What the History of Drugs Can Teach Us About the Current Cannabis Legalization Process: Unfinished Business

Abstract

Over time, there have been considerable changes in the variety, availability, production, distribution, and use and user(s) of psychoactive substances, the meaning of substance use and its impact on users and their social or physical environment(s). This article reviews the mechanisms of introduction of psychoactive substances such as alcohol, tobacco, coffee, tea and cannabis to populations and communities that did not have them before. It considers the historical tension between early adopters who greet new substances with various levels of enthusiasm in their eagerness to enjoy what they believe to be the benefits of using these substances, and those focused on what they believe to be the negative aspects of use, who decry these new substances with horror. With more nonusers than users in the population, social policies tend to be directed at preventing, restricting, or punishing selected use, users and .drugs., using controls and interventions such regulation, incarceration, death sentence, treatment, prevention, legalization, taxation, among others. Whatever their intent or wished-for impact, all had consequences that produced additional, unplanned for, and (often) negative effects. This paper will consider some of these sequences as they occurred historically with other substances in light of the current shift to legalization and normalization of cannabis, noting the mechanisms of use, controls, and consequences of some types of formal interventions and give some attention to how and what we can learn from our experiences in order to plan ahead and become better prepared to successfully deal with the ‘unexpecteds’ of that well-known ‘hell’ paved with good intentions.

Keywords:

• addiction, psychoactive substances, alcohol, tobacco, tea, coffee, cannabis, history, controls, regulation, criminalization, legalization, normalization, driving under the influence of drugs

GLOSSARY

• Early adopters: A term used in modern marketing studies referring to opinion leaders whose behavior serves as the bellwether for new trends that are copied by others in society.

• Normalization: A term used when working with handicapped persons who were institutionalized, stigmatized and marginalized because of conditions or behaviors that were considered abnormal; the mechanism whereby they/their behaviors became gradually integrated into mainstream society as norm boundaries expanded to encompass what persons and behaviors that were previously considered undesirable, abhorrent, and devalued. This process of normalization is applied to the acceptance of such behaviors and/or persons as just another variety of normal behavior in that society and that culture.

Notes

¹ Medicinal uses include: Coca leaf chewed to facilitate physical labor in the low oxygen High Andes of South America; Energizing effects of coffee (Weinberg BA, Bealer BK (2001). The world of caffeine. Routledge. pp. Page 3–4, Cited in http://en.wikipedia.org/wiki/History_of_coffee#Possible_ first_uses—Tobacco as an earache and toothache pain killer (Heckewelder, History, Manners and Customs of the Indian Nations who Once Inhabit- ed Pennsylvania, p. 149 ff. Cited in http://en.wikipedia.org/wiki/History_of_tobacco http://en.wikipedia.org/wiki/Opium#Ancient_use

² Religious use included: –Sacramental wine in the Christian tradition; Seder or Passover wine in the Jewish tradition. http://en.wikipedia.org/wiki/P- assover_Seder—Coffee initially used for religious purposes in the Islamic world. (Grigg D {2002} The worlds of tea and coffee: Patterns of consum- ption Geo Journal, Vol. 57, No. 4, pp. 283-294 Cited in http://en.wikipedia.org/wiki/History_of_coffee#Possible_first_uses); Tobacco among North American Natives http://en.wikipedia.org/wiki/History_of_tobacco

³ Social use included: smoking a peace pipe http://en.wikipedia.org/wiki/History_of_tobacco; socializing in bars or at cocktail parties, toasting heads of State or newly-weds at formal banquets; English afternoon tea, Japanese tea ceremony.

⁴ http://www.newscientist.com/article/dn17373-animals-on-drugs-11-unlikely-highs.html#.VMdqFNKUdIE downloaded 1/27/15

⁵ http://en.wikipedia.org/wiki/History_of_tobacco#European_discovery

⁶ The Pope threatened to excommunicate anyone who ‘took tobacco in the porchway [sic] of or inside a church, whether it be by chewing it, smoking it with a pipe or sniffing it in powdered form through the nose’. http://en.wikipedia.org/wiki/Tobacco_control

⁷ Gilman SL, Zhou X (2004) A Global History of Smoking. Reaktion Books, p. 16 http://books.google.com/books?id=mM5bYb_uVcwC &pg=PA9&source=gbs_toc_r&cad=3#v=onepage&q&f=false

⁸ James I King of England was at the same time James VI King of Scotland of the Royal House of Stuart.

⁹ The King wrote A Counterblaste [sic] to Tobacco, describing smoking as: ‘A custom [sic] loathsome to the eye, hateful to the nose, harmful [sic] to the brain, dangerous to the lungs, and in the black stinking fume thereof, nearest resembling the horrible Stygian smoke of the pit that is bottomless [sic]’ http://en.wikipedia.org/wiki/Tobacco_control

¹⁰ http://en.wikipedia.org/wiki/Tobacco_smoking#Popularization

¹¹ Gilman SL, Zhou X (2004) op. cit.

¹² Gilman SL, Zhou X (2004) op. cit.

¹³ Health warnings on cigarette packages in a number of countries, banning smoking in public places.

¹⁴ No sales to minors, cannot be picked up on a self-serve basis among regular goods in grocery stores, must be asked for at the customer service desk, etc.

