Schaffer Library of Drug Policy

Marihuana: A Signal of Misunderstanding

Social Impact of Marihuana Use - A PUBLIC HEALTH APPROACH

US National Commission on Marihuana and Drug Abuse

Table of Contents
I. Marihuana and the Problem of Marihuana
Origins of the Marihuana Problem
The Need for Perspective
Formulating Marihuana Policy
The Report
II. Marihuana Use and Its Effects
The Marihuana User
Profiles of Users
Becoming a Marihuana User
Becoming a Multidrug User
Effects of Marihuana on the User
Effects Related to Pattern Use
Immediate Drug Effects
ShortTerm Effects
Long Term Effects
Very Long Term Effects
III. Social Impact of Marihuana Use
IV. Social Response to Marihuana Use
V. Marihuana and Social Policy
Drugs in a Free Society
A Social Control Policy for Marihuana
Implementing the Discouragement Policy
A Final Comment
Ancillary Recommendations
Legal and Law Enforcement Recommendations
Medical Recommendations
Other Recommendations
Letter of Transmittal
Members and Staff
History of Marihuana Use: Medical and Intoxicant
II. Biological Effects of Marihuana
Botanical and Chemical Considerations
Factors Influencing Psychopharmacological Effect
Acute Effects of Marihuana (Delta 9 THC)
Effects of Short-Term or Subacute Use
Effects of Long-Term Cannabis Use
Investigations of Very Heavy Very Long-Term Cannabis Users
III. Marihuana and Public Safety
Marihuana and Crime
Marihuana and Driving
Marihuana - Public Health and Welfare
Assessment of Perceived Risks
Preventive Public Health Concerns
Marihuana and the Dominant Social Order
The World of Youth
Why Society Feels Threatened
The Changing Social Scene
Problems in Assessing the Effects of Marihuana
Marihuana and Violence
Marihuana and (Non-Violent) Crime
Summary and Conclusions: Marihuana and Crime
Marihuana and Driving
History of Marihuana Legislation
History of Alcohol Prohibition
History of Tobacco Regulation
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National Commission on Marihuana and Drug Abuse

Marihuana: A Signal of Misunderstanding

Chapter III

Social Impact of marihuana use


The Commission broadly defines public health concerns as all health problems which affect people en masse and are thereby difficult to treat on a traditional physician-to-patient basis. This category would include social and economic dependence and incapacity. A health problem which spreads to other susceptible members of the society cannot be controlled by the individual physician. This view coincides with the concept of preventive medicine, recognizing that all public health problems must be dealt with on both an individual and societal level.

To illustrate, the increasing incidence of deaths due to lung cancer subsequent to chronic, heavy tobacco usage is a major public health concern. In this instance, prevention of smoking and ascertaining the cause of the malignancies, rather than the individual treatment of each case by a physician, define the public health dimension. A major concern exists because the population at risk is large and growing, and the risk of harm is great.

In addition to the risk of large numbers of the populace being affected, the issue of contagion must also be examined. Unlike infectious diseases such as influenza and smallpox, where the person affected " catches" the ailment unintentionally, those individuals who use marihuana choose to come into contact with it. The contagion model is relevant only insofar as social pressure from proselytizing friends and social contacts play a role in spreading the use of the, drug. This dimension exists with marihuana, as well as alcohol and tobacco.

After assessing the potential harm to the individual and society, the size of the population at risk and the contagion aspect, society must determine the nature of the control mechanism used to deal with the problem, and how nine]) of its health resources, manpower and facilities will be allocated to meet the perceived threat to the public health. Therefore, an analysis of the relative risk of marihuana use must be undertaken. We must examine not only the effects of the drug on the individual but also determine which groups are at risk and why.

Practically all substances consumed by man are potentially dangerous to the physical or mental health of the individual if used irresponsibly or by particularly sensitive persons. Certain substances are sufficiently complex in their effects that societal control is necessary to reduce risk, for example, fluorides added to the water supply, prescription drugs, and food additives. The degree of concern and control varies, depending on relative public health dangers.


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