President's Blog

As Co-Chairs of the ASAM Writing Committee tasked with developing a response to state-level marijuana legalization proposals, we are proud of ASAM’s leadership and decision to educate its members about the dangers inherent in the policy proposals to legalize marijuana.

Many physicians have serious, legitimate concerns about how drug use and drug addiction is treated within the United States. Some look to marijuana legalization proposals as ways to separate the problem of addiction from the criminal justice system. Others look to legalization proposals as ways to increase funding of treatment. We recognize that the marijuana policy issues are complex and we may never achieve consensus in this policy arena. What is abundantly clear to us as a result of the writing process and our research is that such proposals, if passed, would directly impact our nation’s health. Specifically, rates of marijuana use and substance use disorders, including addiction, would increase.

The full extent of outcomes of marijuana legalization is truly unknown because nowhere in the world is the use, sales, and production of marijuana legal. But, based on what is known about the harmful effects of marijuana use and the relationship of marijuana use by youth to its availability and perception of harm, we know we cannot support marijuana legalization.

Availability and access to screening, diagnosis, and treatment for marijuana-related substance use disorders must be improved, but these changes are not tied solely to the illegal status of marijuana.

As physicians in the leading organization specializing in addiction medicine, we see daily examples in our practices that marijuana is a drug of abuse that has serious negative consequences for many users. While legal drugs of alcohol and tobacco currently cause the most serious damage, both in terms of costs and harm to public health and public safety, states with active “medical” marijuana industries have begun to see the costs of quasi-legal marijuana.

Proposals to make marijuana – or any other drug of abuse – more widely available and acceptable, cannot be supported by addiction specialists. The public health is not served by expanded availability, increased acceptability or commercial activities that promote and seek to extend marijuana use.

We thank ASAM for providing much-needed leadership on this relevant public health policy issue.

Dr. Norman Wetterau, President of NYSAM, has submitted this week's blog entry. Contributions from our Chapters, Committees and members are always welcome.

The New York Chapter of ASAM has been actively involved in trying to shape state legislation. Three years ago the Uniform Accident and Sickness Policy Provision Law (UPPL) was passed working closely with the state medical society. We also helped convince several state senators to vote for drug reform, which reduced some sentences and required that every county have a drug court. Last year we found legislation that would prohibit convicting anyone of a crime for possession of small quantities of drugs after a 911 call to report a drug overdose. We called this the Good Samaritan law. The law was going nowhere until we took this issue to the state medical society and together pushed it forward. We met the sponsors, made phone calls to get the committees to consider it and during the last week of the session made calls to get the assembly and senate bills aligned. The law passed and was signed by the governor in 2011.

Every year we work hard to help defeat medical marijuana. We work with Drug Free Schools. The other medical organizations do not want to actively oppose the law, since the sponsor is the head of the assembly health committee. We have met with senators every year, especially those on the health committee. We have passed out copies of the ASAM white paper on this subject. We have made it clear that the issue is not whether Marijuana helps people feel better, but how medications are approved. We support FDA approved, nonsmoked marijuana derivatives. We have pointed out that Sativex is such a product and is being field tested in our state. One of the Drug Policy Alliance positions is that the FDA does not allow research on medical marijuana. Clearly this product is being tested in our state, so we can refute this and other statements made by the Drug Policy Alliance. Unfortunately the pro medical marijuana people have a lot of money behind them, but we have so far been successful.

What are some of the secrets to our success?  Our leaders are also involved in the state medical society and academy of family practice. Both these organizations have lobbyists, whom we know and help. They in turn help us on the issues where we agree. Even on the issue of medical marijuana they will provide us with advice and information. I spend three to five days a year in Albany. Other people also help. After public policy committee conference calls, the members write letters and make phone calls. A chapter needs one or two leaders who will advise others as to whom to write and whom to call. Those chapter leaders need connections to advise them. In our case, we use the state medical society, academy of family physicians, legal action center and drug free schools. The bills are all on the state website. Once you visit a senator’s or assembly office you get to know the staff and can always call them for follow-up.

Find one or two people to provide leadership and then choose one issue. Begin by spending a day visiting legislators. You do not always win, but so far we have had great successes.

Norman Wetterau MD    President NYSAM