Alcohol consumption causes far greater harms to the individual user and to society than does the use of cannabis, according to a new review published online in the Journal of Psychopharmacology, the journal of the British Association of Psychopharmacology.

Investigators at the Imperial College of London assessed “the relative physical, psychological, and social harms of cannabis and alcohol.” Authors reported that cannabis inhalation, particularly long-term, contributes to some potential adverse health effects, including harms to the lungs, circulatory system, as well as the exacerbation of certain mental health risks. By contrast, authors described alcohol as “ a toxic substance” that is responsible for nearly five percent “of the total global disease burden.”

Researchers determined, “A direct comparison of alcohol and cannabis showed that alcohol was considered to be more than twice as harmful as cannabis to [individual] users, and five times more harmful as cannabis to others (society). … As there are few areas of harm that each drug can produce where cannabis scores more [dangerous to health] than alcohol, we suggest that even if there were no legal impediment to cannabis use, it would be unlikely to be more harmful than alcohol.”

They concluded, “The findings underline the need for a coherent, evidence-based drugs policy that enables individuals to make informed decisions about the consequences of their drug use.”

The researchers’ findings should hardly come as a revelation. Last week, a just-published study that was completely ignored by the mainstream media reported that alcohol consumption increased lung cancer risk by 30 percent.

Surprised? You shouldn’t be. After all, a February 2011 World Health Organization report concluded that alcohol consumption causes a staggering four percent of all deaths worldwide, more than AIDS, tuberculosis or violence. A just-published analysis in the American Journal of Preventive Medicine finds that in the United States alone, an estimated 79,000 lives are lost annually due to excessive drinking. The study further estimates that the overall economic cost of excessive drinking by Americans is $223.5 billion annually.

Naturally, any health costs related to cannabis use pale in comparison. A 2009 review published in the British Columbia Mental Health and Addictions Journal estimated that health-related costs per user are eight times higher for drinkers of alcoholic beverages than they are for those who use cannabis, and are more than 40 times higher for tobacco smokers. “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,” investigators concluded.

In an op/ed I wrote last year entitled “Pot Versus Alcohol: Experts Say Booze Is the Bigger Danger,” I cited the findings of numerous independent commissions, all of which pronounced that the risks of marijuana were nominal compared to those associated with booze. You can read these findings here and much of this evidence is discussed in even greater detail in my book, Marijuana Is Safer: So Why Are We Driving People to Drink?

Nevertheless, despite its enormous societal toll, alcohol remains celebrated in this country — American Craft Beer Week is now endorsed by the U.S. Congress — while cannabis remains arbitrarily criminalized and demonized. It’s a situation illogical enough to drive most anyone to drink.

“First they ignore you, then they laugh at you, then they fight you, then you win.”
– Mahatma Gandhi

What can I say? I’m flattered. David Mineta, deputy director for demand reduction in the Office of National Drug Control Policy, has taken time to publicly respond to little ol’ me. I wonder if they pronounce ‘Armentano’ phonetically at the Drug Czar’s office?

The back story: Last week NORML Board member Paul Kuhn and I published a guest commentary in Nashville’s largest daily newspaper, The Tennessean, opining in favor of H.R. 2306, the ‘Ending Federal Marijuana Prohibition Act of 2011. Here’s an excerpt:

Marijuana legalization bill offers safer alternative
via The Tennessean

We know tobacco is the leading cause of death in America, contributing to 400,000 deaths each year. So it’s hardly any wonder the FDA will require the placement of prominent warning labels. Alcohol is the third-leading cause of death in America. The World Health Organization reported earlier this year that “alcohol causes nearly 4 percent of deaths worldwide, more than AIDS, tuberculosis or violence.”

… What about marijuana? With every other drug from Advil and alcohol to Zantac, a correct dose is effective, but too high a dose kills the patient. No dose of marijuana is capable of causing a fatal overdose.

… And unlike alcohol and tobacco, adverse effects of even heavy cannabis use are minimal. There is no epidemiological evidence in any country, after scores of studies and centuries of use by tens of millions of people, that marijuana smokers have a shorter life expectancy than non-smokers.

… They don’t become violent at sports events or beat their spouses and children. They don’t get heart disease, cancer, brain damage or any other deadly illness at a higher rate than those who abstain. In fact, a pair of studies conducted by Kaiser Permanente found that marijuana use, even long-term, was not associated with elevated levels of mortality or incidences of cancer, including types of cancers associated with tobacco smoking.

… America is on a path to allow adults to choose a safer alternative to tobacco and alcohol. And create more tax revenue and more jobs in Tennessee. And more freedom.

Apparently quite a few people read our editorial, including some folks at the Drug Czar’s office. And it must have gotten under their skin because yesterday the White House responded with this.

Movement for legalized marijuana ignores dangers
via The Tennessean

Proponents of marijuana legalization often argue it will do everything from fixing our economy to ending violent crime (“Marijuana legalization bill offers safer alternative,” Tennessee Voices, Aug. 15). Yet, the science is clear: Marijuana use is not a benign drug and it is harmful to public health and safety.

… Would marijuana legalization make Tennessee healthier or safer? One needs to look no further than Tennessee’s current painful experience with prescription drug abuse. In Tennessee, prescription drugs are legal, regulated, and taxed — and yet rates of the abuse of pain relievers in the state exceed the national average by more than 10 percent.

Nationally, someone dies from an unintentional drug overdose — driven in large part by prescription drug abuse — on average every 19 minutes. What would America look like if we had just as many people using marijuana as we currently have smoking cigarettes, abusing alcohol, and abusing prescription drugs?

