Written Testimony Regarding Marijuana Regulation Before the Indiana Criminal Law and Sentencing Policy Study Committee

July 28, 2011 I applaud the members of the Criminal Law and Sentencing Policy Study Committee for holding this important public hearing regarding marijuana policy in Indiana. THE CASE FOR LEGALIZATION/REGULATION NORML believes that only through state government regulation will we be able to bring necessary controls to the marijuana market. By enacting state and local legislation on the use, production, and distribution of marijuana, state and local governments can effectively impose controls regarding: * which citizens can legally produce marijuana; * which citizens can legally distribute marijuana; * which citizens can legally consume marijuana; * and where, and under what circumstances, is such use legally permitted. By contrast, the criminal prohibition of marijuana provides law enforcement and state regulators with no legitimate market controls. This absence of state and local government controls jeopardizes rather than promotes public safety. HISTORY OF MARIJUANA USE Humans have cultivated and consumed marijuana since virtually the beginning of recorded history. Cannabis-based textiles dating to 7,000 B.C.E have been recovered in northern China, and the plant s use as a medicinal and euphoric agent date back nearly as far. In 2008, archeologists in Central Asia discovered over two-pounds of cannabis in the 2,700-year-old grave of an ancient shaman. After scientists conducted extensive testing on the material s potency, they concluded, [T]he most probable conclusion is that [ancient] culture[s] cultivated cannabis for pharmaceutical, psychoactive, and divinatory purposes. [1] Today over 17,000 studies pertaining to the marijuana plant, its unique active constituents (cannabinoids), and the human body s own marijuana-like chemicals (endocannabiods) exist in the scientific literature.[2] We now know far more about cannabis than most foods we eat or pharmaceutical drugs we ingest. Just what exactly do we know? The consistent conclusion drawn by the available scientific literature is that cannabis, when consumed in moderation by adults, poses little threat to public health. Indiana lawmakers should consider regulating it accordingly.

MARIJUANA S IMPACT ON THE BODY The physical, therapeutic, and psychoactive effects one experiences after ingesting marijuana are derived primarily from a family of unique chemicals in the plant known as cannabinoids. Of the dozens of cannabinoids in marijuana, only one THC is significantly psychoactive. Most active chemicals in the plant possess therapeutic properties but do not induce euphoria. Some compounds, most specifically the cannabinoid cannabidiol (CBD) counter act the psychoactive properties of THC, acting as marijuana s anti-marijuana mechanism. The reason a person experiences psychological, therapeutic, or physical effects after ingesting marijuana is largely because cannabinoids interact with individual receptors, so-called CB1 and CB2 receptors, located throughout the body. The CB1 receptors reside predominantly in the brain and regulate the drug s psychoactive effects. The CB2 receptors are located throughout the human body, and play a role in regulating many of the cannabinoids therapeutic effects. Because the majority of the body s CB1 receptors are located in the frontal lobe region of the brain s cerebral cortex (which regulates emotional behavior) and the cerebellum (a region in the back of the brain that primary controls motor coordination), but not the brain stem (which controls life-preserving functions like breathing), ingesting marijuana is believed to be pharmacologically incapable of causing a fatal overdose, regardless of dosage or THC potency. According to a 1995 report prepared for the World Health Organization, There are no recorded cases of overdose fatalities attributed to cannabis, and the estimated lethal dose for humans extrapolated from animal studies is so high that it cannot be achieved by recreational users. [3] The specific psychological, therapeutic, and physical effects experienced after consuming marijuana vary from person to person, and many of these effects are dependent on the percentage of THC or other cannabinoids present in the marijuana consumed. Moreover, cannabis naive users tend to feel different effects compared with more experienced users. For example, if an inexperienced user consumes too much cannabis at one time, they may experience a mix of unpleasant physical and psychological feelings, such as a tachycardia (rapid heart beat), dry mouth, and a growing sense of paranoia. (These adverse effects are commonly referred to as a panic attack. ) Fortunately these feelings, while mildly unpleasant, are only temporary and pose little-to-no actual long-term risk to the users health. As cannabis consumers become more experienced, they become more tolerant to some of the drug s physical effects. Users also learn to better self-regulate (or titrate ) their dosage to avoid any dysphoric symptoms such as paranoia. As a result, most experienced marijuana consumers describe the cannabis high as a pleasant experience that helps them to relax, socialize or unwind. Recently, investigators at the University of Alberta, Canada, conducted a series of lengthy interviews with male and female cannabis consumers to better determine why adults use marijuana. They reported that the majority of individuals who use cannabis recreationally do so to enhance relaxation. Researchers concluded: [M]ost adult marijuana users regulate use to their recreational time and do not use compulsively. Rather, their use is purposively intended to enhance their leisure activities and manage the challenges and demands of living in contemporary modern society. Generally, participants reported using marijuana because it enhanced relaxation and concentration, making a broad range of leisure activities more enjoyable and pleasurable. [4]

