijuana provides patients with pain relief. This would make the usage of drug controllable, ingredients would be well known and experts would determine the appropriate healing quantity. Legalization for medical purposes is also necessary to encourage the pharmaceutical industry to invest in further research of marijuana's healing properties.


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No

  • Legalizing medical marijuana opens door to bad definitions of "pain". People who are addicted to a drug are especially driven to find loopholes. In countries where marijuana has already been introduced for medical purposes, this has been the case. Legalizing marijuana would pose a bad example and trigger pressures for the legalization of other drugs.


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HIV/AIDS: Is marijuana good for treating HIV/AIDS?

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Yes

  • Marijuana improves immune system functions in patients with HIV Donald Abrams, M.D., et al. "Short-Term Effects of Cannabinoids in Patients with HIV-1 Infection". Annals of Internal Medicine. August 19, 2003 - "Patients receiving cannabinoids [smoked marijuana and marijuana pills] had improved immune function compared with those receiving placebo. They also gained about 4 pounds more on average than those patients receiving placebo."[5]


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No

  • Marijuana damages the immune system; risky for HIV/AIDS sufferers. U.S. Institute of Medicine Report. Marijuana and Medicine: Assessing the Science Base. March, 1999 - "The most compelling concerns regarding marijuana smoking in HIV/AIDS patients are the possible effects of marijuana on immunity. Reports of opportunistic fungal and bacterial pneumonia in AIDS patients who used marijuana suggest that marijuana smoking either suppresses the immune system or exposes patients to an added burden of pathogens. In summary, patients with preexisting immune deficits due to AIDS should be expected to be vulnerable to serious harm caused by smoking marijuana."


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Psychological disorders: Can marijuana help treat marijuana?

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Yes

  • Marijuana can help treat bipolar disorders: Scientists and mentally-ill sufferers of bipolar disorder have independently made the discovery that cannabis can improve this medical condition, whether mania or depression. It may also reduce side effects of other drugs used in its treatment, such as Lithium, Carbamazepine (Tegretol) or Valproate (Depakote). Moreover, 30-40% of patients with bipolar disorder are not consistently helped by or cannot tolerate standard medications.


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No

  • There are psychological consequences to smoking marijuana. A number of studies have reported that the negative effects of smoking marijuana for people with psychological problems are profound. This is most significantly in young women, where rates of mental health problems were many times higher in daily cannabis users.
  • Cannabis causes higher rates of depression and anxiety problems. Cannabis also triggers the onset or relapse of schizophrenia in predisposed people and also exacerbates the symptoms generally.



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Treating the terminally ill: Can marijuana use help the terminally ill cope with their illness?

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Yes

  • Marijuana helps the terminally ill cope with their ebbing life. Because smoked marijuana can give rapid relief from great suffering to some patients, quickly improving such patients' comfort and mental outlook, the terminally ill can still maintain their human dignity and suffer less.
  • The benefits of marijuana for the terminally ill outweigh risks. Consumer Reports. Editorial. May, 1997 - "Consumer Reports believes that, for patients with advanced AIDS and terminal cancer, the apparent benefits some derive from smoking marijuana outweigh any substantiated or even suspected risks. In the same spirit the FDA uses to hasten the approval of cancer drugs, federal laws should be relaxed in favor of states' rights to allow physicians to administer marijuana to their patients on a caring and compassionate basis."[6]



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No

  • Alternatives to marijuana should be used to ease the terminally ill For the terminally ill, the use of marijuana can no longer be considered a therapeutic intervention but one of several procedures used to ease the ebbing of life of the terminally ill. However, for this purpose doctors should prescribe antiemetic and analgesic therapies of proven efficacy, rather than marijuana smoking that also causes side effects.




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Health: Is marijuana fairly harmless health-wise or even spiritually beneficial?