¹⁵ Studies of the health consequences on tobacco use started in the pre-World War II period in Germany—as did anti-smoking campaigns. (Anti-tobacco movement in Nazi Germany, http://en.wikipedia.org/ wiki/Anti-tobacco_movement_in_Nazi_Germany#Hitler.27s_attitude_ towards_smoking). This effort was forgotten in the post-World War II period when it would have been an unpleasant reminder of the Nazi regime. In the 1950s British researchers led a new impetus in research on the health consequences of tobacco use. The USA Surgeon General's report (Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States, released on January 11, 1964 http://en.wikipedia.org/wiki/Smoking_and_Health:_Report_of_the_Ad- visory_Committee_to_the_Surgeon_General_of_the_United_States) gave an impetus to current anti-smoking efforts.

¹⁶ The Church of Christ Latter Day Saints (Mormon) founded in the 19^th century forbids the use of Tobacco.

¹⁷ History of tea. http://en.wikipedia.org/wiki/History_of_tea#Portugal

¹⁸ Imports of tea into Britain began in the 1660s http://en.wikipedia.org/wiki/History_of_tea

¹⁹ Sources of British tea were not limited to China but were also imported from British tea plantations India and other British possessions in Asia, etc., http://en.wikipedia.org/wiki/History_of_tea

²⁰ Large scale British tea trade was the result of the need for a return cargo for ships coming back from the East Indies. http://en.wikipedia.org/wiki/History_of_tea#United_Kingdom

²¹ Tea came later to France and Germany, but, after an early fad, it was never as popular as in Britain. http://en.wikipedia.org/wiki/History_of_tea

²² The National Coffee Association of USA, Inc. (undated) The History Of Coffee. http://ncausa.org/ i4a/pages/index.cfm?pageid=68 retrieved Jan 9, 2015.

²³ http://en.wikipedia.org/wiki/History_of_coffee#Arab_world_and_spr- ead_to_Europe

²⁴ The National Coffee Association of USA, Inc. (undated) Coffee Comes to Europe. The History Of Coffee. http://ncausa.org/i4a/pages/index.cfm?pageid=68

²⁵ King Charles II of England tried to ban coffee houses in the late 17^th Century. http://en.wikipedia.org/wiki/History_of_coffee#cite_note-22

²⁶ Both tea and coffee were consumed in coffee houses.

²⁷ The American Revolution was planned in a coffee house. (Weinberg BA, Bonnie K. Bealer BK (2004) The World of Caffeine: The Science and Culture of the World's Most Popular Drug. Routledge. p. 183. (on Line).

²⁸ http://en.wikipedia.org/wiki/Pope_Clement_VIII#Coffee

²⁹ The French anthropologist-ethnologist posited that alcoholic beverages operated as a socializing and civilizing tool in man's development from living and adapting as gatherers to their choosing to become settled and creating communities. This process also included the important socializing process of gift giving, or exchange behaviors.

³⁰ Allaman Allamani et al (2014) Drinking patterns in 12 European countries: Unplanned contextual factors and planned alcohol control policy measures. Substance Use and Misuse. 49:12.

³¹ The word, term, concept “addictive/addiction is a loaded one which is used and misused by a range of stakeholders, each with their own agendas.

³² McGovern PE (2009) Uncorking the Past, Berkeley, California: Berkeley University Press

³³ McGovern PE (2007) Ancient Wine: The Search for the origins of Viniculture, Princeton NJ, :Princeton University Press

³⁴ Porter R, Teich M, eds (1995) Drugs and Narcotics in History, Cambridge: Cambridge University Press.

³⁵ Standage T (2005) A History of the World in 6 Glasses N.Y.C.: Walker and Co.

³⁶ According to Pliny the Elder of ancient Rome, Faustian Falernian wine ‘takes light when a flame is applied to it’ The Fourteenth Book [sic] of Pliny [sic] Natural [sic] History. (http://en.wikipedia.org/wiki/Falernian_wine) This suggests an alcohol content of about 15% alcohol by volume This is not unrealistic as the production process for Falernian wine requires the use of juice from grapes that have been frozen while still on the vine (as is done in making ‘ice wine’ today), with the juice then going through ‘freeze distillation’ (using snow) which acts to increase the alcohol content of the wine. http://en.wikipedia.org/wiki/Fractional_freezing#Freeze_distillation

³⁷ Roman wine was exported to Spain, Gaul, Germany and as far afield as Britain when it was a Roman colony. http://en.wikipedia. org/wiki/Ancient_Rome_and_wine#Expansion_of_viticulture

³⁸ ‘Through trade, military campaigns, and settlements’ Romans brought viticulture and wine-making throughout the lands of the Roman empire. http://en.wikipedia.org/wiki/Ancient_Rome_ and_wine#Expansion_of_viticulture retrieved Jan. 9, 2015.

³⁹ The popularity of Bordeaux wine in England started with the marriage Eleanor, Duchess of Aquitaine (a wine producing region in Southern France) to Henry II, King of England in the 12^th century CE. http://en.wikipedia.org/wiki/History_of_Bordeaux_wine

⁴⁰ The extensive Phoenician maritime trade network permitted wine trade throughout the Ancient world. http://en.wikipedia.org/ wiki/Phoenicians_and_wine#Early_history_in_wine_trading

⁴¹ ‘Tobacco was introduced to Eurasia in the late 17th century where it followed common trade routes’ http://en.wikipedia.org/wiki/Tobacco_smoking

⁴² Distillation of alcoholic beverages in Europe was discovered in the 12^th century CE. Its consumption became more common by about the 15^th century after it had been used as a remedy for plague (‘Black Death’). Lower cost production methods, and tax changes made distilled beverages cheaper and more readily available. http://en.wikipedia.org/wiki/Distilled_beverage#History_of_distillation http://en.wikipedia.org/wiki/Gin#History

⁴³ Fur trade. http://en.wikipedia.org/wiki/Fur_trade retrieved Jan. 9, 2015.

