One toke over the line?

Manitou Springs, a resort town at the foot of Pike’s Peak in Colorado, takes pride in its weirdness. A popular T-shirt touts the town’s elevation—6,412 feet above sea level—with the slogan, “Dude, I think the whole town is high!”

But now that Colorado’s Amendment 64 has made recreational marijuana legal in the state, Manitou Springs is wrestling with just how weird, and how high, since “64” (to use Colorado shorthand) allows towns to decide for themselves whether to have retail dispensaries.

Like Manitou Springs, many communities are grappling with how to handle pot. Since 2012, Washington has also legalized marijuana for recreational use, and medical marijuana is now legal in 24 states (see graphic). Moral and ethical concerns about pot use are changing. In the 1980s, critics derided the Reagan administration’s War on Drugs and called Nancy Reagan’s “Just Say No” campaign simplistic, but marijuana use among teens plummeted during that era. By 1990 four of five Americans thought marijuana should be illegal.

Today, most Americans favor legalization. In Oklahoma, one of the nation’s reddest states, Democratic state Sen. Constance Johnson is heading an effort to legalize marijuana with, she said, “Genesis 1:29 as the basis of this campaign.” (Genesis 1:29 says, “God said, ‘Behold, I have given you every herb bearing seed … upon the face of all the earth.’”) Johnson hopes to collect 160,000 signatures to put both recreational and medical marijuana on the ballot in November.

Johnson’s debatable use of Scripture aside, other questions remain: Is marijuana safe? (See sidebar.) Do we know what will happen to its price (and therefore its demand) when it becomes legal? Is smoking a joint for relaxation or recreation at home really different from having a glass of wine or, for that matter, cups of coffee that can also have a mind-altering effect?

Rob Schwarzwalder of the Family Research Council has examined these questions and concluded that marijuana should not be legalized, for “marijuana is intrinsically hallucinogenic, and is mind-altering in even the smallest doses.” Schwarzwalder said marijuana today has much higher levels of THC (tetrahydrocannabinol), the psychoactive ingredient, than did marijuana available in years past: “This is not your father’s toke.”

Marijuana has more than 60 active ingredients, and Schwarzwalder acknowledged that in pill form some of them can have positive health effects, such as relieving pain or reducing seizures. He does not object to the use of medical derivatives of marijuana in carefully created compounds and for specific applications, “but there’s a difference between taking a pill and smoking a joint. … Medication taken in pill form is not hallucinogenic.”

Schwarzwalder thinks carefully crafted public policy can allow medical uses of marijuana while maintaining a firm stand on legalization, which both he and the FRC oppose: “We use opiates as pain relievers, but no one advocates the legalization of opium.”

AFTER WALKING a long and difficult road with his daughter Mallory, emergency room doctor Tom Minahan has come to that same position. He opposes the legalization of marijuana but has become an advocate for medical marijuana.

Minahan, the father of four, is the medical director for two pro-life pregnancy care centers and is active in a California evangelical church: “We take our Christian faith seriously.” But Minahan and his wife Carrin found themselves in a faith-challenging situation when Mallory, now 11, had her first epileptic seizures at 14 months: “Over the next decade or more, we tried everything.” Mallory tried a dozen drugs, sometimes three at once, to try to control or eliminate the 30-40 seizures she had each month.

Nothing worked, so the Minahans considered giving their daughter Felbatol, which has such serious side effects—including a significant chance of death—that it is truly a last resort. Minahan hated the idea of giving his daughter a drug that might kill her, and the doctor in him was aware of the Hippocratic Oath he had taken: “First, do no harm.” But, he said, “I was at the end of the line. I remember driving to work one day praying, ‘OK, God. I give up. Either fix her or take her home.’”

Before giving Mallory the drug, Minahan decided to attend a conference on Cannabis and Epilepsy at New York University, where he “was surprised to find only a few tie-dyed people. Most of them were pretty normal.” He learned about a strain of marijuana called AC/DC (after the rock band) that is low in the hallucinogenic THC and high in CBD (cannabidiol), a non-hallucenogenic compound. Some people with seizures had success taking an oil made from AC/DC.

Minahan had concerns about the long-term side effects of the marijuana oil. That’s one of the problems with allowing widespread marijuana use: The research on both health effects and societal effects is minimal. That may seem surprising since marijuana has been used widely for a half-century, and archaeologists have found cannabis seeds in Chinese and other tombs dating back at least 3,000 years, but large-scale and long-term scientific studies that meet rigorous academic standards are rare.

Yet for Minahan, the marijuana oil couldn’t be worse than the seizures and drugs that had taken over Mallory’s life. She had not been in school for three years. The constant worry and stress strained his marriage. So beginning in October 2013 he gave marijuana a try and “saw immediate effects.” The frequency of seizures declined and Mallory started needing less of her other drugs. By July 2014 Minahan could say, “Mallory’s had just one seizure in the past five weeks. She’s back in school. We have our daughter back. We have our lives back.”

