What Americans Need 

to Know About 

MARIJUANA

Important facts about our nation’s 

most misunderstood illegal drug

office of national drug control policy
I. There is a serious drug problem in this country, and 

marijuana is a much bigger part of the problem than 

most people realize.

• Marijuana is the most widely used illicit drug in America. 

Of the nearly 20 million current illicit drug users, 

14.6 million (about 75 percent) are using marijuana.1

• Of the 7.1 million Americans suffering from illegal drug

dependence or abuse, 60 percent abuse or are dependent 

on marijuana.2

• Of all youth age 12-17 in drug treatment in 2000, nearly 62

percent had a primary marijuana diagnosis.4 Approximately

half were referred to treatment through the criminal justice

system and half through other sources, including self-referral.5

• The average age of initiation for marijuana use generally has been getting younger.6

• Along with the bad news, however, come signs of improvement (see graph, below):

➤ Among 10th graders, past-year and past-month use of marijuana or hashish

decreased from 2001 to 2002, as did daily use in the past month.7

➤ There has been slow but steady progress toward reduced marijuana use rates

among 8th graders. Their past-year marijuana-use rate of 14.6 percent in 2002 

is the lowest since 1994, and well below their recent peak of 18.3 percent in 1996.8

➤ At 30.3 percent for past-year

marijuana use, 10th graders

are at their lowest level since

1995 and somewhat below

their recent peak of 34.8 

percent in 1997. The past-year

use rate for 12th graders is

down, albeit only modestly,

from 38.5 percent in their

recent peak year (1997) to 

36.2 percent in 2002.9

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 1

More young people are

now in treatment for

marijuana dependency

than for alcohol or 

for all other illegal 

drugs combined.3

6.2

7.2

9.2

13.0

15.8

18.3 17.7

16.9 16.5

15.6 15.4

14.6

16.5

15.2

19.2

25.2

28.7

33.6

34.8

31.1 32.1 32.2 32.7

30.3

23.9

21.9

26.0

30.7

34.7

35.8

38.5 37.5 37.8 36.5 37.0

36.2

5

10

15

20

25

30

35

40

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Eighth Grade

Tenth Grade

Twelfth Grade

Marijuana: Trends in Annual Prevalence of Use by Subgroups

for Eighth, Tenth, and Twelfth Graders

Percentage who used in last twelve months

Monitoring the Future, National Survey Results on Drug Use, 1975-2002
II. Myths and Misperceptions

Many of the things Americans “know” about marijuana are myths or misperceptions. People need to

know the truth about this harmful drug.

MYTH 1

Marijuana is harmless.

Marijuana is far from harmless; in fact, recent scientific findings about the drug are startling. 

Most of the drug treatment for young people in the United States is for marijuana alone. Marijuana

emergency-room mentions have skyrocketed over the past decade, and the drug is associated with an

increased risk of developing schizophrenia, even when personality traits and pre-existing conditions

are taken into account.

FACTS:

Health Consequences

• Marijuana smoke contains 50 percent to 70 percent more carcinogenic hydrocarbons

than does tobacco smoke.10 Using marijuana may promote cancer of the respiratory

tract and disrupt the immune system.11

• Marijuana smokers have a heightened risk of lung infection.12

• Long-term use of marijuana may increase the risk of chronic cough, bronchitis, 

and emphysema, as well as cancer of the head, neck, and lungs.13

• Mentions of marijuana use in emergency room visits have

risen 176 percent since 1994, surpassing those of heroin.14

• In 2001, marijuana was a contributing factor in more than

110,000 emergency department visits in the United States.15

• Marijuana can cause the heart rate, normally 70 to 80 beats

per minute, to increase by 20 to 50 beats per minute or, in

some cases, even to double.17

• In a 2003 study, researchers in England found that smoking

marijuana for even less than six years causes a marked

deterioriation in lung function. The study suggests that 

marijuana use may rob the body of antioxidants that protect

cells against damage that can lead to heart disease and cancer.18

• Marijuana affects alertness, concentration, perception, coordination, and reaction time—

skills that are necessary for safe driving. A roadside study of reckless drivers in Tennessee

found that 33 percent of all subjects who were not under the influence of alcohol and who

were tested for drugs at the scene of their arrest tested positive for marijuana.20 In a 2003

Canadian study, one in five students admitted to driving within an hour of using marijuana.21

