Was Legalizing Weed a Mistake? A Debate.

This episode of "The Free Press" features a debate on the legalization of marijuana, evaluating its consequences on society, health, and law.

1. Legalization has significantly shifted public opinion, with a majority now supporting it.
2. High-potency marijuana is linked to increased risks of psychosis and other health issues.
3. The marijuana industry's influence resembles that of tobacco, with potential public health implications.
4. Decriminalization and regulation might mitigate some negative effects, but challenges remain in implementation.
5. The episode reflects broader societal debates about drug policy, public health, and personal freedom.

1: Introduction

Overview of the legalization timeline and current state of public opinion on marijuana. Includes significant quotes, such as Kevin Sabet's comparison of marijuana's current state to tobacco in the 1950s.

2: Health Impacts

Discusses studies showing increased health risks from marijuana use, especially among youth. Quotes include Dr. Peter Grinspoon's views on medical marijuana benefits.

3: Industry Influence

Analyzes the marijuana industry's marketing strategies and public health implications, similar to the tobacco industry. Quotes from both advocates provide perspectives on industry regulation.

4: Legal and Social Dimensions

Considers legal reforms and social justice issues related to marijuana use and incarceration rates. Includes perspectives on how legalization could reduce harm and improve social equity.

• Educate yourself on the effects of marijuana, particularly if considering medical use.
• Support policies that prioritize public health and safety over industry profit.
• Advocate for comprehensive research into marijuana's health effects.
• If using marijuana, choose regulated products to avoid contaminants.
• Engage in community discussions about drug policy and its social implications.

It’s been a little over a decade since cannabis was first legalized recreationally in the United States. As of today, recreational weed is legal in 24 states and the District of Columbia, and Americans have never been more pro-weed. In a Gallup poll from last November, 70 percent of U.S. adults said they support the federal legalization of marijuana, up from 50 percent in 2013 and a mere twelve percent in 1969.

In May, the Biden administration moved to reclassify marijuana from Schedule I, where it sits alongside heroin and LSD, to Schedule III, a category of drugs that the DEA says have a “moderate to low potential for physical and psychological dependence.” States with legal marijuana report economic benefits, a reduced burden on the criminal justice system, and positive health outcomes for patients with chronic pain and epilepsy.

But is legal cannabis really such a no-brainer? A recent study found that marijuana use—whether through smoking, edibles, or vapes—is associated with a higher risk of heart attack and stroke. Other studies have consistently shown that so-called “high-potency cannabis” increases the risk of psychotic episodes in young users.

Today, a debate with two leading advocates both for and against the legalization of marijuana: has decriminalization worked? Or should it be reconsidered with more sober eyes? And is the most widely used and most socially acceptable illicit drug in the world, actually. . . dangerous?

Dr. Peter Grinspoon is a physician and medical cannabis specialist at Massachusetts General Hospital and an instructor at Harvard Medical School. He is the author of Seeing Through the Smoke: A Cannabis Specialist Untangles the Truth About Marijuana.

Kevin Sabet was a drug policy adviser for presidents Clinton, Bush, and Obama. He is the co-founder of Smart Approaches to Marijuana, an advocacy group that has emerged as the leading opponent of marijuana legalization in the United States. He is the author of Smoke Screen: What the Marijuana Industry Doesn’t Want You to Know.

People

Michael Moynihan, Dr. Peter Grinspoon, Kevin Sabet, Snoop Dogg

Companies

None

Books

"Seeing Through the Smoke" by Dr. Peter Grinspoon, "Smokescreen" by Kevin Sabet

Guest Name(s):

Dr. Peter Grinspoon, Kevin Sabet

Content Warnings:

None

Whole Foods Market
Host the ultimate backyard barbecue with Whole Foods Market. It's the hot grill summer event through July 16 with sizzling sales on no antibiotics ever. Boneless beef, rib eye steak and beef New York strip steak. Plus, check out sales on sustainable wild caught Alaska, sockeye salmon, organic strawberries and more. In a hurry.

Choose, grab and go favorites like picnic salads and sushi. Plus, plenty of cooler, friendly beverages. Make it a hot girls summer at Whole Foods Market. From the free press, this is honestly, I'm Michael Moynihan. We can go to the park at the dog smoke.

Josh Hammer
Okay, last time. This is drugs. This is your brain on drugs. Any questions? Snoop, why do you like cannabis so much?

It's a peace situation with me. Every time that I've always been around it. I've seen beautiful things happen. I've seen people, you know, it's been. A little over a decade since cannabis was first legalized recreationally in the United States.

Winds of change are blowing through Washington state this morning, and you might say they smell a little funny. A new law is now in effect, the first of its kind in the US that is allowing adults to own marijuana for non medical use. As of today, weed is legal in 24 states and the District of Columbia. And Americans have never been more pro. Weed in my view.

Michael Moynihan
As I said, I happen to believe. That marijuana should be legal all over this country. All right, we've got to continue that effort.

In a Gallup poll from last November, a full 70% of us adults said they support the federal legalization of marijuana, up from 50% in 2013 and a mere 12% in 1969. When Gallup first asked the question this May, the Biden administration moved to reclassify marijuana from a schedule one drug, where it sits alongside heroin and LSD, to schedule three, a category of drugs that the DEA says have a, quote, moderate to low potential for physical and psychological dependence. The decision to move marijuana out of the same class as drugs such as heroin and bath salts will bring huge implications for research on the potential medical benefits of marijuana. Huge impact on criminal justice, huge impact on federal banking regulations and the US economy, as it's already a multibillion dollar industry. But is legal cannabis really such a no brainer?

A recent study found that marijuana use, whether through smoking edibles or vapes, is. Is associated with a higher risk of heart attack and stroke. Other studies have consistently shown that so called high potency cannabis increases the risk of psychotic episodes in young users. As more states consider the issue, Florida, Indiana, and Wisconsin are all flirting with legalization. It's important to ask, has decriminalization worked, or should marijuana be reconsidered with, well, more sober eyes?

And is the most widely used and socially acceptable illicit drug in the world actually dangerous? I wish you didn't smoke weed.

Snoop Dogg
You're not the same when you smoke. And I miss my friend. Today I sit down with two leading advocates both for and against the legalization of marijuana. Doctor Peter Grinspoon is a physician and medical cannabis specialist at Mass General Hospital and an instructor at Harvard Medical School. He's the author of seeing through the smoke.

Michael Moynihan
A cannabis expert untangles the truth about marijuana. Kevin Sabet was a drug policy advisor for Presidents Clinton, Bush and Obama. Hes the co founder of Smart approaches to Marijuana, an advocacy group that has emerged as the leading opponent of marijuana legalization in the United States. Hes the author of Smokescreen what the marijuana industry doesnt want you to know. Well be right back.

Whole Foods Market
Host the ultimate backyard barbecue with Whole foods Market. It's the hot grill summer event through July 16 with sizzling sales on no antibiotics ever. Boneless beef, rib eye steak and beef, New York strip steak. Plus, check out sales on sustainable wild caught Alaska, sockeye salmon, organic strawberries and more. In a hurry.

Choose, grab and go favorites like picnic salads and sushi. Plus, plenty of cooler, friendly beverages. Make it a hot girl summer at Whole Foods Market. Hey, guys, Josh Hammer here, the host of America on Trial with Josh Hammer, a podcast for the first podcast network. Look, there are a lot of shows out there that are explaining the political news cycle, what's happening on the hill, to this, to that.

Josh Hammer
There are no other shows that are cutting straight to the point when it comes to the unprecedented law fair, debilitating and affecting the 2024 presidential election. We do all that every single day right here on America on trial with Josh Hammer. Subscribe and download your episodes wherever you get your podcast. It's America on trial with Josh Hammer. Why don't we start with you, Kevin.