MARIJUANA USE VERSUS ALCOHOL USE Throughout history, alcohol and marijuana have been the two most popular social relaxants consumed by western civilizations. Yet the risks posed by marijuana and alcohol both to the individual consumer and to society as a whole are far from equal.For example, a 2009 report published in the British Columbia Mental Health and Addictions Journal Visions estimated, "In terms of [health-related] costs per user: tobacco-related health costs are over $800 per user, alcohol-related health costs are much lower at $165 per user, and cannabis-related health costs are the lowest at $20 per user."[5] Why the dramatic discrepancy? Quite literally, alcohol is an intoxicant; cannabis is not. The word intoxicant is derived from the Latin noun, toxicum, meaning: "a poison." It's an appropriate description for booze. Alcohol is toxic to healthy cells and organs, a side effect that results directly in some 35,000 deaths per year from illnesses like cirrhosis, ulcers, and heart disease.[6] Furthermore ethanol, the psychoactive ingredient in beer, wine, and hard liquor, is carcinogenic. Following ethanol's initial metabolization by the body it is converted to acetaldehyde. This is why even moderate drinking is positively associated with increased incidences of various types of cancer, including cancers of the breast, stomach, liver, esophagus, and pancreas.[7] Heavy alcohol consumption can depress the central nervous system inducing unconsciousness, coma, and death and is strongly associated with increased risks of injury. According to the U.S. Centers for Disease Control, alcohol plays a role in about 41,000 fatal accidents per year.[8]) Alcohol consumption also plays a primary role in the commission of acts of violence. In fact, according to the federal Bureau of Justice Crime Statistics, alcohol consumption plays a role in the commission of approximately one million violent crimes annually. By contrast, cannabinoids are remarkably non-toxic. Unlike alcohol, marijuana is incapable of causing fatal overdose and its use is inversely associated with aggression and injury.[9] Unlike alcohol, the use of cannabis is not linked to increased risk of mortality or various types of cancer including lung cancer and may even reduce such risk. For instance, a 2009 study in the journal Cancer Prevention Research reports that moderate use of marijuana is associated with "a significantly reduced risk of head and neck squamous cell carcinoma."[10] A separate 2006 population case-control study, funded by the U.S. National Institutes of Health and conducted by the University of California at Los Angeles, also reported that lifetime use of cannabis was not positively associated with cancers of the lung or aerodigestive tract, and further noted that certain moderate users of the drug experienced a reduced cancer risk compared to non-using controls.[11] Finally, a 1997 retrospective cohort study of 65,000 examinees by Kaiser Permanente concluded, Compared with nonusers/experimenters (lifetime use of less than seven times), ever- and current use of marijuana were not associated with increased risk of cancer, [including] tobacco-related cancers or with cancer of the following sites: colorectal, lung, melanoma, prostate, breast, [or] cervix. [12] In 2011, the website of the National Cancer Institute, a branch of the federal government, acknowledged: Cannabinoids may cause antitumor effects by various mechanisms, including induction of cell death, inhibition of cell growth, and inhibition of tumor angiogenesis and metastasis. Cannabinoids appear to kill tumor cells but do not affect their nontransformed counterparts and may even protect them from cell death. [13] MARIJUANA S IMPACT ON THE BRAIN

