Marijuana Legalization and the Opioid Crisis

In 2012 Washington and Colorado became the first states to legalize marijuana for recreational use and since 2016 eight states plus the District of Columbia have followed suit (Girard, 2018).  As of 2017 twenty-eight states had legalized the medical use of marijuana (Girard, 2018).  While there are several proposed benefits to the legalization of marijuana (decrease in violent crime, less incarcerations, more taxable income) it has existed for a relatively short time, which makes weighing the pros and cons of its legalization difficult to measure.  Since the legalization of marijuana, The University of Colorado emergency department has experienced an increase in accidental ingestion of marijuana by children, a spike in burn center admissions as well as increased visits for pure marijuana intoxication, all of which were unexpected effects (Monte, Zane, & Heard, 2015).  Marijuana accounts for half of all drug related arrests in the United States and therefore decriminalization of marijuana would reduce incarcerations (Caulkins, Kasunic, Kleiman, & Lee, 2014).  In regards to violent crime reductions, there doesn’t appear to be any connection to marijuana legalization and reduction in violent crime (Maier, Mannes, & Koppenhofer, 2017).

Alcohol is more detrimental than marijuana, although it is a legal substance.  There are no documented deaths from marijuana, while alcohol intoxication can lead to coma and death.  Marijuana does not prove to have any physical dependence associated but strong psychological dependence, which can cause laziness, decreased concentration and memory loss (Girard, 2018).  Alcohol can lead to loss of emotional control and impair decision making, which can result in driving while intoxicated or engaging in violent behavior, not to mention the long-term effects on the liver (Girard, 2018).  The most pressing drug crisis at this time is not marijuana or alcohol but the abuse of prescription opioids.

The 2016 Comprehensive Addiction and Recovery Act authorized education campaigns but did not appropriate funds for them and the 21at Century Cures Act designated almost a billion dollars towards prevention strategies but there has been minimal attention paid to its implementation and effectiveness (Koh, 2017).  Education of lay people in administering the opioid agonist Naloxone has proven effective in places like Massachusetts and law officers and emergency medical personnel now carry it in Pennsylvania.  Intranasal Naloxone is even easier to administer than the intramuscular route and should be immediately rolled out as widely available in all public places.  Prescribing accountability must be enacted in every state and every effort must be made to minimize any new opioid prescriptions.  This must be framed as a public health crisis and the public’s perception of pain and how it should be treated must change.  Pain has never killed anyone but prescription pain-killers, which often leads to use of heroin due to its wider availability has taken thousands of lives.  Those addicted to prescription pain killers and or heroin often engage criminal activity in order to support their addiction in any way possible.  Synthetic forms of opioids, such as fentanyl, are sold on the street as a heroin substitute but is more potent and leads to many more overdoses by its users (Girard, 2018).  The approach to the opioid crisis must be multifactorial from healthcare providers, parents, educators, lawmakers, law enforcement and the general public.  Naloxone must be made available to the entire public for reversal of overdose, pain must be tolerated by patients and caregivers, and all prescribers must be made accountable in a national database in order to combat the prescription opioid epidemic.

References

Caulkins, J., Kasunic, A., Kleiman, M., & Lee, M. (2014). Understanding drug legalization. International Public Health Journal, 6(3), 283-294. Retrieved from https://search-proquest-com.ezproxy2.library.drexel.edu/docview/1625577341?pq-origsite=summon&accountid=10559

Girard, J. E. (2018). Criminalistics: Foresnsic science, crime, and terrorism (4th ed.). Burlington, MA: Jones & Barlett Learning.

Koh, H. K. (2017, September 17). Community-based prevention and strategies for the opiod crisis. Journal of the American Medical Association, 318(11), 993-994. http://dx.doi.org/10.1001/jama.2017.13767

Maier, S., Mannes, S., & Koppenhofer, E. (2017, May 8). The implications of marijuna legalization and decriminalization in the United States. Contemporary Drug Problems, 4(2), 125-146. http://dx.doi.org/10.1177/0091450917708790

Monte, A., Zane, R., & Heard, K. (2015, January 20). The implications of marijuana legalization in Colorado. Journal of the American Medical Association, 313(3), 241-242. http://dx.doi.org/10.1001/jama.2014.17057

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