Despite his experience, Minahan is “not a proponent of marijuana first. … We don’t need America stoned.” He knows that medical marijuana is often a ruse for recreational use and believes people should first exhaust conventional means. But, he says, “It’s wrong—I would even say it’s unchristian—that we make children take potentially deadly drugs because we won’t give them access to marijuana oil.”

Though Minahan opposes recreational use, he may see a benefit from its legalization: cheaper pot. Minahan currently pays about $2,000 per month for Mallory’s marijuana oil, of which his insurance pays nothing. Legalization or even the less radical step of decriminalization—a fine rather than jail time for possession of small amounts—will likely cause a large drop in the price of pot.

That will likely increase consumption said Beau Kilmer, co-director of the RAND Drug Policy Research Center and co-author of Marijuana Legalization: What Everyone Needs To Know.

As governments try to discover the “Goldilocks” price for pot—the price that is “just right”—they realize how complicated it is. If the price of marijuana is too low, consumer demand skyrockets—but so do the problems associated with widespread use of marijuana. If the price is too high, the black market thrives and tax revenues plummet.

Washington state tried to solve this price/demand problem by placing dramatic taxes on marijuana: 25 percent excise taxes on every wholesale transaction, plus the final retail sale, plus normal sales taxes. That keeps legal marijuana costing about $20 per gram, which is more expensive than black-market pot.

These difficult issues are just the tip of the iceberg. RAND’s Kilmer says his research “opened my eyes to how little we know about the full range of consequences of major marijuana reforms.” That’s why he favors a go-slow approach: “Given the enormous uncertainty about the outcomes of policy changes and the strong possibility of unintended consequences, it is reasonable to incorporate a sunset provision that makes the laws revert back to what they were before reform … unless extended by the voters or the legislature.”

Few states are following that advice. Neither Colorado nor Washington has a sunset provision in its legislation, and none of the provisions on the fall ballot has sunset provisions.

WHICH TAKES US BACK to Manitou Springs. On a cold night back in January, more than 200 people attended a heated city council meeting, the largest crowd in anyone’s memory in this town of barely 5,000 people. At issue: Could recreational marijuana be legally sold in the town? Mayor Marc Snyder and others in favor said the tax revenue would be more than $160,000 per year, “very significant” for a town the size of Manitou.

Those opposed said the revenue projections—though required by law—have little basis in experience and will likely prove wildly inaccurate. Besides, opponents said, much of the money would have to pay for the problems pot sales would create. Because surrounding towns—including Manitou’s much larger neighbor Colorado Springs—had banned marijuana sales, opponents said Manitou Springs would become a destination for marijuana tourism, a place people would come to get high. A few argued that smoking pot was just plain wrong.

The final vote of the Manitou Springs City Council was 6-1 to allow retail sales, but over the summer enough voters signed a citizen petition that the question will be back before voters in November. Although Amendment 64 passed in 2012 with 68 percent of the vote, when voters have cast ballots on retail sales in their own towns, the pro-pot vote has been much lower. Manitou Springs Mayor Marc Snyder thinks the November vote—even in this town that takes pride in its progressive posture—“could be very close.”

Until then, Manitou Springs’ single retail store, Maggie’s Farm—named after the Bob Dylan song celebrating nonconformity—opened on the last day of July at 4:20 p.m., which since the 1970s has been known in the drug culture as “high time,” when school lets out and users light up. About 75 persons waited in the rain to get in. Among them: Kevin “Sarge” MacDonald, a Manitou Springs city councilman.

More than one local news report noted that the marijuana dispensary is conveniently located next to a Loaf ’N Jug, a Colorado-based convenience store chain. It seems unlikely, though, that a case of the munchies will be the only side effect of legalizing recreational marijuana.

Weed killer?

In early 20th-century America, officials warned of the dangers of “marihuana” smoking, claiming it could drive men to insanity and unleash murderous passions. Their fears were exaggerated, but advocates for legalized marijuana today exaggerate in the opposite direction when they claim the drug is “nontoxic” and not addictive.

The American Society of Addiction Medicine, which strongly opposes legalization, says marijuana proves addictive for nearly 1 in 10 habitual users. The mind-altering chemical tetrahydrocannabinol, contained in the cannabis plant, impairs judgment and motor skills and doubles a driver’s risk of having a car accident. (Americans made an estimated 455,000 marijuana-related emergency room visits in 2011.)

According to the National Institute on Drug Abuse, marijuana’s effects include:

Marijuana smoke irritates the lungs, though it’s unclear whether it can cause lung cancer. Use of the drug has been associated with depression, anxiety, and psychosis. Pregnant women who use marijuana are endangering their children’s mental abilities: The drug can interfere with fetal neurodevelopment.

In a widely cited 2012 study from New Zealand, young teenagers who began using pot lost an average of eight IQ points by the time they turned 38. A brain scan study from earlier this year found that young adults who smoked pot weekly had abnormalities in brain structures related to emotion, reward, and motivation.

The Food and Drug Administration has approved medical treatments derived from marijuana to treat nausea in chemotherapy patients and weight loss in AIDS patients. But doctors say the purported ability of marijuana to treat other diseases—like glaucoma, epilepsy, or rheumatoid arthritis—is rooted in anecdotes, not quality research.