i

For more information visit DEA 

online at www.dea.gov

2010

SPEAKING OUT

Against Drug Legalization

 
ii

A Message from the 

Drug Enforcement Administration

Increasingly the news is full of reports providing misleading or biased information about 

our nation’s drug policies. Whether there are questions about the Drug Enforcement 

Administration’s (DEA) actions to enforce federal law, or challenges to the basic concept 

that drugs are dangerous, there is a growing discussion as to whether our current drug 

policies are effective and appropriate. 

This booklet, Speaking Out Against Drug Legalization, is designed to cut through the 

current fog of misinformation with hard facts. It presents an accurate picture of America’s 

experience with drug use, the nature of the drug problem, and the potential for damage 

if the United States adopts a more permissive policy on drug abuse. The information is 

presented in a bulleted format, in an effort to provide specific points in response to the 

most common myths and facts about drugs and drug abuse.

Drug abuse, and this nation’s response to it, is one of the most important and complex 

challenges facing all Americans—especially our youth. The national drug policies presently 

in place were not dreamed up from an ivory tower of idealism, but instead were constructed 

from the cold realities of experience. 

From a historical perspective, the unique freedoms offered by the United States have 

always depended on a well-informed public. Accordingly, the DEA hopes you will use 

the scrupulously researched facts you find in this booklet to help you educate your friends 

and family. 
iii

A Message from the International

Association of Chiefs of Police

Every year, the use and abuse of drugs kills tens of thousands of Americans and condemns 

countless others to a life of addiction, misery and pain. Yet, despite these horrific statistics, 

there is a broad scale effort underway to “legalize” illegal narcotics in communities and 

states throughout the country. All too often, supporters of these initiatives mislead the 

public about the impact of drug legalization and ignore the harm that the wide spread 

use of narcotics will have on a community. 

The simple truth is that legalizing narcotics will not make life better for our citizens, ease 

the level of crime and violence in our communities nor reduce the threat faced by law 

enforcement officers. To suggest otherwise ignores reality. 

There is a reason why the International Association of Chiefs of Police (IACP) and every major 

law enforcement organization opposes efforts at drug legalization or decriminalization. 

We are public safety experts who have witnessed first-hand the damage and horror that 

drug abuse visits on society. We have witnessed the lost promise of a child who becomes 

addicted to drugs and whose life descends into the never-ending hell of dependency and 

squalor. We have viewed the pain and anguish on the faces of parents and relatives who 

have lost a loved one to a drug overdose. 

Far from being an answer to these problems, drug legalization will condemn tens of 

thousands of our fellow citizens to a life of dependency and horror and endanger the lives 

of countless innocent others who share the roads and their communities. 

This publication is an invaluable resource which provides law enforcement executives 

and officers, elected officials, community leaders, teachers, parents and all those who 

are concerned about community safety with the information and resources they need in 

order to accurately inform the public of the dangers of drug legalization. 
iv

 

A Message from the Drug Enforcement Administration ii

A Message from the International Association of Chiefs of Police iii

Popular Myths About Drug Legalization: 2

Myth #1 The enforcement of drug laws contributes to the 

 violence along the southwest border 2

Myth #2 Legalizing and taxing marijuana will help local economies 4

Myth #3 Federal drug laws infringe on states rights 6

Myth #4 Prohibition didn’t work in the 20’s, and it won’t work now 9

Myth #5 Congress is attempting to legislate morality 11

Endnotes 12

Summary of the Top 10 Facts on Legalization 13

Fact 1: Significant progress has been made in fighting drug use and 

 drug trafficking in America 15

Demand Reduction 15

Supply Reduction 16

Fact 2: A balanced approach of prevention, enforcement, and 

 treatment are the keys in the fight against drug abuse 18

Stopping Drug Initiation 18

Reducing Drug Abuse and Addiction 19

Drug Courts 19

Risk Perception 20

Enforcing Drug Laws 20

Fact 3: Drug use is regulated and access to drugs is controlled 

 because drugs can be harmful 22

Cocaine 24

Heroin 26

Marijuana 28

Table of Contents
v

Fact 4. Smoked marijuana has never been approved and will never be approved for medical use 31

Impacts of marijuana use on mental health 32

Impacts of marijuana use on physical health 34

Statements by medical organizations 37

Fact 5: Drug control spending is a minor portion of the U.S. budget. Compared to the social costs 

 of drug abuse and addiction, government spending on drug control is minimal 39

Social Costs 39

Costs to the Taxpayer 45

Fact 6: Legalization of drugs will lead to increased use and increased levels of addiction 46

Failed legalization ventures 46

Alcohol and tobacco costs 47

Alcohol costs to society 47

Tobacco costs to society 48

Fact 7: Crime, violence, and drug use go hand-in-hand 50

Drug use and crime 51

Victims of drug crimes 51

Drug use and violence 52

Fact 8: Alcohol and tobacco have caused significant health, social, and crime problems in this country, 

 and legalized drugs would only make the situation worse 54

Prohibition 55

Fact 9: Europe’s more liberal drug policies are not the right model for America 57

The Netherlands 58

Fact 10: Most non-violent drug users get treatment, not jail time 61

Policy shift to treatment 62

Endnotes 65
1

SPEAKING OUT

Against Drug Legalization
Myths 

Popular

About Drug 

Legalization

2

• Some have proposed legalizing drug consumption in the 

United States as a way to reduce border violence. This ignores 

scientific, legal, and social arguments that highlight 

what legalizing drugs would cost the United States, 

and that marijuana legalization would be a failed 

law enforcement strategy for both the United States 

and Mexico. 

• Criminals won’t stop being criminals if we 

make drugs legal. Individuals who have chosen 

to pursue a life of crime and violence aren’t likely 

to change course, get legitimate jobs, and become 

honest, tax-paying citizens just because we legalize 

drugs. The individuals and organizations that smuggle 

drugs don’t do so because they enjoy the challenge 

of “making a sale.” They sell drugs because that’s 

what makes them the most money. 

• The violence in Mexico is a reflection of a 

larger battle as to whether Mexico will be governed 

under the rule of law, or the rule of the gun. We 

should take steps to reduce the killings by the 

drug cartels in Mexico and along our Southwest border, but 

suggesting that legalizing dope is going to make a difference in 

this effort makes no sense. The fight in Mexico is over money, 

and not just money generated by drugs, but for any illegal 

activity where profits can be made. 

• Drug-related violence in Mexico is not a fight over market 

access or distribution chains in the United States, but the result 

of major Mexican drug trafficking organizations vying for 

control of both the drug smuggling routes leading into and out 

of Mexico, and transportation corridors along the border. 

• Marijuana is only a part of the illegal drug traffic moving 

between Mexico and the United States. Changing the status 

of marijuana in the United States will not stop drug traffickers’ 

motivations for moving drugs to U.S. markets. Remember, drug 

traffickers do what they do for money, not for altruistic reasons. 

Regardless of the legal status of marijuana, there will still be 

“The enforcement of drug laws 

contributes to violence along the 1 Southwest border.”
3 Speaking Out Against Drug Legalization

profits to be made in other drugs, guns, people, or other contraband. Just as organized 

crime didn’t end when alcohol prohibition in the U.S. was lifted in 1933 (see section on 

prohibition, page 58), drug trafficking and its associated violence isn’t going to dissipate if 

the United States decides to legalize marijuana.

• In 2008, according to the Interagency Assessment of Cocaine Movement, approximately 90 

percent of the cocaine destined for the United States transited the Mexico/Central America 

corridor—an estimated 16.8 metric tons of cocaine entered the United States by way of the 

Southwest border.

• According to DEA intelligence estimates, 80 percent of the methamphetamine consumed in 

the U.S. now comes from Mexico-based drug trafficking organizations. Methamphetamine 

seizures along the Southwest border have increased from 1,170 kilograms in CY 2001 to 

2,232 kilograms in CY 2008, a 91-percent increase.

• The National Drug Intelligence Center estimates that Mexican and Colombian Drug 

Trafficking Organizations generate, remove, and launder between $18 billion and $39 

billion in wholesale drug proceeds annually, a large portion of which is believed to be 

bulk-smuggled out of the United States over the Southwest border. 1

• Enforcement efforts make a positive difference in reducing drug-related violence. First, it 

makes it harder for traffickers to move their product. Over the last 18 months, price and 

purity data collected by the DEA show the price of methamphetamine and cocaine is up, 

while the purity of these same drugs is down. Intelligence reporting confirms that trafficking 

organizations are having problems moving product into the United States, and the demand 

is such that they are able to charge more for a weaker product. While law enforcement 

efforts along the Southwest border, in the Caribbean, and in Mexico have seen repeated 

successes, there have been no significant changes in demand reduction activities in the 

United States.

• A comprehensive strategy addressing drug use and trafficking from all angles can and does 

make a difference. DEA supports an effective, comprehensive national drug control strategy, 

and we are working with the Department of Justice and the Office of National Drug Control 

Policy as they develop this strategy.

• We need to be aware of the nature of addiction itself and support research in this key 

area. We should continue to be advocates for effective and proven prevention efforts that 

reduce drug abuse and addiction. We must provide treatment for those that need it, and 

we must enforce our nation’s drug laws which fundamentally help protect our citizens and 

communities. 
4 Speaking Out Against Drug Legalization

• Marijuana is a dangerous, mind-altering drug. That’s the conclusion the Food and Drug 

Administration (FDA) came to after reviewing all of the available information. The same can be 

said of alcohol and tobacco—both legal drugs (and currently outside of the FDA’s jurisdiction). 

How could anyone argue that adding a third substance to that mix is going to be beneficial? 

• Alcohol and tobacco have proven harmful, addictive, and difficult to regulate. Alcohol is the 

third leading cause of death in the United States—each year over 100,000 Americans die of 

alcohol-related causes. The Surgeon General estimates that problems resulting from alcohol use 

and abuse cost society almost $200 billion every year, and that these costs are far higher than 

any revenue generated by alcohol taxes.2

• Tobacco, the other substance that often is suggested as a model for ‘legal’ marijuana, offers 

a picture of a similarly bleak future. The Center for Disease Control estimates that the total 

economic costs associated with cigarette smoking is approximately $7.18 per pack of cigarettes 

sold in the United States. The revenue generated to cover these costs? The federal excise tax is 

$1.01 per pack of cigarettes.3

 The median state cigarette excise tax rate, as of January 1, 2007, is 

80 cents.4 This hardly sounds like an “economic windfall” that cures our budget woes.

• If we were to regulate marijuana, we would have to concede that it’s acceptable for society to 

profit from a person’s addiction. There were approximately 38,000 overdose deaths for illicit 

drugs and non-medical use of prescription drugs during 2006, according to the Center for 

Disease Control.5 How much are those lives worth?

• The cost of treatment and rehabilitation from addiction and usage associated illnesses far 

outweighs the cost of any revenue possibly be generated; a government estimate of the cost of 

drug use just for one year (2002) was more than $180 billion. Regulation hasn’t kept prescription 

drugs, alcohol, or tobacco from being abused. The excise taxes that are collected from these 

activities only cover a portion of the costs of their misuse. 

• Studies demonstrate that when people perceive the use of drugs as harmless, drug use increases—

if marijuana or other drugs were legalized, it is certain that the perceived harm would decrease, 

making the incidence of use rise, regardless of age-related regulations. 

“Legalizing and taxing marijuana will help 

local economies by reduceing crime and 2 increasing tax revenue.”
5 Speaking Out Against Drug Legalization

• Suggesting that the only costs, caused by the illegality of drugs are law enforcement costs ignores 

lives and livelihoods lost due to addiction and overdose. Lowering or eliminating the legal 

restrictions for drugs will result in increased availability, and greater use, with higher healthcare 

costs and increased criminal activity. We have seen these costs go up when other nations have 

gone down this path, and we should not make the same mistakes. 

• For example, when The Netherlands liberalized their drug laws allowing the public sale of 

marijuana, they saw marijuana use among 18-25 years olds double, and the heroin addiction 

levels triple. They have since reversed this trend, and have begun implementing tighter drug 

controls. Indeed, today over 70 percent of Dutch municipalities have local zero-tolerance laws.6

Similarly, when the United Kingdom relaxed their drug laws to allow physicians to prescribe heroin 

to certain classes of addicts, they saw an entirely new class of youthful users emerge. According 

to social scientist James Q. Wilson, the British Government’s experiment with controlled heroin 

distribution resulted in a minimum of a 30-fold increase in the number of addicts in 10 years. 

(See page 60 for more details on European legalization experiments.)

• While the notion that each individual can make their own choices without affecting anyone 

is a nice theory, it is impractical in today’s interconnected world. The health and social costs 

generated by addiction are borne not just by the drug user, but by everyone. The purpose of an 

effective drug policy should be to lessen the harm that illegal drugs do to our society. Lowering 

or eliminating the current legal and social restrictions that limit the availability and social 

acceptance of drug use would have the opposite result, both domestically and internationally.

• Some have hypothesized that there has already been a loss of state tax revenue because of 

actions taken against marijuana traffickers who purport to be operating in furtherance of state 

marijuana legalization laws. In fact, this is a question that some jurisdictions in California have 

raised directly with the Department of Justice. In summary, the Department of Justice replied that 

income derived from the sale of marijuana, whether in California or not, represents proceeds of 

illegal drug trafficking, and as such is forfeitable under federal law. 

• The State of California is neither an innocent owner nor a lien holder in regards to collecting 

illegal drug proceeds.7 All right, title, and interest in property subject to forfeiture under the 

Controlled Substance Act – including all money and other proceeds of illegal drug sales – shall 

vest in the United States upon commission of the illegal act giving rise to the forfeiture.8

 Under 

the supremacy clause of the United States Constitution, a state may not impose a sales tax, or 

any other tax, on the property of the United States.9
6 Speaking Out Against Drug Legalization

• Nonetheless, if a government entity wishes to assert a legal claim to any seized funds, the Civil 

Asset Forfeiture Reform Act of 2000 (CAFRA) provides a mechanism for it to do so, which begins 

by submitting a claim in a timely manner and in the appropriate legal proceeding. In evaluating 

whether to maintain a legal claim please consider that general creditors lack standing to contest 

the federal forfeiture of property.10 Thus, if a state or local government asserts that it is a general 

creditor based upon unreported and/or unpaid sales taxes, it might look to those entities whose 

property was seized, rather than the federal government, for relief. 

• If instead the state or local governments claim some specific interest in the seized funds – funds 

which were derived from the distribution of a controlled substance – then such an interest would 

have to be evaluated according to principles of federal forfeiture law.11 To date, no state or local 

entity has made such claims. 

• The federal government does not focus its marijuana enforcement resources on individual 

patients with cancer or other serious illnesses, and the Attorney General has directed that this 

remain the case. 

• The Attorney General has determined that the Department of Justice will focus its investigation, 

enforcement, and prosecution efforts regarding the manufacture and distribution of marijuana 

on significant drug traffickers. Indicators of significant drug trafficking may include citizen 

complaints, use of firearms, violence, sales to minors, marketing, sales for profit, excessive 

amounts of cash, money laundering, excessive volumes of controlled substances, requests for 

federal assistance from local law enforcement, sale of other illegal drugs, or any other identified 

factor that would demonstrate that marijuana growers or distributors are trying to use state laws 

as a shield for illegal activity.

• Any change to the legal status of marijuana should be done through the mechanisms established by 

the Controlled Substances Act (CSA), which requires action by the Food and Drug Administration 

(FDA) and the DEA, or by Congress. 

• The state’s rights “argument” is most popular in discussions regarding “medical” marijuana ballot 

initiatives that have passed in 14 States. Marijuana remains a Schedule I controlled substance 

under the CSA.12 This is consistent with the fact that the drug has never been approved by the 

FDA for marketing in the United States because scientific studies have never established that 

marijuana can be used safely and effectively for the treatment of any disease or condition.13

Marijuana’s placement in Schedule I of the CSA results in the following legal consequences: 

marijuana may not be dispensed for medical use in the United States; it is illegal to manufacture, 

distribute, or possess marijuana for any purpose (other than government-approved research); and 

there is no “medical necessity” defense to the CSA prohibitions relating to marijuana.14 

“Drug laws infringe on state’s rights.” 3
7 Speaking Out Against Drug Legalization

• The Supreme Court’s decisions in United States v. Oakland Cannabis Buyers’ Cooperative 

(OCBC)

15 and Gonzales v. Raich16 make clear, regardless of whether one complies with the 

California marijuana legalization law, it remains illegal under the CSA for any person to cultivate, 

distribute, or possess marijuana for claimed “medical reasons.” 

• The United States has also signed various international treaties to control illegal drug activity.17 The 

International Narcotics Control Board (INCB) of the United Nations is charged with monitoring 

compliance with the drug control treaties. The INCB pointed out that the state marijuana initiatives 

recently passed in the United States are contrary to United States federal law. The report called on 

the United States to “vigorously enforce its federal law” in the face of these initiatives. The report 

further stated: “The decision of whether a substance should be authorized for medical use has 

always been taken, and should continue to be taken, in all countries by the bodies designated to 

regulate and register medicines. Such decisions should have a sound medical and scientific basis 

and should not be made in accordance with referendums organized by interest groups.”18

• The authority of the DEA to investigate those growing, selling, or possessing marijuana, irrespective 

of state law, has been reaffirmed by recent rulings by the United States Supreme Court. In rejecting 

the notion that marijuana activities purportedly taking place in compliance with California law 

and supposedly on a “wholly intrastate” basis are beyond the reach of Congress’ commerce 

clause authority, the Supreme Court stated in Raich: 

The CSA designates marijuana as contraband for any purpose; in fact, by characterizing 

marijuana as a Schedule I drug, Congress expressly found that the drug has no 

acceptable medical uses. Moreover, the CSA is a comprehensive regulatory regime 

specifically designed to regulate which controlled substances can be utilized for 

medicinal purposes, and in what manner... Thus, even if respondents were correct 

that marijuana does have accepted medical uses and thus should be re-designated as 

a lesser schedule drug, the CSA would still impose controls beyond what is required 

by California law. The CSA requires manufacturers, physicians, pharmacies, and other 

handlers of controlled substances to comply with statutory and regulatory provisions 

mandating registration with the DEA; compliance with specific production quotas; 

security controls to guard against diversion; record keeping and reporting obligations, 

and prescription requirements. Furthermore, the dispensing of new drugs, even when 

doctors approve their use, must await federal approval.19 
8 Speaking Out Against Drug Legalization

The Court also provided the following explanation for rejecting the marijuana trafficker’s commerce 

clause argument in Raich:

Given the enforcement difficulties that attend distinguishing between marijuana 

cultivated locally and marijuana grown elsewhere, and concerns about diversion 

into illicit channels, we have no difficulty concluding that Congress had a rational 

basis for believing that failure to regulate the intrastate manufacture and possession 

of marijuana would leave a gaping hole in the CSA.20

• In addition, the Supreme Court’s decision in OCBC makes clear that the marijuana activities 

of a California “cannabis club” are illegal under the CSA. The Supreme Court rulings indicate 

unequivocally that the CSA prohibitions on manufacturing, distributing, and possessing marijuana 

apply regardless of whether the person engaging in such activity claims to have a “medical 

necessity,” claims to be acting in accordance with state law, or claims to be acting in a wholly 

intrastate manner. 

• The DEA is responsible for enforcing the CSA. Accordingly, DEA is obligated to take all appropriate 

law enforcement actions, use all of the tools at our disposal, and to investigate any organization, 

including marijuana distribution facilities (sometimes referred to by their operators as “cannabis 

clubs”) that are engaged in the unlawful manufacture and distribution of controlled substances.

• Some have hypothesized that there has already been a loss of state tax revenue because of 

actions taken against marijuana “dispensaries.” In fact, this is a question that some jurisdictions 

in California have raised directly with the Department of Justice. In summary, the Department 

replied that income derived from the sale of marijuana, whether in California or not, represents 

proceeds of illegal drug trafficking, and as such is forfeitable under federal law. 

• The State of California is neither an innocent owner nor a lien holder in regards to collecting 

illegal drug proceeds.21 All right, title, and interest in property subject to forfeiture under the CSA 

– including all money and other proceeds of illegal drug sales – shall vest to the United States 

upon commission of the illegal act giving rise to the forfeiture.22 Under the supremacy clause 

of the United States Constitution, a state may not impose a sales tax, or any other tax, on the 

property of the United States.23

• Nonetheless, if a state entity wishes to assert a legal claim to any seized funds, CAFRA provides 

a mechanism for it to do so, which begins by submitting a claim in a timely manner and in the 

appropriate legal proceeding. In evaluating whether to maintain a legal claim please consider 

that general creditors lack standing to contest the federal forfeiture of property.24 Thus, if a 

state or local entity asserts that it is a general creditor based upon unreported and/or unpaid 

sales taxes, it might look to those entities whose property was seized, rather than the federal 

government, for relief. 
9 Speaking Out Against Drug Legalization

• Claims that prohibition didn’t work overlook the fact that most historians agree that national 

prohibition succeeded both in lowering consumption and in retaining political support until 

the great depression radically changed voters’ priorities. Repeal resulted more from this 

contextual shift than from characteristics of prohibition itself.

• One favorite argument of those who claim prohibition didn’t work point to the growth of 

organized crime. Although organized crime flourished under its sway, historians trace the 

beginnings of organized crime in the United States to the mid to late-1800s. Organized 

crime existed before prohibition was enacted, and persists long after its repeal. 

• The laws and enforcement mechanisms created after 1919 by the 18th Amendment and 

the Volstead Act, which charged the Treasury Department with enforcement of the new 

restrictions, was far from all-embracing. The amendment prohibited the commercial 

manufacture and distribution of alcoholic beverages; it did not prohibit use, nor production 

for one’s own consumption. 

• Alcohol consumption declined dramatically during prohibition. Cirrhosis death rates for 

men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to State mental hospitals 

for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928. 

• Arrests for public drunkenness and disorderly conduct declined 50 percent between 1916 

and 1922. For the population as a whole, the best estimates are that consumption of alcohol 

declined by 30 percent to 50 percent. Violent crime did not increase dramatically during 

prohibition. Homicide rates rose dramatically from 1900 to 1910 but remained roughly 

constant during prohibition’s 14 year rule.26 Organized crime may have become more 

visible and lurid during prohibition, but it existed before and after.

• Following the repeal of prohibition, alcohol consumption increased. Prohibition did not end 

alcohol use, but it did succeed in reducing, by one-third, the consumption of a product that 

had wide historical and popular sanction.

• The parallel between alcohol prohibition in the 1920’s and the current status of marijuana, 

heroin, and other dangerous drugs is tenuous. The 18th Amendment took a popular activity, 

alcohol sales, which was widely tolerated, and made it illegal. It did so after more than a 

century of growing concern over the effects of excessive alcohol consumption was having on 

society. In contrast, the use of marijuana, heroin, or other controlled drugs has never been 

a widely accepted activity. 