Michael Moynihan
What is your kind of broad idea about where we are with marijuana in America right now? Well, I think we're sort of where we were with tobacco in 1955. We're in a place where we have a good amount of research. Of course, we've had tobacco research since, for over 100 years now about the harms of tobacco, even though it was kept from the public for so long by an industry who tried to make money. And we had politicians on both sides of the aisle as well as every kind of celebrity you can imagine, sports, Hollywood, et cetera, incessantly endorsing smoking in every way they could.

Josh Hammer
And in some ways, I feel like we're there right now for marijuana. I think we often conflate decriminalization, legalization, and medical marijuana. And even within medical marijuana, we conflate different issues. So everyone from, unfortunately, the president of the United States on down sometimes sort of conflates the issues. Are you an advocate for legalization?

No, I'm not. I'm not. Decriminalization. Well, yes, decriminalization. So let me talk about that.

So, decriminalization, essentially removing criminal penalties for using marijuana, whether people grow it on their own, gift it to their friends, whatever, but generally, a policy that wouldn't treat this like other things that we have legalized, I don't think we have a good track record of that. And I think with legalization in America, it's really commercialization. So my issue is with commercialization. It's with promotion, it's with this industry. And it's very hard in the US to say, well, we can legalize marijuana, but do it in a sort of safe and regulated way, free of corporate influence.

We can talk about that theoretically and in our ivory tower, but it's not the reality on the ground at all. It's never been the reality in capitalist America. So I have a big problem with legalization because I think it's also promoting this. Now, one might say, well, who cares? That's the capitalist system.

Who cares if we're promoting it? It's not a big deal. Marijuana is not that harmful, some might say. And that goes to where I think the science is a lot clearer and a lot different than what most Americans think about marijuana, thanks to, by the way, the industry and their propaganda. Today's marijuana is not Woodstock weed.

It's not what most baby boomers used in college. It's not what most millennials used. And it's been essentially industrialized to be much stronger than it ever has. And I think we're downplaying the negative impacts. For example, the psychosis risk of five fold increased risk doesn't mean a definite thing.

And Peter and I think we'll agree on some of this stuff. I'm not saying it's definitely going to happen to you, but I sort of think of it as like a speed limit. Plenty of people will speed and they'll be fine. They won't get into a car accident. But we have speed limits because we know that when you go over the speed limit, you're increasing your risk of having a problem.

And so we think that that's more important, we're not going to throw you in prison if you're driving 10 miles over the speed limit. But we're going to discourage speeding. And I think we should discourage especially the heavy use of marijuana, especially for those under 30. And I think we've done a terrible job at that with our sort of current legalization in many states. Doctor PeTer Grinspoon, you have a book that came out last year called seeing through the smoke.

Michael Moynihan
A cannabis specialist untangles the truth about marijuana. It seems to me that when I'm reading about this debate, there are many truths, not to be postmodern about it, but there seems to be people that have different ideas of what is true. In your estimation, what is true about marijuana now, you're an advocate for legalization, decriminalization, and I presume also casual use, you think is perfectly fine also? Well, I think with cannabis, there's a lot more common ground that people think there is. This doesn't have to be an issue that we all beat each other senseless about in our society.

Snoop Dogg
I think that in terms of harms, most people would agree that it's not good for teenagers. We really try to discourage the use, unless, like, you know, my brother Danny was growing up and he was dying of cancer, and it really, really improved his quality of life. It helped him keep down food for the last year of his life. So generally, we say to teenagers, just say, wait. We agree that cannabis may trigger or destabilize people with psychosis.

This is pretty rare, but it's not, you know, we do not recommend it in people with a history or family history of psychosis. And I think that it's not thought to be safe in pregnant or breastfeeding women. Now, we also don't know that a lot of the medications that I prescribe as a primary care doctor for the last 25 years are safe. It presents a problem, like, how do you treat a pregnant woman with sciatica? And is cannabis necessary now that it's legal, it's regulated, it's tested, people won't be smoking it.

Ideally, they'll be using a tincture and edible. Is that necessarily more dangerous than the nonsteroidals of the opiates? I mean, how do we treat pain? As sort of a longer conversation, but I think there are certain groups of people that should avoid cannabis. And the older the people start, the better.

That said, I think that there's common ground. 94% of Americans believe in legal access to medical marijuana. It's because it helps people for chronic pain, for anxiety, for insomnia. I think there's a lot of common ground in the medical community and with the public at large that it helps people. It's a question of whether it fixes the problem versus just alleviate symptoms.

We could debate about whether it fixes this or that problem, inflammation, spasticity with multiple sclerosis, but it certainly unquestionably helps people with the symptoms. I think that we have a lot of common ground, a lot more common ground than people think in this issue. And that's actually what I discovered in my book. I think the pro cannabis people tend to idealize it and think it cures everything. And they should be as interested as everybody else, more interested than anybody else about harms.

What are the harms of cannabis? Because the us government has not been very truthful about cannabis during the war on drugs, a lot of people just flat out reject any discussion about potential harms. In fact, I've had patients in my primary care clinic say to me, why should I believe you about a COVID vaccine? The government lied about cannabis and how sort of a long conversation about different people, different times, different agendas, different departments. But I also think the anti cannabis people need to be a little bit more open minded.

Like the American Medical association, they don't represent doctors at all. That's why like 80% of doctors used to be members and now like 10% of doctors are members. They still, when they reference medical marijuana, put it in these like derogatory quotation marks. And there are probably like ten to 20 medical marijuana patients in this country who overall are doing pretty well and are using less dangerous drugs, like fewer opiates and fewer benzodiazepines and fewer the ambiens. You can't argue the cannabis for your average adult person, especially if not smoked, if legal, fused in a modest amount, is more dangerous than something like Ambien, which is implicated in like 10% of car accidents.

So the final thing I'll say is I think that criminalization is the worst case scenario. I'm just not a big fan of criminalizing what people do anyways. It just makes the product dangerous. And if people are struggling, like say they're addicted to cannabis or to anything else, it gives them an extra problem. They have the problem, or all the problems that maybe they're overusing cannabis because they're anxious or depressed or have trauma, you know, it makes all the problems worse to get law enforcement involved.

I agree with Kevin and that we don't need to have a lot of promotion. I'm happy to ban advertising for pharma, alcohol, tobacco and cannabis completely. I don't think any of these need to be promoted, but at the same time, people shouldn't be criminalized for it. And I think with education and regulation, we could do a lot more towards having people as adults use this drug sensibly. Doctor Grinsman, you talk about time and over time, how we've had these conversations.

Michael Moynihan
Time seems to be an important factor in this. I mean, your father, Lester Grinspoon, who is a pioneer, wrote a book in 1971, so long ago, that there was a different spelling of marijuana on the title. It's with an h. And this was marijuana reconsidered. He was reconsidering marijuana.

Now let's fast forward to now. Are we reconsidering something that is totally different than what your father was looking at in 1971 in terms of potency and how much THC is in marijuana, edibles, vapes, or smoked marijuana? It's kind of a different product now, isn't it? I agree that it's not your grandfather's cannabis, as Kevin said. But you know, it's kind of funny.

Snoop Dogg
When I was growing up and people were debating, like a lot of really prominent people debating legalization in my living room, like the Carl sagans of the world and the Allen Ginsburg. And, you know, one criticism of legalization back then is that you had to smoke a whole joint and it was bad for your lungs. Now, a criticism of it is it's so strong, you just have to take a puff. It's like the plant can't win. If it's too weak, is bad for you.