⁴⁴ 18^th Century Gin Craze. http://www.history.co.uk/study-topics/history-of-london/18th-century-gin-craze retrieved Jan. 9, 2015.

⁴⁵ Noah ‘planted a vineyard: and he drank of the wine, and was drunken;’ http://www.kingjamesbibleonline.org/Genesis-Chapter-9/

⁴⁶ According to the Christian world view of that period this was a fate worse than death.

⁴⁷ Signer of the American Declaration of Independence and father of American Psychiatry.

⁴⁸ Rush B. (1790) An Inquiry into the Effects of Spirituous Liquors on the Human Body and the Mind. Boston: Thomas and Andrews, (Library Company of Philadelphia) Cited in http://en.wikipedia.org/wiki/Benjamin_Rush#Mental_health

⁴⁹ ‘[F]armers in a Connecticut community formed a temperance association in 1789 to ban the making of whiskey’ http://en.wikipedia.org/ wiki/Temperance_movement_in_the_United_States .

⁵⁰ Viz. Woman's Christian Temperance Union, Salvation Army http://en.wikipedia.org/wiki/Temperance_movement

⁵¹ In 1881, Kansas became the first American state to outlaw alcoholic beverages in its Constitution. http://en.wikipedia.org/wiki/ Prohibition_in_the_United_States#Development_of_the_prohibition_m- ovement

⁵² In Canada, the province of Prince Edward Island brought in Prohibition in 1901. http://en.wikipedia.org/wiki/Prohibition_in_ Canada#Local_option

⁵³ The Faroes Islands, Iceland, Norway, Finland, and the Russia Empire (afterwards the Soviet Union), all had prohibition during at least some of the years of World War I. http://en.wikipedia.org/wiki/ Prohibition#Nordic_countries, http://en.wikipedia.org/wiki/List_of_co- untries_with_alcohol_prohibition

⁵⁴ Prohibition in Canada was voted in province-by-province in the context of World War I (mainly between 1916 and 1921), and again repealed province-by-province after the war (mainly between 1921 and 1927). http://en.wikipedia.org/wiki/Prohibition_in_Canada#Local_option

⁵⁵ The US began efforts to bring in national Prohibition in 1917 at the start of the American involvement in World War I, but this did not come into effect until 1920 with the 18th amendment to the American Constitution known as the Volstead Act. http://en.wikipedia.org/wiki/Prohibition_in_the_United_States#Develo- pment_of_the_prohibition_movement

⁵⁶ The Canadian province of Prince Edward Island remained ‘dry’ until 1948. Some communities, including enclaves in some of the largest cities in the country, have remained ‘dry’ into the 21st Century. http://en.wikipedia.org/wiki/Prohibition_in_Canada#Local_option

⁵⁷ Prohibition ended in the United States of America in 1933 after the ratification of the Twenty-first Amendment repealed the Eighteenth Amendment that had instituted Prohibition. http://en.wikipedia.org/wiki/Prohibition_in_the_United_States#Develo- pment_of_the_prohibition_movement

⁵⁸ State-wide Prohibition ended in Kansas in 1948. As of April 2013, Kansas still has not ratified the 21st Amendment to the American Constitution which ended nationwide Prohibition in 1933. http://en.wikipedia.org/wiki/Alcohol_laws_of_Kansas#Recent_develo- pments

⁵⁹ Popham RE, Schmidt W (Compilers), (1958) Statistics Of Alcohol Use And Alcoholism In Canada, 1871–1956; First Report. Williams RG, Bronetto J, Cooper CP (Assistance), Seeley JR (Foreword). Addiction Research Foundation of Ontario. [Toronto] University of Toronto Press.

⁶⁰ http://en.wikipedia.org/wiki/Temperance_movement#Legislative_su- ccesses_and_failures

⁶¹ Prior to Prohibition, drinking was mainly a man's activity carried out in the tavern domain of men. During Prohibition, the speakeasy is where both men and women congregated and drinking by women became commonplace.

⁶² Okrent D (2010) The Last Call: The Rise And Fall Of Prohibition. NY: Scribner

⁶³ Health problems related directly to alcohol included liver cirrhosis, alcohol dependence, alcoholism, alcoholic psychosis, alcohol poisonings, alcoholic esophageal varices, alcoholic cardiomyopathy. Alcohol contributed indirectly to the development or worsening of cardiovascular, cancerous, and other general medical conditions, such as the morbidity and mortality associated with alcohol related traffic accidents.

⁶⁴ Legal problems include alcohol offenses (e.g., drinking in circumstances prohibited by law–time, place, underage drinking), traffic offenses due to drunk driving, litigation relating to collision property damage and other losses in alcohol related motor vehicle traffic accidents affecting not only the drunk driver but also persons who were in the same vehicle or in other vehicles, and their families, friends, work fellows, and communities.

⁶⁵ Work problems include job absenteeism, sub-par job performance by hung-over workers or those under the influence of alcohol, resulting in economic loss from reduced productivity, and the cost of recruitment and training of supplementary or replacement staff needed to compensate for lost productivity due to premature mortality of experienced staff or the reduced productivity of persons with alcohol problems.