“Prohibition didn’t work in the 20’s and 4it doesn’t work now.”
10 Speaking Out Against Drug Legalization

• In addition, the idealistic goals of prohibition went beyond what many initial supporters 

of prohibition thought they were supporting, and lacked flexibility that would allow policy 

adjustments to changes in the facts surrounding alcohol. In contrast, our nation’s current drug 

laws are built upon the Controlled Substances Act, which contains a series of increasingly 

restrictive schedules that allow for the appropriate regulation of various drugs, as well as a 

mechanism to move substances from one regulatory status to another should new information 

about the use of a controlled substance be established.

• Not only are the facts of prohibition misunderstood, but the lessons are misapplied to 

marijuana legalization. The real lesson of prohibition is that the society can, indeed, make 

a dent in consumption through laws. There is a price to be paid for such restrictions, of 

course. But for drugs such as heroin and cocaine, which are dangerous but currently largely 

unpopular, that price is small relative to the benefits.
11 Speaking Out Against Drug Legalization

• John Adams, who helped draft the Constitution and later became our second president, 

declared, “Our Constitution was made only for a moral and religious people. It is wholly 

inadequate to govern of any other.” This means that any and all just laws must be based on 

moral considerations. Our elected representatives are therefore bound to legislate morality. 

• Morality is about right and wrong, and that’s what laws put into legal form. All laws legislate 

morality (even speed limits imply a moral moral judgement). Everyone in politics — 

conservatives, libertarians and liberals — is trying in some degree to legislate morality. The 

complaint then, is not whether or not Congress is attempting to legislate morality, but whose 

morality is Congress attempting to legislate?

• The expectation that Congress will make these moral judgments comes from the Constitution, 

which decreed that a majority of the citizens, through the representatives elected to do our 

bidding, were given the right, the duty and responsibility, to make laws that would ensure 

domestic tranquility, defend our borders, and promote a safe and wholesome environment 

for us all. These are all moral judgments.

• The Constitution also lays out the structure by which these moral judgments will be made. 

The principal of majority rule, the balance of power between the president, the; judiciary; 

and the Congress, and even the bi-cameral structure of Congress all work to provide an 

effective mechanism to legislate morality that is consistent with the desires—and therefore 

we must assume the morals—of a majority of Americans.

“Through drug laws Congress is attempting to 5 legislate morality.”
12 Speaking Out Against Drug Legalization

 

Notes

 1. “National Drug Threat Assessment,” December 2009, page III.

 2. Marin Institute Fact Sheet, “The Costs of Alcohol,” June 24, 2008.

 3. As of April 1, 2009.

 4. See: http://www.CDC.gov/tobacco.

 5. Heron, et al, “Deaths: Final Data for 2006,” U.S. Dept of Health and Human Services, Centers for 

Disease Control and Prevention, National Vital Statistics Reports, Vol. 57, Number 14, April 2009, DHHS 

Pub No (PAS) 

2009-1120 (Tables 21 and 22), see: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf. 

 6. INTRAVAL Bureau for Research and Consistency, “Coffeeshops in the Netherlands 2004,” Dutch 

Ministry of Justice, June 2005, http://www.intraval.nl/en/b/b45_html. 

 7. See: 21 U.S.C. § 881. 

 8. 21 U.S.C. § 811(h).

 9. See: McCullough v. Maryland, 17 U.S. 316 (1819); see also U.S. v. Cal. State Bd. of Equalization, 650 

F.2d 1127 (9th Cir. 1981), 456 U.S. 901 (1982), aff’d, 456 U.S. 985 (1982), reh’g denied.

 10. See, e g.: U.S. v. $20,193.39 U.S. Currency, 16 F.3d 344, 346 (9th Cir. 1994).

 11. See, e.g.: 18 U.S.C. § 983(d)(3) and 21 U.S.C. § 853(n)(6)(B). 

 12. 21 U.S.C. § 812(c), Schedule I(c)(10). 

 13. See 66 Fed. Reg. 20038, 20050-52 (2001) (DEA denial of petition to remove marijuana from schedule 

I based on FDA scientific and medical evaluation), pet. for review dismissed, Gettman v. DEA, 290 F.3d 430 

(D.C. Cir. 2002).

 14. U.S. v. Oakland Cannabis Buyers’ Cooperative 532 U.S. 483, 491, 494 & n.7 (2001). 

 15. 532 U.S. 483 (2001).

 16. Gonzales v. Raich, 545 U.S. 1 (2005).

 17. The main drug control treaties currently in force to which the United States is signatory are: The Single 

Convention on Narcotic Drugs, 1961, 18 U.S.T. 1407; The Convention on Psychotropic Substances, 1971, 

32 U.S.T. 543; and the Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 

1988, 28 I.LM. 493. Among the United States obligations pursuant to these treaties are: (i) To enact and 

carry out legislation disallowing the use of Schedule I drugs outside of authorized research; (ii) To make it a 

criminal offense, subject to imprisonment, to traffic in illicit drugs or to aid and abet such trafficking; and (iii) 

To prohibit the cultivation of marijuana except by persons licensed by, and under the direct supervision of, 

the federal Government.

 18. U.N. International Narcotics Control Board, United Nations, “Report 1998” at par. 259, U.N. Sales 

No. E.99.XI.1, http://www.incb.org/incb/en/annual_report_1998.html. 

 19. 545 U.S. at 27-28.

 20. 545 U.S. at 22 

 21. See 21 U.S.C. § 881. 

 22. 21 U.S.C. § 811(h).

 23. See: McCullough v. Maryland, 17 U.S. 316 (1819); see also U.S. v. Cal. State Bd. of Equalization, 650 

F.2d 1127 (9th Cir. 1981), 456 U.S. 901 (1982), affirmed, 456 U.S. 985 (1982), registration denied.

 24. See, e g., U.S. v. $20,193.39 U.S. Currency, 16 F.3d 344, 346 (9th Cir. 1994).

 25. See, e.g., 18 U.S.C. § 983(d)(3) and 21 U.S.C. § 853(n)(6)(B). 

 26. Moore, Mark H., “Actually, Prohibition Was a Success,” Harvard’s Kennedy School of Government, 

October 16, 1989.

(End notes continued on page 65)
On Legalization

Summary of the TOP

FACTS

Fact 1: Significant progress has been made in fighting drug use 

and drug trafficking in America. 

Legalization advocates claim that the fight against drugs has 

not been won and is, in fact, unwinnable. They frequently state 

that people still take drugs, drugs are widely available, and that 

efforts to change this are futile. They contend that legalization 

is the only workable alternative. The facts are contrary to 

such pessimism.

Fact 2: A balanced approach of prevention, enforcement, 

and treatment are the keys in the fight against drug abuse. 

A successful drug policy must apply a balanced approach of 

prevention, enforcement, and treatment. All three aspects 

are crucial. For those who end up hooked on drugs, there 

are innovative programs, like drug courts, that offer nonviolent users the option of seeking treatment. 

Fact 3: Drug use is regulated and access to drugs is 

controlled because drugs can be harmful. 

There is a popular misconception that some illegal drugs 

can be taken safely, with many advocates of legalization 

going so far as to suggest it can serve as medicine to heal 

anything from headaches to bipolar diseases. Many of 

today’s drug dealers are savvy businessmen, and know 

how to capitalize on declining perceptions of risk associated 

with drug use. 

 

Fact 4: Smoked marijuana has never been and will never be 

scientifically approved medicine. 

According to the Institute of Medicine, there is no future for 

smoked marijuana as medicine. However, the prescription drug 

Marinol—a legal and safe version of medical marijuana which 

isolates the active ingredient of THC—has been studied and 

approved by the Food and Drug Administration as safe medicine 

when used as prescirbed. The difference between Marinol and 

marijuana is that you have to get a prescription for Marinol from 

a licensed physician—you can’t buy it on a street corner, and 

you don’t smoke it. 

13
14 Speaking Out Against Drug Legalization

Fact 5: Drug control spending is a minor portion 

of the U.S. budget. Compared to the social costs 

of drug abuse and addiction, government spending 

on drug control is minimal.

Legalization advocates claim that the United States 

has wasted billions of dollars in its anti-drug efforts. 

But for those saved from drug addiction, these are 

not wasted dollars. Moreover, our fight against drug 

abuse and addiction is an ongoing struggle that 

should be treated like any other social problem. 

Would we give up on education or poverty simply 

because we haven’t eliminated all the problems we 

have with them? 

Fact 6: Legalization of drugs will lead to increased 

use and increased levels of addiction. 

Legalization proponents claim that making 

illegal drugs legal would not cause more of these 

substances to be consumed, nor would addiction 

increase. They claim that many people can use 

drugs in moderation and that many would choose 

not to use drugs, just as many abstain from alcohol 

and tobacco now. Yet how much misery can already 

be attributed to alcoholism and smoking?

Fact 7: Crime, violence, and drug use go 

hand-in-hand. 

Six times as many homicides are committed by 

people under the influence of drugs than by those 

who are looking for money to buy drugs. Most drug 

crimes aren’t committed by people trying to pay for 

drugs; they’re committed by people on drugs. 

Fact 8: Alcohol and tobacco have caused significant 

health, social, and crime problems, and legalized 

drugs would only make the situation worse.

The “legalization lobby” claims drugs are no more 

dangerous than alcohol, no more harmful than 

smoking cigarettes. But drunk driving is one of the 

primary killers of Americans. Do we want our bus 

drivers, nurses, and airline pilots to be able to take 

drugs one evening, and operate freely at work the 

next day? Do we want to make “drugged” driving 

another primary killer? 

Fact 9: Europe’s more liberal drug policies are not 

the right model for America.

The “legalization lobby” claims that the “European 

model” of the drug problem is successful. However, 

since legalization of marijuana in the Netherlands, 

heroin addiction levels have tripled. Their “Needle 

Park” is a poor model for America. 

Fact 10: Most non-violent drug users get treatment, 

not jail time. 

There is a popular myth that America’s prisons 

are filling up with drug users arrested for simple 

possession of marijuana. This is a myth. In reality, a 

vast majority of inmates in state and federal prison 

for marijuana have been found guilty of much 

more than simple possession, and many of those 

serving time for marijuana possession pled down to 

possession in order to avoid prosecution on more 

serious charges.
15 Speaking Out Against Drug Legalization

Legalization advocates claim that the fight against drugs has not been won and is, in fact, 

unconquerable. They frequently state that people still take drugs, drugs are widely available, and 

that efforts to change this are futile. They contend that legalization is the only workable alternative. 

The facts are contrary to such pessimism:

Demand Reduction 

• On the demand side, the U.S. has reduced casual use chronic use addiction to drugs, and 

prevented others from even starting to use them. According to the Monitoring the Future National 

Survey, between 2001 and 2008 illicit drug use was down 25 percent among 8th, 10th, and 12th

grade students. That means approximately 900,000 fewer young people are using drugs today, 

compared to 2001. Marijuana use has fallen by 25 percent and youth use of drugs such as 

MDMA/Ecstasy, LSD, and methamphetamine have decreased by more than 50 percent.27

• The 2009 Monitoring the Future Survey reinforces the trends exhibited in 2008, and shows that 

the proportion of students reporting use of illicit drug other than marijuana has been gradully 

declining. The majority of illicit drugs covered in the study has remained the same compared 

with 2008, though most are at levels considerably below the level of the mid-1990s.”28

• Current workforce drug testing data from Quest Diagnostics found that cocaine and 

methamphetamine use among U.S. job applicants and workers in the general workforce 

dropped significantly. Positive tests for cocaine declined by 38 percent from June 2006 to June 

2008. Methamphetamine positive tests dropped almost 50 percent between 2005 and 2007. 

Overall drug use among workers subject to drug testing remains at the lowest level in the last 20 

years.29

• The crack cocaine epidemic of the 1980s and early 1990s has diminished greatly in scope, and 

we’ve reduced the number of chronic heroin users over the last decade. In addition, the number 

of new marijuana users and cocaine users continues to steadily decrease. 

• Yet there is still much progress to be made. There are still far too many people using cocaine, 

heroin, and other illegal drugs. In addition, there are emerging drug threats like the non-medical 

use of prescription pain relievers and over-the-counter cough medicine. But the fact is that our 

current policies balancing prevention, enforcement, and treatment have kept drug usage outside 

the scope of acceptable behavior. 

Fact 1: Significant progress has been made in fighting drug 

 use and drug trafficking in America. 
16 Speaking Out Against Drug Legalization

Supply Reduction 

• There have been many successes on the supply side of the drug fight as well. For example, purity 

levels of Colombian cocaine are declining, according to an analysis of samples seized from 

traffickers and bought from street dealers in the United States. The average purity of cocaine has 

declined from 86 percent in 1998, to 44 percent in 2008. At the same time, the price of one 

gram of cocaine rose 104.5 percent from $97.62 to $199.60. There are a number of possible 

reasons for this decline in purity, including DEA supply reduction efforts in South America.31

• The British Serious Organized Crime Agency (SOCA) reports a similar trend. The price per kilo 

of cocaine has risen from £36,000 per kilo in the summer of 2008 to £45,000 per kilo in March 

2009. In addition, SOCA reported that the purity levels of street sales of cocaine have been 

reduced significantly since the summer of 2008, meaning purchasers were often paying four or 

five times extra for the actual cocaine purchased.32

• DEA has been very active with international efforts targeting precursor chemicals, such as the 

International Narcotics Control Board (INCB) Projects Prism and Cohesion, which have led to 

major precursor seizures and the general development of precursor chemical awareness across 

the globe. Project Prism is a global initiative focusing on the illicit trade of methamphetamine 

precursor chemicals and Project Cohesion focuses on the illicit trade of precursor chemicals 

used to manufacture heroin and cocaine. 

 For instance, between January 2007 and September 2008, the Project Prism Operations Crystal 

Flow (2007) and Ice Block (2008) allowed international authorities to share intelligence and 

prevent an estimated 100 tons of methamphetamine precursor chemicals from being diverted to 

the illicit market. 

• The combined effects of all these measures have disrupted illicit drug production and have 

caused black market prices of precursor chemicals to rise drastically. 

• U.S. border initiatives are having a major impact on the activities of Mexican drug trafficking 

organizations. Excellent cooperation between the U.S. and Mexican governments has resulted 

in the extradition of major traffickers to the U.S. for prosecution; joint operations to stem the flow 

of drugs, chemicals and money across the Southwest border; and the targeting of major drug 

cartels and border “gatekeepers.”

• For example, this cooperation has also resulted in increased import restrictions of ephedrine and 

pseudoephedrine in Mexico, helping to decrease methamphetamine production and reduce the 

flow of methamphetamine from Mexico into the United States. 
17 Speaking Out Against Drug Legalization

• According to data collected by the El Paso Intelligence Center, methamphetamine seizures along 

the Southwest border increased by 91 percent from 1,170 kilograms in 2001 to 2,232 kilograms 

in 2008.

• Trafficking organizations that sell drugs are finding that their profession has become a lot more 

costly worldwide. For example in the mid-1990s, the DEA helped dismantle Burma’s Shan United 

Army, at the time the world’s largest heroin trafficking organization. In two years this operation 

helped reduce the amount of Southeast Asian heroin in the United States from 63 percent of the 

market to 17 percent of the market. In the mid-1990s, the DEA helped disrupt the Cali Cartel, 

which had been responsible for much of the world’s cocaine. 

• Progress does not come overnight. America has had a long, dark struggle with drugs. It’s not a 

war we’ve been fighting for 20 years—we’ve been fighting it for 120 years. In 1880, many drugs, 

including opium and cocaine, were legal. We didn’t know the harm they caused, but we soon 

learned. We saw the highest level of drug use ever in our nation, per capita. There were over 

400,000 opium addicts in our nation. That’s twice as many addicts and users per capita as there 

are today. Like today, we saw rising crime that accompanied drug abuse. But we fought those 

problems by passing and enforcing tough laws and by educating the public about the dangers of 

these drugs. This vigilance worked: by World War II, drug use was reduced to the very margins 

of society, and that’s just where we want to keep it. 

• A successful drug policy must apply a balanced approach of prevention, enforcement, and 

treatment. All three aspects are crucial. For those who end up hooked on drugs, there are innovative 

programs, like drug courts, that offer non-violent users the option of seeking treatment.
18 Speaking Out Against Drug Legalization

• The 2010 National Drug Control Strategy Report highlights three national priorities: stopping drug 

initiation; reducing drug abuse and addiction; and disrupting the market for illegal drugs.34

• In 2008, according to the National Survey on Drug Use and Health, an estimated 20.1 million 

Americans aged 12 or older were current (past month) illicit drug users, meaning they had used 

an illicit drug during the month prior to the survey interview. This estimate represents 8 percent 

of the population aged 12 years old or older. Illicit drugs include marijuana/hashish, cocaine 

(including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used 

non-medically. 35

• Over the years, some people have advocated a policy that focuses narrowly on controlling the 

supply of drugs. Others have said that society should rely on treatment alone. Still others say 

that prevention is the only viable solution. These are outdated approaches to a modern, effective 

strategy. Today, there is general agreement that we must integrate all three aspects in a balanced 

strategy if we are to continue to make progress. 

Stopping Drug Initiation

• No one starts life wanting to be a drug addict. We must teach our children about the dangers 

and consequences of drug use, teach them what to do when they are offered drugs, and keep 

re-enforcing these lessons. Research has shown that if a child can reach adulthood without ever 

having tried drugs, the chances of him ever being addicted are significantly less.37

• The 2010 National Drug Control Strategy lays out a comprehensive support to prevention 

programs, including building on community level activities, targeted substance abuse prevention 

programs in schools and institutions of higher learning, in the workplace, on the roads, in the 

military, and on the playing fields. This comprehensive approach means educating the public 

about the dangers of drug use, as well as working with medical and pharmaceutical organizations 

to prevent the diversion of prescription drugs.38 

Fact 2: A balanced approach of prevention, enforcement, 

 and treatment are the keys in the fight against drug abuse. 
19 Speaking Out Against Drug Legalization

Reducing Drug Abuse and Addiction

• Substance abuse treatment costs our nation over one half-trillion dollars annually, and treatment 

can help reduce these costs by far more than the expense of that treatment.39

• Conservatively, every $1 invested in addiction treatment programs yields a return of between $4 

and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to 

health care are included, total savings can rise to $12 for every $1 invested.

 

Drug Courts

• For those who end up hooked on drugs there are also programs, like drug courts, that offer 

non-violent users the option of seeking treatment. Drug courts provide court supervision, unlike 

voluntary treatment centers. Drug courts are a good example of a balanced approach to fighting 

drug abuse and addiction in our country. These courts are given a special responsibility to handle 

cases involving drug-addicted offenders through an extensive supervision and treatment program. 

Drug court programs use the varied experiences and skills of a wide variety of law enforcement 

and treatment professionals: judges, prosecutors, defense counsel, substance abuse treatment 

specialists, probation officers, law enforcement and correctional personnel, educational and 

vocational experts, community leaders and others — all focused on one goal: to help cure 

addicts of their addiction, and keep them cured.

• Nationwide, 75 percent of drug court graduates remain arrest-free at least two years after leaving 

the program.40

• A 2000 Vera Institute of Justice report concluded that “the body of literature on recidivism is now 

strong enough that despite lingering methodological weaknesses, to conclude that completing a 

drug court program reduces the likelihood of future arrest.” 41

• The largest statewide study on drug courts to date was released in 2003 by the Center for Court 

Innovation (CCI). The study analyzed the impact of the New York State drug court system. The 

study found that the re-conviction rate among 2,135 defendants who participated in six of the 

state’s drug courts was, on average, significantly lower (13 percent to 47 percent) over three 

years than the for the same types of offenders who did not enter the drug court. The study also 

concluded that drug court cases reached initial disposition more quickly than conventional court 

cases, and that the statewide drug court retention rate was approximately 65 percent, exceeding 

the national average of 60 percent.42

• Nonviolent drug offenders in drug courts in St. Louis, Missouri, who were placed in treatment 

instead of prison generally earned more money and took less from the welfare system than those 

who successfully completed probation. The study compared the 219 individuals who were the 

program’s first graduates in 2001 with 219 people who pleaded guilty to drug charges during 

the same period and completed probation. For each drug court graduate, the cost to taxpayers 

was $7,793, which was $1,449 more than those on probation. However, during the two years 
20 Speaking Out Against Drug Legalization

following program completion, each graduate cost the city $2,615 less than those on probation. 

These savings were realized in higher wages and related taxes paid, as well as lower costs for 

health care and mental health services.43

• Drug courts save taxpayers money. The Urban Institute estimates a favorable cost/benefit ratio as 

high as $3.36 for every $1.00 invested in treating drug-addicted offenders in drug courts.44

Risk Perception

• The perception of risk also plays an important part in whether kids abuse drugs and other 

substances. Researchers from the UIC ImpacTeen Project and University of Michigan Youth 

Education and Society Project (YES!) reported in 2000 that marijuana use among youth 

decreased as marijuana prices and perceived harmfulness rose. Their study also assessed the 

extent to which trends in marijuana prices and perceptions of use risks predict cycles in youth 

marijuana use. Their research noted that use of marijuana among high school seniors declined 

to a recorded low between 1981 and 1992, when price more than tripled. The trend reversed 

itself after 1992, when price fell by 16 percent. The study shows that perceived risk of harm 

from marijuana use had a substantial impact on the reduction in marijuana use between 1981 

and 1992 (as perceived risk rose) and in the subsequent increase in use after 1992 (as perceived 

risk declined).45 These conclusions are consistent with ones reached earlier by the University of 

Michigan investigators, who for years have argued the importance of perceived risk in explaining 

trends in the use of various drugs.

Enforcing Drug Laws

• Enforcement of our laws creates risks that discourage drug use. Laws which clearly define what 

is legal and illegal and send a strong signal to young and old alike what the boundaries are. 

• Law enforcement plays an important role in the drug court program. It is especially important 

in the beginning of the process because it often triggers treatment for people who need it. Most 

people do not volunteer for drug treatment. It is more often an outside motivator, like an arrest, 

that gets —and keeps— people in treatment. If treatment fails it is important for judges to keep 

people incarcerated. 