If it's too strong, it's bad for you. I do believe that we fetishize and overemphasize THC. And I think cannabis recreational medicinal would be a lot safer if we focused much less on sky high THC, which unfortunately is what people want. But that's where some regulation maybe could come in and focus more on breeding up some of the more medicinal cannabinoids, like CBD, which can help mitigate some of the side effects of the THC. I'm not a huge fan of the concentrates.

I would probably agree with Kevin about that. The like wax and the shatter, this like 90% those don't have medical uses. But at the same time, I don't believe in criminalizing them or banning them because then they just show up in the illicit market and people use them anyways and they're ten times more dangerous. So again, it all comes back to not banning these products but educating people and trying to shift the societal sort of expectation and norm to lower THC and just a more healthful way of using this stuff. Kevin, on that THC question, Peter says we focus too much on it.

Michael Moynihan
And there are certain states, I mean, with Vermont being one of them, there are caps on how much THC can be in legally sold products. Is that what you think the problem is? Is that when you say there's an increased amount of psychosis among certain people, is that because of THC content? What is it that is provoking that, that didn't provoke that, or didn't seem to provoke that in the past? Well, it's both the content and the quantity consumed.

Josh Hammer
So you mentioned Vermont, which probably represents less than 3% of the entire legal marijuana market. And their caps aren't even that good. And they're about to be repealed by the industry who doesn't want them because it's preventing them from making more money. So it's definitely the outlier. I wish it wasn't.

We need to have caps. There's no reason why we need to be selling 99% THC. I don't disagree with a lot of what Peter said, which is good, but these concentrates that are up to 99% THC, they're a direct product of marijuana legalization. Pablo Escobar didn't come up with them. As bad as he is, it was good old american innovation under the sort of guise of veneer of legality and regulation, which is almost nonexistent in states that is a direct product of the commercialization.

Are these products so the underground market would not have the capacity to create at scale and branding the flavors, the kinds, the varieties that we see on these state legal markets. So there is a difference. By the way, the underground market has gotten bigger since legalization in most states, not smaller. It's responding to demand. It's responding to the fact that they don't have to play by any rules or pretend to play by any rules.

Michael Moynihan
Like pay taxes on that? Yeah. And they can undercut the legal market. A lot was said. I think we have to unpack from Peter.

Josh Hammer
When it comes to medical, I don't think anyone has a problem with either the situation where somebody truly has a debilitating, sort of late stage cancer or terminal disease that, frankly, I don't care if they're smoking methamphetamine, let alone marijuana. So that's not really the issue here. And also most of us, I would say, on the sort of people that are skeptical of legalization, I've never heard anybody saying we shouldn't do more research into marijuana's components and try and deliver non smoked medical products that you can get from a pharmacy, not a girl with a bikini on in Venice beach pretending to sell you a medical marijuana card for your headache or. Or hang nail. So I think that has become.

It's made a mockery, actually. Now, you could argue, well, the advocates had to do that because the government hasn't researched marijuana. That's often the argument. I mean, there's tens of thousands of research studies. Even though marijuana is a schedule one drug, other schedule one drugs have a lot of research on them, too.

It does make it harder. No doubt about it. I've been a big proponent of easing those restrictions. There are a lot of things you could do. Frankly, funding is the chief thing that you can do.

It has nothing to do with scheduling to increase the research. So I think Peter and I would agree that we need more research. We need more funding. Frankly, traditional pharma has not been very interested in marijuana. Not because they're like, you know, hippies and think that it should be left to the people.

It's because they don't really see it as a money maker. They don't see a lot of medical value, but whatever, we should do the research. You mentioned people like Allen Ginsburg and sort of that generation. I think it is so ironic that I went to Berkeley. So I understand this, and I like to joke that I had a group called Citizens for a drug free Berkeley, which was about as popular as the coalition for a wine free France.

Right. Yeah, I know. I walked right into the fire. Seriously? Yeah.

I wasn't the most popular kid on campus, actually. I will say there were a lot of people behind the scenes who liked what I was doing. Anyway, besides the point, my point of saying this is that it's ironic that the sort of hippie generation, the Allen Ginsburgs, the counterculture, has unknowingly, knowingly, I don't know, walked right into the corporate trap. This is not about people wanting to just sing Kumbaya in a drum circle and smoke some joints. This is about Wall street.

These are the people that have never smoked marijuana in their life, but they have a stock index that they follow every day with the different stocks, with the marijuana companies that are operating on it. This is about money. This is about corporate capture. And that, I think, is just completely lost on some very well meaning sort of ex hippies that are rediscovering marijuana and thinking, sure, let's legalize it. It's not that big of a deal.

I also think we've just greatly underestimated the harms when it comes to things like heart disease, stroke, issues with the lungs. Obviously, smoking anything is not good for you. Peter, you look like you wanted to jump in there a few times. I don't agree that the illicit market has gotten bigger since legalization. Before legalization, by definition, the illicit market was zero.

Snoop Dogg
The legal market was 0% of the market. And how it's like in Massachusetts is probably like half to two thirds. We're getting there. The problem is, the states tax it too high. And then to get cannabis in Massachusetts, for example, that isn't illegal through the illicit market is about half as expensive.

Of course, you get what you pay for. If it goes to the legal market, it's, you know, you know what you're getting. It's tested for pesticides, for fungus, for heavy metals. You basically know, more or less the concentration and the different components. Cannabis isn't like cocaine, where people use, like, more and more and more, sort of like alcohol.

People titrate to their own level of comfort. Like, if I. I would never have more than one beer. I'd just be asleep. And other people drink, like, two or three over the course of a barbecue.

Um, and it's the same with cannabis. If you use too much, you get really spaced out and anxious. If you don't use enough, it doesn't do anything. And then the. The vast majority of people titrate to their own level of comfort.

For example, when I used to use it in college, it would be like a puff. I never would take more than a puff, just like alcohol. But I feel good with a puff, but less than a puff obviously didn't do anything. And if I took three puffs, I'd have an awful, awful experience. And the problem with potency limits is that people will smoke twice as much of the 10% THC.

Rather than taking two puffs of the 20% THC, they'll take four puffs of the 10% THC. So that's not necessarily good. And the second thing is, it does drive it into the illicit market, and then a smaller percentage of people will get the safer regulated cannabis, and a larger percentage will be in the illicit market. So I do think we need to study very carefully the health effects of these really, really, really strong concentrates. I personally think the main danger from having THC being so high and having these concentrates is accidental overconsumption.

Accidental overconsumption from edibles and in general, has been going up. Most people titrate to their own level of comfort. So that's why I'm not a huge fan of the THC limits. Kevin, what about that? I mean, I drink, I don't buy everclear, and, you know, down all of that for all that.

Michael Moynihan
I mean, I know how to control myself. I mean, what is the counter argument to that? Well, most drinkers control themselves like you do. And now the research that just came out by probably the smartest person alive studying drug policy, John Calkins out of Carnegie Mellon has shown that actually, although it's about ten to 15% of people who drink alcohol do so daily, and in a very harmful way, it's now approaching 50% of people who used marijuana in the last month are doing so daily. Yeah, this story got a lot of press.

Snoop Dogg
Would you ban Everclear? But, Kevin, would you ban Everclear? I mean, I might. I would certainly not allow the advertising. I would certainly not think it's a good idea for politicians to be saying that it's no big deal and we should be legalizing this.

Josh Hammer
So I might. I might ban Everclear. But honestly, Everclear isn't producing the psychotic breaks. And it's a lot of, it's problematic, for sure, but people, for some reason, with alcohol, are able to titrate. I don't see that with cannabis at all.