There is little scientific evidence to substantiate the notion that marijuana use permanently or significantly damages the brain. In adults, cannabis consumption is not associated with residual deficits in cognitive skills, as measured by magnetic resonance imaging, neurocognitive performance testing, or fMRI imaging. Most recently, Harvard Medical School researchers performed magnetic resonance imaging on the brains of long-term cannabis users (reporting a mean of 20,100 lifetime episodes of smoking) and controls (subjects with no history of cannabis use). Imaging displayed no significant differences between heavy marijuana smokers compared to non-smokers.[14] Additional clinical trials have reported similar results. An October 2004 study published in the journal Psychological Medicine examined the potential adverse effects of marijuana on cognition in monozygotic male twins. It reported an absence of marked long-term residual effects of marijuana use on cognitive abilities. [15] Likewise, a 2002 clinical trial published in the Canadian Medical Association Journal determined, Marijuana does not have a long-term negative impact on global intelligence. [16] Though a handful of studies have reported that long-term users sometimes perform differently than non-users on certain cognitive tests immediately after ceasing their cannabis use, these same studies report that both former users and non-users test similarly within a matter of days. Notably, a 2001 study published in the journal Archives of General Psychiatry found that long-term cannabis smokers who abstained from the drug for one week "showed virtually no significant differences from control subjects (those who had smoked marijuana less than 50 times in their lives) on a battery of 10 neuropsychological tests." Investigators further added, Former heavy users, who had consumed little or no cannabis in the three months before testing, [also] showed no significant differences from control subjects on any of these tests on any of the testing days. [17] Most recently, a just-published study nearly 2,000 young Australian adults for eight years and found that marijuana has little long-term effect on learning and memory and any cognitive damage that does occur as a result of cannabis use is reversible. [18] MARIJUANA S IMPACT ON DRIVING PERFORMANCE While it is well established that alcohol consumption increases motor vehicle accident risk, evidence of marijuana s culpability in on-road driving accidents and injury is nominal by comparison. Numerous onroad and traffic simulator studies report that cannabis psychomotor impairment is seldom severe or long lasting, and variations in driving behavior after marijuana consumption are noticeably less pronounced than the impairments exhibited by drunk drivers. Unlike motorists under the influence of alcohol, individuals who have recently smoked cannabis are aware of their impairment and try to compensate for it accordingly, either by driving more cautiously or by expressing an unwillingness to drive altogether.[19] As noted in a 2008 Israeli study assessing the impact of marijuana and alcohol on driving performance, [S]ubjects seemed to be aware of their impairment after THC intake and tried to compensate by driving slower; alcohol seemed to make them overly confident and caused them to drive faster than in control sessions. [20] A previous review by Toronto s Centre for Addiction and Mental Health reached a similar conclusion, finding: [S]ubjects who have received alcohol tend to drive in a more risky manner. The more cautious behavior of subjects who have received marijuana decreases the impact of the drug on performance,

whereas the opposite holds true for alcohol. [21] In closed course and driving simulator studies, marijuana s acute effects on driving include minor impairments in tracking (eye movement control) and reaction time, as well as variation in lateral positioning, headway (drivers under the influence of cannabis tend to follow less closely to the vehicle in front of them), and speed (as previously noted, drivers tend to decrease speed following cannabis inhalation).[22] A handful of studies have reported a positive association between very recent cannabis exposure and a gradually increased risk of vehicle accident, though this increased risk is far lower than the risk presented by the consumption of even small amounts of alcohol. For example, a 2007 case-control study published in the Canadian Journal of Public Health reviewed 10years of US auto-fatality data. Investigators found that U.S. drivers with blood alcohol levels of .05, a level below the legal limit for intoxication in the United States, experienced an elevated crash risk that was more than three times higher than individuals who tested positive for marijuana.[23] A prior review of auto accident fatality data from France reported similar results, finding that drivers who tested positive for any amount of alcohol had a four times greater risk of having a fatal accident than did drivers who tested positive for marijuana.[24] Both studies noted that, overall, few traffic accidents appeared to be attributed to driver s operating a vehicle while impaired by cannabis. Under Indiana law it is illegal for any diver to operate a vehicle if they possess detectable levels of cannabis in their bodily fluids. MARIJUANA REGULATION PROMOTES PUBLIC SAFETY Marijuana is not a harmless substance no potentially mind-alerting substance is. But this fact is precisely why its commercial distribution ought to be controlled and regulated by the state in a manner similar to the licensed distribution of alcohol and cigarettes two legal substances that cause far greater harm to the individual user and to society as a whole than cannabis ever could. The above findings demonstrate that any risk presented by marijuana smoking falls within the ambit of choice we should permit the individual in a free society. Therefore NORML supports the establishment of a taxed and regulated marijuana market. Such a scheme would give greater control to state law enforcement officials and regulators by imposing proper state restrictions and regulations on this existing and widespread marijuana market. AN ALTERNATIVE: THE CASE FOR DECRIMINALIZATION Assuming that lawmakers may be hesitant to impose such a scheme of marijuana legalization, NORML would also like to outline several arguments in favor of a policy of marijuana decriminalization. Under present law, minor marijuana possession offenses are classified as a criminal offense, punishable by up to one-year in jail and a $5,000 fine. Amending this law to make such minor possession cases a civil rather than criminal offense (a policy change that is sometimes referred to as 'decriminalization') is a common sense, fiscally responsible alternative that will cut costs, improve public safety, and have a positive impact on the quality of life of tens of thousands of Indianans. Arrest statistics indicate that approximately six percent of all statewide criminal arrests are for marijuana violations.[25] Decriminalization would spare these minor marijuana offenders from criminal