⁶⁶ Alcohol related social costs include the costs of alcohol related medical care, prevention programs, policing, incarceration, etc.

⁶⁷ Some common synonyms: marijuana, marihuana, Mary Jane, grass, weed, dope, pot, reefer, shit, joint, hash, hash oil, buds,, ganja, herb, sinsemilla, blow, blunt, boom, green, gangster, kilobricks, Thai sticks, sativa. There are also numerous names for special varieties such as ‘Acapulco Gold.’

⁶⁸ http://www.drugabuse.gov/publications/drugfacts/marijuana

⁶⁹ Tetrahydrocannabinol (THC) appears to be the most psycho-active ingredient in cannabis.

⁷⁰ Evidence of cannabis use has been found dating from the third Millennium BCE in Romania and in China. http://en.wikipedia.org/wiki/Cannabis_%28drug%29#History

⁷¹ Pipes—some dating from the 17th Century—dug up from the garden of noted playwright William Shakespeare's home in Stratford-upon-Avon contained traces of cannabis. (Bard ‘used drugs for inspiration’ BBC News Thursday, 1 March, 2001, 09:54 GMT. http://news.bbc.co.uk/2/hi/entertainment/1195939.stm Cited in http://en.wikipedia.org/wiki/Cannabis(drug)#cite_note-Shakespeare-BBC-2001-128

⁷² In the mid-16^th century cannabis spread to the western hemisphere when Spaniards imported hemp to Chile and Peru. http://en. wikipedia.org/wiki/Cannabis#History_of_cannabishttp://www.ukcia. org/culture/history/chrono.php

⁷³ In 1870 CE, cannabis is listed in the US Pharmacopoeia as a medicine for various ailments. It remained there until 1941. http://www.ukcia.org/culture/history/chrono.php

⁷⁴ It is said that in 1378 CE, Emir Soudom Sheikhouni of Joneima in Arabia ordered ‘that all cannabis plants in his territory be destroyed and that anyone caught eating cannabis have their teeth pulled out’ http://www.ukcia.org/culture/history/.

⁷⁵ In 1484 CE, Pope Innocent VIII singles out cannabis as an unholy sacrament of the Satanic mass. http://www.ukcia.org/culture/history/chrono.php

⁷⁶ In 1923, ‘the South African delegate to the League of Nations claims mine workers are not as productive after using “dagga” (Cannabis) and calls for international controls’ http://www.ukcia.org/culture/history/chrono.php

⁷⁷ In the mid-16th century CE, the English Queen Elizabeth I decreed ‘that land owners with 60 acres or more must grow cannabis” or face a £5 fine.’ http://www.ukcia.org/culture/history/chrono.php

⁷⁸ In the mid-16th century CE, King Philip of Spain ordered ‘cannabis to be grown throughout his Empire from modern-day Argentina to Oregon.’ http://www.ukcia.org/culture/history/chrono.php

⁷⁹ In 1916, South African mine workers were encouraged to smoke because ‘after a smoke the native work hard and show very little fatigue.’ The usual mine practice was to allow three daily ‘smokes’ ( like coffee breaks). http://news.bbc.co.uk/2/hi/programmes/panorama/4079668.stm

⁸⁰ http://en.wikipedia.org/wiki/Legal_history_of_cannabis_in_the_Unit- ed_States#Early_history_.28pre-1850s.29

⁸¹ In answer to the question ‘Can you get high from smoking leaves?’, the following was posted ‘Back in the seventies that's all we smoked there were no autoflowering[sic] strains [sic] that would bloom and finish outdoors. Got us plenty high.’ by frmrboi, Dec 28, 2010. http://www.rollitup.org/t/can-you-smoke-the-leaf.50673/

⁸² Anslinger HJ (1930s) Director, US Federal Bureau of Narcotics. Cited in: http://en.wikipedia.org/wiki/Legal_history_of_cannabis_ in_the_United_States#Federal_Bureau_of_Narcotics_.281930.29

⁸³ Rumors started that Mexicans, Blacks and other foreigners were snaring white children with marijuana. (Guither P (undated) Why is Marijuana Illegal? In: http://www.drugwarrant.com/articles/why-is-marijuana-illegal/

⁸⁴ http://www.pbs.org/wgbh/pages/frontline/shows/dope/etc/cron.html

⁸⁵ Newspapers in 1934 editorialized: ‘Marihuana influences Negroes to look at white people in the eye, step on white men's shadows and look at a white woman twice.’ http://www.drugwarrant.com/articles/why-is-marijuana-illegal/

⁸⁶ Notably, the USA was a signatory to the 1925 International Opium Convention (registered as a treaty with the League of Nations, 1928); this partially restricted international trade in Indian hemp (cannabis). http://en.wikipedia.org/wiki/International_Opium_Convention

⁸⁷ http://en.wikipedia.org/wiki/Legal_history_of_cannabis_in_the_Unit- ed_States

⁸⁸ http://en.wikipedia.org/wiki/Legal_history_of_cannabis_in_the_Unit- ed_States#Marijuana_Tax_Act_.281937.29

⁸⁹ Cannabis was outlawed in South Africa in 1911, in Jamaica in 1913, and in the United Kingdom and New Zealand in the 1920s. Canada criminalized cannabis in the Opium and Drug Act of 1923, before any reports of use of the drug in Canada. http://en.wikipedia.org/wiki/Cannabis_%28drug%29#History