2 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA

Smoking marijuana

leads to changes in the

brain similar to those

caused by the use of

cocaine and heroin.16
• Marijuana users have more suicidal thoughts and are four

times more likely to report symptoms of depression than

people who never used the drug.22

• The British Medical Journal recently reported: “Cannabis

use is associated with an increased risk of developing

schizophrenia, consistent with a causal relation. This

association is not explained by use of other psychoactive

drugs or personality traits relating to social integration.”23

Social Consequences

• Heavy marijuana use impairs the ability of young people to concentrate and retain

information during their peak learning years. Tetrahydrocannabinol (THC), the main

active chemical in marijuana, changes the way sensory information gets into and is

processed by the part of the brain that is crucial for learning and memory.24

• Animal studies indicate that marijuana use may interfere with brain function and create

problems with the perception of time, possibly making the user less adept at tasks that

require sustained attention.25

• Marijuana use has been associated with poor performance in school. One report

showed that youths with an average grade of D or below were more than four times as

likely to have used marijuana in the past year as youths with an average grade of A.26

• Marijuana users in their later teen years are more likely to have an increased risk of

delinquency and more friends who exhibit deviant behavior. They also tend to have

more sexual partners and are more likely to engage in unsafe sex.27

Economic Consequences

• Use of marijuana and other illicit drugs comes at significant expense to society in terms

of lost employee productivity, public health care costs, and accidents.28

• Americans spent $10.6 billion on marijuana purchases in 1999.29

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 3

The British Lung

Foundation reports that

smoking three or four

marijuana joints is as

bad for your lungs 

as smoking 20 tobacco

cigarettes.19
MYTH 2

Marijuana is not addictive.

Marijuana has been proven to be a psychologically addictive drug. Scientists at the National Institute

on Drug Abuse have demonstrated that laboratory animals will self-administer THC in doses equivalent to those used by humans who smoke marijuana.30

FACTS:

• Marijuana is much more powerful today than it was 30 years ago, and so are its mindaltering effects. Average THC levels rose from less than 1 percent in the mid-1970s to

more than 6 percent in 2002. Sinsemilla potency increased in the past two decades

from 6 percent to more than 13 percent, with some samples containing THC levels of

up to 33 percent.31

• Subjects in an experiment on marijuana withdrawal

experienced symptoms such as restlessness, loss of

appetite, trouble with sleeping, weight loss, and shaky

hands.32

• According to one study, marijuana use by teenagers

with prior serious antisocial problems can quickly lead

to dependence on the drug. The study also found that,

for troubled teenagers using tobacco, alcohol, and

marijuana, progression from their first use of marijuana to regular use was about as rapid as their progression to regular tobacco use, and more rapid than the

progression to regular use of alcohol.33

4 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA

Some heavy users of 

marijuana show signs of

dependence, developing

withdrawal symptoms

when they have not

used the drug for a 

period of time.
MYTH 3

Youth experimentation with marijuana is inevitable.

Drug use can be prevented. The majority of young people do not use drugs, and there are proven

ways to keep kids from starting. Contrary to popular belief, marijuana use is not a rite of passage.

It is a risky behavior with serious consequences. Every American has a role to play in the effort to

reduce marijuana use—at home and on the job, in schools, places of worship, and civic or social

organizations. Working together, we can reaffirm healthy attitudes about marijuana use.

FACTS:

• Surveys show that parents are the biggest influence in

their children’s decisions about drug use.34 Parents must

actively engage in educating their children and help them

make healthy decisions.

• We know that when we push back against the drug problem, it recedes. Marijuana use has been dramatically lower

in the past—even in the last decade—and it can be

reduced again.35

MYTH 4

Marijuana is not associated with violence, as are drugs like

cocaine and heroin. The criminalization of marijuana is what leads

to crime, not the drug itself.

It’s not simply the trafficking of drugs that causes crime at home and abroad. Crime also results

from the behavior of people who have drug dependencies.

FACTS:

• Research shows a link between frequent marijuana use and increased violent 

behavior.36

• Young people who use marijuana weekly are nearly four times more likely than

nonusers to engage in violence.37

• More than 41 percent of male arrestees in sampled U.S. cities tested positive for

marijuana.38

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 5

Contrary to popular

belief, marijuana use is

not a rite of passage.

It is a risky behavior

with serious 

consequences.
MYTH 5

Prisons are filled with non-violent, casual marijuana users.

Most law enforcement officials would attest that simple marijuana users rarely get sent to jail. 

