The Green Mistake

Trends of leisure activities have certainly changed in this country over the years. And, generally speaking, it’s not the government’s job to tell you what you’re allowed to do for fun. People argue all day about the line between true freedom and government rules and regulations. And the best way we can think about this is to hope that our legislators on Capitol Hill are constantly thinking about the well-being of our people and the health of our nation. This short intro truly sums up a key issue on the floor of Congress. Currently, about 20 pieces of legislation have been drafted and introduced by veteran senators and presidential candidates such as Elizabeth Warren (D-MA) and Cory Booker (D-NJ) to legalize marijuana across this entire nation. This is a significant time in our country as 33 states have allowed for medical marijuana and 10 states have legalized recreational marijuana. The question of whether we become like Canada or stay away like Sweden has become a hot topic in the 2020 race for the presidency.

So, I want to talk about marijuana and give you the facts from scientific research that will either assure you of your beliefs or clear up some myths about the most commonly used illicit drug in America. I will only give you numbers that have come from reputable, peer-reviewed journals, which are products of years of painstaking research. I’ve had the marijuana debate with several people, and the proponents of marijuana legalization make 3 key arguments, each of which I want to address:

  1. Marijuana is not that bad for you, and it’s safer than alcohol.
  2. In states that marijuana has been legalized, marijuana usage, alcohol usage, and opioid usage have all gone down.
  3. Marijuana can be taxed and will provide great economic benefits to our country.

When comparing the effects of marijuana and alcohol on the body, it’s important to note that these drugs affect the body in different ways, and the amount of research done on alcohol far outweighs marijuana. You’ve probably already heard a lot about the negative effects of alcohol and the cognitive impairment it brings along, but what exactly does marijuana do to your body? Marijuana has been linked to some types of cancer (and cancer in offspring), chronic cough, cognitive impairments (in learning, memory, and attention), impairments in academic achievement, and development of schizophrenia. Scary, right? Well, what’s scarier is that in states that have legalized marijuana such as Washington, 8th grade and 10th grade kids perceive marijuana as less harmful and their marijuana usage has increased compared to pre-legalization. With all the country’s debate, kids don’t see marijuana as very dangerous, particularly because 10 states have legalized it.

I’ve heard numerous people say that marijuana helps them calm down, and this is supported by research, but only in the short term. Studies describing long term effects clearly state that marijuana is associated with anxiety, depression, poorer sleep quality, and organ damage. The few studies comparing the harmfulness of marijuana to alcohol have shown that marijuana is more neurotoxic while alcohol has greater negative effects on the liver. It is important to note that there is a consensus on the negative effects of alcohol on the health of the American people; however, the prevalence of alcohol usage makes banning the drug impossible. But, it’s not too late to fight marijuana. Instead of adding another addictive drug to the market, wouldn’t we want to keep it off?

And this brings the discussion to the next point made by proponents, which is that marijuana legalization leads to reductions in marijuana, alcohol, and opioid usage. Looking at the numbers, this simply is not true. Statistics from states that have legalized marijuana (even if it’s just medical marijuana) show that marijuana usage goes up after legalization. Furthermore, 22% of medical marijuana users have admitted to selling their drug to non-medical users! It’s a clear picture: greater availability leads to greater usage. Now, after marijuana was legalized in Colorado, Washington, and Oregon, a few articles came out saying that alcohol sales in the state would be hurt because people will be substituting marijuana for alcohol. Lawmakers for marijuana legalization treasured these initial numbers and predictions…. until the Distilled Spirits Council came out and said that the legalization of marijuana in these states had absolutely no negative effect on alcohol sales. In actuality, the Distilled Spirits Council reported that spirit sales have increased by 4% in Oregon, 5% in Washington, and 8% in Colorado since each state’s respective legalization date. This data, in addition to studies tracking adolescents over several years, have shown that alcohol and marijuana are not substitutes, but rather they are complements in deteriorating health.

Now, for opioids. So, opioid usage has gone down since recreational marijuana was legalized in 10 states. Big win for marijuana lovers? Well, not quite. During the same time that recreational marijuana was being legalized in some states, our nation began tackling the opioid crisis.

Legislators and our president realized that tens of thousands of people were dying from opioid overdoses. To tackle the problem, strict legislation was passed, in tandem with new rules by the CDC, to limit the amount of opioids prescribed to patients by physicians. This time, less availability led to less usage. Reductions in opioid usage has been a win for our nation, but we must take caution before we attribute that positive outcome to the legalization of a different harmful substance.

Lastly, we can talk about money. America is in a debt crisis. Our nation’s debt has exceeded $22 trillion, and we don’t have a bipartisan plan to pay off our debts. Is the legalization and taxation of marijuana the solution? The states that have legalized marijuana have raised over a billion dollars in tax revenue, but the reality is that much greater costs are being incurred. Health costs of marijuana use have already been estimated to be $4.50 for every dollar raised in tax revenue, and the costs associated with federal legalization are unknown. With all of this in mind, I encourage you to take an active role in politics by choosing candidates based on their views regarding issues such as marijuana that could greatly affect the well-being of our nation.

Sources:

Alcohol Clin Exp Res. 2016 Jan;40(1):33-46. doi: 10.1111/acer.12942. Epub 2015 Dec 21.

Am J Psychiatry. 2019 Feb 1;176(2):98-106. doi: 10.1176/appi.ajp.2018.18020202. Epub 2018 Oct 3

Ann Epidemiol. 2017 May;27(5):342-347.e1. doi: 10.1016/j.annepidem.2017.05.003. Epub 2017 May 10.