• Price and availability can also affect the choice of whether to abuse drugs. Strong drug enforcement 

affects the price and purity of drugs and impacts demand. A study released in 2005, Marijuana 

Use and Policy: What We Know and Have Yet To Learn, by Rosalie Liccardo Pacula found that 

price matters, and marijuana prevalence rates are responsive to changes in perceived risk.47

• In addition, even though the number of marijuana primary diagnoses was significantly lower 

than those for alcohol, heroin, and cocaine, the mean length of stay for marijuana episodes was 

three times longer than for alcohol and heroin discharges, and more than two times longer than 

for cocaine diagnoses with the mean charge per marijuana discharge was nearly twice as large 

as those for any of the other substances. 
21 Speaking Out Against Drug Legalization

• According to DEA’s System to Retrieve Information on Drug Evidence (STRIDE) database, the 

average price per pure gram of methamphetamine increased 73 percent from January 2007 

through September 2008, from $141.42 to $244.53. During the same period, the purity of 

meth dropped 31 percent. From January 2007 through September 2007, there was a 44 percent 

increase in the average price per pure gram of cocaine in the United States (from $95.35 to 

$136.93), and there was a corresponding 15 percent decrease in cocaine purity in the illegal 

drug market in the United States.

• These findings support earlier indicators of reductions in cocaine availability in 37 American 

cities, based on law enforcement intelligence reports and unprecedented reductions in the 

number of employees testing positive for cocaine in workplace drug tests. 

• The National Survey on Drug Use and Health estimated the number of past month 

methamphetamine users declined by over half between 2006, and 2008. The numbers were 

731,000 in 2006, 529,000 in 2007, and 314,000 in 2008. It also reported an estimated 2.1 

million people aged 12 or older who used cocaine in the past month in 2008 versus 2.4 million 

2006, and a significant decline in crack users from 702,000 in 2006 to 359,000 in 2008.48
22 Speaking Out Against Drug Legalization

• There is a popular misconception that some illegal drugs can be taken safely, with many advocates 

of legalization going so far as to suggest it can serve as medicine to heal anything from headaches to 

bipolar diseases. Many of today’s drug dealers are savvy businessmen, and know how to capitalize 

on declining perceptions of risk associated with drug use. 

• Marijuana is sold in California by some traffikers as a food product, including as an ingredient in 

baked goods, soda, liquids, peanut butter, cereal, soup, and ice cream. The food products are typically 

labeled, “3X,” “6X,” “9X” and “10x,” which describes its THC potency. There are no standards at all 

for these products: they are not inspected by anyone prior to selling them; there are no expiration 

dates; no list of ingredients, and no danger warnings on packaging. Some of these marijuana food 

and beverage products have been packaged in wrappers and labels made to purposely resemble 

legitimate food items.49

Fact 3: Drug use is regulated, and access to drugs

 is controlled, because drugs can be harmful.

DEA agents preparing to

enter a meth lab.

A device used to manufacture meth.
23 Speaking Out Against Drug Legalization

• Marijuana traffickers often advertise recommendations for “medical” marijuana or your money 

back.50 In 2006 in Los Angeles, a Van Nuys area patrol officer was dispatched to Grant High 

School to investigate an assault. While walking across campus, the officer observed a card placed 

on several vehicles in the school parking lot that advertised medical marijuana recommendations 

at JT Medical Group, Inc., in North Hollywood (approximately 1/2 mile from the school). The 

card stated, “Yes, in the State of California, it is still legal to own, grow, and smoke medical 

marijuana as long as you do it properly. Qualifying 

is simple and our experienced physicians are more 

than happy to help you.” The card also stated, “If 

you do not qualify for a recommendation your visit 

is free.” 

• Drug dealers create marijuana and cocaine 

products sold as candy.51 They created “cheese” 

in the Dallas area by mixing acetaminophen, 

diphenhydramine hydrochloride, and up to 8 

percent heroin.52 They imprint Ecstasy pills with 

cartoon characters and designer logos.

• Because of the new marketing tactics of drug promoters, and an increasing drumbeat from those 

seeking to legalize drugs, attitudes towards drugs are softening. Attitudes toward substance 

abuse, often seen as harbingers of change in use rates, began turning upward in 2009. “The 2009 

Monitoring the Futrue Survey is a warning sign, and the continued erosion in youth attitudes 

and behavior toward substance abuse should give pause to all parents and policymakers,” 

said Director Gil Kerlikowske, of the White House Office of National Drug Control Policy. 

“Considering the troublesome data from national and local surveys, this latest data confirms 

that we must redouble our efforts to implement a comprehensive, evidenced-based approach to 

preventing and treating drug use.”53

• Use of illegal drugs has deadly consequences. According to a report in the February 9, 2007 

Morbidity and Mortality Weekly Report, “In 2004, poisoning was second only to motor-vehicle 

crashes as a cause of death from unintentional injury in the United States. Nearly all poisoning 

deaths in the United States are attributed to drugs, and most drug poisonings result from the 

abuse of prescription and illegal drugs.”54

• To further examine this trend, Centers for Disease Control analyzed current data from the 

National Vital Statistics System. The report determined that poisoning mortality rates in the 

United States increased each year from 1999 to 2004, rising 62.5 percent during the five-year 

period. The increase in deaths due to unintentional poisoning occurred almost exclusively among 

those whose deaths were attributed to unintentional drug poisoning. By 2004, drug poisoning 

accounted for 19,838 deaths, or 94.7 percent of all unintentional poisoning deaths.55 

• Drug use is deadly—far deadlier than alcohol. In 2006, 38,396 persons died of drug-induced 

causes in the United States. By comparison, there were 22,073 deaths due to alcohol-induced 

causes.56 This means deaths caused by drug use are almost 174 percent higher than those due 

to alcohol. 

By 2004, drug poisonings 

accounted for 19,838 

deaths, or 94.7 percent of 

all unintentional poisioning 

deaths.
24 Speaking Out Against Drug Legalization

• During this same timeframe, an estimated 20.4 million Americans aged 12 or older (8.3 percent 

of the population) were current (past month) illicit drug users, meaning they had used an illicit 

drug during the month. By comparison, an estimated 125 million Americans aged 12 or older 

(50.9 percent) were current (past month) drinkers, meaning they had at least one drink during 

the last 30 days. Even if you only consider the 23 percent of individuals who reported binge 

drinking in the last month, you are still looking at more than one-fifth of Americans (57 million 

people) aged 12 or older, a significantly larger user population than those reporting using illicit 

drugs. This means that approximately six times as many Americans use alcohol than illicit drugs. 

More people die from drug-related causes than alcohol, but more people consume alcohol than 

drugs.57

Cocaine 

• Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine is not a new 

drug — in fact, it is one of the oldest known drugs. The pure chemical, cocaine hydrochloride, 

has been an abused substance for more than 100 years, and coca leaves, the source of cocaine, 

have been ingested for thousands of years.58

• Cocaine abuse has a long history and is rooted into the drug culture in the United States. It is an 

intense euphoric drug with strong addictive potential. With the increase in purity, the advent of 

the free-base form of the cocaine (“crack”), and its all too easy availability on the street, cocaine 

continues to burden both the law enforcement and health care systems in America. 59

• Cocaine’s effects appear almost immediately after a single dose, and disappears within a few 

minutes or hours. Taken in small amounts (up to 100 mg), cocaine usually makes the user feel 

euphoric, energetic, talkative, and mentally alert, especially to the sensations of sight, sound, 

and touch. It can also temporarily decrease the need for food and sleep. Some users find that 

the drug helps them perform simple physical and intellectual tasks more quickly, while others 

experience the opposite effect.60

Solidified cocaine known as CRACK coaine Cocaine in powdered form
25 Speaking Out Against Drug Legalization

• The short-term physiological effects of cocaine include constricted blood vessels; dilated pupils; and 

increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams 

or more) intensify the user’s high, but may also lead to bizarre, erratic, and violent behavior. These 

users may experience tremors, vertigo, muscle twitches, paranoia, or with repeated doses a toxic 

reaction closely resembling amphetamine poisoning. Some users of cocaine report feelings of 

restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of 

cocaine, or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or 

seizures followed by respiratory arrest.61

• Because cocaine is a powerfully addictive drug users may have difficulty predicting or controlling 

the extent to which they will continue to want or use the drug. Cocaine’s stimulant and addictive 

effects are thought to be primarily a result of its ability to inhibit the re-absorption of dopamine 

by nerve cells. Dopamine is released as part of the brain’s reward system, and is either directly or 

indirectly involved in the addictive properties of every major drug of abuse.62

• A significant tolerance to cocaine’s high may develop, with many addicts reporting that they seek but 

fail to achieve as much pleasure as they did from their first experience. Some users will frequently 

increase their doses to intensify and prolong the euphoric effects. While tolerance to the high 

can occur, users can also become more sensitive to cocaine’s anesthetic and convulsant effects, 

without increasing the dose taken. This increased sensitivity may explain some deaths occurring 

after apparently low doses of cocaine.63

• Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high 

doses, leads to a state of increasing irritability, restlessness, and paranoia. This may result in a 

full-blown paranoid psychosis in which the individual loses touch with reality and experiences 

auditory hallucinations.64

• According to the 2008 National Survey on Drug Use and Health (NSDUH), an estimated 2.1 

million people aged 12 or older used cocaine in the past month in 2008 versus 2.4 million in 2006. 

The number of past month crack users also declined significantly to 359,000 in 2008 vs. 702,000 

in 2006.65

• The 2008 Monitoring the Future Survey found that trends in 30-day prevalence of cocaine use 

among 8th, 10th, and 12th graders has shown a marked decrease from 2006. Reported cocaine use 

by 8th graders decreased from 1 percent to 0.8 percent, by 10th graders from 1.5 percent to 0.9 

percent, and for 12th graders from 2.5 percent in 2006 to 1.3 percent in 2008. 66 

• According to 2006 Drug Abuse Warning Network (DAWN) data released in August 2008, cocaine 

is the most frequently reported illegal drug in hospital emergency department visits, accounting for 

close to 1 in 3 (31 percent) of drug related emergency room visits.67 
26 Speaking Out Against Drug Legalization

Heroin

• Heroin is an illegal, highly addictive drug. It is both the most abused, and the most rapidly 

acting of opiates. Heroin is processed from morphine, a naturally occurring substance extracted 

from the seed pod of certain varieties of poppy plants. It is typically sold as a white or brownish 

powder, or as the black sticky substance known on the streets as “black tar heroin.” Although 

purer heroin is becoming more common, most street heroin is “cut” with other drugs or with 

substances such as sugar, starch, powdered milk, or quinine. Street heroin can also be cut with 

strychnine, fentanyl, or other poisons. Because heroin abusers do not know the actual strength 

of the drug or its true contents, they are at risk of overdose or death. Heroin also poses special 

problems because of the transmission of HIV and other diseases that can occur from sharing 

needles or other injection equipment.68

• First synthesized from morphine in 1874, heroin was not extensively used in medicine until 

the early 1900s. Commercial production of the new pain remedy was first started in 1898. It 

initially received widespread acceptance from the medical profession, and physicians remained 

unaware of its addiction potential for years. The first comprehensive control of heroin occurred 

with the Harrison Narcotic Act of 1914. Today, heroin is an illicit substance having no medical 

utility in the United States.69

• Heroin can be injected, smoked, or sniffed/snorted. Injection is the most efficient way to administer 

low-purity heroin. The availability of high-purity heroin, however, and the fear of infection by 

sharing needles has made snorting and smoking the drug more common. National Institute 

on Drug Abuse (NIDA) researchers have confirmed that all forms of heroin administration are 

addictive.70

Heroin in a powdered form. Black tar heroin.
27 Speaking Out Against Drug Legalization

• Chronic users may develop collapsed veins, infection of the heart lining and valves, 

abscesses, cellulites, and liver disease. Pulmonary complications, including various types of 

pneumonia, may result from the poor health condition of the abuser, as well as from heroin’s 

depressing effects on respiration. In addition to the effects of the drug itself, street heroin may 

have additives that do not readily dissolve and result in clogging the blood vessels that lead 

to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches 

of cells in vital organs.71

• Addiction is one of the most significant effects of heroin use. With regular heroin use, 

tolerance to the drug develops. Once this happens, the abuser must use more heroin to 

achieve the same intensity or effect that they are seeking. As higher doses of the drug are 

used over time, physical dependence and addiction to the drug develops.72

• Withdrawal, which in regular abusers may occur as early as a few hours after the last dose, 

produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, 

cold flashes with goose bumps (“cold turkey”), kicking movements (“kicking the habit”), and 

other symptoms. Major withdrawal symptoms peak between 48 and 72 hours after the last 

dose, and subside after about a week. Sudden withdrawal by heavily dependent users who 

are in poor health is occasionally fatal.73

• The U.S. heroin market is supplied entirely from foreign sources. Heroin is produced and 

made available in the United States from four distinct geographical areas: South America 

(Colombia), Mexico, Southeast Asia (primarily Burma), and Southwest Asia (principally 

Afghanistan). Heroin remains one of the least used illegal drugs, with around one percent of 

the population having tried it.

AUSTRIA

ITALY

SPAIN

GERMANY

FRANCE

PORTUGAL

HUNGARY

ROMANIA

BULGARIA

TURKEY

DENMARK

POLAND

BELARUS

UKRAINE CZECH

SLOVAKIA

GREECE

CYPRUS

NETH.

BELGIUM

IRELAND

YUGOSLAVIA

ALBANIA

MOLDOVA

LITHUANIA

LATVIA

LUX.

CROATIA SLOVENIA SWITZ.

MACEDONIA

U. S. A.

CANADA

MEXICO THE BAHAMAS

CUBA

PANAMA

EL SALVADOR

GUATEMALA

BELIZE HONDURAS

NICARAGUA

COSTA RICA

JAMAICA

HAITI

DOM. REP.

ARGENTINA

BOLIVIA

COLOMBIA

VENEZUELA

PERU

BRAZIL

FRENCH GUIANA

SURINAME

GUYANA

CHILE

ECUADOR

PARAGUAY

URUGUAY

KENYA

ETHIOPIA

ERITREA

SUDAN

EGYPT

NIGER

MAURITANIA

MALI

NIGERIA

SOMALIA

NAMIBIA

LIBYA

CHAD

SOUTH AFRICA

TANZANIA

Dem. Rep.

of Congo

ANGOLA

ANGOLA

ALGERIA

MADAGASCAR

MOZAMBIQUE

BOTSWANA

ZAMBIA

GABON

CENTRAL AFRICAN

REPUBLIC

TUNISIA

MOROCCO

UGANDA

SWAZILAND

LESOTHO

MALAWI

BURUNDI

RWANDA

TOGO

BENIN GHANA

COTE

D'IVOIRE

LIBERIA

SIERRA LEONE

GUINEA

BURKINA FASO

GAMBIA

CAMEROON

ZIMBABWE

CONGO

WESTERN

SAHARA (occupied by Morocco)

DJIBOUTI

SENEGAL

GUINEA BISSAU

Canary

Islands

JORDAN

ISRAEL

LEBANON

ARMENIA AZERBAIJAN

GEORGIA KYRGYZSTAN

TAJIKISTAN

KUWAIT

QATAR

U. A. E.

YEMEN

SYRIA

IRAQ

IRAN

OMAN

SAUDI ARABIA

AFGHANISTAN

PAKISTAN

INDIA

CHINA

KAZAKHSTAN

TURKMENISTAN

UZBEKISTAN

CHINA

MYANMAR

CAMBODIA

BHUTAN NEPAL

SRI LANKA

LAOS

BANGLADESH

PAPUA

NEW GUINEA

JAPAN

MONGOLIA

SOUTH KOREA

NORTH KOREA

AUSTRALIA

NEW ZEALAND

U. K.

VANUATU FIJI

Burma Afghanistan

Colombia

Heroin suppliers to the United States
28 Speaking Out Against Drug Legalization

• Within the United States, there are two distinct heroin markets:

o East of the Mississippi River, highly pure white powder heroin from South America is 

the predominant type, entering the United States primarily through the Caribbean.

o West of the Mississippi River, black tar heroin from Mexico is the predominant type, 

entering the United States through the Southwest border.

• From 2005 to 2008, heroin use in the general U.S. workforce has increased 34 percent, from 

2.9 per thousand to 3.9 per thousand, according to the National General Workplace Drug 

Testing Index maintained by Quest Diagnostics.

• According to 2009 Monitoriing the Future survey data, estimated heroin use among high 

school seniors has decreased slightly, from 1.5 percent in 2007 to 1.2 percent in 2009.74

• According to the 2008 National Survey on Drug Use and Health, there were an estimated 

114,000 persons aged 12 and older who used heroin for the first time within the past year. 

The number of heroin initiates has not significantly changed since 2002, when the estimated 

number was 117,000. 75

• According to the Centers for Disease Control, the incidence of heroin-caused death has 

increased 11 percent, from one per million in 2004 to 1.1 per million in 2005.

• According to 2006 Drug Abuse Awareness Network data, the estimated number of heroindriven emergency department visits declined from 214,432 to 189,780 (from 13 percent to 11 

percent of all drug-driven ED visits) between 2004 and 2006.76

Marijuana 

• Drug legalization advocates in the United States single out marijuana as a different kind of 

drug, unlike cocaine, heroin, and methamphetamine, because they say it’s less dangerous. 

However, marijuana is not as harmless as some would have you believe.

• Harvard University researchers report that the risk of heart attack is five times higher than 

usual in the hour after smoking marijuana.77

• The National Institute of Health found that a person who smokes five joints per week may be 

taking in as much tar and cancer-causing chemicals into their lungs as someone who smokes 

a pack of cigarettes every day.

78

• Marijuana is much more potent today than in the past. The University of Mississippi found 

that the average THC (the active ingredient in marijuana} content rose from 2.8 percent (1985) 

to 10.1 percent (March 2009).79 
29 Speaking Out Against Drug Legalization

• Smoking marijuana weakens the immune system, 80 and raises the risk of lung infections.81

• Other studies indicate that smoked marijuana causes cancer, respiratory problems, increased 

heart rate, loss of motor skills, and damage to the immune system.

• Yale School of Medicine reports that long- term exposure to marijuana smoking is linked to 

the same health problems as tobacco smoke, such as daily cough and phlegm production, 

more frequent acute chest illnesses, a heightened risk of lung infections, and a greater 

tendency toward obstructed airways.82

• The National Multiple Sclerosis Society stated there is no convincing evidence that marijuana 

benefits people with MS, and does not recommend it as a treatment.83

A marijuana cultivation lab.
30 Speaking Out Against Drug Legalization

• When marijuana is smoked, its effects begin immediately after the drug enters the brain 

and last from 1 to 3 hours. If marijuana is consumed in food or drink, the short-term effects 

begin more slowly, usually in 1/2 to 1 hour, and last longer, for as long as 4 hours. Smoking 

marijuana deposits several times more THC into the blood than does eating or drinking the 

drug.84

• Within a few minutes after inhaling marijuana smoke, an individual’s heart begins beating 

more rapidly, the bronchial passages relax and become enlarged, and blood vessels in the 

eyes expand, making the eyes look red. The heart rate, normally 70 to 80 beats per minute, 

may increase by 20 to 50 beats per minute or in some cases even doubles.85

• As THC enters the brain, it causes a user to feel euphoric—or “high”—by acting in the brain’s 

reward system, and in areas of the brain that respond to stimuli such as food and drink as 

well as most drugs of abuse. THC activates the reward system in the same way that nearly all 

drugs of abuse do, by stimulating brain cells to release the chemical dopamine.86

• A marijuana user may experience pleasant sensations, colors and sounds may seem more 

intense, and time appears to pass very slowly. The user’s mouth feels dry, and he or she may 

suddenly become very hungry and thirsty. His or her hands may tremble and grow cold. The 

euphoria passes after awhile, and then the user may feel sleepy or depressed. Occasionally, 

marijuana use produces anxiety, fear, distrust, or panic.87

• Cancer of the respiratory tract and lungs may be promoted by marijuana smoke. Marijuana 

has the potential to promote cancer of the lungs and other parts of the respiratory tract because 

marijuana smoke contains 50 percent to 70 percent more carcinogenic hydrocarbons than 

tobacco smoke.88

• Marijuana’s damage to short-term memory seems to occur because THC alters the way in 

which information is processed by the hippocampus, a brain area responsible for memory 

formation. In one study, researchers compared marijuana smoking and nonsmoking 12thgrader’s scores on standardized tests of verbal and mathematical skills. Although all of the 

students had scored equally well in 4th grade, those who were heavy marijuana smokers, 

(i.e., those who used marijuana seven or more times per week), scored significantly lower in 

12th grade than nonsmokers. Another study of 129 college students found that among heavy 

users of marijuana critical skills related to attention, memory, and learning were significantly 

impaired, even after they had not used the drug for at least 24 hours.89
31 Speaking Out Against Drug Legalization

• According to the Institute of Medicine, there is no future in smoked marijuana as medicine. 

However, the prescription drug Marinol—a legal and safe version of medical marijuana which 

isolates the active ingredient of THC—has been studied and approved by the Food and Drug 

Administration (FDA) as safe medicine when used as prescribed. The difference between Marinol 

and smoked marijuana is that you have to get a prescription for Marinol from a licensed physician. 

You can’t buy it on a street corner, and you don’t smoke it. 

• Unlike smoked marijuana—which contains more than 400 different chemicals, including most 

of the hazardous chemicals found in tobacco smoke— Marinol has been studied and approved 

by the medical community and the FDA. 

• There are no FDA-approved medications that are smoked. Smoking is generally a poor way to 

deliver medicine. It is difficult to administer safe, regulated dosages of medicines in smoked 

form. Secondly, the harmful chemicals and carcinogens that are byproducts of smoking create 

entirely new health problems. There is four times the level of tar in a marijuana cigarette, for 

example, than in a tobacco cigarette. 

• Morphine, for example, has proven to be a medically valuable drug, but the FDA does not 

endorse the smoking of opium or heroin. Instead, scientists have extracted active ingredients 

from opium, which are sold as pharmaceutical products like morphine, codeine, hydrocodone, 

or oxycodone. In a similar vein, the FDA has not approved smoking marijuana for medicinal 

purposes, but has approved the active ingredient-THC in the form of scientifically regulated 

Marinol. 

• The DEA helped facilitate the research on Marinol. The National Cancer Institute approached 

the DEA in the early 1980s regarding their study of THC in relieving nausea and vomiting. As a 

result, the DEA facilitated the registration and provided regulatory support and guidance for the 

study. In California, researchers are studying potential uses for marijuana and its ingredients for 

conditions such as multiple sclerosis and pain. Neither the medical community nor the scientific 

community has found sufficient data to conclude that smoked marijuana is the best approach to 

dealing with these important medical issues. 

• The most comprehensive, scientifically rigorous review of studies of smoked marijuana was 

conducted by the Institute of Medicine, an organization chartered by the National Academy 

of Sciences. In a report released in 1999, the Institute did not recommend the use of smoked 

marijuana, but did conclude that active ingredients in marijuana could be isolated and developed 

into a variety of pharmaceuticals, such as Marinol. 

Fact 4. Smoked marijuana has never been, and

 will never be scientifically approved for medical use.