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Yes

  • Marijuana is no more harmful than tobacco and alcohol Although cannabis does indeed have some harmful effects, it is no more harmful than legal substances like alcohol and tobacco. As a matter of fact, research by the British Medical Association shows that nicotine is far more addictive than cannabis. Furthermore, the consumption of alcohol and the smoking of cigarettes cause more deaths per year than does the use of cannabis (e.g. through lung cancer, stomach ulcers, accidents caused by drink driving etc.). The legalisation of cannabis will remove an anomaly in the law whereby substances that are more dangerous than cannabis are legal whilst the possession and use of cannabis remains unlawful.
  • Marijuana can have a beneficial mind-altering effect if used right Marijuana use can alter one's perception of reality or consciousness. The alteration need not be thought of as spiritual or religious to be respected for what it is; a fresh look on a reality that we are programed as humans to perceive only in a particular manner. Marijuana can help humans perceive that complex reality from simply a different perspective, which can benefit our appreciation for that reality and our unique and limited perceptions of it. With this more intelligent approach to marijuana consumption, it is easy to argue that mental, perceptual, and societal benefits exist.
  • Weighing marijuana's "mind-expansion" against its costs is subjective Who can say that marijuana use is "worth it" or "not worth it"? Many individuals strongly believe that marijuana use has a "mind expanding" effect that makes the health costs worth it. Other disagree. But can the government or anyone conclude for us all that "it's not worth it"? No. With so much subjectiveness involved, marijuana should not be illegal.
  • Legalization would change drug consumption from a criminal to a health issue The biggest issue with marijuana relates to the health problems it creates, with lung problems, "addiction", short-term memory loss, energy loss, and even the risk of schizophrenia. The social costs are little different than those with alcohol or cigarettes. Therefore, it should be treaty as a health issue, rather than a crime issue.
  • Marijuana is not addictive There is no evidence that marijuana physically addictive. While it may be psychologically addictive, in the sense that people like it and want to do it again, this is little different than alcohol. But, certainly, cigarettes are more addictive than marijuana. And, since cigarettes are physically addictive and yet legal, should addictiveness really be a barometer for a substance's illegality? No.


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No

  • Marijuana is worse for individuals and society than alcohol Both alcohol and marijuana impair judgement. And, both have can have damaging health effects on internal organs and cause death if over-consumed. Yet, the distinguishing feature of marijuana is that it has greater long-term effects on memory, cognition, and motivations. Marijuana is more the drug of "losers in life" than alcohol. If one primary objective in society is to produce as many succesfull, "winners" as possible, alcohol is less costly to this objective than marijuana. Also, much less is known about he health effects of marijuana than of alcohol; making caution toward legalizing marijuana more appropriate. It is, therefore, fitting that marijuana be illegal while alcohol be legal.
  • Marijuana is worse for individuals and society than tobacco Both cigarettes and marijuana do damage to the lungs. But, marijuana smoke is much more potent, and can do much more damage. Marijuana use reduces hormone levels and sperm count unlike cigarettes. And, marijuana impairs judgement, does long term damage to the mind, and can cause psychosis. Cigarrettes have none of these mental costs. In addition, the health effects of tobacco are much better documented than those of marijuana. Therefore, it is appropriate that cigarrettes be legal while marijuana be illegal.
  • Marijuana is addictive There are many studies that demonstrate a "dependency" relationship evolving between individuals and marijuana.
  • Marijuana use causes apoptosis or programmed cell death Unlike alcohol and tobacco, cannabis has a hallucinatory effect on the mind. This is inherently dangerous in itself. Furthermore, just like other drugs, there are many individuals addicted to cannabis who will resort to crime in order to fund their addiction.[citation needed] The legalization of cannabis will lead to the drug becoming more readily available, which in turn will mean that many more people will gain access to it. This will subsequently lead to an increase in the crime rate. Initial statistics from the Netherlands shows that the decriminalization and eventual legalization of cannabis did led to an increase in crime in Dutch society[citation needed].
  • Uncertainty of marijuana's health effects makes illegality prudent There certainly remains uncertainty and debate about marijuana's health effects. This makes it prudent to error on the side of caution and maintain illegality in states where this is the status quo. What if, for example, a state decided to legalize marijuana, to only discover five years later that marijuana has a dramatically more negative impact on human cognition than previously thought, or that it substantially increased the risks of psychosis? This would be politically and socially damaging. More scientific conclusions should be reached before decisive action is taken in any direction.