⁹⁰ E.g., Opium Convention signed at The Hague on January 23, 1912. https://www.unodc.org/documents/wdr/WDR_2008/WDR2008_100 years_drug_control_league.pdf

⁹¹ The 1936 Geneva Trafficking Conventions banned illicit international cannabis trade. http://en.wikipedia.org/wiki/Legal_history_of_ cannabis_in_the_United_States#The_1936_Geneva_Trafficking_Conve- ntions

⁹² The Single Convention on Narcotic Drugs of 1961 signed under United Nation auspices is an international treaty that prohibits production and supply of cannabis (among other substances), except under license for specific purposes, such as medical treatment and research. Drugs are listed under a number of categories depending on their perceived level of harmfulness. There are currently 184 signatory countries to the treaty. http://en.wikipedia.org/wiki/Single_ Convention_on_Narcotic_Drugs, http://en.wikipedia.org/wiki/Single_ Convention_on_Narcotic_Drugs#Regulation_of_cannabis

⁹³ http://en.wikipedia.org/wiki/Legal_history_of_cannabis_in_the_Unit- ed_States#Reorganization_.281968.2C_1973.29

⁹⁴ http://en.wikipedia.org/wiki/Legal_history_of_cannabis_in_the_Unit- ed_States#Mandatory_sentencing_.281952.2C_1956.29

⁹⁵ Simplistic interventions embodied by the ‘Just say no!’ slogan ‘created and championed by First Lady Nancy Reagan’ (wife of Ronald Reagan, USA President 1981-1989) were even less credible. http://en.wikipedia.org/wiki/Just_Say_No#Effects

⁹⁶ The United Nations which functions as a global systemic, ideologically-driven drug control stakeholder, deems cannabis the most-used illicit drug in the world. It estimates that approximately 4% of the adult world population (162 million people) used cannabis annually (UNODC. World Drug Report 2010. United Nations Publication. p. 198. Cited in: http://en.wikipedia.org/wiki/ Cannabis_(drug)#cite_note-UN-WDR-2010-18), that approximately 0.6% (22.5 million) use cannabis daily, whereas 7 million are ‘chronic’ (continually intoxicated) users http://www.unodc.org/pdf/ WDR_2006/wdr2006_chap2_biggest_market.pdf).

⁹⁷ Substance Abuse and Mental Health Services Administration (SAMHSA) (2013) Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NS- DUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, pp. 13-14. http://www.samhsa.gov/ data/NSDUH/2012SummNatFindDetTables/Index.aspx

⁹⁸ Results are from Gallup's annual Consumption Habits poll, conducted July 10-14, .Saad L (2015) ‘In U.S., 38% Have Tried Marijuana, Little Changed Since 80s’ http://www.gallup.com/poll/163835/tried-marijuana-little-changed-80s.aspx

⁹⁹ Hippy folk singer Donovan (1966), Rock and Roll stars Keith Richards and Mick Jagger of the Rolling Stones (1967), and Paul McCartney of the Beatles (1980) were sentenced for possession of cannabis. (http://www.ukcia.org/culture/history/chrono.php). Cannabis users include: American President Clinton who said he smoked but ‘did not inhale’ (https://www.youtube.com/watch?v=cpBzQI_7ez8), President Barack Obama who said ‘I inhaled frequently. That was the point”. (Barack Obama “I inhaled frequently” “That was the point’ https://www.youtube.com/watch?v=cpBzQI_7ez8), American Secretary of State and Presidential hopeful John Kerry (‘John Kerry on Drugs’ http://www.ontheissues.org/2004/John_Kerry_Drugs.htm), Michael Bloomberg, New York City mayor and founder of the Bloomberg financial and media empire (Steinhauer J (2002) ‘Bloomberg Says He Regrets Marijuana Remarks’ The New York Times April 10 http://www.nytimes.com/2002/04/10/nyregion/bloomberg-says-he-regrets-marijuana-remarks.html, Financier and philanthropist George Soros has supported Uruguay's push to legalize cannabis (Castaldi M, Llambias F (Tue Dec 10, 2013 7:49pm EST) ‘Uruguay becomes first country to legalize marijuana trade.’ Reuters. http://www.reuters.com/article/2013/12/11/us-uruguay-marijuana-vot e-idUSBRE9BA01520131211; other famous Cannabis users include: Steve Jobs, founder of computer firm Apple and movie studio Pixar, Astronomer Carl Sagan http://www.alternet.org/drugs/7-successful-famous-cannabis-smoking-geniuses,

¹⁰⁰ In the USA all materials prepared by the US Federal government are in the public domain.

¹⁰¹ Prisons are full of people in for marijuana possession. Top 10 Marijuana Myths and Facts. http://www.rollingstone.com/culture/lists/top-10-marijuana-myths-and-facts-20120822/myth-prisons-are-full-of-peo ple-in-for-marijuana-possession-19691231; Alexander M (2010) The New Jim Crow: Mass Incarceration in the Age of Colorblindness. New York: The New Press )

¹⁰² Not all arrests lead to prosecutions, and relatively few people prosecuted and convicted of simple possession end up in jail. Most are fined or are placed into community supervision. About 40,000 inmates of state and federal prison have a current conviction involving marijuana, and about half of them are in for marijuana offenses alone; most of these were involved in distribution. Less than one percent are in for possession alone. http://www.rollingstone.com/culture/lists/top-10-marijuana-myths-and-facts-20120822/myth-prisons-are-full-of-people-in-for-marijuana-possession-19691231