In fact, a substantial number of states and localities rate simple possession of marijuana as a 

misdemeanor, subject only to a small fine. Our prisons are not filled with people whose only crime

was smoking marijuana. The vast majority of those behind bars for marijuana offenses are 

mid- and large-scale traffickers and distributors. 

FACTS:

• Less than one percent of all state prison inmates in 1997 were serving time just for

marijuana possession (0.7 percent), and only 0.3 percent of marijuana-possession

offenders were in prison on a first offense.39

• On the federal level, nearly 98 percent of the 7,991

offenders sentenced for marijuana crimes in 2001 were

guilty of trafficking. Only 2.3 percent—186 people—

were sentenced for simple possession of marijuana.40

• The median amount of marijuana involved in the conviction in federal court of marijuana-only possession

offenders in 1997 was 115 pounds. In other words, half

of all federal prisoners convicted just for marijuana possession were arrested with quantities exceeding 115

pounds.41

6 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA

The vast majority of

those behind bars for

marijuana offenses are 

mid- and large-scale

traffickers and 

distributors.
III. The Mission

Responsible public policy seeks to reduce access to and availability of marijuana. Once people

know the facts about the drug, it is important that they work to develop a comprehensive

approach for preventing and reducing its use. Moreover, law enforcement agencies at all levels

should make it a top priority to intensify detection and removal of marijuana-growing operations.

• Curbing access to marijuana is a major challenge. A 2001 survey found that 55 percent

of kids age 12-17 agreed that marijuana would be “fairly easy” or “very easy” to obtain

and was available from a wide variety of sources.42

Our responsibility as employers, colleagues, neighbors, family members, and friends is to get the

marijuana user beyond denial and into effective treatment and lifelong recovery.

• Reduce the denial gap

➤ Of the 5.6 million people who met the criteria for drug dependence and abuse specified 

in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders in 

2001, 4.6 million (92 percent) did not acknowledge they had a problem.43

• Treatment works

➤ Federal spending for substance-abuse treatment has risen sharply in recent years, 

increasing from about $2.2 billion in 1993 to nearly $3.3 billion in 2003.44

➤ The federal government sponsored the Cannabis Youth Treatment Study (CYT),45 which

developed innovative and effective treatment methodologies.

❖ Using these treatment approaches, the percentage of young people reporting abstinence

from marijuana use went from 4 percent upon

entering the study to 13 percent within 3

months, and to 34 percent after 6 months. The

percentage of those having no past-month

symptoms of marijuana abuse or dependence

went from an initial 19 percent to 39 percent

within 3 months, and to 61 percent after 6

months.

❖ The CYT study found that brief interventions,

or structured efforts to interrupt and stop an individual’s drug use, could be

very successful, especially with low-severity clients (such as those who are

not yet dependent).

❖ The advantage of brief interventions is that they can be carried out in nonmedical environments by non-medical staff. The screening and brief intervention approach is currently being used in a variety of settings (such as

emergency rooms and social service agencies), and it has been found to be

both clinically and cost effective.

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 7

Treatment for 

marijuana is widely

available in a variety 

of forms. There is no

“wrong pathway”

to treatment.
➤ Drug courts, or supervised programs that offer alternatives to incarceration, are a common

means of providing treatment for drug users. Established to handle the growing caseload

of low-level drug offenses, drug courts separate non-violent users from people charged

with trafficking and other serious drug crimes.

❖ Recidivism rates among all drug court participants have ranged from 5 percent to 28 percent; for graduates of drug courts, the recidivism rate is less

than 4 percent.46

❖ Drug courts are expanding rapidly, and the federal government is helping 

to fuel this growth. The President’s proposed FY 2004 budget includes an

increase in drug-court funding from the currently enacted $45 million to 

$68 million.47 More than 1,000 drug courts are in operation around the

country, and approximately 400 are in development. To date, some 300,000

adults and juveniles have enrolled in drug court programs.48

➤ Communities can take action now. We urge treatment programs and providers to employ

these proven methods. For materials and more information, visit www.health.org.

Related Issues

1. Marijuana v. tobacco and alcohol: the case against legalization

• Alcohol and tobacco pose significant risks, especially to young people.

• Alcohol and tobacco cost society a great deal every

year in terms of crime, lost productivity, tragedies, and

deaths. Why legalize marijuana and add a third drug to

the current list of licit threats? 