If you look at the average user of cannabis, the typical marijuana user pre 2000 was essentially using, if you looked at, even if they were smoking a joint every night, was like 4.5 or six milligrams a day of THC. The average daily user today, assuming there's more grams in the joint, which there are, and the THC is about 20%, and this is only the smokers, not the people using the concentrates and edibles, they're going from 4.6 milligrams in 2000 to over 300 milligrams today. Kevin, they don't smoke the whole joint. Nobody smokes 300 milligrams. Well, if you studies, though, Peter, I mean, look, I wish if I were.

Snoop Dogg
To smoke 300 milligrams, I would be high for weeks, and I would have a horrible experience. I mean, nobody does that. I want you to be right, and I wish your experience was like others, but what we're seeing is close to half of those past month users are now using it daily. I would also say this idea that we're sort of, we're able to kind of regulate it. You know what?

Josh Hammer
You're getting this idea that, you know, at least you know what you're getting. No, you don't know what you're getting. My book, smokescreen, went undercover into the marijuana sort of underworld, into the business. I talked to lab owners, I talked to former state bureaucrats who literally led marijuana regulation efforts. And by the way, that book is two years old.

There's been so much since then. Essentially, most of these labs are cooking the books. There are things in the, first of all, there are pesticides and bacteria and things in marijuana that are absolutely never reported. Marijuana is a very thirsty plant. It's very easy to get.

It's very easy to become contaminated. These people mass producing it really could care less about these micro levels that will add up, but on their own may not make a difference, so they won't show up. The THC levels are often wrong. These things that are labeled CBD, THC, people think they're getting some, like, scientifically validated, sort of FDA approved, magical mixture of THC and CBD where we're able to do it by the milliliter. They're not getting anything.

They don't know what they're getting. Is that not maybe not easily fixed, but fixed by tighter regulations? I mean, I recall maybe 10, 15, 20 years ago that we had no standard for what was organic. So people are just saying anything was organic. Those kinds of things could be free range.

I think it could be. Although again, we've seen regulators be corrupted by this and this industry. I mean, frankly, half the people that have been the main state legislators advocating for legalization and putting the bills through the legislature have gone on into the marijuana industry. So, yes, this is a problem with a lot of things. I don't think that's the chief issue.

My point is just to rebut this sort of idea that right now you kind of know what you're getting all of the time. Peter, 25 states, 24 states DC, and then a bunch more that have medical marijuana, have legalized marijuana consumption for private individuals. What would you make of how that has played out? Did it play out as you expected? Do you see some problems with it?

Michael Moynihan
I mean, obviously there's good things where people aren't clogging up the jails with marijuana offenses anymore. But how do you see that landscape now after we've had a number of years of legalization? Well, I fundamentally think legalization is better than any other option, not just for cannabis, I think for all drugs. I think personally, nobody would be dying from fentanyl overdoses if people with chronic pain and people with addiction could actually get treatment. We just have a very frayed safety net in our society, and that's why people are buying drugs on the street.

Snoop Dogg
And I think we've made a lot of progress of legalization. I agree with some of the criticisms with Kevin. I think the thing that would make it more coherent is if we had federal legalization, if we had a standard dose, five milligrams of thc, if we had standard packaging, if edibles were individually packaged, it would be like federal guidelines. So, like, a little kid, four year old, couldn't eat a whole package of edibles and end up in the emergency room. The problem is, some states do a really good job, and some states don't do such a good job.

And it's just incoherent because the regulations are different from every state. I happen to live in a state in Massachusetts where what Kevin's saying isn't true. You do know what you're getting. I mean, sure, if in a $50 billion industry, you can go undercover and find a couple of dozen people that are acting unethically, but the cannabis industry is complicated. Kevin has a little bit of a cartoonish version of that because it does have a lot of bad actors in it, from tobacco and alcohol.

I would agree with him about that. But it also has a lot of people that are sort of very mission driven, sort of from the movement that are. That are very, very caring about their product and very interested in, like, well, being of people. It's a mixture of people. I feel bad.

I think the bad people are sort of pushing the good people out, and I think if we don't act, it's going to end up more. I mean, the bad people are investing billions. That's the issue. I mean, the mom and pop, I really, again, this is my issue, is not like the mom and pop kind of thing. We're growing our organic cannabis to making sure we have responsible to some adults.

Josh Hammer
That's not my main issue. My main issue is that we are seeing the billions of tobacco and alcohol investment, and, by the way, hedge fund and venture capitalists, and I just. That story never ends well. And I just think we're walking into this trap of big tobacco now. What's wrong with people in a business context saying, there's a huge demand for this, and I want to start a business, and look, as Peter says, better than buying this stuff off the street.

Michael Moynihan
And there's some serious business people that are making some serious products? No, but I'd rather have 5% of people using marijuana and buying it off the street, by the way. They don't buy it off the street. They get it from friends and family. They grow it their own.

Josh Hammer
It's not this sort of shady character with, you know, heroin and marijuana and meth. That's sort of the character of the 1980s commercial. Well, but most, most kids and most people get marijuana from friends and family. They know the source. But, however, I'd much rather have 8% of people doing that than 30% to 40% of people doing it under the guise of sort of legality and government regulation, when we have never regulated anything.

While alcohol taxes are a fourth of what they were during the korean war, adjusted for inflation, because we have a massive alcohol industry, tobacco, it took 100 years for us to wake up and millions of people dead to say, you know what? Maybe we shouldn't be advertising this. Maybe we need to have restrictive age limits. We're now moving towards tobacco prohibition. Countries are completely prohibiting tobacco, moving on towards that now because they know that when you prohibit something, it's not perfect and you don't want to criminalize people for doing something.

I'm not saying that. But when you discourage and you try and keep access and availability low, you just generally have fewer people doing it. And, I mean, this may just come down to like, do we want fewer people doing it, or do we not mind if more people are doing it? Do we want to discourage it or encourage it? I think if we want to discourage it, you have a sort of modified decriminalization, not a sort of criminalized war on drugs, sort of disproportionate sentencing.

I'm not saying any of that. I want to get rid of mandatory minimums. I don't want to be putting marijuana users in jail. I do not think they should have criminal records. I think President Biden should go further than he has and expunge all the records, which has not done, by the way.

And this idea of rescheduling, unfortunately, the administration is using it. I hate to say this because he was the head of, we reported to the vice president when I was in the Obama administration, and he is the founder of ONDCP. He's against the legalization of marijuana. So we share a lot of things in common. But what we don't share in common is this false idea that rescheduling marijuana has something to do with criminal justice reform, when really the main thing that we know it does is give the pot industry a tax break because it will allow them to deduct business expenses and advertise even more.

That's not being talked about. Peter, I want to ask you something associated to that comment, and I'd like to come back to Kevin on it, too. The increase in the number of people smoking marijuana or ingesting marijuana, why do you think that's happened? You can find studies that kind of say anything, right? I mean, I saw this study that was the Journal of the American Medical Association's pediatrics study that said that the legalization they found was, quote, not associated with adolescent's likelihood or frequency of cannabis use.

Michael Moynihan
So I see something like that, and I say, well, maybe according to this study, that the legalization isn't actually creating more marijuana users. What do you think it is that is creating more marijuana users? Well, first of all, you're right. Fortunately, legalization hasn't been associated with an increase in teen usage of cannabis. The dispensaries are really hard to get into.

Snoop Dogg
You actually have to have an id and a cannabis card if it's medical cannabis. If not just an id, they check. A drug dealer doesn't check id. And also, maybe it's less cool now that grandma's taking a puff on her couch for the rheumatoid arthritis. Maybe it's just, like, less cool for the teenagers.

You find something else to do to rebel. But that study that you showed did show an increase in users in cannabis. It also showed a decrease in the daily uses of alcohol. And there's robust evidence, contradictory, but pretty robust evidence, that people are substituting cannabis for alcohol. And what's really incoherent about the schedule three scheduling is that cannabis, by every metric, is safer than, obviously, than tobacco, which kills half a million people a year.