¹⁰³ http://www.drugpolicy.org/drug-war-statistics

¹⁰⁴ Offense Statistics based on prior month's data—Last Updated: Saturday, 27 December 2014. http://www.bop.gov/about/statistics/statistics_inmate_offenses.jsp

¹⁰⁵ Miles K (2014) Just How Much The War On Drugs Impacts Our Overcrowded Prisons, The Huffington Post. Posted: 03/10/2014 7:30 am EDT Updated: 04/03/2014 11:59 pm EDT. http://www.huffingtonpost.com/2014/03/10/war-on-drugs-prisons-info graphic_n_4914884.html

¹⁰⁶ Kalt BC (2003) The Exclusion of Felons from Jury Service. Public Law & Legal Theory Working Paper Series Research Paper No. 01-04. Michigan State University, College of Law. http://papers.ssrn.com/sol3/papers.cfm?abstract_id=420840

¹⁰⁷ Viz. Lists of licensed occupations in Florida https://www.myfloridalicense.com/intentions2.asp, https://appsmqa.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

¹⁰⁸ NORML (founded 1970) High Times (1974—newspaper), Patients Out of Time (1995–medical cannabis), Students For Sensible Drug Policy (1998), Coalition for Rescheduling Cannabis (2002) Americans for Safe Access (2002—medical cannabis), National Cannabis Industry Association (2010).

¹⁰⁹ Cannabis coffee shops, where the consumption of cannabis is tolerated despite its being illegal, were introduced in the Netherlands in the 1970s. http://en.wikipedia.org/wiki/Cannabis_coffee_shop

¹¹⁰ In 1973 Oregon decriminalized cannabis. http://en.wikipedia.org/ wiki/Legal_history_of_cannabis_in_the_United_States#Efforts_to_decri- minalize_.281970s.E2.80.93.29

¹¹¹ In 1978, Robert Randall was the first person to win access to the federal cannabis supply through the Compassionate Investigational New Drug (IND) Programing (FDA) . http://www. medicalcannabis.com/patients-care-givers/federal-ind-patients/

¹¹² Nov. 5, 1996—California Becomes First State to Legalize Medical Marijuana. http://medicalmarijuana.procon.org/view.timeline.php? timelineID=000026

¹¹³ http://medicalmarijuana.procon.org/view.resource.php?resourceID =000881

¹¹⁴ A top UN official says marijuana legalization in the US violates international law. http://www.vox.com/2014/11/12/7205927/weed-legalization-alaska-oregon/in/6914992

¹¹⁵ Dec. 17, 2014—New Law Bans Justice Department from Using Funds Against Medical Marijuana in States Where It Is Legal. http://medicalmarijuana.procon.org/view.timeline.php?timelineID =000026

¹¹⁶ Oct. 28, 2014—US Justice Department Will Not Enforce Federal Marijuana Laws on Native American Reservations. http://medicalmari- juana.procon.org/view.timeline.php?timelineID=000026/

¹¹⁷ During the midterm November 2014 election, 57.6% of Florida voters were in favor of legalizing medical cannabis but the proposition failed to reach the 60% of voters needed to pass. (‘Florida's Marijuana Legalization Fails In The 2014 Election Results, Amendment 2 Supporters Vow To Try Again’ (Posted: November 4, 2014) http://www.inquisitr.com/1586470/floridas-marijuana-legalization-fail s-in-the-2014-election-results-amendment-2-supporters-vow-to-try-again/). As of January 27, 2015, Florida Republican state senator Jeff Brandes has filed a new major bill to legalize cannabis. (CAPUTO M (01/26/2015 1:23 PM 01/26/2015 7:09 PM) ‘Florida senator files major medical-marijuana bill on who can get supply’ Miami Herald. http://www.miamiherald.com/news/politics-government/state-politics/article8162274.html)

¹¹⁸ As of January 2015, Bangladesh, the Netherlands, North Korea, Spain, Uruguay have legalized cannabis to some extent. In addition, a number of countries have not legalized, but tolerate cannabis to a degree. http://en.wikipedia.org/wiki/Legality_of_cannabis_by_country. Uruguay, the first country to fully legalize cannabis, has not actually made any progress on implementation. (Oppenheimer A (01/10/2015 7:00 AM 01/10/2015 9:21 PM) ‘Let's legalize pot, but not like Uruguay’! Miami Herald. http://www.miamiherald.com/news/local/news-columns-blogs/andres-oppenheimer/article5761536.html#storylink=cpy)

¹¹⁹ There are legal problems with writing a prescription for an illegal product, hence the written ‘recommendation.’ The term ‘prescriber’ will be used even if all they can do is write a recommendation.

¹²⁰ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071601/

¹²¹ http://www.unitedpatientsgroup.com/resources/beginners-guide

¹²² Common characteristics of pill mills include: cash-only/no insurance; no appointments; armed guards; little or no medical records; grossly inadequate physical examinations; and large prescription doses that exceed the boundaries of acceptable medical care. http://myfloridalegal.com/pages.nsf/Main/AA7AAF5CAA22638D852 5791B006A30C8

¹²³ Impaired Driving: Get the Facts. Injury Prevention & Control: Motor Vehicle Safety. CDC>Motor Vehicle Safety>Impaired Driving. Centers for Disease Control and Prevention. http://www.cdc.gov/Motorvehiclesafety/impaired_driving/impaired-drv_factsheet.html

