Non-Medical Marijuana: Rite of Passage or Russian Roulette? | The National Center on Addiction and Substance Abuse

Non-Medical Marijuana: Rite of Passage or Russian Roulette?

Non-Medical Marijuana: Rite of Passage or Russian Roulette?

Published: July 1999

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This white paper is a comprehensive report on non-medical marijuana, drawing a clear distinction between medical and general use of the drug. It focuses on the suitable public policy for governing the general non-medical use of marijuana, analyzing the likely effects of both decriminalization and legalization, reviewing the historical lessons of America’s marijuana policy and considering the experience of the Netherlands, which had decriminalized marijuana use. It also details the risks to teens of marijuana use and explores marijuana as a gateway drug.


This CASAColumbia white paper involved a comprehensive review and synthesis of information from relevant publications.


Legalization or decriminalization of non-medical marijuana would pose a serious threat to millions of America’s children, increasing their use of this dangerous drug and taking away critical support for parents, teachers and others attempting to steer kids away from drugs. The report found that in 1996 (the latest numbers available at the time of publication), more teens age 19 and younger entered treatment for marijuana abuse and dependence than for any other substance, including alcohol. In fact, nearly as many teens and children were admitted to treatment for marijuana as were admitted for abuse of and dependence on all other substances combined. Teens and marijuana are a dangerous combination.

The report recognized that the determination of the medical value of marijuana should be made by physicians and scientists, but found that any such determination had no relevance to prohibition of the general use of marijuana.

In light of the discussion about the medical use of marijuana, the report stresses the serious consequences of non-medical marijuana use, especially by children, which include:

  • Impairment of short-term memory, concentration and motor skills, critical for a child’s intellectual and social development
  • Greater likelihood of use of another illegal drug, such as cocaine or heroin
  • Increased likelihood of having unprotected sex or sex with multiple partners, leaving minors at greater risk of pregnancy, AIDS and other sexually transmitted diseases
  • Slowed reaction time, impaired coordination and decreased attention span, leading to increased traffic crashes and fatalities
  • Possible long-term physical and psychological dependence

The report also suggests that a policy that decriminalizes or legalizes marijuana for adults while continuing to ban it for minors is unlikely to be effective. Although the sale of tobacco is prohibited for those under 18 and alcohol for those under 21, the report notes that the use of these drugs by adolescents far exceeds that of marijuana, clearly demonstrating that age restrictions on the use of substances that are available to the entire population are difficult to enforce. Despite the massive public education campaign against smoking, rates of tobacco use among young people remained steady from 1978 to 1998, while over the same time period, marijuana use decreased by approximately 50%.

The report also concludes that:

  • The statistical link between marijuana and other drugs like LSD, cocaine or heroin is stronger than those between smoking and lung cancer, high cholesterol and heart disease, and asbestos and lung cancer
  • The higher THC content available in today’s marijuana makes psychotic and other reactions (anxiety, agitation, delusions, amnesia, confusion and hallucinations) more likely
  • One marijuana cigarette is the equivalent of 4 tobacco cigarettes in terms of tar, 5 tobacco cigarettes in terms of carbon monoxide and 10 tobacco cigarettes in terms of damage to airways
  • Because the law has a normative as well as a punitive function, decriminalizing marijuana would decrease its perceived harmfulness and lead to more widespread use


The report recommends expanded prevention, treatment and research to ensure that even if we cannot achieve a 100% drug-free America, we can at least minimize the number of users and the consequences of their use and maintain a drug policy founded on the beliefs that drug use can be prevented and drug abuse can be treated.

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