And then alcohol. Alcohol. There were 172,000 alcohol related deaths last year, and these are the two substances that are descheduled. And now cannabis is stuck in schedule three with, like, ketamine and tylenol, with codeine. It's totally disproportionate.

So I sort of think that cannabis should be descheduled. I may strongly think that because it all has to do with, like, education and regulation, not with, like, this prohibition, which has been such a dismal failure. And I think people are using more cannabis because, one, they're substituting. Your average person might not want to break the law. And in a perfect world, at the end of a hard day, we'd all like, you know, eat tofu, meditate, exercise, go for a walk.

We wouldn't need something. But a lot of people, at the end of the day, need something, and the only legal option since what, 1933 has been alcohol. Now that there's a legal choice between alcohol and cannabis, some people are going to say, I like cannabis better. Other people don't like it and won't use it. The people that it makes anxious, the people that it makes sleepy, the people that just don't like the feeling.

But other people are going to say, this isn't fattening. So then why wouldn't we just decriminalize that? Say, grow your own, get it from a friend, we're not going to bother you. Which has basically kind of been a default even before legalization. I mean, to me, that's so different.

Josh Hammer
If that, if your argument is like, some people want to smoke a joint instead of have a shot of bourbon, okay, so what? Why do we have to create a multi billion dollar industry that promotes you? First of all, most people aren't going to grow it. Second of all, you don't want to be dependent on getting it. Some people know people who grow it, a lot of people don't.

Snoop Dogg
And like, I don't understand why you can go to a corner store and buy like a six pack of beer, but you can't go to a, I'll tell you why, and buy a joint when it's like the joint, harmful. If anything, the reason you can do that is this sneaky thing called history and culture. And I wish it wasn't the case. When you look at alcohol, morbidity, mortality, I think Peter and I would agree on how horrible it's been. But part of the reason it's been horrible is because it's been legal, normalized, and part of our culture for 5000 years.

Josh Hammer
Cannabis has been used for thousands of years, but not by 80% of western civilization. We're stuck with it culturally. It's why prohibition wasn't going to last. But would you, would you recommend interrupting those thousands of years of, I mean, if I could go back 5000 in a perfect world for you, and you obviously don't like this stuff, would you say that we could regulate more, more penalties, kind of broke apart Anheuser Busch, whatever it might be? Yeah.

Michael Moynihan
I mean, is that. Yeah, no, for sure. I mean, you do. I don't know anybody in public health who wouldn't answer yes to that. I've never met anybody who doesn't.

Josh Hammer
Oh, absolutely. I don't know anyone in public health. So that's a precious. Well, because of the dramatic, it doesn't mean that we want to prevent you from drinking a beer once in a while. But the issue is because of the dramatic problems, it's to me, it's kind of like saying, my headlights are broken, and so let's break my tail lights too, just to be consistent with, like, alcohol you can get, but like, why can't you get marijuana?

It doesn't jive with me. Alcohol, again, sort of stuck with it. Tobacco, by the way, it's not more harmful than cannabis by every metric. It's certainly more deadly in that direct deaths with that. But when you look at mental health, when you look at a lot of things, you can drive and smoke a cigarette.

You can build the Brooklyn bridge. Everybody had a cigarette off. We wouldn't want them to be using marijuana because it messes with your mind. Tobacco's different, but anyway, also harmful. Tobacco became, this is a very.

Tobacco is an instructive lesson, though, too, because it became deadly when we commercialize and industrialized it. Tobacco had been used for thousands of years by a lot of people, too. They weren't dying of dead of lung cancer. They weren't getting heart attacks, emphysema because of it. That happened because 100, 2030 years ago, industrial revolution, more than that, we had the ability to create a cigarette for the first time in human history, which was essentially, you know, all these problem, you know, cancer causing chemicals, et cetera, all this junk with the nicotine and tobacco.

And again, that's because of legalization and commercialization. So if we were smoking using the old kind of tobacco and pipes, whatever, we wouldn't be having that. We have the scale of the problem because of the commercialization. An example of how commercialization and legalization in the United States of America, it makes an activity more harmful than it would be. The other thing I just want to say incorrect, is that the teen usage picture is absolutely mixed.

It is different state by state. When you look at certain states, in terms of the data that they use, and this is getting a little bit into the details, but I think it's important they often exclude the areas that have the most cannabis use because those schools are not participating in these surveys. It's purely voluntary. I think there's a major selection bias. The other thing we're not talking about is 18 to 25 year olds.

Your brain is developing til, you know, Peter will tell you, 25, maybe 30. The young adult cannabis rate in this country and in legal states has skyrocketed since we've had legalization. So I wouldn't, like, paint this rosy picture. Like, why aren't young people using marijuana under legalization? You look at other studies, twelve to 17 year olds are seeing a higher increase in legalized states for what we call cannabis use disorder, which is marijuana addiction.

Deb Hasen, I know Peter knows this research out of New York, who's a very prominent cannabis researcher, has found one in three people who use marijuana in the last year have a cannabis use disorder, which is another way of saying they're basically addicted. Well, it's a macro level. This is why Kevin's organization gets in trouble, because they sort of cherry pick data points. We're not getting in trouble. Kevin, hold on.

Snoop Dogg
Let me, let me let you talk with us, please. No, no, finish. But we're not getting in trouble. No, that's why you don't. Guys don't have a lot of credibility, because, like.

Josh Hammer
Credibility, I swear to God. I'll let you respond. I mean, the credibility of a smart approach is to marijuanas and tatters, because a study will come out that'll be like, you know, youth has got use has gone down in all groups except for a small bump in, like, 14 year olds in two months. And then they'll pick that data and they'll do advertisements about that particular data point when even Nora Volkow, the head of the National Institute of Drug Abuse, states that. And she is not a cannabis loving hippie by any means, she even concedes that cannabis use in legal states is not rising.

Snoop Dogg
So I just don't think it's true. And I agree with you about the promotion. We don't need to be promoting cannabis. We don't need to be promoting alcohol, tobacco, or pharma drugs. But at the same time, people have a right to experiment with their consciousness and to use intoxicants.

Every single society, you can't name a society that hasn't used intoxicants. The only thing that changes is the intoxicants. And as long as you're not driving, you're not violent, you're not hurting anybody, there's no reason to involve law enforcement. So the things you're suggesting sort of reflect your morality of, like, you know, the industry shouldn't make money and more people shouldn't use drugs or alcohol. But the fact is, people have a right to make these choices.

I agree that the more we pollute the discussion with advertising, which I'm not a fan of, it's harder for people to make informed decisions. And this is why, again, cannabis advocates have to understand the harms so they could make informed decisions, and cannabis opponents have to understand the benefits so that we could all make informed decisions. But I just don't think you could say that someone has the right to go in and buy alcohol, but they don't have the right to go in and buy cannabis again, especially because cannabis is the less harmful for most people of the two substances. So I just. We can agree to disagree, but, you know, I've been treating people with this for 25 years, and I've been studying it my whole life, and I just don't think you can, you can take away those freedoms from people.

Michael Moynihan
Kevin, would you agree that alcohol is by and large, more harmful than cannabis? I think it depends on the metric. When it comes to mental health, absolutely not. When it comes to psychosis and schizophrenia. No, it's death.

Josh Hammer
Well, no death. Direct deaths because of alcohol poisoning, yes. But when you look at suicidality, that cannabis is the number one drug more than alcohol, implicated in suicidality for young people, especially in legal states. Is that a causation or correlation? Well, I don't know.

It's showing up. I'm not sure. I mean, this sort of causation and correlation, I mean, it's like that was a question they said about lung cancer and in tobacco. Kevin, is that worse than alcohol? The correlation is stronger than alcohol.