Predictably, the government’s response isn’t an actual rebuttal at all; it’s a classic red herring. Of course some people misuse prescription drugs. Some people overdose on them too. But what does any of this have to do with arresting adults who consume cannabis, which is relatively non-toxic and is incapable of causing human overdose? Further, if the drug warriors engaged in even a hint of consistency then they would be arguing for the criminal prohibition of cigarettes, alcohol, and prescription drugs. And lots of other things.

Yet when it comes to Americans’ use of substances like tobacco, booze, and prescription drugs — substances that pose far greater dangers to health than does cannabis — the White House recognizes that prohibition is not the answer: regulation and education are. So why does the Drug Czar’s office fail to apply this same common-sense principle to pot? Perhaps it has something to do with the federal requirement requiring the office to lie about legalization.

Finally, as to the specific question: ‘What would America look like if we had just as many people using marijuana as are presently using tobacco, alcohol, and prescription medications?’ Well, what does America look like today? After all, the federal government imposed criminal prohibition over 70 years ago; yet today that very same federal government admits that over one out of ten Americans admit to having using cannabis in the past year. In several states, among those age 18 to 25 almost half admit to having consumed cannabis recently! In other words, the reality is that America under a policy of cannabis regulation would like very much the same as it does today — except that society would be spending far less money to target, arrest, prosecute, and incarcerate marijuana offenders. And perhaps some people would less frequently consume prescription drugs and alcohol.

Contrary to the frame put forward by the Drug Czar’s office, the question isn’t ‘What if Americans consumed marijuana?’ Tens of millions of Americans have and do consume marijuana. Most do so privately and responsibly. Legalizing cannabis simply acknowledges this reality and seeks to regulate the behavior appropriately. It’s that simple. So why doesn’t the Drug Czar get it?

“Alcohol causes nearly four percent of deaths worldwide, more than AIDS, tuberculosis or violence.” That was the finding promoted earlier this year of the World Health Organization.

Summarized Reuters, who reviewed the report: “Approximately 2.5 million people die each year from alcohol related causes. … The harmful use of alcohol is especially fatal for younger age groups and alcohol is the world’s leading risk factor for death among males aged 15-59. … Alcohol is a causal factor in 60 types of diseases and injuries. … Its consumption has been linked to cirrhosis of the liver, epilepsy, poisonings, road traffic accidents, violence, and several types of cancer, including cancers of the colorectum, breast, larynx and liver.”

Nonetheless, WHO concluded, “[A]lcohol control policies are weak and remain a low priority for most governments despite drinking’s heavy toll on society from road accidents, violence, disease, child neglect and job absenteeism.”

The same can’t be said for cannabis — which governments far and wide continue to treat as public enemy #1, despite its relatively nominal risks.

Of course the reason we see these startling links between alcohol consumption and disease is because ethanol, the psychoactive compound in alcohol, and acetaldehyde (what ethanol is converted to after ingestion), pose toxic risks to health cells and organs. By contrast, marijuana’s active compounds — the cannabinoids — pose little comparable risk to healthy cells and organs, and are incapable of causing fatal overdose.

So answer me again: Why do we celebrate consumers and manufacturers of alcohol while we simultaneously target, arrest, prosecute, and incarcerate consumers and producers of a far safer substance?

That was the question we set out to answer when authoring the book Marijuana Is Safer: So Why Are We Driving People to Drink? It’s a question that has galvanized the public. This week, the Facebook page for Marijuana Is Safer surpassed 500,000 ‘fans,’ making it one of the all-time most popular book tiles on the social network.

As a result, publisher Chelsea Green is offering a special discount this week on copies of Marijuana Is Safer. Use the code SAFER at the link here and learn how you can obtain copies of Marijuana Is Safer for a significantly reduced price. Then ask your elected officials: ‘Why are we driving people to drink?’

Lifetime use of marijuana is rarely associated with emergency room visits, according to an analysis of epidemiologic survey data published online by the American Journal of Emergency Medicine.

Investigators at the University of Michigan reviewed the overall prevalence of drug-related emergency department (ED) visits among lifetime users of illicit substances. Researchers analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions, which is a nationally representative survey of 43,093 residents age 18 or older. The study is the first to use nationally representative data to examine patterns and correlates of drug-related ED visits.

Among those surveyed, subjects that reported using cannabis were the least likely to report an ED visit (1.71 percent). Respondents who reported lifetime use of heroin, tranquilizers, and inhalants were most likely (18.5 percent, 6.3 percent, and 6.2 percent respectively) to report experiencing one or more ED visits related to their drug use.

Investigators concluded, “[M]arijuana was by far the most commonly used (illicit) drug, but individuals who used marijuana had a low prevalence of drug-related ED visits.”

A 2009 Swiss study published in journal BMC Public Health previously reported that the use of cannabis was inversely associated with injuries requiring hospitalization.

A prior case-control study conducted by the University of Missouri also reported an inverse relationship between marijuana use and injury risk, finding, “Self-reported marijuana use in the previous seven days was associated … with a substantially decreased risk of injury.”

Most recently, a RAND study published this month reported that fewer than 200 total patients were admitted to California hospitals in 2008 for “marijuana abuse or dependence.” By contrast, there are an estimated 73,000 annual hospitalizations in California related to the use of alcohol.

These findings belie the myth that adult marijuana use is a primary cause of hospitalizations or ED visits. The reality is that few if any therapeutic or psychoactive substances possess a safety profile comparable to cannabis.