• As a result of legal settlements and vigorous public 

education efforts, many Americans are aware of the 

dangers of dependence and addiction associated with

alcohol and tobacco use. Even so, alcohol and tobacco

remain a significant part of the American health problem.

8 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA

Why legalize marijuana

and add a third drug to

the current list of licit

threats?
2. Gateway theory

• A direct cause-and-effect relationship between marijuana use and subsequent use of

other drugs is hard to prove. Studies show, however, that of the people who have ever

used marijuana, those who started early are more likely to have other problems later

on. For example, adults who were early marijuana users were found to be:

➤ 8 times more likely to have used cocaine;49

➤ 15 times more likely to have used heroin;50

➤ 5 times more likely to develop a need for treatment of abuse or dependence 

on any drug.51

• The Journal of the American Medical Association reported a study of more than 300

sets of same-sex twins. The study found that marijuana-using twins were four times

more likely than their siblings to use cocaine and crack cocaine, and five times more

likely to use hallucinogens such as LSD.52

3. Medical marijuana

• Our medical system relies on proven scientific research, not polling results.

• About 100 years ago, leaders in this country created the U.S. Food and Drug

Administration (FDA) to make sure that medicine falls under the “safe and effective”

standard before it is sold on the open market.

• Research has not demonstrated that smoked marijuana is helpful as medicine.53

• A component in marijuana—THC—has been approved in pill form by the FDA. It’s

called Marinol, and though it is not frequently prescribed, the U.S. supports the right of

doctors to prescribe this drug if they feel it would best serve their patients’ needs. The

U.S. Drug Enforcement Administration (DEA) even lowered the scheduling on Marinol to

make it easier for doctors to prescribe the drug.

• Marijuana smoke contains more than 400 chemicals and increases the risk of cancer,

lung damage, and poor pregnancy outcomes.54

• The U.S. continues to support research into the medical efficacy of certain isolated

properties of marijuana.

• Even if smoking marijuana makes people “feel better,” that is not enough to call it a

medicine. If that were the case, tobacco cigarettes could be called medicine because

they are often said to make people feel better. For that matter, heroin certainly makes

people “feel better” (at least initially), but no one would suggest using heroin to treat a

sick person.

• Marijuana use causes precancerous changes in the body similar to those caused by

tobacco use. Smoking pot delivers 3 to 5 times the amount of tars and carbon monoxide

into the body. It also damages pulmonary immunity and impairs oxygen diffusion.55 How

could changes such as these be good for someone dying of cancer or AIDS?

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 9
4. State initiatives

• Voters at the state and local levels want to make

decisions that are appropriate for their communities,

but to so so they must have accurate information.

• Well-financed and organized campaigns have contributed to the misperception that marijuana is harmless or may even have health benefits.

• These campaigns are led not by medical professionals or patients-rights groups, but by pro-drug donors

and organizations in a cynical attempt to exploit the

suffering of sick people.

5. The European experience

• The “nirvana” offered by the Dutch example is extremely dubious; in fact, the Dutch

government is now reconsidering its laws and policies regarding drugs.

• Increased availability of marijuana leads to increased use of this and other drugs, 

and it creates additional problems as well:

➤ After coffee shops started selling marijuana and use of the drug became 

normalized, marijuana use between 1984 and 1996 nearly tripled—from 

15 percent to 44 percent—among 18- to 20-year-old Dutch youth.56

➤ While our nation’s consumption of cocaine has decreased by 70 percent over 

the past 15 years, cocaine consumption in Europe (primarily Western Europe) 

has increased.57

10 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA

Marijuana is being

used as a wedge issue

by a small minority to

push a political 

agenda calling for

drug legalization.
6. Drug testing in schools

• Marijuana use affects the growth and development of

young minds; it can inhibit students’ ability to concentrate

and retain information during the critical learning years.

• Student drug testing can be an important tool in preventing

and treating youth drug use.

• It is important for parents, school officials, and community

leaders to examine the nature and extent of their youth

drug problem to determine if testing is appropriate for their

schools.