Drug Alcohol Depend. 2017 Jan 1;170:181-188. doi: 10.1016/j.drugalcdep.2016.10.025. Epub 2016 Oct 26.

J Subst Abuse Treat. 2017 Oct;81:53-58. doi: 10.1016/j.jsat.2017.07.012. Epub 2017 Jul 29.

JAMA Pediatr. 2017 Feb 1;171(2):142-149. doi: 10.1001/jamapediatrics.2016.3624.

JAMA Psychiatry. 2018 Jun 1;75(6):585-595. doi: 10.1001/jamapsychiatry.2018.0335.

Wilkinson S. T. (2013). Medical and recreational marijuana: commentary and review of the literature. Missouri medicine110(6), 524–528.

So, you’re unhappy with the US healthcare system…

Chances are that you are part of the nearly 80% of people who are unsatisfied with the costs of healthcare in our country. And it’s justified! Articles come out almost daily talking about the trillions of dollars spent on healthcare in the United States each year and the stark difference between costs of care in the US versus countries such as Canada. Even when we look back at history, it seems as if nothing has changed. In the 1940s, during Truman’s presidency, 82% of Americans said that hospital care and physician fees were too high. In 1990, papers were published saying that 89% of Americans were in favor of fundamental changes to our healthcare system. So why, after nearly 100 years, can’t we get it right? Movies such as Sicko have come out to show the public that healthcare in the US should be “free” like it is in Canada and that our government is cheating us! In no way is our healthcare system perfect (it has a great amount of room for improvement), but it’s all about perspective. With such a personalized service such as healthcare, it’s important to look at the issue from numerous angles before jumping on the ‘socialized medicine’ bandwagon.

Socialized medical systems are monetarily cheaper. This is a fact. Regardless of what those on the right or left try to say, there is simply too much published evidence showing that administrative costs in the US healthcare system are far greater than any nation embracing a socialized system. However, these studies are only comparing costs in dollars spent, while in reality, there is a price for time and an incalculable value for life. A socialized medical system may cost less on a balance sheet, but it would be a disservice to the American people to base the future of our healthcare system on whether the expenses are higher on a balance sheet. Let’s talk about Canada as an example for what all this means. Canada has a single-payer healthcare system, meaning that medical coverage for all citizens is publicly funded. Those public funds come from Canadians’ tax dollars, so healthcare is not “free,” but rather everyone is paying for each other as a collective. This single-payer system does not incentivize physicians to see more patients or work longer hours because each physician is on a salary that stays the same whether they see five patients or twenty patients in a day. Because of this and numerous other factors, average wait times to see a family practice physician, see a specialist, or even visit the emergency room are considerably longer in Canada compared to the United States. Although sources vary, the average wait time to see a physician in the US is 3-4 weeks while in Canada, estimates of averages are as high as 18 weeks. These long wait times frequently result in physical and emotional stress for a patient, loss of work productivity, time, and money. Worse, thousands of patients have died simply waiting for care. All this begs the question: what are the real costs of socialized medicine?

There are numerous issues with our healthcare system that must be focused on instead of fundamental shifts that have a slim chance of passing in Congress. The real issues can be seen right here at home. Various hospitals, whose main goals are to maximize profits, call themselves non-profit hospitals in order to avoid paying taxes. Researchers have found that non-profit hospitals act incredibly similar to for-profit hospitals and the “community benefit” promised in exchange for their tax exemption is questionable. Another issue is that we have physicians who practice defensive medicine by ordering many unnecessary tests because they look at patients as potential litigants. Studies have shown that up to 90% of physicians practice defensive medicine due to fear of litigation, and this greatly increases the overall costs of our healthcare system while also failing to benefit the patient or the physician. Arguably the most important problem with our healthcare system is a near total lack of price transparency. If every hospital clearly laid out the fees associated with each medical procedure, market forces would come into play and drive down the price of healthcare for all of us. By keeping prices secret, which is supported by large hospital lobbying groups, hospitals gain while we as healthcare consumers pay an absurd amount for our care.

We all haven’t mined for coal or dealt first-hand with our debt crisis, but all of us have received healthcare from the United States healthcare system, and that’s what makes healthcare such a personal public policy issue. And it would be wrong for me to say that we are not happy with the quality of care provided. Physicians, nurses, and other medical staff in the United States provide excellent care that even attracts individuals from other countries when dire medical attention is needed. Americans highly rate the quality of care provided to them, but like most large-scale systems, improvements can always be made. It is important, however, to make and fight for those improvements with caution because the health of the American people and our nation are at stake.

Sources:

Blendon RJ, Benson JM. Americans’ Views On Health Policy: A Fifty-Year Historical Perspective. Health Affairs. 2001;20(2):33-46. doi:10.1377/hlthaff.20.2.33.

Woolhandler S, Himmelstein DU. The Deteriorating Administrative Efficiency of the U.S. Health Care System. New England Journal of Medicine. 1991;324(18):1253-1258. doi:10.1056/nejm199105023241805.

Health Aff (Millwood). 2014 Sep;33(9):1586-94. doi: 10.1377/hlthaff.2013.1327.

Sekhar MS, Vyas N. Defensive medicine: a bane to healthcare. Ann Med Health Sci Res. 2013;3(2):295–296. doi:10.4103/2141-9248.113688