 
32 Speaking Out Against Drug Legalization

• DEA supports ongoing research into potential medicinal uses of marijuana’s active 

ingredients. As of April 2009, there are 123 researchers registered with DEA to perform 

studies with marijuana, marijuana extracts, and non-tetrahydrocannabinol marijuana 

derivatives that exist in the plant, such as cannabidiol and cannabinol. Studies include 

evaluation of abuse potential, physical/psychological effects, adverse effects, therapeutic 

potential, and detection. Nineteen of the researchers are approved to conduct research 

with smoked marijuana on human subjects.

Impacts of use on mental health 

• A study published in the March 2008 Journal of the American Academy of Child and 

Adolescent Psychiatry cited the harm of smoking marijuana during pregnancy. The study 

found a significant relationship between marijuana exposure and child intelligence. 

Researchers concluded that “prenatal marijuana exposure has a significant effect on 

school-age intellectual development.”102

• Doctors at Yale University documented 

marijuana’s damaging effect on the brain 

after nearly half of 150 healthy volunteers 

experienced psychotic symptoms, including 

hallucinations and paranoid delusions, 

when given THC, the drug’s primary active 

ingredient. The findings were released during 

a May 2007 international health conference 

in London.103

• American scientists have discovered that the 

active ingredient in marijuana interferes with synchronized activity between neurons in 

the hippocampus of rats. The authors of this November 2006 study suggest that action of 

tetrahydrocannabinol, or THC, might explain why marijuana impairs memory.104

• A pair of articles in the Canadian Journal of Psychiatry reflect that cannabis use can trigger 

schizophrenia in people already vulnerable to the mental illness, and assert that this fact 

should shape marijuana policy.105 

• Memory, speed of thinking, and other cognitive abilities get worse over time with 

marijuana use, according to a study published in the March 14, 2006 issue of Neurology, 

the scientific journal of the American Academy of Neurology. The study found that 

frequent marijuana users performed worse than non-users on tests of cognitive abilities, 

including divided attention and verbal fluency. Those who had used marijuana for 10 

years or more had more problems with their thinking abilities than those who had used 

marijuana for five-to-10 years. All of the marijuana users were heavy users, which was 

defined as smoking four or more joints per week.106

Memory, speed of thinking, 

and other cognitive 

abilities get worse over 

time with marijuana use...
33 Speaking Out Against Drug Legalization

• According to several recent studies, marijuana use has been linked with depression and suicidal 

thoughts, in addition to schizophrenia. These studies report that weekly marijuana use among teens 

doubles the risk of developing depression and triples the incidence of suicidal thoughts.107

• Dr. Andrew Campbell, a member of the New South Wales (Australia) Mental Health Review 

Tribunal, published a study in 2005 which revealed that four out of five individuals with 

schizophrenia were regular cannabis users when they were teenagers. Between 75-80 percent 

of the patients involved in the study used cannabis habitually between the ages of 12 and 21.108

In addition, a laboratory-controlled study by Yale scientists, published in 2004, found that THC 

“transiently induced a range of schizophrenia-like effects in healthy people.”109

• Carleton University researchers published a study in 2005 showing that current marijuana users 

who smoke at least five “joints” per week did significantly worse than non-users when tested on 

neurocognition tests such as processing speed, memory, and overall IQ.110

• Robin Murray, a professor of psychiatry at London’s Institute of Psychiatry and consultant at 

the Maudsley Hospital in London, wrote an editorial which appeared in The Independent, on 

March 18, 2007, in which he states that the British Government’s “mistake was rather to give the 

impression that cannabis was harmless and that there was no link to psychosis.” Based on the 

fact that “...in the late 1980s and 1990s psychiatrists like me began to see growing numbers of 

young people with schizophrenia who were taking large amounts of cannabis” Murray claims 

that “...at least 10 percent of all people with schizophrenia in the UK would not have developed 

the illness if they had not smoked cannabis.” By his estimates, 25,000 individuals have ruined 

their lives because they smoked cannabis. He also points out that the “skunk” variety of cannabis, 

which is very popular among young people in Great Britain, contains “15 to 20 percent THC, 

and new resin preparations have up to 30 percent.”111 

• Dr. John MacLeod, a prominent British psychiatrist states: “If you assume such a link (to 

schizophrenia with cannabis) then the number of cases of schizophrenia will increase significantly 

in line with increased use of the drug.” He predicts that cannabis use may account for a quarter 

of all new cases of schizophrenia in three years’ time.112

• A study from the National Institute of Drug Abuse found that people who smoked marijuana had 

changes in the blood flow in their brains even after a month of not smoking. The marijuana users 

had PI (pulsatility index) values somewhat higher than people with chronic high blood pressure 

and diabetes, which suggests that marijuana use leads to abnormalities in the small blood vessels 

in the brain. These findings could explain in part the problems with thinking and remembering 

found in other studies of marijuana users.113

• In a presentation on “Neuroimaging Marijuana Use and Effects on Cognitive Function” Professor 

Krista Lisdahl Medina suggests that chronic heavy marijuana use during adolescence is associated 

with poorer performance on thinking tasks, including slower psychomotor speed and poorer 

complex attention, verbal memory, and planning ability. “While recent findings suggest partial 

recovery of verbal memory functioning within the first three weeks of adolescent abstinence 

from marijuana, complex attention skills continue to be affected. Not only are their thinking 

abilities worse, their brain activation to cognitive task is abnormal.”114
34 Speaking Out Against Drug Legalization

Impacts of marijuana use on physical health

• A long-term study of over 900 New Zealanders by the University of Otago, New Zealand 

School of Dentistry has found that “heavy marijuana use has been found to contribute to gum 

disease, apart from the known effects that tobacco smoke was already known to have.”115

• A study from Monash University and the Alfred 

Hospital in Australia has found that, “bullous lung 

disease occurs in marijuana smokers 20 years earlier 

than tobacco smokers. Often caused by exposure to 

toxic chemicals or long-term exposure to tobacco 

smoke, bullae is a condition where air trapped in the 

lungs causes obstruction to breathing and eventual 

destruction of the lungs.” Dr. Matthew Naughton 

explains that, “marijuana is inhaled as extremely hot 

fumes to the peak inspiration and held for as long 

as possible before slow exhalation. This predisposes 

the lungs to greater damage, and makes marijuana 

smokers more prone to bullous disease as compared 

to cigarette smokers.”116

• In December 2007 researchers in Canada reported that “marijuana smoke contains significantly 

higher levels of toxic compounds—including ammonia and hydrogen cyanide—than tobacco 

smoke and may therefore pose similar health risks. Ammonia levels were 20 times higher in 

the marijuana smoke than in the tobacco smoke, while hydrogen cyanide, nitric oxide and 

certain aromatic amines occurred at levels 3-5 times higher in the marijuana smoke.”117

• Marijuana worsens breathing problems in current smokers with chronic obstructive pulmonary 

disease (COPD), according to a study released by the American Thoracic Society in May 2007. 

Among people age 40 and older, smoking cigarettes and marijuana together boosted the odds 

of developing COPD to 3.5 times the risk of someone who smoked neither.

• According to a 2005 study of marijuana’s long-term pulmonary effects by Dr. Donald Tashkin 

at the University of California, Los Angeles, marijuana smoking deposits significantly more 

tar and known carcinogens within the tar, such a polycyclic aromatic hydrocarbons, into the 

airways. In addition to precancerous changes, marijuana smoking is associated with impaired 

function of the immune system components in the lungs.127

• Scientists at Sweden’s Karolinska Institute, a medical university, have advanced their 

understanding of how smoking marijuana during pregnancy may damage the fetal brain. 

Findings from their study, released in May 2007, explain how endogenous cannabinoids exert 

adverse effects on nerve cells, potentially imposing life-long cognitive and motor deficits in 

afflicted new born babies.119 

Bullous lung disease 

occurs in marijuana 

smokers 20 years 

earlier than tobacco 

smokers.
35 Speaking Out Against Drug Legalization

• According to new research from Vanderbilt University the use of marijuana by women trying to 

conceive or those recently becoming pregnant is not recommended, as it endangers the passage 

of the embryo from the ovary to the uterus and can result in a failed pregnancy. A study with 

mice has shown that marijuana exposure may compromise the pregnancy outcome because 

an active ingredient in marijuana, tetrahydrocannabinol (THC), interferes with a fertilized egg’s 

ability to implant in the lining of the uterus.125 

• Infants exposed to marijuana in the womb show subtle behavioral changes in their first days 

of life, according to researchers in Brazil. The newborns were more irritable than non-exposed 

infants, less responsive, and more difficult to calm. They also cried more, startled more easily, 

and were jitterier. Such changes have the potential to interfere with the mother-child bonding 

process. “It is necessary to counter the misconception that marijuana is a ‘benign drug’ and 

to educate women regarding the risks and possible consequences related to its use during 

pregnancy,” Dr. Marina Carvahlo de Moraes Barros and her colleagues concluded.126

• A 2007 study from New Zealand reports that cannabis smoking may cause five percent of lung 

cancer cases in that country.120

• Researchers at the Fred Hutchinson Cancer Research Center in Seattle found that frequent 

or long-term marijuana use may significantly increase a man’s risk of developing the most 

aggressive type of testicular cancer, nonseminoma. Nonseminoma is a fast-growing testicular 

malignancy that tends to strike early, between the ages of 20 and 35, and accounts for about 

40 percent of all testicular-cancer cases.”121

• While smoking tobacco cigarettes is known to be a major risk factor for the bladder cancer 

most common among people age 60 and older, researchers are now finding a correlation 

between smoking marijuana and bladder cancer. In a study of younger patients with transitional 

cell bladder cancer, Dr. Martha Terriss found that 88.5 percent had a history of smoking 

marijuana. 

• Marijuana smoke has many of the same carcinogen-containing tars as cigarettes and may get 

even more of them into the body because marijuana cigarettes are unfiltered and users tend 

to hold the smoke in their lungs for prolonged periods. Dr. Terriss notes that more research is 

needed, but does recommend that doctors who find blood in a young patient’s urine sample 

follow-up with questions about marijuana use, and more strongly consider ruling out bladder 

cancer as the cause.122

• According to a review of decades of research on marijuana smoking and lung cancer, smoking 

marijuana can cause changes in lung tissue that may promote cancer growth. However, it is 

not possible to directly link pot use to lung cancer based on existing evidence. Nevertheless, 

researchers indicate that the precancerous changes seen in studies included in their analysis, 
36 Speaking Out Against Drug Legalization

as well as the fact that marijuana smokers generally inhale more deeply and hold smoke in their 

lungs longer than cigarette smokers, and that marijuana is smoked without a filter, do suggest that 

smoking marijuana could indeed boost lung cancer risk. It is known, they add, that marijuana 

smoking deposits more tar in the lungs than cigarette smoking does.123

• Smoking three cannabis joints will cause you to inhale the same amount of toxic chemicals as a 

whole pack of cigarettes, according to researchers from the French National Consumers’ Institute. 

Cannabis smoke contains seven times more tar and carbon monoxide than cigarette smoke. 

Someone smoking a joint of cannabis resin rolled with tobacco will inhale twice the amount of 

benzene and three times as much toluene as if they were smoking a regular cigarette.124

• Smoked marijuana is associated with an increased risk of the same respiratory symptoms as tobacco, 

including coughing, phlegm production, chronic bronchitis, shortness of breath and wheezing. 

Because cannabis plants are contaminated with a range of fungal spores, smoking marijuana may 

also increase the risk of respiratory exposure by infectious organisms (i.e., molds and fungi).128

• In its October, 2006, issue of NIDA Notes, Dr. Tashkin notes that. “Biopsies of bronchial tissue 

provide evidence that regular marijuana smoking injures airway epithelial cells, leading to 

dysregulation of bronchial epithelial cell growth and eventually to possible malignant changes...

moreover, marijuana smoking deposits significantly more tar and known carcinogens within 

the tar, such as polycyclic aromatic hydrocarbons, in the airways than tobacco.” In addition to 

precancerous changes, Dr. Tashkin found that” marijuana smoking is associated with a range of 

damaging pulmonary effects, including inhibition of the tumor-killing and bactericidal activity of 

alveolar macrophages, the primary immune cells within the lung.”130

• Legalization advocates claim that the United States has wasted billions of dollars in its anti-drug 

efforts. But for those saved from drug addiction, these are hardly wasted dollars. Compared to the 

social costs of drug abuse and addiction—whether in taxpayer dollars, or in pain and suffering—

government spending on drug control is minimal. 
37 Speaking Out Against Drug Legalization

•	 The American Medical Association (AMA) has always endorsed “well-controlled” studies of

marijuana and related cannabinoids in patients with serious conditions for which preclinical,

anecdotal, or controlled evidence suggests efficacy and the application of such results to the

understanding and treatment of disease.” In November 2009, the AMA amended its policy,

urging that maruijuana’s status as a Schedule I controlled substance be reviewed “with the

goal of facilitating the conduct of clinical research and development of cannabinoid-based

medicines, and alternate delivery methods.” The AMA also stated that “this should not be

viewed as an endorsement of state-based medical cannibis programs, the leagalization of

marijuana, or the scientific evidence on the therapeutic use of cannibis meets the current

standards for prescription drug product.90

•	 The American Cancer Society “does not advocate inhaling smoke, nor the legalization of

marijuana,” although the organization does support carefully controlled clinical studies for

alternative delivery methods, specifically a THC skin patch.91

•	 The American Academy of Pediatrics believes that “any change in the legal status of

marijuana, even if limited to adults, could affect the prevalence of use among adolescents.”

While it supports scientific research on the possible medical use of cannabinoids as opposed

to smoked marijuana, it opposes the legalization of marijuana.92

•	 The National Multiple Sclerosis Society has stated that it could not recommend that

medical marijuana be made widely available for people with multiple sclerosis for symptom

management, explaining: “This decision was not only based on existing legal barriers to its

use but, even more importantly, because studies to date do not demonstrate a clear benefit

compared to existing symptomatic therapies and because issues of side effects, systemic

effects, and long-term effects are not yet clear.”93

•	 In a reversal of their 2006 official position, the Australian Medical Association (AMA) has

called on the state government of Western Australia to introduce harsher marijuana laws.

The AMA cited a recent review of international research on the links between marijuana

and mental illness. AMA president Dr. Rosanna Capolingua said that “soft marijuana laws

certainly do not help support the message that marijuana is not a soft drug.”94 

Statements by Medical Organizations
38 Speaking Out Against Drug Legalization

•	 The United Nations Economic and Social Council has expressed concern about the trend

towards the development of lenient policies relating to cannabis and other drugs that are not in

accordance with international drug control treaties; and that such trends may have a negative

impact on efforts being made to eradicate cannabis cultivation and combat drug trafficking.95

•	 The International Narcotics Control Board issued a statement urging other countries to

considerthe real dangers of cannabis.“...cannabis is classified underinternational conventions

as a drug with a number of personal and public health problems. It is not a ‘soft’ drug as some

people would have you believe. There is new evidence confirming well-known mental health

problems, and some countries with a more liberal policy towards cannabis are reviewing their

position. Countries need to take a strong stance towards cannabis abuse.”96

•	 The British Medical Association (BMA) voiced extreme concern that downgrading the

criminal status of marijuana would “mislead” the public into believing that the drug is safe. The

BMA maintains that marijuana “has been linked to greater risk of heart disease, lung cancer,

bronchitis and emphysema.”97 The 2004 Deputy Chairman of the BMA’s Board of Science

said that “[t]he public must be made aware of the harmful effects we know result from smoking

this drug.”98 Unfortunately, the British Government did not heed their Medical Association’s

warning and downgraded cannabis from Class B to a Class C drug in 2004. This resulted in

an increase of crime and various health problems, which later prompted a reversal, according

to United Kingdom’s Home Office.99 As a result, on May 8, 2008, the Home Office announced

that cannabis will be reclassified as a Class B drug.100 

Speaking Out Against Drug Legalization 38
39 Speaking Out Against Drug Legalization

Social Costs 

• In 2002, drug abuse cost American society an estimated $181 billion.132 More important were the 

losses that are imperfectly symbolized by those billions of dollars—the destruction of lives, the 

damage of addiction, fatalities from car accidents, illness, and lost opportunities and dreams. 

Loss of life

• The number of drug overdose deaths in the United States continues to increase, representing a 

serious threat to public health. To a significant extent, these deaths are related to increases in 

prescription drug abuse. Rates of overdose deaths are currently four to five times higher than 

during the black tar heroin epidemic of the mid-1970s, and more than twice the rates during the 

peak years of crack cocaine in the early 1990s. In 2005 there were 22,400 drug overdose deaths 

in the United States, compared to approximately 17,000 homicides in the same year.133

• According to a report in the February 9, 2007 Morbidity and Mortality Weekly Report, “In 2004, 

poisoning was second only to motor-vehicle crashes as a cause of death from unintentional 

injury in the United States. Nearly all poisoning deaths in the United States are attributed to 

drugs, and most drug poisonings result from the abuse of prescription and illegal drugs.” 

• The CDC determined that poisoning mortality rates in the United States increased 62.5 percent 

a year from 1999 to 2004. The increase in deaths because of unintentional poisoning occurred 

almost exclusively among those whose deaths were attributed to unintentional drug poisoning. 

By 2004, drug poisoning accounted for 19,838 deaths, or 94.7 percent of all unintentional 

poisoning deaths.134

• In 2006, an estimated 8.3 percent of Americans aged 12 or older were current (past month) illicit 

drug users, resulting in over 38,000 deaths from drug-induced causes. By comparison, there 

were just over 125 million (or 50.9 percent of all Americans) current alcohol users and just over 

22,000 deaths due to alcohol-induced causes.135 

Fact 5: Drug control spending is a minor portion of the U.S. budget.

 Compared to the social costs of drug abuse and addiction, 

 government spending on drug control is minimal.
40 Speaking Out Against Drug Legalization

• Legalization would result in skyrocketing costs that would be paid by American taxpayers and 

consumers. Legalization would significantly increase drug use and addiction—and all the social 

costs that go with it. With the removal of the social and legal sanctions against drugs, many 

experts estimate the user population would at least double. For example, a 1994 article in the 

New England Journal of Medicine stated that it was probable, that if cocaine were legalized, the 

number of cocaine addicts in America would increase from two million to at least 20 million. 

• If we were to regulate marijuana or other drugs, we would have to agree that it’s acceptable for 

society to profit from a person’s addiction. There were approximately 38,000 overdose deaths 

for illicit drugs and non-medical use of prescription drugs in 2006 according to the Center for 

Disease Control.136 How much are those lives worth?

Related Health Care Costs

• Drug abuse drives some of America’s most costly social problems—including domestic violence, 

child abuse, chronic mental illness, the spread of AIDS, and homelessness. Drug treatment costs, 

hospitalization for long-term drug-related disease, and treatment of the consequences of family 

violence burden our already strapped health care system. 

• In 2006, there were more than 1,742,887 hospital emergency department drug misuse or abuse 

admissions in the United States.137 

• “Substance abuse is the most commonly reported modifiable behavior impeding TB elimination 

efforts in the United States,” according to an analysis of tuberculosis cases reported to the Center 

for Disease Control and Prevention between 1997 and 2006. Nearly one-fifth of the patients 

reported substance abuse in the year before their TB was diagnosed.138

• The Centers for Disease Control and Prevention has estimated that 36 percent of new HIV cases 

are directly or indirectly linked to injecting drug users.139 Drug abuse and addiction have been 

linked with HIV/AIDS since the beginning of the epidemic. While intravenous drug use is well 

known in this regard, less recognized is the role that drug abuse plays more generally in the 

spread of HIV – the virus that causes AIDS – by increasing the likelihood of high-risk sex with 

infected partners. This is because the addictive and intoxicating effects of many drugs, which can 

alter judgment and inhibition, and lead people to engage in impulsive and unsafe behaviors.140

Treatment Needs

• In 2008, an estimated 22.2 million persons aged 12 or older were classified with substance 

dependence or abuse (8.9 percent of the population aged 12 or older). Of these, 3.1 million 

were classified with dependence on or abuse of both alcohol and illicit drugs; 3.9 million were 

dependent on or abused illicit drugs but not alcohol; and 15.2 million were dependent on or 

abused alcohol but not illicit drugs.141
41 Speaking Out Against Drug Legalization

• There were 23.1 million persons aged 12 or older in need of treatment for illicit drug or 

alcohol use. Of these, only 2.3 million people received treatment at a specialty facility. 

That means that 20.8 million people who needed treatment from a specialty facility did not 

receive it.142 If we do not have the resources to treat all the people who are substance abusers 

how will we handle the increased workload generated with the legalization of illicit drugs?

Workplace 

• The American workplace bears many significant costs resulting from alcohol and drug abuse. 

The 2007 there were 20.4 million adults classified with substance abuse or dependence, 

60.4 percent (12.3 million) of them were employed full time. Of the estimated 17.4 million 

adult users of illicit drugs 18 or older, 75 percent (13.1 million people) are employed either 

full or part-time. These figures underscore the costs of substance use in the workforce, 

including accidents and injuries, absenteeism, low morale, and productivity losses.143

• In addition, legalization—and the increased addiction it would spawn—would result in lost 

workforce productivity and the unpredictable damage that it would cause to the American 

economy. In 2002, productivity losses due to drug abuse cost the economy almost $128.6 

billion.144

• Drug use by workers leads not only to more unexcused absences and higher job turnover 

rates, but also presents an enormous safety problem in the workplace.145 Nearly twice as 

many current illicit drug users skipped one or more days of work due to illness or injury in 

the past month compared to workers who did not abuse drugs.146

• There has been some success with reducing the use of drugs in the workplace. Effective drug 

free workplace programs are helping to reduce substance abuse among the workforce by 

letting workers know that drug use is not acceptable and by offering help to those that need 

it. Drug testing programs have contributed to the decline in illicit drug use, including cocaine 

and methamphetamine. Over the past twenty years, positive drug test results declined from 

13.6 percent in 1988 to 3.6 percent in 2008. 147

Traffic Accidents

• In 2007, over 1.4 million drivers were arrested for driving under the influence of alcohol and

narcotics. Drugs other than alcohol are involved in about 18 percent of motor vehicle driver 

deaths. These other drugs are generally used in combination with alcohol.148
42 Speaking Out Against Drug Legalization

o According to a study published in Traffic Injury Prevention, more than half of motor 

vehicle crash drivers tested positive for drugs other than alcohol in a Level-1 trauma 

center. In a 90-day study, nearly two-thirds of trauma center admissions were victims 

of motor vehicle crashes (MVC). Blood and urine was collected from 168 MVC 

victims of whom 108 were identified as the driver in the crash. Toxicology results 

indicated that 65.7 percent of drivers tested positive for either commonly abused 

drugs or alcohol. More than half of the drivers tested positive for drugs (51percent) 

other than alcohol, with one in four drivers testing positive for marijuana use. 149

Studies drawing similar conclusions about the connection between drug use and 

traffic accidents were in studies conducted in Australia,150 British Columbia,151 and 

France.152

o An issue of the Morbidity and Mortality Weekly Report, published in December of 

2006, reported that of the 784 motor vehicle fatalities that took place in West Virginia 

2004-2005. Almost half (47.3 percent) of all those victums tested positive for alcohol 

or drugs, 11.1 percent tested positive for both, and more than one quarter (26 percent) 

of those who died tested positive for drug use.153

• Every day, 36 people in the U.S. die, and approximately 700 more are injured, in motor 

vehicle crashes that involve an alcohol-impaired driver. The annual cost of alcohol-related 

crashes totals more than $51 billion.154 According to the National Highway Traffic Safety 

Administration, vehicle accidents are the leading cause of death among young people age 

16-20.155 If we legalized drugs and had more impaired drivers on the road, what would the 

increased cost in lives and dollars be?