Snoop Dogg
Is it not true? Well, no, actually, the correlation for psychosis and schizophrenia is much stronger for cannabis than it is for alcohol. That's what I mean. And this is where this sort of credibility and tatters kind of thing is hilarious, because, Peter Grinspoon, unfortunately, we agree on a lot of things, but if you're going to go there, I unfortunately have to go there, too, which is that, you know, your point of view. It's why you bashed the AMA.

Josh Hammer
And one of the first things you said is absolutely the flat earth point of view of all the major medical associations in this country, of all the general, of the who, of the, of the general scientific consensus. But what I'm glad is that you're honest, though, and you're honest about why you feel this way, because at the end, and you said this in the beginning, too, but just now, at the end, when you last spoke, it's really about freedom. And it comes from a libertarian argument that we should legalize all drugs, including fentanyl, methamphetamine, and crack cocaine. So I'm glad you're open about that. But I think the listeners should know that we're advised by all the major, most of the major scientists doing research in the world have some kind of advisory role with us.

We take no money from any of these industries. We are totally outspent by the pot industry when it comes to regulations, and we're really just looking after public health and public safety. It's not our interest to over exaggerate the data. I said the team used is mixed. I didn't say it's increasing everywhere.

But I think there's reasons why it's mixed. So I just think, like, when we talk about that, you know, it's important that folks, and you have a valid argument, Peter, but it's important people understand. It's grounded in more of a libertarian. You know, we think all drugs should be legal. Why don't I have the right to get this if I have the right to get alcohol?

Mine comes from a scientific and practical perspective, which is that, you know, we cannot ban alcohol anymore. But two wrongs don't make a right. Alcohol legalization has caused more harm than any with tobacco than any other public health policy we've ever had. We're comfortable with that trade off because we want the right to drink. Now, do we want to also make the right to smoke weed and right to get high?

Then where does that lead us? Barack Obama famously said, where does that lead us? What, should we just then legalize crack cocaine? Should we legalize meth? You're saying yes.

So I'm glad you're being honest, but a lot of the proponents and a lot of the industry make it sound like it sort of stops with weed. It doesn't. And that's another worry that I have. Peter, is that a fair recapitulation of your views, that let's legalize fair recapitulation. Of a part of my views.

Snoop Dogg
I mean, I do believe that people have the right to experiment with their consciousness, but my view on cannabis is more grounded in the fact that I've been treating people with medical cannabis for the last 25 years, and not everybody does well, but by and large, the patients do really well. I mean, to see someone with multiple sclerosis that's failed all the other medications. Have you published this, Peter? Peer reviewed journal. So we can see.

Josh Hammer
I mean, we believe you, but we want to see their experiences. We'd love FDA, I'm sure, would love to see it when they develop a medication. So we'd love to see that research. Well, hold on, Kevin. There's.

Snoop Dogg
I'm a clinician educator. I'm not a primary researcher. There are actually plenty of people researching and publishing. I mean, there. There are a lot of state level initiatives.

There are now, like, 4 million medical cannabis patients in this country. And at the state level, there's a lot of research into this going on. The way I view cannabis is like another tool in our tool belt, right? If you come in with pain, see, Kevin, you have really bad sciatica. You're miserable.

You can't walk. You can't sleep. I could blast you with oxycodone. And I'm not afraid to do that if that's what you need. We could give you nonsteroidals.

They're not as strong. They hurt your kidneys. They cause 10,000 heart attacks a year. They cause ulcers, they cause bleeding. We could give you tylenol.

Then you'd be mad at me because tylenol doesn't do anything. And cannabis is like another tool in the toolbox. So, you know, it's certainly not a cure all, and some people don't tolerate it at all. And as we've both agreed upon, it can have pretty grievous side effects, including and the fact that it could trigger psychosis. It doesn't cause schizophrenia.

That's a whole other discussion. But it could certainly trigger it and make it happen earlier, which is a big deal, because then people don't develop their adult skills and they spend more of their life in a psychotic state. But the fact is, cannabis shouldn't be discriminated against compared to other medications. And I would say that there is a libertarian component to my argument, because people do have the right to experiment with their consciousness. Why criminalize what people do anyways?

It doesn't make any sense. Just harms people. Law enforcement is a huge cottage industry in this country, and they have such a vested interest. When they ended prohibition in 1933, they had this huge law enforcement apparatus, and then they're like, what are we going to do with this law enforcement apparatus? Then Harry Enslinger, the head of the federal department of Narcotics, is like, hey, let's criminalize cannabis so we can keep these hundreds of thousands of law enforcement people gainfully employed.

I mean, it really is a cottage industry harming people. I mean, criminalization is the worst case scenario. So there is a libertarian component to what I'm saying, but it's also grounded in, like, treating people for a quarter of a century and seeing how well they do and seeing how destructive alcohol is to so many people's lives.

Michael Moynihan
Up next, the surprising and contested link between cannabis use and psychosis. We'll be right back.

The New York Times had a story the other day that kind of surprised me as somebody who is not deep in the weeds on these issues, and it was the story that we talked about. Cannabis tops alcohol as America's daily drug of choice. But there was a sentence in it that surprised me, and the sentence was this. In the last decade, research has shown that frequent cannabis use, and particularly the use of high potency products with levels of THC greater than 10%, is a risk factor for the onset of schizophrenia in other psychotic disorders. What do you make of that?

Because, I mean, it seems that that is kind of the scientific consensus now, isn't it? No, it's not the scientific. I write a lot in my book about that study in particular. What's her name? I forget the researcher.

Snoop Dogg
She did four studies and she actually concluded the opposite the study six months later. Then she went back and concluded that, again, she flip flopped. But the problem is that was just an associational study, and there's no way to say that people who are pre psychotic and who are treating themselves are gravitated towards higher cannabis as opposed to the cannabis is somehow neurotoxic and causes the psychotic state. I just had a piece about this in CNN. A third theory is that high cannabis use and psychosis are sort of co located in the same genes.

So either the cannabis can cause the psychosis, the psychosis can cause the cannabis, or the same genes can cause a high cannabis use and the psychosis. But the fact is that in the 1950s, there were like hundreds of thousands of cannabis users worldwide. Now there are hundreds of millions. It has gone up a thousand times the number of users of cannabis. And the rates of schizophrenia, again, I think it can aggravate or destabilize people with schizophrenia or make it give you an earlier onset, which is a total loss for public health.

But the rates of schizophrenia have been rock solid over the last 70 years. At 1%, we would have to have an increase in the rates of schizophrenia if cannabis were causing the schizophrenia. The cannabis is neurotoxic and causes schizophrenia theory. Of the three theories I just went through. So cannabis does not cause the schizophrenia.

Part of the problem is publication bias. If something shows something sexy gets published, a study that shows a harm of cannabis will be published. A study that doesn't show a harm of cannabis is boring. Nobody sees it. A study that doesn't show a benefit, nobody looks at it.

If it shows a benefit, it gets in CNN, USA Today. And the same with these studies about psychosis. Whenever they come up with one of these associational studies, then they sort of finesse the words and they make it sound like the cannabis is causing the psychosis. Well, they don't really know that. Again, I do not treat people with psychosis or family history of psychosis with cannabis, because I think that certainly it can destabilize people and it's dangerous, but it doesn't cause a third of cases, she said.

A third of cases in Amsterdam, and like 25% of of cases of psychosis in Paris were because people were smoking cannabis that was 11%, as opposed to cannabis that was 9% above 10%. It was not a good study, and I dont agree at all. The thing id push back hardest on is the fact that thats scientific consensus. I work with physicians every day, I educate physicians every day, ranging from oncologists that tend to be supportive of cannabis to these adolescent psychiatrists who tend to be very skeptical because they see these rare but tragic cases of the cannabis contributing to the psychosis. And the fact is, the whole spectrum of physicians is moving towards a much more tolerant attitude, and most physicians believe in people being allowed to have access to medical marijuana.

