I am a huge fan of the Office of National Drug Control Policy’s (ONDCP) Director Michael Botticelli and hold both him and the transforming ONDCP agency he leads in the highest regard. I could write endlessly on what an amazing recovery advocate and ally we have found in Director Botticelli and the ONDCP’s recovery-oriented approach to addressing the nation’s substance misuse challenges. To that end, what follows is in no way an attack on Director Botticelli and the ONDCP but more so a challenge to the substance use disorder prevention, treatment and recovery field – this is directed at the practitioners, advocates, individuals and family members in recovery, researchers and educators who all share the common goal of making prevention, early intervention and recovery from a substance use disorder more accessible and available to all.
Currently we see a debate raging on regarding the legalization of marijuana. This debate has been supercharged in recent weeks by Director Botticelli’s reiteration of the federal government’s stance on opposing the legalization of marijuana as some states have moved toward legalization. Director Botticelli cited the ideas of marijuana as a “gateway drug”, young people having a low perception of risk regarding the use of marijuana and research that supports the dangers of marijuana use on the developing brain as some of the core reasons for opposing legalization. Many experts and advocates are in agreement and see the legalization of marijuana as potentially increasing use among youth. Many other experts and advocates disagree and see this as a step backwards in what has been forward momentum around decriminalizing substance use and substance use disorders.
While I do not pretend to know the best direction to go in, I do believe there are some aspects of this debate that are important for all of us to consider. As a person in long-term recovery from a substance use disorder who has utilized an abstinence-based pathway to recovery for close to 11 years, I recognize that for me personally, using marijuana – whether it is illegal or legal – is not something that is in the best interest of my recovery and therefore not something I can engage in. Just like the act of indulging in the currently legal substances of alcohol, tobacco and McDonalds cheeseburgers is not in alignment with the practices I need to maintain my health and wellness, marijuana is in the same boat. Moreover, I can recognize that my abstinence from alcohol, tobacco and McDonalds cheeseburgers is what remains the best practice for me personally while not imposing my personal needs and choices on other people. Millions of individuals can use these substances and eat a cheeseburger afterwards without it moving into problem use or a substance use disorder. I just happen to not be one of them. I do not need to oppose other people’s use of these substances just because it would not be a good idea for me and many of my friends. I recognize that many of my friends and I, despite sometimes living in still siloed recovery systems that do not allow for us to see it, are actually in the minority when it comes to this need for abstinence only.
In addition to the idea that abstinence from marijuana is not the goal of nor necessary for more individuals than not, another point to consider is the following. Alcohol, a legal drug and the most deadly, has seen a steady decline among youth and was actually used less than marijuana among 8th graders in 2014 according to the National Institute on Drug Abuse. The use of tobacco, another legal and the second most deadly drug, has also steadily declined among young people. The idea that legalization increases use falls flat when we look at steady decreases in the use of these two substances. Perhaps we ought to explore more how education and prevention efforts may have aided in this decline and how these efforts can be enhanced and more effective when substances are in fact legal. At the very least, the data shows that marijuana use among youth is already happening at a rate higher than that of legal substances, so keeping marijuana illegal doesn’t seem to be working out too well for our nation’s young people.
To reiterate, I do not pretend to know the answer as to whether the legalization of marijuana would increase or decrease use among youth. I believe more unbiased research is needed and there is much to consider. What I do know however is that we have a lot of evidence showing continued decreased use among youth when it comes to legal substance use with increases in illegal substance use. I also know that we have a lot of old thinking still pervading how we approach this issue and that some of us who subscribe to and apply the abstinence-based pathway in our own lives have difficulty seeing other possibilities outside of only abstinence. Ultimately, for those of us who practice, advocate, educate, shape policy around and aim for change in the area of substance misuse, I only propose that we step back for a moment and think more openly, critically and broadly about the idea of legalizing marijuana use. We owe it to our young people to be doing just that.