• In 2008 there were 10 million persons aged 12 and older who reported driving under the 

influence of illicit drugs during the past year. The rate was highest among young adults aged 

18 to 25.156 

• According to the National Institute on Drug Abuse funded study, a large number of American 

adolescents are putting themselves and others at great risk by driving under the influence 

of illicit drugs or alcohol. In 2006, 30 percent of high school seniors reported driving after 

drinking heavily or using drugs, or riding in a car whose driver had been drinking heavily or 

using drugs, at least once in the prior two weeks. 

• Dr. Patrick O’Malley, lead author of the study, observed that “driving under the influence 

is not an alcohol-only problem. In 2006, 13 percent of seniors said they drove after using 

marijuana while ten percent drove after having five or more drinks.” 
43 Speaking Out Against Drug Legalization

• “Vehicle accidents are the leading cause of death among those aged 15 to 20,“ added Dr. 

Nora Volkow, Director of NIDA. “Combining the lack of driving experience among teens with 

the use of marijuana and/or other substances that impair cognitive and motor abilities can be 

a deadly combination.”157 Can we afford to legalize drugs and increase the percent of youth 

driving under the influence?

Family Problems

• More than 8.3 million children under 18 years of age lived with at least one parent who was 

dependent on or abused alcohol, and/or an illicit drug this past year. Of these, almost 7.3 

million lived with a parent who was dependent on or abused alcohol and about 2.1 million 

lived with a parent who is dependent on or abused illicit drugs. This means that more than 

1 in 10 children in the United States under the age of 18 live with a substance-dependent or 

substance-abusing parent.158

• “The research increasingly shows that children growing up in a home with alcohol-and 

drug-abusing parents suffer – often greatly,” according to SAMHSA Acting Administrator Eric 

Broderick. “The chronic emotional stress in such an environment can damage their social and 

emotional development and permanently impede healthy brain development, often resulting 

in mental and physical health problems across the lifespan. This underlines the importance of 

preventive interventions at the earliest possible age.”159

• According to the 2005 National Center on Addiction and Substance Abuse Report, alcohol and 

drug abuse are diseases with severe consequences for all family members, particularly children. 

Children of substance abusing parents are likelier to become substance abusers themselves. 

Alcohol and drug-abusing parents are three times likelier to abuse their children and four times 

likelier to neglect them than parents who do not abuse these substances. Children of alcohol 

and drug abusers are at increased risk of accidents, injuries, and academic failure. Such 

children are more likely to suffer conduct disorders, depression or anxiety, conditions that also 

increase the risk that children will drink and use drugs themselves.160

• Substance abusers’ households tend to be high in conflict, likelier than others to include 

yelling, insults, and serious arguments. Substance abusing parents tend to engage in fewer 

family activities with their children. Parental substance abuse is one of the main problems 

facing families who are reported for child endangerment. Parental substance abuse increases 

the incidence of family violence, divorce, financial problems, and exposure to crime. 161

• There is even greater risk to children whose parents use and manufacture methamphetamine. 

Methamphetamine abusers often produce the drug in their own homes and apartments, using 

hazardous chemicals such as hydrochloric acid, iodine, and anhydrous ammonia. Children 

who inhabit such homes often inhale dangerous fumes and gases and ingest toxic chemicals 
44 Speaking Out Against Drug Legalization

or illicit drugs. These children commonly test positive for methamphetamine, and suffer 

from short and long-term health consequences. They are also often neglected, leading to 

psychological and developmental problems. In 2004 U.S. law enforcement agencies report 

having seized 9,895, illicit methamphetamine laboratories in 2004. These agencies report 

that 2,474 children were affected by these laboratories (i.e., they were exposed to chemicals, 

they resided at laboratory sites, or they were displaced from their homes).162

• A study by Rand Corporation estimates that methamphetamine cost American society $23.4 

billion in 2005. 

Tax, Sale, and Advertising Consequences

• Advocates argue that legalization will lower prices for drugs. But that raises a dilemma: If 

the price of drugs is low, many more people will be able to afford them and the demand for 

drugs will explode. For example, if the cost of cocaine production is as low as $3 per gram 

and is sold at retail price, a single unit could be bought for as little as ten cents. That means 

a young person could buy six hits of cocaine for the price of a candy bar. On the other hand, 

if legal drugs are priced too high, through excise taxes, for example, illegal traffickers will be 

able to undercut them. 

• Advocates of legalization argue that a legal market could be limited to those above a certain 

age level, as it is for alcohol and cigarettes. Those under the age limits would therefore not 

be permitted to buy drugs at authorized outlets. But teenagers today have found many ways 

to circumvent age restrictions, whether by using false identification, or by buying liquor and 

cigarettes from older friends. According to the 2007 SAMSHA National Household Survey 

on Drug Abuse, there were 4.6 million persons aged 12 or older who had used alcohol for 

the first time within the past 12 months; this averages to approximately 12,500 initiates per 

day. Most of the 4.6 million (85.9 percent) recent initiates were younger than 21 at the time 

of initiation.164 With drugs, teenagers would have an additional outlet: the highly organized 

illegal trafficking networks that would undoubtedly concentrate their marketing efforts on 

young people to make up for the business they lost to legal outlets. 

• Alcohol and tobacco have proven harmful, addictive, and difficult to regulate. Alcohol is the 

third leading cause of death in the United States—each year over 100,000 Americans die of 

alcohol-related causes. The Surgeon General estimates that problems resulting from alcohol 

use and abuse cost society almost $200 billion every year, and these costs are far higher than 

revenue generated by alcohol taxes.165

• Tobacco, the other substance that often is suggested as a model for how we could have 

‘legal’ marijuana, offers a picture of a similarly bleak future. The Center for Disease Control 

estimates that the total economic costs associated with cigarette smoking is approximately 

$7.18 per pack of cigarettes. The tax revenue generated to cover these costs? The federal 

excise tax is $1.01 per pack of cigarettes.166 The median state cigarette excise tax rate, as of 

January 1, 2007, is 80 cents.167 This hardly sounds like the “economic windfall” that will cure 

our budget woes. 
45 Speaking Out Against Drug Legalization

Costs to the Taxpayer 

• In FY 2009, the total federal drug control budget requested was $14.8 billion.168 In comparison, 

the Department of Education’s FY 2009 budget request was almost 10 times this amount: 

$137.6 billion.169 Education is a long-term social concern, with new problems that arise 

with every new generation. The same can be said of drug abuse and addiction. Yet nobody 

suggests that we should give up on our children’s education. Why, then, would we give up 

on helping to keep them off drugs and free from addiction? 

• On the surface, advocates of legalization present an appealing, but simplistic, argument that 

by legalizing drugs we can move vast sums of money from enforcing drug laws to solving 

society’s ills. But as in education and drug addiction, vast societal problems can’t be solved 

overnight. It takes time, focus, persistence – and resources.

• Legalization advocates fail to note the skyrocketing social and welfare costs, not to mention 

the misery and addiction that would accompany the outright legalization of drugs. 

• Legalization advocates also fail to mention that, unless drugs are made available to children, 

law enforcement will still be needed to deal with the sale of drugs to minors. In other words, 

a vast black market will still exist. Since young people are often the primary target of pushers, 

many of the criminal organizations that now profit from illegal drugs would continue to do 

so. 

• Furthermore, it is reasonable to assume that the health and societal costs of drug legalization 

would also increase exponentially. Drug treatment costs, hospitalization for long-term drugrelated diseases, and treatment of family violence would also place additional demands on 

our already overburdened health care system. More taxes would have to be raised to pay for 

a system already bursting at the seams. 

• Criminal justice costs would likely increase if drugs were legalized. It is quite likely that 

violent crime would significantly increase with greater accessibility to dangerous drugs—

whether the drugs themselves are legal or not. In 2004, one in four violent offenders in 

prison committed their offenses under the influence of drugs.170 More taxes would have to 

be raised to pay for additional law enforcement personnel, which is already overburdened by 

crimes and traffic fatalities associated with alcohol. Law enforcement is already challenged 

by significant alcohol-related crimes. More users would probably result in the commission 

of additional crimes, causing incarceration costs to increase as well.

• A 2004 study by the Bureau of Justice Statistics of federal and state prisoners measured drug 

dependence and abuse for the first time. Fifty-three percent of state and 45 percent of federal 

prisoners met the criteria for drug dependence or abuse.171 
46 Speaking Out Against Drug Legalization

• Legalization proponents claim that making illegal drugs legal would not cause more of these 

substances to be consumed, nor would addiction increase. They claim that many people can 

use drugs in moderation, and that many would choose not to use drugs, just as many abstain 

from alcohol and tobacco now. Yet how much misery is already attributable to alcoholism 

and smoking?

• It’s clear from history that periods of lax controls are accompanied by more drug abuse, and 

that periods of tight controls are accompanied by less drug abuse.

o During the 19th century, morphine was legally refined from opium and hailed as a 

miracle drug. However, many soldiers on both sides of the Civil War who were given 

morphine for their wounds became addicted to it. In 1880, many drugs, including 

opium and cocaine, were legal — and like some drugs today were seen as benign 

medicine not requiring a doctor’s care and oversight and addiction skyrocketed. 

o By 1900, about one American in 200 was either a cocaine or opium addict. Among 

the reforms of this era was the federal Pure Food and Drug Act of 1906, which 

required manufacturers of patent medicines to reveal the contents of the drugs they 

sold. In this way, Americans learned which of their medicines contained heavy doses 

of cocaine and opiates — drugs they had now learned to avoid.

o Specific federal drug legislation and oversight began with the 1914 Harrison Act, the 

first broad anti-drug law in the United States. Enforcement of this law contributed 

to a significant decline in narcotic addiction in the United States. Addiction in the 

United States eventually fell to its lowest level during World War II, when the number 

of addicts was estimated at somewhere between 20,000 and 40,000. Many addicts, 

faced with disappearing supplies, were forced to give up their drug habits.

Failed Legalization Ventures

• In 1975, the Alaska Supreme Court ruled that the state could not interfere with an adult’s 

possession of marijuana for personal consumption in the home. The court’s ruling became 

a green light for marijuana use. Although the ruling was limited to persons 19 and over, 

teens were among those increasingly using marijuana. According to a 1988 University of 

Alaska study, the state’s 12 to 17-year-olds used marijuana at more than twice the national 

average for their age group. Alaska’s residents voted in 1990 to re-criminalize possession of 

marijuana.175

Fact 6: Legalization of drugs will lead to increased use

 and increased levels of addiction. 
47 Speaking Out Against Drug Legalization

• By 1979, after 11 states decriminalized marijuana and the Carter administration had 

considered federal decriminalization, marijuana use shot up among teenagers. That year, 

almost 51 percent of 12th graders reported they used marijuana in the last 12 months. By 

1992, with tougher laws and increased attention to the risks of drug abuse, that figure had 

been reduced to 22 percent, a 57-percent decline.176

• Other countries have also had this experience. The Netherlands has had its own troubles 

with increased use of cannabis products. From 1984 to 1996, the Dutch liberalized the 

use of cannabis. Surveys reveal that lifetime prevalence of cannabis in Holland increased 

consistently and sharply during those years. For the age group 18-20, the increase went 

from 15 percent in 1984 to 44 percent in 1996. 177

• The Netherlands is not alone. Switzerland, with some of the most liberal drug policies in 

Europe, experimented with what became known as “Needle Park”. Needle Park became 

a mecca for drug addicts throughout Europe. It was an area where addicts could come to 

openly purchase drugs and inject heroin without police intervention or control. Because of 

the rapid decline in the neighborhood surrounding Needle Park, with increased crime and 

violence, led authorities to finally close it in 1992.178

Alcohol and tobacco costs

• What is disconcerting is that alcohol and tobacco are often pointed to as ‘models’ for how 

the government could regulate the use of marijuana. This suggestion ignores the significant 

costs that society pays because of the ease of availability of alcohol and tobacco.

• The relationship between legalization and increased use becomes evident when you consider 

two current “legal drugs,” tobacco and alcohol. The number of users of these “legal drugs” is 

far greater than the number of users of illegal drugs. The 2008 National Household Survey on 

Drug Abuse reports an estimated 129 million Americans used alcohol at least once a month. 

About 70.9 million Americans used tobacco at the same rate. But less than 20.1 million 

Americans used illegal drugs at least once a month.179

Alcohol costs to society

• According to the National Institute on Alcohol Abuse and Alcoholism, millions of Americans 

are heavy drinkers and they have a greater risk of liver disease, heart disease, sleep disorders, 

depression, stroke, bleeding from the stomach, sexually transmitted infections from unsafe 

sex, and several types of cancer. Heavy drinkers may also have problems managing diabetes, 

high blood pressure, and other conditions.180

• The Centers for Disease Control estimates that between 2001 and 2005, there were 

approximately 79,000 deaths annually due to excessive alcohol use,181 making excessive 

alcohol use the third leading cause of death in the United States.182
48 Speaking Out Against Drug Legalization

• The economic cost of alcohol abuse was about $185 billion in 1998, which translated into 

roughly $683 for every man, woman, and child living in the United States.183

Tobacco costs to society

• Tobacco, the other substance that is often suggested as a model for how we could have ‘legal’ 

marijuana, offers a picture of a similarly bleak future. According to the Surgeon General, 

tobacco is the leading preventable cause of death in the United States.184 Cigarette smoking 

causes an estimated 438,000 deaths, or about one of every five deaths, each year—including 

approximately 38,000 deaths from secondhand smoke exposure.185,186

• During 2000-2004, cigarette smoking was estimated to be responsible for $193 billion in 

annual health-related economic losses in the United States ($96 billion in direct medical 

costs and approximately and $97 billion in lost productivity).187 This translates to an estimated 

total economic cost of $10.47 per pack of cigarettes sold in the United States.188

• How much tax revenue is generated to cover the cost of tobacco use? In 2008, the average 

retail price of a pack of cigarettes in the United States was $4.35 (including federal, state, 

and municipal taxes).189 The median state cigarette excise tax rate, as of January 1, 2008, was 

$1.190 The federal cigarette tax is $1.01.191 This hardly sounds like the “economic windfall” 

that will cure our budget woes.

• If we were to regulate marijuana, we would agree that it’s acceptable for society to profit 

from a person’s addiction. There were approximately 38,000 overdose deaths for illicit drugs 

and non-medical use of prescription drugs for 2006 according to the Center for Disease 

Control.192 Legalization would multiply the cost by greatly adding to the class of drugaddicted Americans. To put it in perspective, less than 8 percent of the population uses illegal 

drugs of any kind. That’s 19 million regular users of all illegal drugs, compared to 71 million 

tobacco users, and over 127 million alcohol users.193 How much are those lives worth?

• Use of illicit drugs and alcohol is more common among current cigarette smokers than 

nonsmokers. Among persons aged 12 or older, 20.4 percent of past month cigarette smokers 

reported current use of an illicit drug compared with 4.2 percent of persons who were not 

current cigarette smokers in 2008. Past month alcohol use was reported by 67.4 percent of 

current cigarette smokers compared with 46.7 percent of those who did not use cigarettes in 

the past month. The association also was found with binge drinking (44.6 percent of current 

cigarette users vs. 16.5 percent of current nonusers) and heavy drinking (16.8 vs. 3.8 percent, 

respectively).194

• It’s clear that there is a relationship between legalization and increasing drug use, and that 

legalization would result in an unacceptably high number of drug-addicted Americans. 
49 Speaking Out Against Drug Legalization

• When legalization advocates suggest that easy access to drugs won’t contribute to greater levels 

of addiction, they aren’t being candid. The question isn’t whether legalization will increase 

addiction levels—it will— it’s whether we care or not. The compassionate response is to do 

everything possible to prevent the destruction that addiction causes, not make it easier to harm 

ourselves, our community and our future. 
50 Speaking Out Against Drug Legalization

• Proponents of legalization have many theories regarding the connection between drugs and 

violence, claiming that drug use is a victimless crime, that users are putting only themselves in 

harm’s way, and as a result have a right to use drugs. 

• Other proponents of legalization contend that if drugs were legalized, crime and violence 

would decrease, believing that it is the illegal nature of drug production, trafficking, and use that 

fuels crime and violence, rather than the violent and irrational behavior that drugs themselves 

prompt. Proponents state that users commit crimes to pay for drugs because they are not easily 

obtained, and if drugs were legal, profits associated with drugs because of their illegal status 

would disappear, and the black market and criminal activity of traffikers would be eliminated.

o Yet, under a legalization scenario, a black market for drugs would still exist, and it would 

be a vast black market. If drugs were legal for those over 18 or 21, there would be a 

market for everyone under that age. People under the age of 21 consume the majority of 

illegal drugs, so an illegal market and organized crime to supply it would remain—along 

with the organized crime that profits from it. 

o If only marijuana were legalized, drug traffickers would continue to traffic in heroin and 

cocaine. In either case, drug-related violence would not be ended by legalization.

o If only marijuana, cocaine, and heroin were legalized, there would still be a market 

for PCP and methamphetamine. Where do legalizers want to draw the line? Or do they 

support legalizing all drugs, no matter how addictive and dangerous?

• Drug use often causes an individual to do things they normally wouldn’t do if they were free 

of the influence of drugs. The greatest weakness in the logic of legalizers is that the violence 

associated with drugs is simply a product of drug trafficking. That is, if drugs were legal, then 

most drug crime would end. But violent crime is often committed not because people want to 

buy drugs, but because people use drugs. Drug use changes behavior and exacerbates criminal 

activity. 

Fact 7: Crime, violence, and drug use go hand-in-hand. 
51 Speaking Out Against Drug Legalization

Drug use and crime

• Scientific studies support the connection between drug use and crime. Drug users are not only 

harming themselves, they are harming anyone who may have the misfortune of crossing their 

path. Dr. Mitchell Rosenthal, head of Phoenix House, a major drug treatment center, has pointed 

out that, “there are a substantial number of abusers who cross the line from permissible selfdestruction to becoming ‘driven’ people who are ‘out of control’ and put others in danger of their 

risk-taking, violence, abuse, or HIV infection.”195

• In the 2004 Survey of Inmates in state and federal correctional facilities, 32 percent of state 

prisoners and 26 percent of federal prisoners said they had committed their current offense while 

under the influence of drugs. Among state prisoners, drug offenders (44 percent) and property 

offenders (39 percent) reported the highest incidence of drug use at the time of the offense. 

Among federal prisoners, drug offenders (32 percent) and violent offenders (24 percent) were the 

most likely to report drug use at the time of their crimes.196

• Research clearly demonstrates that marijuana has the potential to cause problems in daily life and 

make a person’s existing problems worse. In one study, heavy marijuana abusers reported that 

the drug impaired several important measures of life achievement including physical and mental 

health, cognitive abilities, social life, and career status.197 Several studies associate workers’ 

marijuana smoking with increased absences, tardiness, accidents, workers’ compensation 

claims, and job turnover.198

• Results from NIDA’s Monitoring the Future survey indicate that in 2006 more than 13 percent 

of high school seniors admitted to driving under the influence of marijuana in the weeks prior 

to the survey.199 Marijuana intoxication can cause distorted perceptions, impaired coordination, 

difficulty in thinking and problem solving, and problems with learning and memory. Research 

has shown that marijuana’s adverse impact on learning and memory can last for days or weeks 

after the acute effects of the drug wear off.200 As a result, someone who smokes marijuana every 

day may be functioning at a suboptimal intellectual level all of the time.

Victims of Drug Crimes

• Drug-related crime victimization occurs in many forms. Many drug users resort to violent crimes 

that include homicide, assault, and armed robbery. Drug use may contribute to situations such 

as domestic violence. In an attempt to obtain their drug of choice, drug users may also commit 

non-violent crimes, such as identity theft. 
52 Speaking Out Against Drug Legalization

• The National Center on Addiction and Substance Abuse at Columbia University estimates in a 

2005 report that substance abuse is a factor in at least 70 percent of all reported cases of child 

maltreatment. Adults with substance abuse disorders are 2.7 times more likely to report abusive 

behavior and 4.2 times more likely to report neglectful behavior toward their children.201 

• Maltreated children of substance abusing parents are 

more likely to have poorer physical, intellectual, social, 

and emotional outcomes and are at a greater risk of 

developing substance abuse problems themselves.202 

• Children often test positive for the drug of their parent’s 

choice. For example, child endangerment was charged in 

a case where a child was present in a home with ongoing 

marijuana cultivation and processing. Also, in a separate 

situation, child abuse was reported after a child tested 

positive for marijuana as a result of passive inhalation 

when marijuana smoke was blown into a child’s face so 

they would go to sleep. 

• According to the National Crime Victimization Survey 

(NCVS), there were 5.2 million violent victimizations in 

the U.S. age 12 or older in 2007. Victims of violence were asked to describe whether they 

perceived the offender to have been drinking or using drugs. In 27 percent of the cases victims 

of violence reported that the offender was using drugs or alcohol.203

• The Uniform Crime Reporting Program (UCR) of the Federal Bureau of Investigation (FBI) 

reported that in 2006 5.3 percent of the 14,990 homicides committed that year were narcotics 

related.204

Drug use and violence

• Drug use, crime, and violence go hand in hand. In 2004, 17 percent of state prisoners and 18 

percent of federal inmates said they committed their current offense to obtain money for drugs. 205

• In 2002, about 25 percent of convicted property and drug offenders in local jails had committed 

their crimes to get money for drugs, compared to 5 percent of violent and public order offenders. 