¹²⁴ Testing is done at the state level with the percentage of all traffic fatalities that are tested being different in every state. The data collection forms only have space for 3 substances to be listed. The priority in which substances are tested puts alcohol in first place and cannabis in 4th—cannabis may not be tested if there are some other drugs. The practices in some locations is to start the testing sequence with Alcohol, and, if it is positive for alcohol, to stop further testing. Testing may occur months after the incident, and will not be forwarded with the original report; updates may not be provided. For these and other reasons drug impaired motor vehicle accidents (MVA) and drug impaired MVA fatalities, as well as cannabis impaired MVAs and cannabis impaired MVA fatalities are under-reported. http://www.whitehouse.gov/sites/default/files/ondcp/issues-content/fars_report_october_2011.pdf; Berning A, Smither DD (November 2014) Understanding the Limitations of Drug Test: Information, Reporting, and Testing Practices in Fatal Crashes. Behavioral Safety Research. Traffic Safety Facts Research Note. US Department of Transportation and National Highway And Traffic Safety Administration) Washington, DC, DOT HS 812 072 http://www-nrd.nhtsa.dot.gov/Pubs/812072.pdf

¹²⁵ Kalant H (2004). Adverse effects of cannabis on health: an update of the literature since 1996. Prog Neuropsychopharmacol Biol Psychiatry. Aug;28(5):849-63.

¹²⁶ Hartman RL, Huestis MA (2013). Cannabis effects on driving skills. Clin Chem. Mar;59(3):478-92. doi: 10.1373/clinchem.2012.194381. Epub 2012 Dec 7.

¹²⁷ There is the need to distinguish between pharmacological action, and ones ‘drug experience,’ which is the outcome of the complex interactions between, the chemically active substance, the user and where it is being used, or site. (Zinberg N E (1984) Drug, Set, and Setting: The Basis for Controlled Intoxicant Use. New Haven: Yale University Press)

¹²⁸ Anderson BM, Rizzo M, Block RI, Pearlson GD, O'Leary DS (2010), ‘Sex differences in the effects of marijuana on simulated driving performance,’ J. Psychoactive Drugs (San Francisco, CA: Haight Ashbury Publications, March 1, Vol. 42, No. 1. http:// www.thefreelibrary.com/_/print/PrintArticle.aspx?id=239347323

¹²⁹ Anderson BM, Rizzo M, Block RI, Pearlson GD, O'Leary DS (2010), ‘Sex differences in the effects of marijuana on simulated driving performance,’ J. Psychoactive Drugs (San Francisco, CA: Haight Ashbury Publications, March 1, Vol. 42, No. 1. http:// www.thefreelibrary.com/_/print/PrintArticle.aspx?id=239347323

¹³⁰ Hartman RL, Huestis MA (2013). Cannabis effects on driving skills. Clin Chem. 2013 Mar;59(3):478-92. doi: 10.1373/clinchem.2012.194381. Epub 2012 Dec 7

¹³¹ Lacey JH, Kelley-Baker T, Furr-Holden D, Voas RB, Romano E, Ramirez A, Brainard K, Moore C, Torres P, Berning A (2009) 2007 National Roadside Survey of Alcohol and Drug Use by Drivers Pacific Institute for Research and Evaluation (Calverton, MD: National Highway Traffic Safety Administration, December 2009), p. 9 In: http://www.nhtsa.gov/DOT/NHTSA/Traffic%20Injury%20Control/ Articles/Assoc…

¹³² J, age 72, a college-educated American and experienced driver and cannabis user for over half a century, denies any awareness of impairment when driving ‘high.’ He says “Everything is happening so fast. It's too fast,” and states that slowing down when driving is a way of dealing with his changed time perception (personal communication, February 2015).

¹³³ Chrome search result obtained on January 25, 2015, at 7:50 am (Eastern seaboard time=GMT-5)

¹³⁴ In Colorado where recreational cannabis is legal, of all traffic citations issued by the Colorado State Patrol, 12.5% were for marijuana-impaired traffic citations. In: Healy J (2014) ‘After 5 Months of Sales, Colorado Sees the Downside of a Legal High’ The New York Times, June 01; Correction: June 8, 2014. http://www.nytimes.com/2014/06/01/us/after-5-months-of-sales-colorado-sees-the-downside-of-a-legal-high.html?_r=0

¹³⁵ Brookoff D, Cook CS, Williams C, Mann CS (1994) Testing reckless drivers for cocaine and marijuana. New England J Med. Aug 25; 331(8):518-522. http://www.nejm.org/doi/pdf/10.1056/NEJM199408253310807 Downloaded from nejm.org on January 25, 2015.

¹³⁶ Field Sobriety Testing. Impaired Driving . National Highway And Traffic Safety Administration, and National Center For State Courts. http://home.trafficresourcecenter.org/Impaired-Driving/Field-Sobriety-Testing.aspx

¹³⁷ Kelly J (July 27, 2010). ‘Has the most common marijuana test resulted in tens of thousands of wrongful convictions?’. AlterNet http://www.alternet.org/story/147613/has_the_most_common_marijua- na_test_resulted_in_tens_of_thousands_of_wrongful_convictions

¹³⁸ Oral fluid assays for most drugs of abuse are still in the developmental stage, and an accurate/reliable assay for cannabis ‘is still illusive to diagnostic manufacturers.’ Available rapid point-of-collection oral fluid tests with drivers indicate poor specificity, sensitivity and positive predictive values for drugs of abuse. Cannabinoids appear to be especially difficult to detect in oral fluids, as very little drug is excreted into the saliva. http://www.nhtsa.gov/ people/injury/research/stateofknwlegedrugs/stateofknwlegedrugs/pag- es/3Detection.html

¹³⁹ Verstraete A, Puddu, M (2000). Evaluation of different roadside drug testing equipment. EU Contract DG VII RO-98-SC 3032, Available on website www.rosita.org.