• The goal of school-based drug testing is not to trap and

punish students who do drugs. Rather, it is to prevent drug dependence and to help

drug-using students stop and find treatment before the problem gets worse.58

• According to the Journal of Adolescent Health, a school in Oregon that drug-tested 

student-athletes had a rate of drug use that was one-fourth that of a comparable

school with no drug-testing policy.59

• After two years of a drug-testing program, Hunterdon Central Regional High School in

New Jersey saw significant reductions in 20 of 28 drug-use categories. Cocaine use by

seniors, for example, dropped from 13 percent to only 4 percent.60

• Testing provides a way for teens to resist peer pressure.61

• Testing helps prevent drug use at a critical time in young people’s lives. Research

shows a strong link between drug dependence and the age of initiation. If people can

be prevented from using drugs as teenagers, their chances of experiencing drug problems as adults are greatly diminished.62

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 11

Student drug testing

helps prevent drug use

at a critical time in

young people's lives.
1 Department of Health and Human Services, Substance Abuse and Mental Health Services

Administration, 2002 National Survey on Drug Use and Health, 2003:

http://www.samhsa.gov/oas/nhsda.htm#NHSDAinfo 

2 Ibid.

3 Department of Health and Human Services, Substance Abuse and Mental Health Services

Administration, Treatment Episode Data Set, 2000:

http://wwwdasis.samhsa.gov/teds00/5.1a.htm

4 Ibid. See also: http://wwwdasis.samhsa.gov/teds00/5.1b.htm

5 Ibid. See also: http://wwwdasis.samhsa.gov/teds00/5.2a.htm

6 Department of Health and Human Services, Substance Abuse and Mental Health Services

Administration, Initiation of Marijuana Use Special Report, 2001: 

http://www.samhsa.gov/oas/NHSDA/2k1NHSDA/vol1/Chapter5.htm

7 Johnston, L.D., O’Malley, P.M., & Bachman, J.G. Monitoring the Future national survey results on

drug use, 1975-2002. Volume I: Secondary school students (NIH Publication No. 03-5375).

Bethesda, MD: National Institute on Drug Abuse, August 2003:

http://monitoringthefuture.org/pubs/monographs/vol1_2002.pdf

8 Ibid.

9 Ibid.

10 Hoffman, D.; Brunnemann, K.D.; Gori, G.B.; and Wynder, E.E.L. On the carcinogenicity of marijuana

smoke. In: V.C. Runeckles, ed., Recent Advances in Phytochemistry. New York: Plenum, 1975.

See also NIDA, Research Report Series: Marijuana Abuse, Oct. 2002:

http://www.nida.nih.gov/ResearchReports/Marijuana/Marijuana3.html

11 Zhu, L.X.; Stolina, M.; Sharma, S.; Gardner, B.; Roth, M.D.; Tashkin, D.P.; and Dubinett, S.M. Delta-9

tetrahydrocannabinol inhibits antitumor immunity by a CB-2 receptor-mediated, cytokine dependent-pathway. J Immunology. 165(1):373-380, 2000: 

12 Tashkin, D.P. Pulmonary complications of smoked substance abuse. West J Med 152: 525-530, 1990.

See also http://www.nida.nih.gov/ResearchReports/Marijuana/Marijuana3.html

13 Ibid.

12 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA

Sources
14 Department of Health and Human Services, Substance Abuse and Mental Health Services

Administration, Drug Abuse Warning Network, Midyear 2002:

http://www.samhsa.gov/oas/dawn.htm

15 Ibid.

16 de Fonseca, R. et al. Activation of Corticotropin-Releasing Factor in the Limbic System During

Cannabinoid Withdrawal. Science. Vol. 276, 1997:

http://www.druglibrary.org/crl/behavior/rodriguez-01.pdf

17 Gilman, A.G.; Rall, T.W.; Nies, A.S.; and Taylor, P. (eds.). Goodman and Gilman’s The

Pharmacological Basis of Therapeutics, 8th Edition. New York: Pergamon Press, 1998.

See also http://www.nida.nih.gov/ResearchReports/Marijuana/Marijuana3.html.

18 Nuttall, SL; Raczi, JL; Manney, S; Thorpe, GH; Kendall, MJ. Effects of smoking and cannabis

use on markers of oxidative stress in exhaled breath condensate. Division of Medical

Sciences, University of Birmingham, Birmingham, England, 2003.