Among state prisoners in 2004 the pattern was similar, with property (30 percent) and drug 

offenders (26 percent) more likely to commit their crimes for drug money than violent (10 percent) 

and public-order offenders (7 percent). In federal prisons property offenders (11 percent) were 

less than half as likely as drug offenders (25 percent) to report drug money as a motive in their 

offenses.206

Adults with substance 

abuse disorders are 2.7 

times more likely to 

report abusive behavior, 

and 4.2 times more likely 

to report neglectful 

beharvior towards 

children.
53 Speaking Out Against Drug Legalization

Figure 1 Percent of Prison and Jail Inmates Who Committed Offense to Get Money for Drugs207

• For experts in the field of crime, violence, and drug abuse, there is no doubt that there is a 

connection between drug use and violence. As Joseph A. Califano, Jr., of the National Center 

on Addiction and Substance Abuse at Columbia University and the former Secretary of Health, 

Education, and Welfare stated, “Drugs like marijuana, heroin and cocaine are not dangerous 

because they are illegal; they are illegal because they are dangerous.”208 Drug use is not a 

victimless crime. If you really want to hear the truth about drug use and subsequent behavior, or 

the arguments of legalizing a specific drug, go talk with a victim of a drug-related crime.

2002 2004 2004

Total 16.4 % 16.6 % 18.4 %

Violent 8.0 9.8 14.8 

Property 26.9 30.3 10.6 

Drugs 24.8 26.4 25.3 

Public-order 5.2 6.9 6.8

Local Jail 

Inmates

State 

Prisoners

Federal 

Prisoners
54 Speaking Out Against Drug Legalization

• The “legalization lobby” claims that drugs are no more dangerous than alcohol, and no more 

harmful than smoking cigarettes. However, drunk driving remains one of the primary ways 

Americans die. Do we want our bus drivers, nurses, and airline pilots to be able to take drugs 

one evening, and operate freely at work the next day? Do we want to add to the destruction 

by making “drugged driving” vastly more common than it already is?

• Drugs are far more addictive than alcohol. According to Dr. Mitchell Rosenthal, director of 

Phoenix House, only 10 percent of drinkers become alcoholics, while up to 75 percent of 

regular illicit drug users become addicted. 

• Even accepting, for the sake of argument, the legalization analogy, alcohol use in the United 

States has taken a tremendous physical and social toll on Americans. Legalization proponents 

would have the problems multiplied by greatly adding to the class of drug-addicted Americans. 

To put it in perspective, less than 8 percent of the population uses illegal drugs of any kind 

regulary. That’s 20 million users of all illegal drugs, compared to 71 million tobacco users, and 

over 129 million alcohol users.209 

• According to the Centers for Disease Control and Prevention, during 2005 there were 

33,541 drug-induced deaths; and 21,634 alcohol-induced deaths (excluding accidents and 

homicides). 210 We all pay a high price for drug use – not only in lives lost, but in social 

costs. The Office of National Drug Control Policy estimates that for the year 2002, societal 

costs associated with drug use in the United States were $180 billion.211 Legalization of drugs 

would compound the problems in the already overburdened health care, social service, and 

criminal justice systems. And it would demand a staggering new tax burden on the public to 

pay for the costs. 

• Drug-impaired driving is also a problem. In 2007, nearly 10 million people reported driving 

under the influence of illicit drugs in the past year. 213 According to the National Highway 

Transportation Safety Administration, drugs -- often in combination with alcohol are used by 

approximately 10 to 22 percent of drivers involved in car accidents.214

• If drugs were widely available under legalization, they would no doubt be easily obtained by 

young people, despite age restrictions. According to the 2008 National Survey on Drug Use 

and Health, more than half (129 million) of Americans aged 12 or older were current drinkers, 

while an estimated 20 million or (8 percent) were current illicit drug users.215

Fact 8: Alcohol and tobacco have caused significant health,

 social, and crime problems in this country, and

 legalized drugs would only make the situation worse.
55 Speaking Out Against Drug Legalization

• If private companies were to handle distribution—as is done with alcohol—the American 

consumer could expect a blizzard of profit-driven advertising encouraging drug use, just as 

we now face with alcohol advertising. If the government were to distribute drugs, either the 

taxpayer would have to pay for its production and distribution, or the government would be 

forced to market the drugs to earn the funds necessary to stay in business. Furthermore, the very 

act of official government distribution of drugs would send the wrong message that drug use is 

safe. 

Prohibition

• Claims that prohibition didn’t work overlook the fact that most historians agree that national 

prohibition succeeded both in lowering consumption and in retaining political support until the 

onset of the Great Depression radically changed voters priorities. Repeal resulted more from 

this contextual shift than from characteristics of prohibition itself.

• One favorite argument of those who claim prohibition didn’t work point to the growth of 

organized crime. Although organized crime flourished under its sway, historians trace the 

beginnings of organized crime in the United States to the mid to late-1800s. Organized crime 

existed before prohibition was enacted, and persisted long after its repeal. 

• The laws developed after 1919 by the 18th Amendment and the Volstead Act, which charged the 

Treasury Department with enforcement of the new restrictions, was far from all-embracing. The 

amendment prohibited the commercial manufacture and distribution of alcoholic beverages; it 

did not prohibit use, nor production for one’s own consumption. 

• Alcohol consumption declined dramatically during prohibition. Cirrhosis death rates for men 

were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals for 

alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

• Arrests for public drunkenness and disorderly conduct declined 50 percent between 1916 and 

1922. For the population as a whole, the best estimates are that consumption of alcohol declined 

by 30 percent to 50 percent. Violent crime did not increase dramatically during prohibition. 

Homicide rates rose dramatically from 1900 to 1910, but remained roughly constant during 

prohibition’s 14 year rule. Organized crime may have become more visible and lurid during 

prohibition, but it existed before and after.

• Following the repeal of prohibition, alcohol consumption increased. Prohibition did not end 

alcohol use, but it did succeeded in reducing, by one-third, the consumption of a product that 

had wide historical and popular sanction.
56 Speaking Out Against Drug Legalization

• It’s wrong to draw a parallel between alcohol prohibition in the 1920’s and the current status 

of marijuana, heroin, and other dangerous drugs. The 18th Amendment took a popular activity, 

alcohol sales, which was widely tolerated, and made it illegal. It did so after more than a century 

of growing concern over the effects that excessive alcohol consumption was having on society. 

In contrast, the use of marijuana, heroin, or other controlled drugs has never been a widely 

accepted activity. 

• In addition, the idealistic goals of prohibition went beyond what many initial supporters of 

prohibition thought they were supporting, and lacked flexibility that would allow policy 

adjustments. In contrast, our nation’s current drug laws are built upon the Controlled Substances 

Act, which contains a series of increasingly restrictive schedules that allow for the appropriate 

regulation of various drugs, as well as a mechanism to move substances from one regulatory 

status to another. 

• A democratic society may decide that recreational drinking is worth the price in traffic fatalities 

and other consequences. But the common claim that laws backed by morally motivated political 

movements cannot reduce drug use is wrong.

• Not only are the facts of prohibition misunderstood, but the lessons are misapplied to the current 

situation. Legalizing drug use will launch us into a new drug epidemic. 

• The real lesson of prohibition is that the society can make a dent in the consumption of drugs 

through laws. There is a price to be paid for such restrictions, of course. But for drugs such as 

heroin and cocaine, which are dangerous but currently largely unpopular, that price is small 

relative to the benefits.

• There is no uniform drug policy in Europe. Some countries have liberalized their laws, while 

others have instituted strict drug control policies, which means that the so-called “European 

Model” is a misnomer. Like America, the various countries of Europe are looking for new ways 

to combat the worldwide problem of drug abuse. 
57 Speaking Out Against Drug Legalization

• Over the past decade, European drug policy has gone through some dramatic changes toward 

greater liberalization. The Netherlands, considered to have led the way in the liberalization 

of drug policy, is only one of a number of Western European countries to relax penalties for 

marijuana possession. Now several European nations are looking to relax penalties on all 

drugs—including cocaine and heroin—as Portugal did in July 2001, when minor possession of 

all drugs was decriminalized (not legalized).

• In recent years the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has 

reported a tendency among European countries to make a stronger distinction in their drug laws 

between those who use drugs and those who sell or traffic drugs. This distinction is reflected in 

the reduction of penalties for drug use in some countries, though others have not changed or 

increased penalties.216 

• EMCDDA reports that recently, the penalties for drug offenses in Europe have generally increased. 

“Most of the reported drug law offenses are related to use and possession for use rather than 

supply, and whereas offenses related to supply have increased by 12 percent, those related to 

possession have increased by over 50 percent.” Cannabis continues to be the drug most often 

associated with drug law offenses in Europe.217

• While cannabis remains the number one drug of choice in Europe, and cocaine use on the rise, 

heroin remains the most serious public health issue and accounts for a large proportion of the 

overall health and social costs associated with drug use.218 Increased cocaine and heroin use are 

not the policy outcomes of an effective drug strategy. 

• The United Kingdom has also experimented with the relaxation of drug laws. Until the mid-1960s, 

British physicians were allowed to prescribe heroin to certain classes of addicts. According to 

political scientist James Q. Wilson, “a youthful drug culture emerged with a demand for drugs 

far different from that of the older addicts.” Many addicts chose to boycott the program and 

continued to get their heroin from illicit drug distributors. The British Government’s experiment 

with controlled heroin distribution, says Wilson, resulted in, at a minimum, a 30-fold increase in 

the number of addicts in 10 years.

• A major newspaper in England, The Independent, reversed its very public stance in support of 

marijuana. After a pro-cannabis editorial appeared in 1997, 16,000 people marched on London’s 

Hyde Park. The editorial and a subsequent march were credited with forcing the government to 

downgrade the legal status of cannabis to Class C. However, an editorial in the March 18, 2007 

issue, titled “Cannabis: An Apology,” states that the paper is reversing its decision. “In 1997, when 

Fact 9: Europe’s more liberal drug policies are not

 the right model for America. 
58 Speaking Out Against Drug Legalization

this paper called for decriminalization, 1,600 people were being treated for cannabis addiction. 

Today, the number is 22,000.” Concerns such as the record number of teenagers requiring drug 

treatment as a result of smoking ‘skunk’ (a highly potent cannabis strain), and the growing proof 

that skunk causes mental illnesses were cited among the reasons for this reversal.227

• In a statement to the press, British Home Secretary Jacqui Smith announced on May 8, 2008, 

that cannabis is being reclassified back to a Class B drug, sending a strong message that the drug 

is harmful. Addressing the House of Commons, Secretary Smith cited the need to update public 

policies to match recent scientific evidence about the serious harms of marijuana use, “the 

enforcement response must reflect the danger that the drug poses to individuals, and in turn, to 

communities.”228 This reclassification went into effect in January, 2009.229

• Liberalization of marijuana laws in Switzerland has likewise produced damaging results. After 

liberalization, Switzerland became a magnet for drug users from many other countries. In 1987, 

Zurich permitted drug use and sales in a part of Platzpitz, dubbed “Needle Park.” By 1992, the 

number of regular drug users at the park reportedly swelled from a few hundred at the outset in 

1987 to about 20,000. The area around the park became crime-ridden, forcing closure of the 

park. The experiment has since been terminated.230

• High levels of alcohol and drug consumption by young people in Europe is leading to an increase 

in unsafe sexual practices and a consequent rise in sexually-transmitted disease infections 

according to a recently published study by the European Institute of Studies on Prevention.231

• According to the latest report on the state of the drug problem in Europe published by the 

European Monitoring Committee on Drugs and Drug Addiction, cocaine use is continuing to 

rise. The report highlights the need for vigilance in response to changes in the opiate problem. 

It records that there are between 1.3 and 1.7 million problem opiate (mainly heroin) users 

throughout the EU and Norway, and points out that heroin accounts for Europe’s largest drugrelated health and social costs.232 The United States has dealt with increases in cocaine use 

and reversed the trend. Rather than point to Europe’s more liberal drug policies as an example 

for United States drug policy, perhaps there are effective lessons that Europe could learn from 

America’s experience.

The Netherlands Experience

• The Netherlands has led Europe in the liberalization of drug policy. “Coffee shops” began to 

emerge throughout the Netherlands in 1976, offering marijuana products for sale. Possession 

and sale of marijuana are not legal, but coffee shops are permitted to operate and sell marijuana 

under certain restrictions, including a limit of no more than 5 grams sold to a person at any one 

time, no alcohol or hard drugs, no minors, and no advertising. In the Netherlands, it is illegal 

to sell or possess marijuana products. So coffee shop operators must purchase their marijuana 

products from illegal drug trafficking organizations. 
59 Speaking Out Against Drug Legalization

o Many Dutch communities are struggling with how to address the increased crime 

and other negative consequences associated with their drug policies. For example, 

according to a New York Times article, “The mayor (of Maastricht) wants to move 

most of the city’s 16 licensed cannabis clubs to the edge of town, preferably close to 

the border (with Belgium and Germany)...Mayor Gerd Leers is reacting to growing 

concerns among residents who “complain of traffic problems, petty crime, loitering 

and public urination. There have been shootings between Balkan gangs. Maastricht’s 

small police force...is already spending one-third of its time on drug-related 

problems.” Cannabis clubs have drawn “pushers of hard drugs from Amsterdam, 

who often harass people on the streets.” The clubs have also attracted people looking 

to buy marijuana in quantity. Piet Tans, a police spokesman also stated that “people 

who come from far away don’t just come for the five grams you can buy legally over 

the counter...they think pounds and kilos; they go to the dealers who operate in the 

shadows.”219

o Moving the clubs did not prove to be an effective strategy to deal with the problem. 

As of January 1, 2010, coffee shops in the province of Limburg (which includes 

Maastricht) will be accessible only to registered members. Justice Minister Ernst 

Hirsch Ballin also stated that “it would become easier to keep minors out of the 

coffee shops.”220

o The growing use of marijuana is responsible for more than increased crime. It has 

widespread social implications as well. The head of Holland’s best-known drug 

abuse rehabilitation center has described what the new drug culture has created: 

The strong form of marijuana that most of the young people smoke, he says, 

produces “...a chronically passive individual—someone who is lazy, who doesn’t 

want to take initiatives, doesn’t want to be active—the kid who’d prefer to lie in bed 

with a joint in the morning rather than getting up and doing something.”221

o Recognizing that the government needs to take firm action to deal with the increasing 

levels of addiction, in April 2001 the Dutch government established the Penal Care 

Facility for Addicts. Like American Drug Treatment Courts, this facility is designed 

to detain and treat addicts (of any drug) who repeatedly commit crimes and have 

failed voluntary treatment facilities. Offenders may be held in this facility for up to 

two years, during which time they will go through a three-phase program. The first 

phase focuses on detoxification, while the second and third phases focus on training 

for social reintegration. 
60 Speaking Out Against Drug Legalization

o Due to international pressure on permissive Dutch cannabis policy and domestic 

complaints over the spread of marijuana “coffee shops,” the Netherlands has 

reconsidered its legalization measures. After marijuana became normalized, 

consumption nearly tripled – from 15 percent to 44 percent – among 18 to 20 yearold Dutch youth.222 As a result of stricter local government policies, the number of 

cannabis “coffeehouses” in the Netherlands was reduced – from 1,179 in 1997 to 

737 in 2004, a 37-percent decrease in seven years.223

o On January 2, 2007, the majority of the City Council in Amsterdam voted in favor of 

introducing a city-wide ban on smoking marijuana in public in areas where young 

people smoking joints had been a public nuisance. Their decision was based upon 

the success of the experimental ban in the city of DeBaarsjes.224

o “Contrary to what is often claimed by supporters of the tolerant Dutch drug policy, 

cannabis usage by young people in the Netherlands is not lower, but actually higher 

than average in Europe,” according to the 2007 European School Survey on Alcohol 

and Other Drugs (ESPAD). “Over one-quarter (28 percent) of Dutch youngsters aged 

15 and 16 surveyed said they have used cannabis sometime in their life, compared 

with an average of 19 percent in Europe. Current cannabis usage (at least once in 

the month prior to the survey) is more than double the European average in the 

Netherlands (15 percent versus 7 percent).”225

o An article published in the Netherlands in April 2009 summarizes the challenge now 

faced by the Dutch as a result of their drug policies. “The Netherlands has risen in 

the ranking order of 35 European countries from number 12 in 2003 to number five 

on recent cannabis usage. . . .Dutch youngsters, possibly due to the liberal climate, 

widely believe that cannabis is innocent and the proportion of school children that 

think regular cannabis usage involves big risks is the lowest in the Netherlands (50 

percent) of all countries surveyed.” 226
61 Speaking Out Against Drug Legalization

• There is a popular belief that America’s prisons are filling up with drug users arrested for 

simple possession of marijuana. This is a myth. In reality, a vast majority of inmates in state 

and federal prison for marijuana have been found guilty of much more than simple possession, 

and many of those serving time for marijuana possession pled down to possession in order to 

avoid prosecution on much more serious charges. 

• The Bureau of Justice Statistics (BJS) divided drug offenders in state prison systems into two 

general categories: trafficking offenses, which accounted for 70 percent of drug law violators, 

and possession offenses, accounting for about 27 percent.234 Out of the total number of 

state inmates doing time for any drug offense, 83 percent had a prior criminal history. In 

other words, the large majority were not first time offenders. They were people who had 

committed crimes in the past, and nearly two-thirds of them (62 percent) had multiple prior 

convictions.235 Marijuana accounted for just 13 percent of all state drug offenders.236

• An examination of the data from the broader perspective of the entire prison population, 

the data shows that in 1997 marijuana was involved in the conviction of only 2.7 percent 

of all state inmates. About 1.6 percent of the state prison populations were held for offenses 

involving just marijuana, while just 0.7 percent were incarcerated with marijuana possession 

as the only charge.237

 Figure 2 Inmates in state prison for marijuana offenses (1997)238 

• If you exclude prisoners with criminal histories, only 0.3 percent of all state inmates were first 

time marijuana possession offenders (see Figure 2). This statistic refers to possession of any 

amount—even as much as a hundred pounds or more—not just “personal use” quantities. 

Of the more than 1.2 million people serving time in state prisons across America, only 3,600 

individuals were sentenced on a first offense for possession of marijuana. Again, this figure 

includes possession of any amount.239

Fact 10: Most non-violent drug users get treatment, not jail time. 

Drug Possession Offenses 5.6% of all state inmates

First-time drug offenders 3.6% of all state inmates

Offenses involving marijuana 2.7% of all state inmates

Prisoners held for marijuana only 1.6% of all state inmates

Prisoners held for marijuana possession only 0.7% of all state inmates

First time offenders held only for 

marijuana possession (any amount) 0.3% of all state inmates

 
62 Speaking Out Against Drug Legalization

• The numbers at the federal level tell a similar story. Out of all drug defendants sentenced in 

federal court for marijuana crimes in 2001, the overwhelming majority were convicted for 

trafficking. Only 2.3 percent (186 people) received sentences for simple possession. Of the 

174 for whom sentencing is known, only 63 actually spent time behind bars.240

• In the same 1997 review that looked at state prisoners, BJS found that drug possession 

offenders made up 18.3 percent of the federal inmate population. BJS researchers calculated 

that 11.9 percent of all federal prisoners in 1997 were serving time on charges that included 

some kind of marijuana violation, and that 9.3 percent were being held only for marijuana 

offenses. 

• If traffickers and repeat offenders were removed from the mix, these numbers drop even 

further. Only 2.2 percent of federal inmates in 1997 had been sentenced just on charges of 

marijuana possession and less than half of that group—only one percent—were first time 

offenders.241

• Current data from the United States Sentencing Commission (USSC) reinforces the BJS 

findings. In 2008, according to the USSC, 25,337 people were sentenced in federal court 

for drug crimes under six offense categories (see Figure 3). Marijuana accounted for 6,337 

and (25.0 percent), and of the 6,337 people sentenced, only 99 people, or 1.6 percent, were 

sentenced for “simple possession” of marijuana. 242

• In 1998, Columbia University’s National Center on Addiction and Substance Abuse (CASA) 

published the results of a three-year study into drug and alcohol abuse/addiction among 

inmates in federal and state prisons and local jails. In Behind Bars: Substance Abuse and 

America’s Prison Population, which used information collected by BJS and other sources, 

CASA stated that, based on the available data, “it appears that few inmates could be in prison 

or jail solely for possession of small amounts of marijuana and the number is likely so small 

that it would have little or no impact on overcrowding or the vast gap between the need for 

treatment and training and available slots.”243

Policy Shift to Treatment

• For those who end up hooked on drugs, there are also programs, like drug courts, that offer 

non-violent users the option of seeking treatment and staying out of either federal or state 

prisons. Drug court programs provide court supervision, unlike voluntary treatment centers. 

These courts are given a special responsibility to handle cases involving drug-addicted 

offenders through an extensive supervision and treatment program. 
63 Speaking Out Against Drug Legalization

• As an alternative to less effective interventions, drug courts quickly identify substanceabusing offenders, and place them under strict court monitoring and community supervision, 

coupled with effective, long-term treatment services. Drug courts represent the coordinated 

efforts of the judiciary, prosecution, defense, probation, law enforcement, mental health, 

social service, and treatment communities to actively and forcefully intervene and break the 

cycle of substance abuse, addiction, and crime. 245

• Drug court programs use the varied experiences and skills of a wide variety of law 

enforcement and treatment professionals: judges, prosecutors, defense counsels, substance 

abuse treatment specialists, probation officers, law enforcement and correctional personnel, 

educational and vocational experts, community leaders, and others — all focused on one 

goal: to help cure addicts of their addiction, and to keep them cured.

• Nationwide, 75 percent of drug court graduates remain arrest-free at least two years after 

leaving the program.246

• A 2000 Vera Institute of Justice report concluded that “the body of literature on recidivism 

is now strong enough, despite lingering methodological weaknesses, to conclude that 

completing a drug court program reduces the likelihood of future arrest.”247

• In a February 2005 report, the Government Accountability Office concluded that adult drug 

court programs substantially reduce crime by lowering re-arrest and conviction rates among 

drug court graduates well after program’s completion, providing overall greater cost/benefits 

for the drug court participants and graduates than comparison group members. 

• Drug courts now exist in a growing number of jurisdictions: e.g., Australia and Canada 

(1999); Ireland (2000); Bermuda, Brazil, Cayman Islands, Jamaica, and Scotland (2001); 

New Zealand, Mauritius, England, Wales, Northern Ireland (2002). 