But if we're all on the same page about it, we could make it a lot safer. The problem is steroids, that we give people all the time. Alcohol, tobacco, psychedelics, psychostimulants, Adderall, all of those cause psychosis as well. So it's not like we're gonna stop using all of these substances. It's a question of how to use them safely to protect people's health.

Michael Moynihan
Kevin, I saw you vigorously shaking your head at a few points in that. You wanna respond, well, there's a lot going back there. Pick one thing. I'll be quick. How about, I promise.

Josh Hammer
So, first of all, on the schizophrenia psychosis. I mean, these aren't sort of these outlier like scientists that have some extra grind against marijuana. This is. I mean, these do go through a peer reviewed process. You know, you look at the other research coming out of south London with Marta Deforte and her husband, Sir Robert Murray, at their Maudsley hospital.

I just gave a lecture there. It's the most prominent psychiatric unit in all of Europe, the Institute of Psychiatry Maudsley NHS in south London. They're finding that using what they call skunk weed, which is about 15% THC for us, that's average over here. For them, it's hypodens. If you do that on a regular basis, you're five times more likely to get psychosis and then schizophrenia.

I mean, there is a lot of research on this coming out. People are not in prison for using marijuana. They haven't been for many years. This is not a reason. That's sort of.

If it was, we'd have a much lower incarceration population. Now that 25 plus states have legalized marijuana, their incarceration rate is not going down because we've legalized marijuana. So, if anything, frankly, the arrests are still disproportionate. By the way, black people aren't making money from legal weed. And there are more potshops and poorer communities of color, which is a kind of environmental racism, which we also see with alcohol stores, many more than in higher income communities, because the higher income communities have more power.

They say, we don't want a potshot. That doesn't increase my housing value, etcetera. We don't want it here, put it over there, even though we like to smoke weed now and again. So there's a lot to unpack with criminal justice. And again, I would say that Peter's like, well, we can make it safer, and I'll end with this, because he ended with this.

Yeah, but people don't want to make it safer. I mean, you do, and that's good. But the people selling this, the people that are making money, you're not, thankfully, yet, as far as I know, selling marijuana, that's good. You don't have your own marijuana brand. I'm happy about that, and I commend you for that, because you probably could in Massachusetts and make some money.

I'm glad you're not doing that. But the people selling this, they want you to use as much of their product as possible, because they rely on addicts, on people using their product daily for their main profit margin. It's the 80 20 rule. The average responsible quote unquote user is not an important person for them. Same thing with alcohol, same thing with tobacco, same thing with opioids.

We know that the majority of people who use opioids didn't do so even in the height of the prescription drug epidemic, didn't do so in a harmful way. It was the minority that did that fed purdue pharma and the Sackler family with their billions. That is exactly what the marijuana industry is doing. And so it's not about, we can make it safer, maybe we can regulate it, and we just need to kind of agree on, is it 15% or 30% that loses the flavor of where we're really at? And where we're really at, I think, is a dangerous place, where we're a society that is absolutely glamorizing, promoting and encouraging the regular use of marijuana.

I don't care about a cancer patient, but that's a problem. I think many listeners will presume this. You're saying rather than putting caps on things and these companies that put but shops in poor neighborhoods, et cetera, is just to get rid of it in the sense that you said about alcohol, this sort of horses out of the barn. It's been a long time. We can't really do much about that.

Michael Moynihan
Are you suggesting that at this point, with 24 25 states having legalized marijuana, that we go back and go back towards making marijuana illegal? And you say that there are not people in jail for this? Okay, so what would happen in Kevin Sabet's world if you could control policy and kind of turn back the clock? I imagine you'd want to do and get rid of this legalization? Yeah, well, look, I think what we would do is not go overboard in terms of arresting people for using marijuana as long as they weren't driving or whatever.

Josh Hammer
I would have a realistic kind of scientific campaign that actually discouraged the use. Again, I would do it. I would treat it like a speed limit where we're discouraging. We know some people will speed and they'll be fine, but that doesn't mean speed limits are junk and we are realistic about it. I wouldn't have it in the commercial market.

I mean, if we lived in Sweden and you could have a sort of nonprofit, state socialist, no label store that would sell something at a fixed amount for a few hours a day to very certain people. And there was one place to go, but we don't live in that. New Hampshire is totally talking about that actually, which is, oh, I would love. To see them do it. I don't think they're.

Michael Moynihan
Look, and Sweden does that with alcohol, by the way, only the state sells it and really hasn't done much about the alcohol consumption. And Washington state has done that about it. Did that about alcohol too, until Costco said, we're in Kirkland, Washington, and we can make a lot of money with booze. And we're going to run a ballot initiative to say that this is about the freedom to drink and this is as american as apple pie. And they won with 52% of the vote.

Josh Hammer
And now Washington state has privatized out. So they started with the public. I don't think we would. I don't think that's where the story ends. So I would say a discouraged sort of decriminalization.

Michael Moynihan
But wouldn't you say, Kevin, that it would be incredibly unpopular if someone was running for office and said, I think the only people who can sell wine in this state is the government? Yeah, you think you want that? But listen, 70% of people need to body. 70% of people drink wine. 20% to 30% use marijuana.

Josh Hammer
This is the wine or less actually that's depending on the metric. So wine does not have the cult by the way. Also wine is very different. I mean you want to talk about the pharmacologically wine in and out of your system in 24 hours. I don't drink wine.

But in and out of your system in 24 hours complements your steak. You do not drink to get drunk. You use marijuana to get high. Okay, you do sometimes, depending on my dad. But you don't always have to.

No, of course you do, but you don't always have to is my point. That's not the always the point. The always the point with marijuana is to get stoned. Okay? Some people, Peter might say, well no, it's like take the edge off, but that's maybe from a very experienced user.

For most people when they're using marijuana, they're getting high, they're drinking a glass of wine, they're not getting drunk. There's fundamental. Go ahead. Yeah, why? Don't give you a chance, Kevin.

Snoop Dogg
Further, it doesn't sound like you've actually been around this many actual marijuana users. I mean people often at a dinner party take like a puff just to relax and to, I mean I remember Jonathan Cokins, the person you cited, is like the most brilliant person ever. I read his book about cannabis. I don't think he'd ever been within 20ft of someone who actually smoked a joint. He said that you just, what you're saying, you made the argument, you, you know, you can have a nice, you're thirsty, you have a beer, but if you smoke cannabis you're just gonna go and get really, really blasted.

And that's just not the case. I mean some people do, some people misuse it. There's no question. I've taken care of 20 plenty alcoholics that just drink wine. The problem is they drink like two bottles a day.

I mean you, of course it doesn't really matter the concentration as much as like the trauma underneath. They say treat the trauma, not the drug, and treat the underlying anxiety and depression. And people are susceptible to all addictions if you don't treat that stuff. And then I agree the substance can absolutely make it worse. But I just don't think it's true that people, the only purpose of getting high is to get stoned.

People take a puff, they talk, they laugh, you remember everything after you've done it. It's not like you're all huge I. Get that was the circles you grew up in, and your dad was the pioneer of legalizing all drugs, saying cocaine is not a big deal, and having those parties in Cambridge, Mass. Which is a great place, but the vast majority of people who are using marijuana, they are doing so to get some kind of intoxicating effect. Kevin, have you ever tried marijuana?

Josh Hammer
Well, that's not an important question at all, because if I have, do you ask a psychiatrist if they tried to jump off of a building? Do you ask someone in law. Wait, wait, wait. Do you ask someone in law enforcement if they've robbed a bank? It's actually not an easy question, because if I say yes.