19 A Smoking Gun: The Impact of Cannabis Smoking on Respiratory Health. The British Lung

Foundation, 2002: http://www.ukcia.org/research/SmokingGun/ASmokingGun.pdf

20 Brookoff, D.; et al. Testing Reckless Drivers for Cocaine and Marijuana. New England Journal

of Medicine, 331:518-522, 1994: http://content.nejm.org/cgi/content/abstract/331/8/518

21 Adlaf, et al. Drinking, Cannabis Use, and Driving Among Ontario Students. Canadian Medical

Association Journal. 168, March 2003: http://www.cmaj.ca/cgi/content/full/168/5/565

22 Bovasso, G. American Journal of Psychiatry. 158:2033-2037, 2001: 

http://ajp.psychiatryonline.org/cgi/content/abstract/158/12/2033?maxtoshow=&HITS

=10&hits=10&RESULTFORMAT=&fulltext=Bovasso&searchid=1053459102669_3546&s

tored_search=&FIRSTINDEX=0&volume=158&issue=12&journalcode=ajp

23 Zammit et. al. Self reported cannabis use as a risk factor for schizophrenia in Swedish 

conscripts of 1969: historical cohort study. British Medical Journal. 325:1199, 2002:

http://bmj.com/cgi/content/abstract/325/7374/1199?etoc

24 NIDA, Marijuana: Facts Parents Need to Know, November 1998:

http://www.nida.nih.gov/MarijBroch/MarijparentsN.html

See also: Pope, H.G. et al, “The Residual Cognitive Effects of Heavy Marijuana Use in College

Students,” Journal of the American Medical Association. Vol. 275 No. 7, 1996.

25 Crystal, J.D., Maxwell, K.W., & Hohmann, A.G. Cannabinoid modulation of sensitivity to time.

Behavioural Brain Research, April 2003. Abstract:

http://dx.doi.org/10.1016/S0166-4328(03)00062-7

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 13
26 Department of Health and Human Services, Substance Abuse and Mental Health Services

Administration. The NHSDA Report: Marijuana Use Among Youths, July 2002:

http://www.samhsa.gov/oas/2k2/YouthMJuse/YouthMJuse.htm

27 Brook, J.S. et al. The risks for late adolescence of early adolescent marijuana use. American

Journal of Public Health, October 1999.

28 Office of National Drug Control Policy, The Economic Costs of Drug Abuse in the United States,

1992-1998. Washington, DC: Executive Office of the President, 2001:

http://www.whitehousedrugpolicy.gov/publications/pdf/economic_costs98.pdf

29 What America’s Users Spend on Illegal Drugs: 1988-2000, Office of National Drug Control Policy,

December 2001:

http://www.whitehousedrugpolicy.gov/publications/pdf/american_users_spend_2002.pdf

30 Self-administration behavior is maintained by the psychoactive ingredient of marijuana in squirrel monkeys,

Gianluigi Tanda, Patrik Munzar, and Steven R. Goldberg, Nature Neuroscience, doi: 10.1038/80577,

November 2000, Volume 3, Number 11, pp 1073 – 1074. Abstract:

http://www.nature.com/cgi-taf/DynaPage.taf?file=/neuro/journal/v3/n11/abs/nn1100_1073.html

See also: http://www.drugabuse.gov/MedAdv/00/NR10-15.html

31 Marijuana Potency Monitoring Project. University of Mississippi, 2002. See also:

http://www.usdoj.gov/dea/pubs/intel/01020/index.html#ma4

http://www.recoverymonth.gov/2003/kit/OverviewAndGeneralFacts.pdf

32 Budney et al., Marijuana abstinence effects in marijuana smokers maintained in their home environment. Archives of General Psychiatry. 58 (10): 917-924. 2001. (NIDA Notes Vol. 17 No. 3):

http://www.drugabuse.gov/NIDA_notes/NNVol17N3/Demonstrates.html

See also Marijuana: Facts for Teens, NIDA, Revised 1998:

http://www.nida.nih.gov/MarijBroch/Marijteenstxt.html

See also State Resources and Services Related to Alcohol and Other Drug Problems for Fiscal Year

1995: An Analysis of State Alcohol and Drug Abuse Profile Data, National Association of State

Alcohol and Drug Abuse Directors, Inc., July 1997.

33 Crowley, T. J.; Macdonald, M. J.; Whitmore, E. A.; and Mikulich. S. K. Cannabis Dependence,

Withdrawal, and Reinforcing Effects Among Adolescents With Conduct Symptoms and Substance

Use Disorders. Drug and Alcohol Dependence, 1998. Abstract:

http://www.drugabuse.gov/ICAW/treatment/treatmentfindings298.html

34 National Survey on American Attitudes on Substance Abuse V: Teens and Their Parents. The

National Center on Addiction and Substance Abuse at Columbia University (CASA), 1999:

http://www.prevlink.org/clearinghouse/catalog/research_statistics/other_research_statistics/attitudes_on_substance_abuse.pdf

14 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA
35 Johnston, L.D., O’Malley, P.M., & Bachman, J.G. Monitoring the Future: National Survey

Results on Drug Use, 1975-2001. Volume I: Secondary School Students (NIH Publication No.