Communication 

Facility

Rent/Manage

Drug Establishment

Simple 

Possesion

Contiuing Criminal 

Enterprise

Protected 

Locations

Drug Trafficing

DRUG TYPE TOTAL N % N % N % N % N % N %

Total 25,337 24,605 97.1% 348 1.4% 18 0.1% 0 0.0% 88 0.3% 2 1.1%

Powder Cocaine 5,889 5,769 98.0% 68 1.2% 6 0.1% 0 0.0% 14 0.2% 3 0.5%

Crack Cocaine 6,168 5,913 95.9% 188 3.0% 1 0.0% 0 0.0% 38 0.6% 28 0.5%

Heroin 1,476 1,436 97.3% 26 1.8% 1 0.1% 0 0.0% 1 0.1% 12 0.8%

Marijuana 6,337 6,196 97.8% 27 0.4% 2 0.0% 0 0.0% 13 0.2% 99 1.6%

Methamphetamine 4,347 4,238 97.5% 24 0.6% 6 0.1% 0 0.0% 18 0.4% 61 1.4%

Other 1,120 1,053 94.0% 15 1.3% 2 0.2% 0 0.0% 4 0.4% 46 4.1%

Figure 3 Primary Drug Type of Offenders Sentenced Under Each Drug Guideline (FY 2008)244 
64 Speaking Out Against Drug Legalization

• Drug courts reflect a transformation of the way courts have traditionally dealt with drugabusing offender criminal casework. The traditional process was adversarial, emphasized 

the efficient but backward-looking adjudication of claims, rights and responsibilities, and 

involved few participants and stakeholders. The transformed process practiced in drug courts 

is collaborative, needs-based, and emphasizes forward-looking, post-adjudication problemsolving, and dispute avoidance, with a wide range of participants and stakeholders. It is 

aimed at efficient case processing and effective case outcomes to stop criminal recidivism 

and drug abuse. 

• When drug abuse prevention fails, the public pays a high price, particularly if abusers commit 

serious offences under the influence of drugs (e.g., domestic violence), or commit crimes to 

help pay for their habit (e.g., burglary, theft).248

• The largest statewide study on drug courts to date was released in 2003 by the Center for 

Court Innovation (CCI). The study analyzed the impact of New York State’s Drug Court system. 

The study found that the re-conviction rate among 2,135 defendants who participated in six 

of the state’s drug courts was, on average, sinificanatly lower (13 percent to 47 percent) over 

three years than the for the same types of offenders who did not enter the drug court. The 

study also concluded that drug court cases reached initial disposition more quickly than 

conventional court cases and that the statewide drug court retention rate was approximately 

65 percent, exceeding the national average of 60 percent.249

• Nonviolent drug offenders in drug courts in St. Louis, Missouri who were placed in treatment 

instead of prison generally earned more money and took less from the welfare system than 

those who successfully completed probation. The study compared the 219 individuals who 

were the program’s first graduates in 2001 with 219 people who pleaded guilty to drug 

charges during the same period and completed probation. For each drug court graduate, the 

cost to taxpayers was $7,793, which was $1,449 more than those on probation. However, 

during the two years following program completion, each graduate cost the city $2,615 less 

than those on probation. The savings were realized in higher wages and related taxes paid, 

as well as lower costs for health care and mental health services.250

• Drug courts save taxpayers money. The Urban Institute estimates a favorable cost/benefit 

ration as high as $3.36 for every $1.00 invested in treating drug-addicted offenders in drug 

courts. 251
65 Speaking Out Against Drug Legalization

 1. “National Drug Threat Assessment,” December 2009, page III.

 2. Marin Institute Fact Sheet, “The Costs of Alcohol,” June 24, 2008.l

 3. As of April 1, 2009.

 4. See: http://www.CDC.gov/tobacco.

 5. Heron, et al, “Deaths: Final Data for 2006,” U.S. Dept of Health and Human Services, Centers for 

Disease Control and Prevention, National Vital Statistics Reports, Vol. 57, Number 14, April 2009, DHHS 

Pub No (PAS) 2009-1120 (Tables 21 and 22), see: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf. 

 6. INTRAVAL Bureau for Research and Consistency, “Coffeeshops in the Netherlands 2004,” Dutch 

Ministry of Justice, June 2005, http://www.intraval.nl/en/b/b45_html. 

 7. See: 21 U.S.C. § 881. 

 8. 21 U.S.C. § 811(h).

 9. See: McCullough v. Maryland, 17 U.S. 316 (1819); see also U.S. v. Cal. State Bd. of Equalization, 650 

F.2d 1127 (9th Cir. 1981), 456 U.S. 901 (1982), aff’d, 456 U.S. 985 (1982), reh’g denied.

 10. See, e g.: U.S. v. $20,193.39 U.S. Currency, 16 F.3d 344, 346 (9th Cir. 1994).

 11. See, e.g.: 18 U.S.C. § 983(d)(3) and 21 U.S.C. § 853(n)(6)(B). 

 12. 21 U.S.C. § 812(c), Schedule I(c)(10). 

 13. See 66 Fed. Reg. 20038, 20050-52 (2001) (DEA denial of petition to remove marijuana from schedule 

I based on FDA scientific and medical evaluation), pet. for review dismissed, Gettman v. DEA, 290 F.3d 430 

(D.C. Cir. 2002).

 14. U.S. v. Oakland Cannabis Buyers’ Cooperative 532 U.S. 483, 491, 494 & n.7 (2001). 

 15. 532 U.S. 483 (2001).

 16. Gonzales v. Raich, 545 U.S. 1 (2005).

 17. The main drug control treaties currently in force to which the United States is signatory are: The Single 

Convention on Narcotic Drugs, 1961, 18 U.S.T. 1407; The Convention on Psychotropic Substances, 1971, 

32 U.S.T. 543; and the Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 

1988, 28 I.LM. 493. Among the United States obligations pursuant to these treaties are: (i) To enact and 

carry out legislation disallowing the use of Schedule I drugs outside of authorized research; (ii) To make it a 

criminal offense, subject to imprisonment, to traffic in illicit drugs or to aid and abet such trafficking; and (iii) 

To prohibit the cultivation of marijuana except by persons licensed by, and under the direct supervision of, 

the federal Government.

 18. U.N. International Narcotics Control Board, United Nations, “Report 1998” at par. 259, U.N. Sales 

No. E.99.XI.1, http://www.incb.org/incb/en/annual_report_1998.html. 

 19. 545 U.S. at 27-28.

 20. 545 U.S. at 22 

 21. See 21 U.S.C. § 881. 

 22. 21 U.S.C. § 811(h).

 23. See: McCullough v. Maryland, 17 U.S. 316 (1819); see also U.S. v. Cal. State Bd. of Equalization, 650 

F.2d 1127 (9th Cir. 1981), 456 U.S. 901 (1982), affirmed, 456 U.S. 985 (1982), registration denied.

 24. See, e g., U.S. v. $20,193.39 U.S. Currency, 16 F.3d 344, 346 (9th Cir. 1994).

 25. See, e.g., 18 U.S.C. § 983(d)(3) and 21 U.S.C. § 853(n)(6)(B). 

 26. Moore, Mark H., “Actually, Prohibition Was a Success,” Harvard’s Kennedy School of Government, 

October 16, 1989.

Notes
66 Speaking Out Against Drug Legalization

 27. National Drug Control Strategy, Office of National Drug Control Policy, “2009 Annual Report,” 

January 2009, page 1; and National Institute for Drug Abuse and the University of Michigan, Monitoring the 

Future, December 11, 2008.

 28. Johnson, L.D., O’Malley, P.M., Bachman, J.G., and Schulenberg, J.E. “Teen marijuana use tilts up, 

while some drugs decline in use.” University of Michigan Press Release, Monitoring the Future 2009, 

www.monitoringthefuture.org.

 29. National Drug Control Strategy, Office of National Drug Control Policy, “2009 Annual Report,” 

January 2009, page 1. 

 30. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration,Office of Applied Studies, “Results from the 2008 National Survey on Drug Use and Health, 

National Findings,” September 2009, page 1.

 31. DEA STRIDE (System to Retrieve Information on Drug Evidence) data, January 2009.

 32. Serious Organised Crime Agency, “Annual Report 2008/09,” May 2009, page 40.

 33. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration, Office of Applied Studies, “Results from the 2007 National Survey on Drug Use and Health,” 

September 2008, page 1.

 34. National Drug Control Strategy, Office of National Drug Control Policy, “2009 Annual Report,” 

January 2009, page 2.

 35. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration,Office of Applied Studies, “Results from the 2008 National Survey on Drug Use and Health, 

National Findings,” September 2008, page 1.

 36. Ibid. Page 1.

 37. ”CORK Bibliography: Adolescents-Initiation of Alcohol and Drug Use,” December 2008, www.

projectcork.org/ bibliographies/data/Bibliography_Adolescents_Initiation%20of%20Alcohol_and_Drug_Use.

html. Last accessed September 22, 2009.

 38. National Drug Control Strategy, Office of National Drug Control Policy, “2009 Annual Report,” 

January 2009.

 39. National Institute on Drug Abuse, “Principles of Drug Addiction Treatment, A Research-Based Guide,” 

Secon Edition, April 2009, page 13.

 40. Roman et al, the Urban Institute and Caliber, “Recidivism Rates for Drug Court Graduates: Nationally 

Based Estimate – Final Report,” Washington D.C., 2003.

 41. Fluellen, R. and Trone, J, Vera Institute of Justice, “Issues in Brief: Do Drug Courts Save Jail and Prison 

Beds?” New York, NY, May 2000.

 42. Rempel, M., Fox-Kralstein, D., Cissner, A., Cohoen, R., Labriola, M., Farole, D., Bader, A., and 

Magnani, M., “The New York State Adult Drug Court Evaluation: Policies, Participants, and Impacts,” 2003.

 43. Institute for Applied Research, “A Cost-Benefit Analysis of the Saint Louis City Adult Felony Drug 

Court,” St. Louis, MO, 2004.

 44. The Urban Institute, “To Treat or Not to Treat: Evidence on the Prospects of Expanding treatment for 

Drug-Involved Offenders,” 2008.

 45. Pacula, R., Grossman, M., Chaloupka, F., O’Malley, P., Johnston, L., and Farrelly, M., “Marijuana and 

Youth,” October 2000.

 46. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration, Office of Applied Studies, “Results from the 2008 National Survey on Drug Use and Health: 

National Findings,” September 2009.

 47. Pacula, Rosalie Liccardo, National Bureau of Economic Research, “Marijuana Use and Policy: What 

We Know and Have Yet to Learn,” Winter 2005, http://www.nber.org/reporter/winter05/pacula.html.

 48. Department of Health and Human Services, Substance Abuse and Mental Health Services .Health, 

National Findings,” September 2009.
67 Speaking Out Against Drug Legalization

 49. In addition to the CSA and FDCA, marketing products in such a manner raises potential trademark 

infringement issues. Letter of response to the Honorable John Conyers, Jr., Chairman of the Committee 

on the Judiciary, U.S. House of Representatives, on enforcement of federal laws with respect to marijuana 

traffickers in California, from Keith B. Nelson, Principal Deputy Assistant Attorney General, July 25, 2008. 

 50. Ibid.

 51. DEA press release, “Designer Cocaine-Candy Flavored Drug Seized in Undercover Investigation: 

Flavors Include Strawberry, Lemon, Coconut and Cinnamon.” See: http://webster/dea/pubs/states/

newsrel/sanfran031008.html, March 10, 2008. Also, DEA press release, “‘Pot Tarts’ and ‘Buddafingers’ 

Manufacturers Busted: DEA arrests 12, seizes marijuana-laced candy and soft drinks in San Francisco Bay 

Area,”see http://webster/dea/pubs/states/newsrel/sanfran031606.html, March 16, 2006.

 52. See: http://www.justthinktwice.com/hot/cheese.cfm.

 53. “Teen Methamphetamine Use, Cigarette Smoking at Lowest Levels in NIIDA’s 2009 Monitoring the 

Future Survey,” Press Release, National Institutes of Health, National Institute on Drug Abuse, December 14, 

2009 p 2. 

 54. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

“Unintentional Poisoning Deaths – United States, 1999-2004,” released February 9, 2007, 56(05); 93-96, 

see: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5605a1.htm.

 55. Ibid.

 56. Heron et al, “Deaths: Final Data for 2006,” U.S. Dept of Health and Human Services, Centers for 

Disease Control and Prevention, National Vital Statistics Reports, Vol. 57, Number 14, April 2009, DHHS 

Pub No (PAS) 2009-1120 (Tables 21 and 22), see: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf. 

 57. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration, 

Office of Applied Studies, “Results from the 2006 National Survey on Drug Use and Health: National 

Findings,” September 2007, pages 2-3.

 58. U.S. Department of Health and Human Services, National Institutes of Health, National Institute on 

Drug Abuse, “Research Report - Cocaine Abuse and Addiction,” www.nida.nih/gov/researchreports/cocaine/

cocaine.html. 

 59. Department of Justice, Drug Enforcement Administration, Office of Diversion Control, www.

deadiversion.usdoj.gov/drugs_concern/cocaine.htm. 

 60. U.S. Department of Health and Human Services, National Institutes of Health, National Institute on 

Drug Abuse, “Research Report - Cocaine Abuse and Addiction.” www.nida.nih/gov/researchreports/cocaine/

cocaine.html. 

 61. Ibid.

 62. Ibid.

 63. Ibid.

 64. Ibid.

 65. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration, Office of Applied Studies, “Results from the 2007 National Survey on Drug Use and Health: 

National Findings,” September 2009.

 66. Johnston, L.D., O’Malley, P. M., Bachman, J. G., and Schulenberg, J. E., Unversity of Michigan, 

December 14, 2009, www.monitoringthefuture.org. “Teen marijuana use tilts up, while some drugs decline.” 

 67. A drug-related Emergency Department (ED) visit is any ED visit related to recent drug use. This is 

the definition of a DAWN case effective January 1, 2003. To be a DAWN case, a drug needs only to be 

implicated in the visit; the drug does not have to have caused the visit. One patient may make repeated 

visits to an ED or to several EDs, thus producing a number of visits. The number of unique patients involved 

in the reported drug-related ED visits cannot be estimated, because no direct patient identifiers are collected 

by DAWN. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration, “Drug Abuse Warning Network, 2006: National Estimates of Drug-Related Emergency 

Department Visits,” Appendix B, Glossary of Terms, August 2008.
68 Speaking Out Against Drug Legalization

 68. National Institutes of Health, National Institute on Drug Abuse, “Research Report: Heroin Abuse and 

Addiction,” May 2005. 

 69. Department of Justice, Drug Enforcement Administration, “Drugs of Abuse,” 2005.

 70. National Institutes of Health, National Institute on Drug Abuse, “Research Report: Heroin Abuse and 

Addiction,” May 2005. 

 71. Partnership for a Drug-Free America, Heroin Addiction, Effects of Heroin, Heroin Facts, 

http://www.drugfree.org. 

 72. National Institutes of Health, National Institute on Drug Abuse, “InfoFacts: Heroin,” May 2006.

 73. Ibid.

 74. Johnston, L.D., O’Malley, P. M., Bachman, J. G., and Schulenberg, J. E., Unversity of Michigan, 

December 14, 2009, www.monitoringthefuture.org. “Teen marijuana use tilts up, while some drugs decline. 

U.S. Department of Health and Human Services, National Institutes of Health, National Institute for Drug 

Abuse.

 75. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration, 

“Results From the 2008 National Survey on Drug Use and Health: National Findings,” September 2009. 

 76. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration, 

“Drug Abuse Warning Network, 2006: National Estimates of Drug-Related Emergency Department Visits,” 

August 2008.

 77. “Marijuana and Heart Attacks,” Washington Post, 3 March 2000. 

 78. “One cannabis joint as bad as five cigarettes,” Reuters, 31 July 2007. See: http://www.reuters.com/

article/healthNews/idUSL3173105820070731. 

 79. Office of National Drug Control Policy press release, “ Increased Potency of Smoked Marijuana May 

Be Responsible for Serious Mental Health Consequences in Teens,” June 12, 2008, and “New Report Finds 

Highest Levels of THC in U.S. Marijuana to Date,” May 14, 2009. 

 80. I.B. Adams and B.R. Martin, “Cannabis Pharmacology and Toxicology in Animals and Humans,” 

Addiction Journal, 91: 1585-1614, 1996.

 81. U.S. Department of Health and Human Services, National Institutes of Health, National Institute on 

Drug Abuse, “Smoking Any Substance Raises Risk of Lung Infections,” NIDA Notes, Volume 12, Number 1, 

January/February 1997.

 82. Tetrault, Jeannette M., MD, et al, “Effects of Marijuana Smoking on Pulmonary Function Respiratory 

Complications: A Systematic Review,” Archives of Internal Medicine, 167:221-228, 2007; Science 

Daily, “Long-term Marijuana Smoking Leads to Respiratory Complaints, see: www.sceincedaily.com/

releases/200702/070212184119.htm. 

 83. “Recommendations Regarding the Use of Cannabis in Multiple Sclerosis,” National Clinical Advisory 

Board of the National Multiple Sclerosis Society, April 2, 2008. 

 84. U.S. Department of Health and Human Services, National Institutes of Health, National Institute on 

Drug Abuse, “Research Report: Marijuana Abuse,” July 2005.

 85. Ibid.

 86. Ibid.

 87. Ibid.

 88. U.S. Department of Health and Human Services, National Institutes of Mental Health, National 

Institute on Drug Abuse, “Research Report: Marijuana Abuse,” October 2001.

 89. Ibid.

 90. American Medical Association, “Policy H-95.952: Medical Marijuana.” See also American Medical 

Association, Featured Council on Scientific Affairs, “Medical Marijuana (A-01),” June 2001. In 2001, the 

AMA updated their policy regarding medical marijuana, reflecting the results of this study.
69 Speaking Out Against Drug Legalization

 91. American Cancer Society, “Experts: Pot Smoking is Not Best Choice to Treat Chemo Side-Effects,” May 

22, 2001. See: HTTP://www.cancer.org/docroot/NWS/content/update/NWS_1_1xU_Experts_Pot_Smoking_

Is_Not_Best_Choice_to_Teat_Chemo_Side_Effects.asp.

 92. American Academy of Pediatrics Committee on Substance Abuse and Committee on Adolescence 

Policy Statement, “Legalization of Marijuana: Potential Impact on Youth,” Pediatrics, Vol. 113, No. 6, June 

2004: 1825-1826. See also Joffe, Alain, MD, MPH, and Yancy, Samuel, MD, “Legalization of Marijuana 

Potential Impact on Youth,” Pediatrics, Vol. 113, No.6, June 2004. 

 93. “Recommendations Regarding the Use of Cannabis in Multiple Sclerosis,” National Clinical Advisory 

Board of the National Multiple Sclerosis Society, April 2, 2008.

 94. “Australia: Doc Group Lobbies for Tougher Western Australia Marijuana Laws, Cites Mental Health 

Threat,” The Western Australia, 24 May 2008. See: http://www.thewest.com/au/default.aspx?MenuID=158&

ContentID=74974.

 95. “Efforts to Counter the Trend Towards the Legalization of Drugs for Non-medical Use,” United Nations 

Economic and Social Council, 44th plenary meeting, 22 July 2003.

 96. International Narcotics Control Board press release, “INCB: U.S. Supreme Court Decision on Cannabis 

Upholds International Law,” Professor Hamid Ghodse, INCB President, 8 June 2005.

 97. “Doctors’ Fears at Cannabis Change,” BBC News, 21 January 2004.

 98. Manchester Online. “Doctors Support Drive Against Cannabis,” Manchester News, 21 January 2004,

 see: http://www.manchesteronline.co.uk/news/s/78/78826_doctors_support_drive_against_cannabis.html. 

 99. UK Home Office press release, “Government crackdown on cannabis,” 7 May 2008, see: http://press.

homeoffice.gov.uk/press-releases/government-crackdown-cannabis.

 100. Ibid.

 101. Ibid. 

 102. Goldschmidt, Lidush, Ph.D., et al, “Prenatal Marijuana Exposure and Intelligence Test Performance 

at Age 6,” Journal of the American Academy of Child & Adolescent Psychiatry, 47(3):254-263, March 2008. 

 103. “A Functional MRI Study of the Effects of Cannabis on the Brain.” Prof. Phillip McGuire, 2nd 

International Cannabis and Mental Health Conference, London, UK, May 1, 2007.

 104. UPI.com, Science News, “Study: Marijuana may Affect Neuron Firing,” November 29, 2006.

 105. Laucius, Joanne, “Journal Articles Link Marijuana to Schizophrenia,” August 28, 2006, 

see: www.Canada.com.

 106. “Memory, Speed of Thinking and Other Cognitive Abilities Get Worse Over Time With Marijuana 

Use, ” March 15, 2006, see: http://www.news-medical.net.

 107. “Drug Abuse: Drug Czar, Others Warn Parents that Teen Marijuana Use Can Lead to Depression,” 

Life Science Weekly, 31 May 2005.

 108 Kearney, Simon, “Cannabis is Worst Drug for Psychosis,” The Australian, 21 November 2005.

 109. Curtis, John, “Study Suggests Marijuana Induces Temporary Schizophrenia-Like Effects,” Yale 

Medicine, Fall/Winter 2004.

 110. “Neurotoxicology: Neurocognitive Effects of Chronic Marijuana Use Characterized,” Health & 

Medicine Week, 16 M ay 2005.

 111. Robin Murray, “Teenage Schizophrenia is the Issue, Not Legality,” Independent on Sunday, 18 March 

2007, see: www.independent.co.uk.

 112. Jonathan Owen, “UN Warns of Cannabis Dangers as it Backs ‘IoS’ Drugs ‘Apology’,” 

Independent on Sunday, 25 March 2007, see: www.independent.co.uk, and “Cannabis-related 

Schizophrenia Set to Rise, Say Researchers,” Science Daily, 26 March 2007, see: www.sciencedaily.com/

releases/2007/03/070324132832.htm.

 113. “Marijuana Use Affects Blood Flow in Brain Even After Abstinence,” Science Daily, 12 February 

2005, see: www.sciencedaily.com/releases/2005/02/050211084701.htm; Neurology, 8 February 2005, 

64.488-493.
70 Speaking Out Against Drug Legalization

 114. “Marijuana Use Takes Toll on Adolescent Brain Function, Research Finds,” Science Daily, 15 October 

2008, see: http://www.scienedaily.com/releases/2008/10/081014111156.htm.

 115. “Heavy Marijuana Use Linked to Gum Disease, Study Shows,” Science Daily, 6 February 2008, see: 

http://www.sciencedaily.com/releases/2008/02/080205161239.htm; “Cannabis Smoking and Periodontal 

Disease Among Young Adults,” The Journal of the American Medical Association, Vol. 299, No. 5, 6 February 

2008, see: http://www.jama.ama-assn.org/cgi/content/full/299/5/25. 

 116. “Marijuana Smokers Face Rapid Lung Destruction – As Much As 20 Years Ahead of 

Tobacco Smokers.” Science Daily, 27 January 2008, see: http://www.sciencedaily.com/

releases/2008/01/080123104017.htm; and “Bullous Lung Disease Due to Marijuana,” Respirology (2008) 

13, 122-127.