Wait, wait, wait. If I say yes, which I would. Hold on, you would say, well, you know, you're a hypocrite because you're saying you shouldn't. And if I say no, you'd say, well, Mark Kleiman never answered that question. Wait, Mark Klein never answered that question.

Neither will I. All right. Well, I mean, you know, it's funny. They asked my dad the same question when he was testifying on legalization in the 1970s, and an angry republican congressman was like, like, Doctor Grinspoon have used cannabis? And my dad was like, well, answer that if you tell me first if I'd be more or less credible if I say that I've tried it.

Snoop Dogg
And the congressman got very angry. But the fact is, more than half of Americans have tried cannabis, and. Hold on. But that's why they're, like, less susceptible to all the propaganda. That's why the whole war on drugs, the whole moral panic about it, is falling apart, because once people try it, they realize you can get too high.

And that's a miserable experience. But generally, it's a pretty benign drug as far as drugs go. Again, it's more benign than alcohol by every single metric. So I just don't think it helps to exaggerate the harms. We agree about many of the harms.

We don't seem like we agree quite as much about the benefits. I don't go along with your decriminalization thing simply because I agree with you that commercialization has its flaws, and there's no perfect system, which is the problem. There's no perfect system that's going to. And I think for something like psychedelics, government owned stores like you were just talking about might make a lot of sense. You don't want, you know, people buying, like, three for one, buy acid and then freaking out.

But I do think that with cannabis, it just. It just doesn't help to exaggerate it. People. I'm not trying to exaggerate it. I've said that plenty of people use it and they don't have a problem.

Josh Hammer
So let me be very clear. Most people who use it don't have a problem. In fact, most people use it. It's a phase. They stop using it.

They don't like it. The fact that the majority of people have tried it once in their life, also irrelevant for me for policy. That's not. I'm talking about the people now, 50% of past month users are using it every day. That's what I'm.

That's kind of the population I'm talking about and trying to discourage. I'm not discouraging the person who uses it once a year on their birthday party and can do that. You know, I've done plenty of things once a year that I wouldn't want to do more than once a year that whatever. Like, that doesn't. Or once in my life.

Yes. And they think we're exaggerating. They think every scientist who has this is exaggerating because they smoked a joint 30 years in their dorm room, and they think that's the. They think that's the norm. And again, I'm not saying treat it like heroin.

I'm not saying treat it like crack or meth. I'm saying the harms are underappreciated. Let's discourage it and not get people to make money off of it, because that story in this country does not ever end well. Kevin Peters said that you kind of overlap and agree on some things about the harms of marijuana, but probably not the benefits. Do you see any benefits to marijuana?

I mean, I think that the components of marijuana we've seen, the research can have benefits to people dealing with nausea related to cancer chemotherapy. I think the literature on pain is a bit mixed. But again, if you think whether it's placebo or not or whatever, that it makes you feel deal with, like, very, you know, certain neuropathic pain or sort of very difficult circumstances, then that's fine. I'm very skeptical of the research about things like PTSD because the research has actually shown that it can make PTSD symptoms worse. And yet we're saying to veterans, you should be able to use marijuana.

I'm very worried about that because of the impact on mental health, but on the positives. Sure there are positives, and we should. They should go through the normal system, be treated like a drug, like everything else would any medication. And are there benefits to somebody using it, quote unquote, recreationally for them. I'm sure there's a benefit of that.

They feel good. I mean, drugs feel great. Of course they want to keep using it. That's a benefit. They feel good.

I don't think that that sort of outweighs the risk to society when you make it more available and accessible. But sure, of course there are benefits. Why don't we, as a final question here, why don't we do a little forward looking stuff, which is sometimes annoying because you have to play Rasputin and pretend that you know it's going to happen. But, Peter, how do you see the landscape of both drug legalization and marijuana use in America in the next decade or two? Well, I think we're going to federally legalize cannabis, which is, in my opinion, a good thing.

Snoop Dogg
The problem with decriminalization. Biden says no to that, though. Right. But the fact is that now about 70% of Americans are in favor of legalization, including a plurality of Republicans. Independence.

I mean, the writing's on the wall, but the good news about this is I think it could make the whole thing a lot safer. We won't have some of the problems that Kevin alluded to some of the states that are much less rigorous than other ones. We could standardize dosing. We could really clamp down. Kevin really understated the criminal justice component.

That's a whole other conversation. I mean, since the 1970s, more than 20 million people, mostly people with black and brown skin, have been arrested for nonviolent cannabis prohibition. And, you know, when you get arrested, even if you're not in prison, it could affect your job, your employment, your student loans, your housing. So it's. We have a lot of work to do with the social justice components, but I think if we have standard doses, standard labeling, standard packaging, and standard messaging, if we come to more common ground about all this, people will believe us.

The problem is the anti cannabis people don't believe someone who's pro cannabis, and the pro cannabis people don't believe someone who's saying something negative about cannabis. I think with common ground and with legalization, the whole thing's going to be a lot safer. And finally, I do agree with Kevin about limiting advertising. And again, I can't say this enough. I don't think the pharma, the alcohol, the cannabis, or the tobacco industries need any help.

They're all doing just fine. Promote an activity that has potential harmfulness. But I do think people have the right to use it. They have the right to purchase it. And that criminalization has just been the wrong direction for the last 50 years.

Michael Moynihan
Kevin, the same question to you, not what you hope will happen, but what you suspect will happen in the next decade in this universe and in this industry. Well, I think it's connected to this issue that Peter brought up with polling. When you just ask people if they should legalize the use of marijuana, yeah, you do get a plurality. But when you actually delineate decriminalization, we actually wanted Gallup to do that. They said, no, that will mess up our time series if you actually separate decriminal legalization, which is very important, because again, Peter's last point is like saying criminalization.

Josh Hammer
It's setting up a false dichotomy between legalization and criminalization. That's a, that we thank God we have more than those choices. And so the polls that Emerson poll did, and we actually asked Emerson to do it, and full disclosure paid for the poll. But they did the poll, and they're one of the most highly, highly respected polling firms in New York. Well, you're laughing, Peter, but just someone had to pay the bill there.

And I'm being transparent. It doesn't mean that we can control the outcome. But the outcome of that poll, when you gave people choices, a huge portion, like, you know, it was a split thing between decriminal medical legalization. When you give people more than one choice, many of them are in favor of legalization because of decriminal. So I don't think we're going to see national legalization.

We might. I mean, I don't have a crystal ball, but, you know, the legalizers have been saying we're going to have national legalization. I remember back in 2008, they said, we're going to have national legalization. During Hillary Clinton's second term in office. You know, they haven't been exactly the most accurate predictors.

Will it be Joe Biden's second term where that will happen? I don't think so. He is, given what's happened in his family, which he doesn't talk about a lot, and given his experience in the drug caucus and drug policy, I just think that this rescheduling thing was the most, it was like his middle ground, his limit. I think he sees it as a comfortable, nice middle ground, even though I have issues with it. And that's going to be where he goes.

I actually think that, ironically, rescheduling might push back the legalization movement rather than expedite it. So we'll see. Doctor Peter Greenspoon, Kevin Sabet, thank you for joining us on earnestly. Thanks for having us. It was fun.

Snoop Dogg
Thank you guys.

Michael Moynihan
Thanks for listening. And thanks so much to doctor Peter Grinspoon and Kevin Sabet for coming on today. If you liked this conversation, if it made you think differently or challenged you, please share this episode with your friends and family and use it as a jumping off point for a conversation of your own. And if you want to support the work we do, you hear there's only one way to do it. Go to thefp.com and become a subscriber today.

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