02-5106). Bethesda, MD: National Institute on Drug Abuse, c. 503 pp. 2002:

http://monitoringthefuture.org/pubs/monographs/vol1_2001.pdf

36 Adolescent Self-reported Behaviors and Their Association with Marijuana Use, Department of

Health and Human Services, Substance Abuse and Mental Health Services Administration,

1999: http://www.samhsa.gov/press/980922fs.htm

See also: Brook, J.S. et al. The risks for late adolescence of early adolescent marijuana use.

American Journal of Public Health, October 1999.

37 Ibid.

38 Preliminary Data on Drug Use & Related Matters Among Adult Arrestees & Juvenile Detainees

2002, Arrestee Drug Abuse Monitoring Program (ADAM):

http://www.adam-nij.net/files/2002_Preliminary_Data.pdf

39 Bureau of Justice Statistics estimates based on the “1997 Survey of Inmates in State and

Federal Correctional Facilities,” National Archive of Criminal Justice Data. For a public-use

copy of the survey data: http://www.icpsr.umich.edu/NACJD/SISFCF/index.html

40 U.S. Sentencing Commission’s 2001 Sourcebook of Federal Sentencing Statistics:

http://www.ussc.gov/ANNRPT/2001/SBTOC01.htm

http://www.ussc.gov/ANNRPT/2001/table33.pdf

41 BJS estimates based on the “1997 Survey of Inmates in State and Federal Correctional

Facilities,” National Archive of Criminal Justice Data. A public-use copy of the survey data is

available at http://www.icpsr.umich.edu/NACJD/SISFCF/index.html

42 Department of Health and Human Services, Substance Abuse and Mental Health Services

Administration, National Household Survey on Drug Abuse, 2001:

http://www.samhsa.gov/oas/nhsda/2k1nhsda/vol1/toc.htm

43 Department of Health and Human Services, Substance Abuse and Mental Health Services

Administration, National Household Survey on Drug Abuse, 2001:

http://www.samhsa.gov/oas/NHSDA/2k1NHSDA/vol2/appendixh_5.htm#tableh.70

http://www.samhsa.gov/news/content/2001nhsda.htm

44 National Drug Control Strategy, FY 2004 Budget Summary, February 2003:

http://www.whitehousedrugpolicy.gov/publications/policy/04budget/fy04budgetsum.pdf

45 The Cannabis Youth Treatment (CYT) Experiment: Preliminary Findings, Sept. 2000:

http://www.samhsa.gov/centers/csat/content/Recoverymonth/0900cannabis.pdf

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 15
16 WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA

46 Looking At a Decade of Drug Courts, Office of Justice Programs Drug Court Clearinghouse and

Technical Assistance Project at American University, Washington D.C., 1999:

http://www.american.edu/academic.depts/spa/justice/publications/decade1.htm

47 National Drug Control Strategy, FY 2004 Budget Summary, February 2003:

http://www.whitehousedrugpolicy.gov/publications/policy/04budget/exec_sum.pdf

48 Office of Justice Programs Drug Court Clearinghouse and Technical Assistance Project, 

American University: http://www.american.edu/justice/publications/drgchart2k.pdf

See also National Drug Court Institute: http://www.ndci.org/courtfacts.htm

49 Initiation of Marijuana Use: Trends, Patterns, and Implications. Analysis Based on data from

NHSDA in 1999 and 2000. Department of Health and Human Services Substance Abuse and

Mental Health Services Administration, 2002:

http://www.samhsa.gov/oas/MJinitiation/MJinitiation.pdf

50 Ibid.

51 Ibid.

52 Lynskey et al. Escalation of Drug Use in Early-Onset Cannabis Users vs. Co-Twin Controls,

JAMA, 289:427-433, 2003: www.csdp.org/research/joc21156.pdf

53 See Marijuana and Medicine: Assessing the Science Base, Institute of Medicine, National

Academy of Sciences, 1999: http://www.nap.edu/html/marimed/

54 Ibid.

55 There is a plethora of literature explaining marijuana’s adverse affect on the respiratory and

immune systems. For a sample, see: Barbers R.G. et al. Differential examination of bronchoalveolar lavage cells in tobacco cigarette and marijuana smokers, Am Rev Respir Dis.