arrest, prosecution, and incarceration, as well as the emotional and financial hardships that follow -including the loss of certain jobs, students loans, federal and state subsidies, and child custody rights. Most adult marijuana users act responsibly and consume marijuana solely within the privacy of their own homes. They are not part of the crime problem and they should not be treated like serious criminals. Decriminalization would maintain the monetary sanctions for marijuana possession violations, but would spare offenders from being saddled with lifelong criminal records. This change would continue to discourage marijuana abuse, while halting the practice of permanently criminalizing thousands of otherwise law abiding citizens of Indiana. DECRIMINALIZATION IMPROVES PUBLIC SAFETY Law enforcement resource allocation is a zero-sum gain. The time that a police officer spends arresting and processing minor marijuana offenders is time when he or she is not out on the streets protecting the public from more significant criminal activity. Decriminalization would allow law enforcement, prosecutors, and the courts to reallocate their existing resources toward activities that will more effectively target serious criminal behavior and keep the public safe. It would also have the added benefit of saving state taxpayers' money and raising revenue. Presently, state and county law enforcement agencies spend millions of dollars per year to enforce marijuana possession laws; millions of dollars are also spent by the courts to adjudicate these cases. Reducing marijuana violations to a civil offense will reallocate law enforcement and judicial resources while simultaneously raising state revenue through the imposition of civil fines. THE PUBLIC SUPPORTS DECRIMINALIZATION Public opinion strongly favors such a reprioritization of law enforcement resources. Marijuana decriminalization enjoys support from the majority of Americans. According to a recent CNN/Time Magazine poll, approximately three out of four citizens favor a fine over criminal penalties for the possession of marijuana.[26] In fact, fourteen states -- including Oregon, Maine, Nebraska, Ohio, and Mississippi -- have already enacted various forms of marijuana decriminalization, replacing criminal sanctions with the imposition of fine-only penalties for minor marijuana offenders.[27] In October 2010, California lawmakers reduced penalties for marijuana possession from a criminal misdemeanor to a civil infraction. Connecticut lawmakers enacted a similar policy on July 1 of this year. In not a single instance have lawmakers recriminalized marijuana after implementing decriminalization. DECRIMINALIZATION WILL NOT INCREASE USE Contrary to the concerns of some, making marijuana possession offenses a civil matter would not negatively impact marijuana use patterns or attitudes. Passage of similar legislation in other states has not led to increased marijuana use or altered adolescents' perceptions regarding the potential harms of drug use. In fact, the only United States government study ever commissioned to assess whether the enforcement of strict legal penalties positively impacts marijuana use found, "Overall, the preponderance of the evidence which we have gathered and examined points to the conclusion that decriminalization has had virtually no effect either on the marijuana use or on related attitudes and beliefs about marijuana use among American young people."[5]

Further, since 1996 fifteen states and the District of Columbia have passed laws exempting stateauthorized patients from arrest and prosecution for their physician-supervised use of marijuana (although Arizona, New Jersey, and Washington, DC have yet to implement these laws). During virtually this entire time teen marijuana use has fallen nationally. Moreover, according to federal statistics, between 2003 and 2008 self-reported monthly pot use among 12 to 17 year-olds dropped precipitously in every state that had enacted medical marijuana legislation.[6] In five states with medical marijuana laws -- Alaska, Montana, Michigan, Nevada, New Mexico, Washington -- reported use fell by more than 20 percent during this time period. In Hawaii, youth pot use fell by more than 30 percent. DECRIMINALIZATION WILL BRING EQUITY TO MARIJUANA LAW ENFORCEMENT Under present law, punishment for minor marijuana offenders varies widely from county to county -with some counties routinely imposing jail time for minor offenders, while others impose far less severe sanctions. In other words, Indianans are being punished differently not based on their actions, but where they live. This process of meting out varying punishments for the same behavior is in violation to our Constitutional desires to maintain equal protection under the law for all. Amending existing criminal penalties to civil fines will bring needed uniformity to our state's sanctions. IN CONCLUSION The goal of this committee is to explore alternative options of Indiana s present marijuana policies. Ideally, such a policy should find effective ways to reduce government expenditures and promote public safety. The most sensible way to achieve this is through regulating cannabis use and production in a manner similar to alcohol. Barring such an effort, lawmakers ought to, at a minimum, consider taking steps to reduce marijuana possession crimes to a civil offense. This alternative is a common sense, fiscally responsible proposal that will cut costs without altering the public's attitudes or use of marijuana.