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Addictiveness: Is marijuana non-addictive? Does this matter?

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Yes

  • Marijuana is not addictive There is no evidence that marijuana physically addictive. While it may be psychologically addictive, in the sense that people like it and want to do it again, this is little different than alcohol. But, certainly, cigarettes are more addictive than marijuana. And, since cigarettes are physically addictive and yet legal, should addictiveness really be a barometer for a substance's illegality? No. Colin Blakemore, Ph.D. Chair, Dept. of Physiology, University of Oxford (U.K.), and Leslie Iversen, Ph.D., Professor of Pharmacology, Oxford University. Editorial, The Times (U.K.). August 6, 2001 - "For some users, perhaps as many as 10 per cent, cannabis leads to psychological dependence, but there is scant evidence that it carries a risk of true addiction. Unlike cigarette smokers, most users do not take the drug on a daily basis, and usually abandon it in their twenties or thirties. Unlike for nicotine, alcohol and hard drugs, there is no clearly defined withdrawal syndrome, the hallmark of true addiction, when use is stopped."
  • Due to its relatively low addiction rates, marijuana is good for medical use. Marijuana is the best drug to be put into medical use since it was ranked lowest for withdrawal symptoms, tolerance and dependence (addiction) potential. It ranked close to caffeine in the degree of reinforcement and higher than caffeine and nicotine only in the degree of intoxication.


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No

  • Marijuana is addictive There are many studies that demonstrate a "dependency" relationship evolving between individuals and marijuana. Alan J. Budney, Ph.D. et al., Professor, University of Arkansas Center for Addiction Research. "Marijuana Abstinence Effects in Marijuana Smokers Maintained in Their Home Environment". Archives of General Psychiatry. October, 2001. - "This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal [...] Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other."[7]
  • Repeated use of marijuana leads to psychological cravings for it. Marijuana by definition meets the criteria for an addictive drug; animal studies suggest marijuana causes physical dependence, and some people report withdrawal symptoms.


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Alternatives: Are there NO good alternatives to marijuana for treatment?

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Yes

  • Marinol is an inadequate alternative to marijuana for certain treatments. Gregory T. Carter, M.D., Co-director, MDA/ALS Center, University of Washington Medical Center Muscular Dystrophy Association website article. October, 2003. - "There are really no other medications that have the same mechanisms of action as marijuana. Dronabinol (Marinol) is available by prescription in capsules, but has the distinct disadvantage of containing only synthetic delta-9-tetrahydrocannabinol (THC) which is only one of many therapeutically beneficial cannabinoids in the natural plant."


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No

  • There are safer and more effective medications than marijuana. -- Bill Frist, M.D. U.S. Senator (R-TN), Correspondence to ProCon.org. October 20, 2003] - "Although I understand many believe marijuana is the most effective drug in combating their medical ailments, I would caution against this assumption due to the lack of consistent, repeatable scientific data available to prove marijuana's medical benefits. Based on current evidence, I believe that marijuana is a dangerous drug and that there are less dangerous medicines offering the same relief from pain and other medical symptoms."[8]
  • Marinol is a good substitute for marijuana in treatments California Narcotics Officers Association. Official policy statement. "The Use of Marijuana as a Medicine". October 31, 2005 - "Marinol differs from the crude plant marijuana because it consists of one pure, well-studied, FDA-approved pharmaceutical in stable known dosages. Marijuana is an unstable mixture of over 400 chemicals including many toxic psychoactive chemicals which are largely unstudied and appear in uncontrolled strengths."[9]


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Individual liberty: Should individuals be at liberty to use marijuana?