1987;135:1271-1275;

Barsky SH, Roth MD, Kleerup E.C, Simmons M, Tashkin DP. Histopathologic and Molecular

Alterations in Bronchial Epithelium in Habitual Smokers of Marijuana, Cocaine, and / or

Tobacco, Journal of the National Cancer Institute, 1998; 90:1198-1205 (Bronchial mucosa

biopsy specimens and brushings demonstrated statistically significant molecular abnormalities in marijuana and/ or cocaine smokers that have been associated with an increased risk

of development of lung cancer.);

Caiaffa WT, Vlahov D, Graham NHM, Astemborski J, Solomon L, Nelson KE, Munoz A. Drug

smoking, Pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial

pneumonia in human immunodeficiency virus-seropositive injection drug users, Am J Respir

Crit Care Med 1994;150: 1493-1498. (Incidence of bacterial pneumonia was 1.93 in seropositive subjects who smoked illegal drugs. Pts reported 87.9 percent smoked marijuana, 25.9

percent used cocaine, and 9.1 percent smoked crack cocaine.);
Fligiel SEG, Roth MD, Kleerup EC, Barsky SH, Simmons MS, Tashkin DP. Tracheobronchial

histopathology in habitual smokers of cocaine, marijuana, and/or tobacco. Chest 1997;

112:319-326 (smokers of cocaine, marijuana, or tobacco had greater abnormalities than controls and the effects were additive. The effects of marijuana were greater than tobacco.)

Gong, H., et al. Acute and subacute bronchial effects of oral cannabinoids. Clin Pharmacol Ther.

1984; 35:26-32;

Roth MD, Arora A, Barsky SH, Kleerup EC, Simmons M, Tashkin DP. Airway inflammation in young

marijuana and tobacco smokers. Am J. Respir Crit Care Med 1998;157:928-937 (conclusion

that smoking marijuana by young adults is associated with significant airway inflammation

similar to tobacco smoking.);

Tashkin, D.P., Shapiro, B.J., Lee, Y.E., and Harper, C.E. Subacute effects of heavy marijuana smoking on pulmonary function in healthy men, NEJM. 1976;294:125-129;

Van Hoozen, BE, and Cross, CE. Marijuana: Respiratory tract effects. Clinical Reviews in Allergy and

Immunology 1997; 15:243-269 (review of the literature on the respiratory effects of marijuana).

56 MacCoun, R., & Reuter, P. Interpreting Dutch cannabis policy: Reasoning by analogy in the

legalization debate. Science. 278, 47-52, 1997: 

http://ist-socrates.berkeley.edu/~maccoun/scienc97.html

57 World Drug Report, United Nations Office for Drug Control and Crime Prevention, 2000:

http://www.unodc.org/unodc/wdr_executive_summary_2000.html

http://www.unodc.org/pdf/world_drug_report_2000/report_2001-01-22_1.pdf

58 What You Need To Know About Drug Testing in Schools, Office of National Drug Control

Policy, 2002: www.whitehousedrugpolicy.gov/pdf/drug_testing.pdf

59 Goldberg et al. Drug testing athletes to prevent substance abuse: background and pilot study

results of the SATURN (student athlete testing using random notification) study, Journal of

Adolescent Health, 32: 1: 16-25, 2002.

60 What You Need To Know About Drug Testing in Schools, Office of National Drug Control

Policy, 2002: www.whitehousedrugpolicy.gov/pdf/drug_testing.pdf

61 Ibid.

62 Initiation of Marijuana Use: Trends, Patterns, and Implications, Substance Abuse and Mental

Health Services Administration, 1999 and 2000 National Household Survey on Drug Abuse,

July 2002: http://www.samhsa.gov/oas/MJinitiation/MJinitiation.pdf

See also: Grant, B. F., & Dawson, D. A. (1998). Age of onset of drug use and its association

with DSM-IV drug abuse and dependence: Results from the National Longitudinal Alcohol

Epidemiologic Survey. Journal of Substance Abuse, 10, 163-173.

Early-onset drug use and risk of later drug problems, Anthony JC, Petronis KR. Department of

Mental Hygiene, Johns Hopkins University, Baltimore, MD, 1995.

WHAT AMERICANS NEED TO KNOW ABOUT MARIJUANA 17
office of national drug control policy