# END #

[1] Russo et al. 2008. Phytochemical and genetic analyses of ancient cannabis from central Asia. Journal of Experimental Botany 59: 4171-4182. [2] L. Hanus. 2008. Pharmacological and therapeutic secrets of plant and brain (endo)cannabinoids. Medicinal Research Reviews 29: 213-271. [3] Wayne Hall. A comparative appraisal of the health and psychological consequences of alcohol, cannabis, nicotine, and opiate use. National Drug and Alcohol Research Centre, University of New South Wales, 1995. [4] Osborne et al. 2008. Understanding the motivations for recreational marijuana use among

Canadians. Substance Use & Misuse 43: 581-583. [5] Gerald Thomas and Chris Davis. 2009. Cannabis, tobacco and alcohol use in Canada: comparing risks of harm and costs to society. Visions: BC s Mental Health and Addictions Journal 5: 11. [6] MSNBC. Alcohol linked to 75,000 U.S. deaths a year. June 25, 2005. [7] Los Angeles Times. Alcohol consumption linked to increase cancer risk. August 3, 2009. [8] MSNBC. Alcohol linked to 75,000 U.S. deaths a year. [9] Gmel et al. 2009. Alcohol and cannabis use as risk factors for injury a case-control crossover analysis in a Swiss hospital emergency department. BMC Public Health 9: 40. [10] Liang et al. 2009. A population-based case-control study of marijuana use and head and neck squamous cell carcinoma. Cancer Prevention Research 2: 759-768. [11] Hashibe et al. 2006. Marijuana use and risk of lung cancer and upper aerodigestive tract cancer: results of a population-baed case-control study. Cancer Epidemiology Biomarkers & Prevention 15: 1829-1834. [12] Sidney et al. 1997. Marijuana use and cancer incidence. Cancer Causes and Control 8: 722-728. [13] http://www.cancer.gov/cancertopics/pdq/cam/cannabis/healthprofessional/page2 [14] Tzilos et al. 2005. Lack of hippocampal volume change in long-term heavy cannabis users. American Journal on Addictions 14: 64-72. [15] Lyons et al. 2004. Neuropsychological consequences of regular marijuana use: a twin study. Psychological Medicine 34: 1239-1250. [16] Fried et al. 2002. Current and former marijuana use: preliminary findings of a longitudinal study of effects on IQ in young adults. CMAJ 166: 887-891. [17] Pope te al. 2001. Neuropsychological performance in long-term cannabis users. Archives in General Psychiatry 58: 909-915. [18] Maia Szalavitz. July 19, 2011. Marijuana not linked with long term cognitive impairment. Time.com. [19] Menetrey et al. 2005. Assessment of driving capability through the use of clinical and psychomotor tests in relation to blood cannabinoid levels following oral administration of 20mg dronabinol or of a cannabis decoction made with 20 and 60mg delta-9-THC. Journal of Analytical Toxicology 29: 327-338. [20] Ronen et al. 2008. Effects of THC on driving performance, physiological state and subjective feelings relative to alcohol. Accident: Analysis and Prevention 40: 926-934. [21] Alison Smiley. Marijuana: On-Road and Driving-Simulator Studies, In: The Health Effects of

Cannabis. (eds. Kalant et al) Canadian Centre for Addiction and Mental Health: 1999. [22] Paul Armentano. Cannabis and Driving: A Scientific and Rational Review. NORML Foundation. 2008. [23] Bedard et al. 2007. The impact of cannabis on driving. Canadian Journal of Public Health 98: 6-11. [24] Laumon et al. 2005. Cannabis intoxication and fatal road crashes in France: a population base casecontrol study. British Medical Journal 331: 1371-1377. [25] http://www.drugscience.org/States/IN/IN_1c.htm [26] Joe Stein. "The New Politics of Pot." Time Magazine. October 27, 2002. [27] http://norml.org/index.cfm?Group_ID=4516 [28] Institute for Social Research, The University of Michigan. Monitoring the Future Occasional Paper 13. Marijuana Decriminalization: The Impact on Youth 1975-1980. Ann Arbor. 1981. [29] http://www.oas.samhsa.gov/2k8state/AppD.htm#TabD-3

Author s Note: Paul Armentano is the Deputy Director for NORML, the National Organization for the Reform of Marijuana Laws, and he is the co-author of the book Marijuana Is Safer: So Why Are We Driving People to Drink (2009, Chelsea Green).