 117. “Marijuana Smoke Contains Higher Levels of Certain Toxins Than Tobacco Smoke,” Science Daily, 

18 December 2007, see: http://sciencedaily.com/releases/2007/12/071217110328.htm; and “A Comparison 

of Mainstream and Sidestream Marijuana and Tobacco Smoke Produced Under Two Machine Smoking 

Conditions,” American Chemical Society, Chemical Research in Toxicology, 17 December 2008.

 118. “Marijuana Worsens COPD Symptoms in Current Cigarette Smokers,” American Thoracic Society, 

Science Daily, 23 May 2007.

 119. “How Smoking Marijuana Damages the Fetal Brain,” Karolinska Institute, Science 

Daily, 29 May 2007.

 120. Martin Johnston, “Cannabis Linked to Lung Cancer Risk,” New Zealand Herald, 27 March 2007.

 121. “Marijuana Use Linked to Increased Risk of Testicular Cancer,” Science Daily, 9 February 2009, 

see: http://www.scienedaily.com/releases/2009/02/090209075631.htm.

 122. Baker, Toni, “Marijuana Use Linked to Bladder Cancer,” January 26, 2006, 

see: http://www.medicalnewstoday.com. 

 123. “Marijuana Tied to Precancerous Lung Changes,” Reuters, 13 July 2006, see: http://today.reuters.

com/misc; see also: “The Association Between Marijuana Smoking and Lung Cancer,” Archives of Internal 

Medicine, 10 July 2006, see: http://archinte.ama.assn.org/cgi/content/full/166/12/1359?maxtoshow. 

 124. “Cannabis More Toxic than Cigarettes: Study,” French National Consumers’ Institute, 60 Million 

Consumers April 2006, see: www.theage.com.au. 

 125. “Conception and Pregnancy Put at Risk by Marijuana Use,” News-Medical.Net, 2 August 2006, see 

also: “Fatty Acid Amide Hydrolase Deficiency Limits Earl Pregnancy Events,” Journal of Clinical Investigation 

research article, 22 March 2006, revised 23 May 2006, see: http://www.jci.org/cgi/content/full/116/8/2122.

 126. “In Utero Marijuana Exposure Alters Infant Behavior,” Reuters, 17 January 2007.

 127. Tashkin, D.P., “Smoked Marijuana is a Cause of Lung Injury,” Monaldi Archives for Chest Disease

 63(2):93-100, 2005.

 128. “Marijuana Associated with Same Respiratory Symptoms as Tobacco,” YALE News Release, 13 

January 2005, see: http://www.yale.edu/opa/newsr/05-01-13-01.all.htm; see also, “Marijuana Causes Same 

Respiratory Symptoms as Tobacco,” 13 January 2005, 14WFIE.com.

 129. News-Medical.Net, 24 May 2006.

 130. See: http://www.nida.nih.gov/DirReports/DirRep207/DirectorReport8.html.

 131. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration, Office of Applied Studies, “Results from the 2007 National Survey on Drug Use and Health: 

National Findings.” September 2008, page 1.

 132. Office of National Drug Control Policy, “The Economic Cost of Drug Abuse in the United States,

 1992-2002,” December 2004, page vi.

 133. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

“Unintentional Poisoning Deaths – United States, 1999-2004,” released February 9, 2007, 56(05); 93-96, 

see: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5605a1.htm.
71 Speaking Out Against Drug Legalization

 134. Heron, et al, “Deaths: Final Data for 2006,” U.S. Department of Health and Human Services, 

Centers for Disease Control and Prevention, National Vital Statistics Reports, Vol. 57, Number 14, April 

2009, DHHS Pub No. (PAS) 2009-1120 (Tables 21 and 22), see: http://www.cdc.gov/nchs/data/nvsr/nvsr57/

nvsr57_14.pdf. 

 135. National Drug Control Strategy, Office of National Drug Control Policy, “2009 Annual Report,”

 January 2009, page 12.

 136. Heron, et al, “Deaths: Final Data for 2006,” U.S. Department of Health and Human Services, 

Centers for Disease Control and Prevention, National Vital Statistics Reports, Vol. 57, Number 14, April 

2009, DHHS Pub No (PAS) 2009-1120 (Tables 21 and 22), see: http://www.cdc.gov/nchs/data/nvsr/nvsr57/

nvsr57_14.pdf.

 137. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration, Office of Applied Studies, “Drug Abuse Warning Network, 2006: National Estimates of 

Drug-Related Emergency. Department Visits,” August 2008, page 7, see: http://DAWNinfo.samhsa.gov/. 

 138. University of Maryland, Center for Substance Abuse Research, CESAR FAX, Vol. 18, 

Issue 17, May 4, 2009, see: www.cesary.umd.edu. 

 139. HIV transmission Continues in the United States,” May 2002, page 1. 

 140. U.S. Department of Health and Human Services, National Institutes of Health, National Institute on 

Drug Abuse, “Research Report on HIV/AIDS,” March 2006, page 1.

 141. U.S. Department of Health and Human Services, Substance Abuse and Mental Health 

Administration, “Results from the 2008 National Survey on Drug Use and Health: National Findings,” 

September 2009, page 6. 

 142. Ibid.

 143. National Drug Control Strategy, Office of National Drug Control Policy, 

“2009 Annual Report,” January 2009, page 7. 

 144. Office of National Drug Control Policy, “The Economic Costs of Drug Abuse in the United States, 

1992-2002,” December 2004, page x. 

 145. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services, 

“Worker Substance Use and Workplace Polices and Programs,” June 2007. 

 146. Ibid, page 4.

 147. “Cocaine use among U.S. workers declines sharply in 2008, according to Quest Diagnostics Drug 

Testing Index. ” press release, May 6, 2009.

 148. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

Motor Vehicle Safety, “Impaired Driving,” January 26, 2009, page 1, see: http://www.cdc.gov/

MotorVehicleSafety/Impaired Driving/impaired_-drv_factsheet.html.

 149. Walsh, J.M., Flegel, R., Cangianelli, L.A., Atkins, R., Soderstrom, C.A.,, Kerns, T.J., “Epidemiology 

of alcohol and other drug use among motor vehicle crash victims admitted to a Level-1 trauma center,” 

Traffic Inj Prev, 2004;5:254 - 60.

 150. Ch’ng, W., Fitzgerald, M., Gerostamoulos, J., Cameron, P., Bui, D., McCaffrey, P., Drummer, O., 

Potter, J., Odell, M., “Drug Use in Motor Vehicle Drivers Presenting to an Australian, Adult Major Trauma 

Centre,” Emerg Med Australas, 19 August 2007, (4):359-65.

 151. Beirness, D.J. and Beasley, E.E., “Alcohol and Drug Use Among Drivers: British Columbia Roadside 

Survey 2008,” Canadian Centre on Substance Abuse, Ottawa, ON, 2009.

 152. Laumon, B., Gadegbeku, B., Martin, JL., Biecheler, MB., “Cannabis intoxication and fatal crashes 

in: population based case-control study,” BMJ, 10 December 2005, 331(7529):1371. 1293-1296.

 154. Ibid. 

 155. National Highway Traffic Safety Administration, “Traffic Safety Facts Research Note,” 

U.S. Department of Transportation Report No. DOT HS 810 821, Washington, D.C. 2007.

 156. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services, 

“Results from the 2008 National Survey on Drug Use and Health: National Findings,” September 2009, 

page 29. 
72 Speaking Out Against Drug Legalization

 157. National Institutes for Health, National Institute on Drug Abuse, “Drug-Impaired Driving by Youth 

Remains a Serious Problem” news release, 29 October 2007. 

 158. Department of Health and Human Services, Substance Abuse and Mental Health Administration, 

Office of Applied Studies, “Children Living with Substance-Dependent or Substance-Abusing Parents: 2002-

2207,” April 16, 2009. 

 159. Ibid.

 160. The National Center on Addiction and Substance Abuse, Columbia University, “Family Matters: 

Substance Abuse and the American Family,” March 2005, page 2.

 161. Ibid.

 162. National Drug Intelligence Center, National Drug Threat Assessment, “The Impact of Drugs on 

Society,” January 2006. 

 163. University of Maryland, Center for Substance Abuse Research, CESAR FAX, Vol. 18, Issue 16, 

“Methamphetamine Cost Society an Estimated $23 billion in 2005; Majority of Costs Related to Addiction, 

Premature Death, Crime and Criminal Justice,” April 27, 2009, see: http://www.rand.org/pubs/monographs/

MG829. 

 164. U.S. Department of Health and Human Services, Substance Abuse and Mental Health 

Administration, “Results from the 2007 National Survey on Drug Use and Health: National Findings,” 

September 2008, page 55.

 165. Marin Institute Fact Sheet: The Costs of Alcohol, June 24, 2008.

 166. As of April 1, 2009.

 167. See http://www.CDC.gov/tobacco. 

 168. Office of National Drug Control Policy, “National Drug Control Budget: FY 2010 Funding 

Highlights,” May 2009, page 2.

 169. U.S. Department of Education, “Fiscal Year 2010 Budget Summary -- May 7, 2009,” accessed May 

20, 2009, at www.ed.gov/about/overview/budget/budget10/summary/edlite-section1.html. 

 170. Department of Health and Human Services, Substance Abuse and Mental Health Administration, 

Office of Applied Studies, “Drug Abuse Warning Network, 2004: Area Profiles of Drug-Related Mortality.” 

2008

 171. Johnston, L.D., Bachman, J.G., and O’Malley, P.M., “Monitoring the Future: Questionnaire Responses 

from the Nation’s High School Seniors.” Institute for Social Research, 1980.Page 266.

 172. Johnston, L.D., Bachman, J.G., and O’Malley, P.M., “Monitoring the Future: Questionnaire Responses 

from the Nation’s High School Seniors.” Institute for Social Research, 1992. Page 327.

 173. Foulkes, Imogen. “Ten years on from Needle Park”. February 4, 2002. www.swissinfo.ch.

 174. U.S. Department of Health and Human Services, Substance Abuse and Mental Health 

Administration, Office of Applied Studies, “Drug Abuse Warning Network, 2004: Area Profiles of 

Drug-Related Mortality,” 2008.

 175. Johnston, L.D., Bachman, J.G., and O’Malley, P.M., “Monitoring the Future: Questionnaire Responses 

from the Nation’s High School Seniors,” Institute for Social Research, 1980, page 266.

 176. Johnston, L.D., Bachman, J.G., and O’Malley, P.M., “Monitoring the Future: Questionnaire Responses 

from the Nation’s High School Seniors,” Institute for Social Research, 1992, page 327.

 177. Foulkes, Imogen, “Ten years on from Needle Park,” February 4, 2002, see: www.swissinfo.ch. 

 178. Ibid.

 179. Department of Health and Human Services, Substance Abuse and Mental Health Services 

Administration Office of Applied Studies, “Results from the 2008 National Survey on Drug Use and Health: 

National Findings,” September 2009.

 180. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of 

Alcohol Abuse and Alcoholism, “Rethinking Drinking: Alcohol and Your Health,” publication no. 09-3770, 

February 2009.
73 Speaking Out Against Drug Legalization

 181 U.S. Department of Health and Human Services, National Institutes of Health, National Institute of 

Alcohol Abuse and Alcoholism, “Rethinking Drinking: Alcohol and Your Health,” publication no. 09-3770, 

February 2009.

 182 Mokdad, A.H., Marks, J.S., Stroup, D.F., Gerberding, J.L., Actual Causes of Death in the United States, 

2000, JAMA 2004, 291(10):1238-1245.

 183. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, 

National Institute on Alcohol Abuse and Alcoholism, “10th Special Report to the U.S. Congress on Alcohol 

and Health,” June 2000.

 184. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 

“Women and Smoking: A Report of the Surgeon General,” Atlanta, GA, 2001.

 185. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

“Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 

1997-2001,” Morbidity and Mortality Weekly Report 2005: 54(25) 625-628.

 186. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

National Center for Health Statistics, “Health, United States, 2005, with Chartbook on Trends in the Health 

of Americans,” Hyattsville, MD, 2006.

 187. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

“Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000-

2004,” Morbidity and Mortality Weekly Report 2008, 57(45):1226-1228.

 188. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 

National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 

“Sustaining State Programs for Tobacco Control: Data Highlights 2006,” Atlanta, 2006.

 189. “The Tax Burden on Tobacco,” Historical Compilation, Orzechowski and Walker, Volume 43, 2008, 

Arlington, VA.

 190. Federation of Tax Administrators, “State Excise Tax Rates on Cigarettes, January 1, 2008,” 

Washington, D.C., 2008. State excise taxes ranged from 7 cents in South Carolina to $2.58 in New Jersey.

 191. U.S. Department of the Treasury, Alcohol and Tobacco Tax and Trade Bureau, “Tobacco: Federal 

Excise Tax Increase and Related Provisions.”

 192. Heron, et al, “Deaths: Final Data for 2006,” U.S. Department of Health and Human Services, Centers 

for Disease Control and Prevention, National Vital Statistics Reports, Vol. 57, Number 14, April 2009, DHHS 

Pub No (PAS) 2009-1120 (Tables 21 and 22), see: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf.

 193. Department of Health and Human Services, Substance and Mental Health Services Administration, 

Office of Applied Studies, “Results from the 2007 National Survey on Drug Use and Health: National 

Findings,” September 2008.

 194. Department of Health and Human Services, Substance and Mental Health Services Administration, 

Office of Applied Studies, “Results from the 2008 National Survey on Drug Use and Health: National 

Findings,” September 2009.

 195. Rosenthal, Mitchell, “Panacea or Chaos? The Legalization of Drugs in America.” January 15, 1993

 196. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, “Drug Use and 

Dependence, State and Federal Prisoners 2004,” October 2006, revised January 2007.

 197. Gruber, A.J., Pope, H.G., Hudson, J.I., Yurgelun-Todd, D., “Attributes of long-term heavy cannabis 

users: A case control study,” Psychological Med, 33(8):1415–1422, 2003, see: http://www.nida.nih.gov/

infofacts/marijuana.html.

 198. Lezin, N., Rolleri, L., Bean, S., Taylor, J., “Parent-child connectedness: Implications for

research, interventions and positive impacts on adolescent health,” ETR Associates, Santa Cruz, CA, 2004.

 199. O’Malley, P.M., Johnston, L.D., “Drugs and driving by American high school seniors, 2001–2006,” J 

Studies on Alcohol and Drugs, 68(6):834–842, 2007.
74 Speaking Out Against Drug Legalization

 200. Gruber, A.J., Pope, H.G., Hudson, J.I., Yurgelun-Todd, D., “Neuropsychological performance in longterm cannabis users,” Arch Gen Psychiatry, 58(10):909–915, 2001.

 201. The National Center on Addiction and Substance Abuse, “Family Matters: Substance Abuse in the 

American Family,” Columbia University, March 2005. 

 202. Goldman, Salus, Wolcott, Kennedy, “A Coordinated Response to Child Abuse and Neglect: The 

Foundation for Practice,” U.S. Department of Health and Human Services, Office on Child Abuse and Neglect, 

User Manual Series (2003), see http://www.childwelfare.gov/pubs/usermanuals/foundation/foundatione.cfm. 

 203. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, “Criminal 

Victimization, 2007,” see: http://www.ojp.usdoj.gov/bjs.abstract/CV07.htm. 

 204. Crime in the United States, 2006.” Murders that occurred specifically during a narcotics felony, such as 

drug trafficking or manufacturing, are considered drug related.

 205. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, “Drug Use and 

Dependence, State and Federal Prisoners 2004,” October 2006, revised January 2007.

 206. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, “Criminal 

Victimization in the United States, 2005,” Statistical Table No. 32, NCJ 215244, December 2006.

 207. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, “Substance 

Dependence, Abuse, and Treatment of Jail Inmates, 2002,” NCJ 209588, July 2005, and “Drug Use and 

Dependence, State and Federal Prisoners, 2004,” NCJ 213530, October 2006.

 208. Califano, Jr., Joseph A., “Should Drugs be Decriminalised? No.” BMJ 2007, 335:967 (10 November), 

doi:10.1136/bmj.39360.464016.AD.

 209. U.S. Department of Health and Human Services, Substance and Mental Health Services Administration, 

Office of Applied Studies, “Results from the 2008 National Survey on Drug Use and Health: National 

Findings,” September 2009.

 210. U.S. Department of Health and Human Services, Center for Disease Control and Prevention, “National 

Vital Statistics Report, 2005,” Vol 56, Number 10, April 24, 2008.

 211. National Drug Control Strategy, Office of National Drug Control Policy, “National Drug Control 

Strategy Data Supplement 2009.”

 212. National Highway Transportation Safety Administration, “Traffic Safety Facts, 2007,” 

DOT HS 810 985.

 213. Department of Health and Human Services, Substance and Mental Health Services Administration, 

Office of Applied Studies, “Results from the 2007 National Survey on Drug Use and Health: National 

Findings,” September 2008.

 214. National Highway Transportation Safety Administration, “Traffic Safety Facts, 2007,” 

DOT HS 810 985.

 215. U.S. Department of Health and Human Services, Substance and Mental Health Services Administration, 

Office of Applied Studies, “Results from the 2008 National Survey on Drug Use and Health: National 

Findings,” September 2009.

 216. European Monitoring Centre for Drugs and Drug Addiction, “2008 Annual Report: The State of the 

Drug Problem in Europe,” Office for Official Publications of the European Communities, Luxembourg, 

June 2008, page 11, see also www.emcdda.europa.eu.

 217. Ibid.

 218. Ibid.

 219. Simons, Marlise, “Cannabis Cafes Get Nudge To Fringes of a Dutch City,” New York Times, 

August 20, 2006.

 220. “Cannabis Bars in Limburg to be for Members Only,” NIS News Bulletin, May 13, 2009,

 see: http://www.nisnews.nl/public/130509_1.htm.

 221. Collins, Larry, “Holland’s Half-Baked Drug Experiment,” Foreign Affairs, May/June 1999, p. 87.
75 Speaking Out Against Drug Legalization

 222. MacCoun, R., Reuter, P., “Interpeting Dutch Cannabis Policy: Reasoning by Analogy in the 

Legalization Debate,” Science, 278, 47-52, 1997, see: http://ist-socrates.berkeley.edu/~maccoun/scienc97.

html.

 223. Report of the International Narcotics Control Board for 2005, International Narcotics Control Board, 

United Nations, New York, 2006, p. 84.

 224. “Amsterdam Bans Smoking of Marijuana in Some Public Places,” Expatica, January 29, 2007, 

see: www.expatica.com/actual/article.asp?subchannel_id=19&story_id-5804. 

 225. Hibell, B., Guttormsson, U., Ahlström, S., Balakireva, O., Bjarnason, T., Kokkevi, A., Kraus, L., 

“The 2007 ESPAD Report - Substance Use Among Students in 35 European Countries,” the Swedish Council 

for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden, 2009.

 226. “Netherlands from 12th to 5th Place in Europe on Cannabis Usage,” NIS News Bulletin, April 4, 2009, 

see: http://www.nisnews.nl/public/040409_1.htm.

 227. “Cannabis: An Apology,” The Independent on Sunday, 18 March 2007, see: www.news.independent.

co.uk/uk/health_medical/article2368994.ece. 

 228. “UK: Cannabis to Be Reclassified as a Class B Drug,” 8 May 2008, see: http://www.scoop.co.nz/

stories/WO0805/S00105.htm.

 229. “Cannabis is Now a Class B Drug,” UK Home Office press release, 26 January 2009.

 230. Cohen, Roger, “Amid Growing Crime, Zurich Closes a Park it Reserved for Drug Addicts,

” The New York Times, 11 February 1992.

 231. “Drug Use by Europe’s Young People Leads to Risky Sexual Behavior,” Medical News Today, 

1 August 2008. see: http://www.medicalnewstoday.com/articles/116883.php.

 232. European Monitoring Centre for Drugs and Drug Addiction. “2008 Annual Report: The State of the 

Drugs Problem in Europe,” Office for Official Publications of the European Communities, Luxembourg, 

June 2008, see: http://www.emcdda.europa.eu. 

 233. Office of National Drug Control Policy, “Who’s Really in Prison for Marijuana?” NCJ 204299.

 234. Mumola, C.J., “Special Report: Substance Abuse and Treatment, State and Federal Prisoners, 1997,” 

Department of Justice, Bureau of Justice Statistics, January 1999, NCJ 172871.

 235. Ibid.

 236. Ibid.

 237. Office of National Drug Control Policy, “Who’s Really in Prison for Marijuana?” NCJ 204299.

 238. Mumola, C.J., “Special Report: Substance Abuse and Treatment, State and Federal Prisoners, 1997,” 

Department of Justice, Bureau of Justice Statistics, January 1999, NCJ 172871.

 239. Office of National Drug Control Policy, “Who’s Really in Prison for Marijuana?” Executive Office of 

the President, Office of National Drug Control Policy, NCJ 204299.

 240. Ibid.

 241. Ibid.

 242. U.S. Sentencing Commission, “2008 Sourcebook of Federal Sentencing Statistics,” 

see: http://www.ussc.gov/ANNRPT/2008/SBTOC08.htm, Table 33, http://www.ussc.gov/ANNRPT/

2008/Table33.pdf. 

 243. “Behind Bars: Substance Abuse and America’s Prison Population,” National Center on Addiction and 

Substance Abuse (CASA) at Colombia University, January 1998.

 244. U.S. Sentencing Commission, “2008 Sourcebook of Federal Sentencing Statistics,” 

see: http://www.ussc.gov/ANNRPT/2008/SBTOC08.htm, Table 33, http://www.ussc.gov/ANNRPT/

2008/Table33.pdf

 245. National Drug Crime Institute, see: www.ndci.org/courtfacts.
76 Speaking Out Against Drug Legalization

 246. Roman, et al, “Recidivism Rates for Drug Court Graduates: Nationally Based Estimate – Final 

Report,” The Urban Institute and Caliber, Washington D.C., 2003.

 247. Fluellen, R., Trone, J, “Issues in Brief: Do Drug Courts Save Jail and Prison Beds?” Vera Institute of 

Justice, New York, NY, May 2000.

 248. United Nations Office on Drugs and Crime, UNODC and Drug Treatment Courts (“Drug Courts”).

 249. Rempel, M, Fox-Kralstein, D., Cissner, A., Cohoen, R., Labriola, M, Farole, D., Bader, A., and 

Magnani, M., “The New York State Adult Drug Court Evaluation: Policies, Participants, and Impacts,” Center 

for Court Innovation, New York, NY, 2003.

 250. “A Cost-Benefit Analysis of the Saint Louis City Adult Felony Drug Court,” Institute for Applied 

Research, St. Louis, MO, 2004.

 251. “To Treat or Not to Treat: Evidence on the Prospects of Expanding Treatment for Drug-Involved 

Offenders,” The Urban Institute, 2008.