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Yes

  • People should be free to use marijuana as long as it harms no one else People should be at liberty to treat their bodies how they want to. Indeed, people are allowed to eat and drink to their detriment and even death, so why shouldn't they be able to harm themselves with marijuana use? This is, of course, assuming that their use does not harm anyone else. This means, as with substances such as alcohol or cigarrettes, that regulations be put in place to ensure that one individual's consumption of marijuana does not violate the liberties of another citizen. If this is achievable with alcohol and cigarettes, it seems achievable with marijuana.
  • Marijuana's social costs should not be arbitrarily discriminated against Marijuana may indeed have indirect social costs, such as increased healthcare costs, increased risks on the road, and others. But, illegalizing marijuana on this basis risks being seen as arbitrary discrimination against marijuana. Wouldn't you also have to illegalize alcohol, tobacco, and fast food on a similar basis. Certainly, the social costs and risks of these substances can be argued as equivalent to the risks of marijuana consumption. Illegalizing marijuana on the basis of its social costs, therefore, opens the law to accusations of being arbitrary, discriminatory, and of double standards. This is not good for the law and the integrity of the social contract.


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No

  • The State is justified in protecting individuals from themselves Even if marijuana's effects were isolated to the individual, there is room for the state to protect individuals from harming themselves. This is why it is illegal to commit suicide or to, in some places, not wear a seat belt. If marijuana's effects are seen as clearly harmful, the state can justly protect its citizens from it.
  • Some are "pressured" into marijuana consumption without a "choice" The notion that individuals should be free to make the choice to consume marijuana is predicated on the notion that they are fully informed of the costs and are in a position of detached judgement. The problem with this assumption is that many individuals grow up in, for instance, ghettos where marijuana is widespread, social pressure to consume is high, and few information is available regarding the costs. In addition, an individual may be illiterate or lack sufficient recourse to uncovering the costs. Is it fair to that individual to expect that they can make a sound judgement? No. The guidance of marijuana's "illegal" status is an important barrier and red flag to such individuals.
  • Marijuana's harm to individuals spill over onto communities and society To argue that individual consumption of marijuana entails only individual consequences is to argue that individuals exist in something of a vacuum. The reality is that citizens within society are highly interconnected and interdependent. If marijuana use leads to the degradation of an individual in various ways, this creates stresses on other individuals who depend on that individual. For example, an individual may be unable to function properly in their job due to their marijuana use, and this may damage the business they are involved with. This damage, in extreme circumstances, could lead to layoffs of other workers or possibly even the disintegration of a business. Another frequent example is the degradation of a family due to marijuana use, and the subsequent degradation of a church and community. To significant degrees, these social damages can be seen as violations of the liberties of other individuals to the extent that liberties can be defined as the opportunity for individuals to seek fulfillment and happiness.
  • Marijuana's public health costs violate tax-payer liberties


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Gateway drug: Is Marijuana not a gateway drug?

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Yes

  • There is little evidence that Marijuana is a gateway drug If marijuana was a gateway drug, you would expect to see high numbers of marijuana consumers also being, for instance, cocaine users. But, this correlation does not really exist. In America, for every roughly one hundred marijuana user, there is only one cocaine user.
  • It is unclear whether Marijuana-use is the cause of wider drug-use A direct causal link between an individual's marijuana consumption and their subsequent "hard" drug consumption. It is completely possible, for instance, that individuals who choose to partake in marijuana consumption are inherently more risk-taking. Therefore, their choice to try cocaine could be completely causally dissociated from their initial consumption of marijuana.
  • Marijuana may be a "gateway drug" because it's in the drug blackmarket Marijuana is often criticized as being a gateway drug to harder drugs, and this is used as a justification for its illegality. Irrespective of a lack of evidence in this regard, there is reason to believe that marijuana's illegality itself could be the cause of Marijuana being a gateway drug. The illegality of marijuana causes its sale, purchase, and consumption to occur in the blackmarket, where the sale, purchase, and consumption of all other hard drugs occur. This means that marijuana's blackmarket existence causes consumers of it to be exposed to a network of other, harder blackmarket drugs, which subsequently increases the likelihood that these consumers will be swayed to try harder drugs. If marijuana was legalized, the sale, purchase, and consumption of marijuana would not take place within these blackmarket, and therefore the link to harder drugs would be broken.
  • Alcohol is more of a gateway drug than marijuana.


