The argument that we, as a nation, can “Make Marijuana Safer by Making It Legal” [Oct. 2014] is shortsighted at best and a public disaster at worst.

Medical marijuana should be legalized for use in every state and under federal law. But it should be restricted to patients who have documented medical conditions that either cannot be controlled with standard medical treatments or for whom those treatments cannot be tolerated.

However, legalization of “recreational” marijuana will have a major detrimental effect on the health of individual users and on the health care system in this country. Decriminalization for possession is a viable option and one that will not put the profit motive into its legal production. It is not an “unjust” law to prohibit marijuana. Yes, arresting users is a waste of money, resources, and lives. But arresting distributors is not.

Prohibition of marijuana is not a violation of our personal liberties. The Constitution was not based on “life, liberty, and the pursuit of happiness.” This reference, from the Declaration of Independence, was not meant to elevate an individual’s desires above those of the common good. It did not have the same meaning and intent that we interpret “happiness” to mean. It was intended to describe an individual’s feeling of self-worth by contributing to society as a whole.

In order to see the detrimental effect that legalization will have on society, you just have to read the accompanying article, “The Impact of Legalization of Marijuana in Colorado” [Oct. 2014]. How many more homeless are there in the state who came specifically to obtain legal marijuana? How many more ED visits and hospitalizations? How many more children will suffer from either accidental or intentional toxic ingestions from edible marijuana products?

Just because there is already one legal intoxicant that permeates society, alcohol, with its consequences of increased motor vehicle accidents, chronic medical conditions, and social issues including marital breakups, spousal and child abuse, lost days from work, and untold millions of dollars spent in hospital visits and care for alcohol-induced medical conditions, does not mean that a “safer” one should also be legalized.

And legalization is not safer for children. True, drug dealers don’t ask for IDs and proof of age. But neither do many bars and liquor stores. Yet children can obtain liquor with false ID cards and through others and will do the same with legalized marijuana.

Legalize medical marijuana, decriminalize recreational use, but do not encourage its use by legalizing recreational marijuana. It will have deleterious effects on everyone in this country, especially the children. It will lead to increased numbers of motor vehicle accidents, learning detriments among young users, increased ED visits and hospital admissions, and increased homelessness and unemployment.

In the AMA’s Code of Medical Ethics, the Principles of Medial Ethics state the following:

“A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.”

The issue becomes, then, what we, as physicians, deem are the best interests of patients.

It goes on to state:

“A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.”

A physician’s first duty is to do no harm. If physicians are seen approving and encouraging the legalization of recreational marijuana, the general public will surmise, “It can’t be that bad since they say it’s safer than alcohol.”

For those physicians who believe that the continued use of marijuana or any other substance that may impede their clinical skills will not be a problem, just ask yourself if you would let a physician who uses marijuana treat a member of your family. If the answer is yes, then perhaps it is time to “heal thyself.”

–Paul Rossi, DO
Cherry Hill, New Jersey

I am glad to see ACEP Now discussing the issues involving marijuana. Although I have very deep personal feelings favoring full legalization, I will try to keep this response based out of my medical perspective.

We are physicians. It is our job to give our medical expertise regarding potentially lethal, disabling, and harmful substances. As an emergency medicine resident, I see the effects of drugs and alcohol literally every shift. Whether the issues are acute intoxications or withdrawal, these issues plague emergency departments everywhere. Not once have I seen an acutely ill patient due to marijuana. Not once due to intoxication, and not once due to withdrawal issues. I cannot count the times I have intubated for heroin intoxications and alcohol intoxications. In Baton Rouge, we now have a very severe problem of synthetic marijuana, of which we have also seen lethal consequences in terms of both morbidity and mortality.

This being said, how can we seriously look into our patients’ eyes, as well as the public’s, and state marijuana is a substance to be feared and outlawed? The public and our patients lose all credibility for us, the same way we looked at our teachers in middle school when they told us if we smoked a joint, we would be moving on to “hard drugs” in no time.

Hopefully, ACEP can mount the courage to look at the facts and stop this backward stance on marijuana.

–Marc Zosky, DO
Baton Rouge, Louisiana