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No

  • Marijuana is a gateway drug Marijuana is considered a "soft" drug, as compared with "harder" drugs such as cocaine, heroine, and crystal meth. This is because it is less addictive and generally considered less harmful than these other drugs. But, the problem is that, as a "soft" drug, marijuana acts as a stepping stone or "gateway" to "harder" drugs. Having tried marijuana and having been indoctrinated into the world of "mind-altering" drugs, people are much more likely to then try harder drugs. The illegality of marijuana creates a barrier before this "gateway".
U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA press release on their report. "Initiation of Marijuana Use: Trends, Patterns and Implications". August 28, 2002. - "A new federal report released today concludes the younger children are when they first use marijuana, the more likely they are to use cocaine and heroin and become dependent on drugs as adults.[...] Increases in the likelihood of cocaine and heroin use and drug dependence are also apparent for those who initiate use of marijuana at any later age".


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Economics: Is legalizing medical marijuana economically wise?

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Yes

  • Reduce government expenditure The cost of battling marijuana distribution and possession is exorbitant. By legalization for medicinal purposes, producers of marijuana can opt to sell the cannabis through legal channels and do not need to be caught, prosecuted, or jailed- all things that require taxpayers money. A Harvard University professor of economics, Jeffrey Miron, calculated legalizing marijuana would save $7.7 billion annually in money spent on enforcing dope laws.The case for legal pot use
  • Increase government income Having it a legal product, the government can tax the marijuana and increase state revenue. Harvard's Miron estimates that tax revenue for legalized pot would run about $2.4 billion annually if it were taxed like all other goods.The case for legal pot use
  • More money for other sectors The money that the government saves from not having to enforce laws to prohibit marijuana, along with the extra tax income from legal sales, can be allocated to more important sectors like education and health-- i.e. better management of funds, better economics.


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No

  • Cannabis as a drug incurs twofold costs to the state. Firstly, a state is paying all the restrictive apparatus caused by marijuana being criminalized. Secondly, its citizens aren't given the medical treatment they need and waste money on less efficient medications. In addition, sufferers and their carers are criminalised by the current policy and forced to trade with underworld dealers for relief from their conditions.


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Use/abuse: Would legalizing medical marijuana increase use and abuse?

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Yes

  • Legalizing medical marijuana does not increase general use and abuse. Mitch Earleywine, Ph.D., Associate Professor of Psychology, State University of New York at Albany Karen O’Keefe, Esq. Attorney & Legislative Analyst. Marijuana Policy Project Report. "Marijuana Use by Young People: The Impact of State Medical Marijuana Laws". September, 2005. - "While it is not possible with existing data to determine conclusively that state medical marijuana laws caused the documented declines in adolescent marijuana use, the overwhelming downward trend strongly suggests that the effect of state medical marijuana laws on teen marijuana use has been either neutral or positive, discouraging youthful experimentation with the drug."[10]



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No

  • Legalizing medical marijuana normalize drug and increase use. Andrea Barthwell, M.D. Former Deputy Director, White House Office of National Drug Control Policy (ONDCP). Chicago Tribune editorial. February 17, 2004. - "By characterizing the use of illegal drugs as quasi-legal, state-sanctioned, Saturday afternoon fun, legalizers destabilize the societal norm that drug use is dangerous. They undercut the goals of stopping the initiation of drug use to prevent addiction.... Children entering drug abuse treatment routinely report that they heard that 'pot is medicine' and, therefore, believed it to be good for them."


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Social: Would legalization entail heavy societal costs?

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Yes

  • Illegal marijuana forces sufferers to purchase on the black market. Presently, cannabis is sold by dealers who have connections with the underworld. The legalization of cannabis will help facilitate the sale of the drug in establishments like Amsterdam’s "coffee houses". This will shift the sale of cannabis away from the criminal underworld. The severance of this ‘criminal link’ will ensure that the users of the drug no longer need to come into contact with organized crime.


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