¹⁴⁰ The usual procedure is to strike a bargain (‘cop a plea’) between the prosecuting and defense attorneys where the accused enters a guilty plea in return for a lower sentence. (Kelly J (July 27, 2010). ‘Has the most common marijuana test resulted in tens of thousands of wrongful convictions?’. AlterNet http://www.alternet.org/ story/147613/has_the_most_common_marijuana_test_resulted_in_tens_ of_thousands_of_wrongful_convictions). Justice may be swift even if it be not done. (to paraphrase Shakespeare)

¹⁴¹ Marijuana and Driving: A Review of the Scientific Evidence. The National Organization for the Reform of Marijuana Laws (NORML) http://norml.org/library/item/marijuana-and-driving-a-review-of-the-scientific-evidence

¹⁴² Cannabis / Marijuana (Δ 9 -Tetrahydrocannabinol, THC). Drugs and Human Performance Fact Sheet. http://www.nhtsa.gov/people/injury/ research/job185drugs/cannabis.htm

¹⁴³ Barceloux DG (3 February 2012). Medical Toxicology of Drug Abuse: Synthesized Chemicals and Psychoactive Plants. John Wiley & Sons. pp. 910–. ISBN 978-1-118-10605-1. Cited in: http://en. wikipedia.org/wiki/Cannabis_(drug)#Detection_of_consumption .

¹⁴⁴ Baselt RC (2008). Disposition of Toxic Drugs and Chemicals in Man. Biomedical Publications. pp. 1513–1518. ISBN 978-0-9626523-7-0. Cited in: http://en.wikipedia.org/wiki/ Cannabis_(drug)#Detection_of_consumption

¹⁴⁵ Armentano P (undated). The ABCs of Marijuana & Drug Testing. Drug Testing. Legal Issues http://norml.org/legal/drug-testing/item/the-abcs-of-marijuana-and-drug-testing.

¹⁴⁶ The per se limits for alcohol impairment are set at 0.08 grams of alcohol per deciliter of blood Blood Alcohol Concentration (BAC). In: Berning A, Smither DD (November 2014) Understanding the Limitations of Drug Test: Information, Reporting, and Testing Practices in Fatal Crashes. Behavioral Safety Research. Traffic Safety Facts Research Note. US Department of Transportation and National Highway And Traffic Safety Administration). Washington, DC, DOT HS 812 072 http://www-nrd.nhtsa.dot.gov/Pubs/812072.pdf.

¹⁴⁷ DuPont RL (2013). Marijuana Use is a Serious Highway Safety Threat: 5 ng/ml Marijuana Impairment Limits Give Drivers a Free Pass to Drive Stoned. Commentary, Institute for Behavior and Health, Inc., http://www.ibhinc.org/pdfs/IBHCommentaryMarijuanaandDrugged- Driving61013.pdf

¹⁴⁸ The majority of drivers are not tested for drugs (only 41% and 40% of drivers were tested in 2008 and 2012, respectively); There are typically higher testing rates of drivers who died in crashes (65% in 2008 and 61% in 2012) compared to surviving drivers (20% in 2008 and 21% in 2012); A driver who tests positive for a drug is not necessarily impaired by the drug; There is no consistent set of policies or procedures for drug testing across States. (Berning A, Smither DD (November 2014) Understanding the Limitations of Drug Test: Information, Reporting, and Testing Practices in Fatal Crashes. Behavioral Safety Research. Traffic Safety Facts Research Note. US Department of Transportation and National Highway And Traffic Safety Administration). Washington, DC, DOT HS 812 072 http://www-nrd.nhtsa.dot.gov/Pubs/812072.pdf)

¹⁴⁹ A Chrome search for ‘cannabis driving lawyers’ (January 25, 2015; 8:30 am=−5 GMT) elicited about 830,000 results of which the first two are: 1. Beckham Solis - Competitive Rates Unmatched Success‎ Ad www.duimiamilawyer.com/‎ [phone] Exclusively Miami-Dade DUI Defense. Beckham Solis, Attorneys at Law has 421 followers on Google+ 2420 SW 22nd Street, Miami, FL‎ · The Home Field Advantage · What Makes Us Different? · Our Client Reviews · Tell Us About Your Case 2. Car Accident Law Firm—Free Consultation—Available 24/7‎ Ad www.caraccidentlawyerfirm.com/‎ [phone] No Fee Unless We Get Money For You!

¹⁵⁰ Vuchinich RE, Heather N (eds.) (2003) Choice, Behavioral Economics and Addiction New York : Pergamon; Kahneman D, et al, Judgment under Uncertainty: Heuristics and Biases, Cambridge University Press.

¹⁵¹ Anon (2012) Cannabis—a valuable drug that deserves better treatment. Mayo Clin Proc. PMID: 22305029 [PubMed—indexed for MEDLINE] PMCID: PMC3538401 .

¹⁵² Busse F, Omidi L, Timper K, Leichtle A, Windgassen M, Kluge E, Stumvoll M (Apr 10, 2008) Lead poisoning due to adulterated marijuana. N Engl J Med.;358(15):1641-2. doi: 10.1056/NEJMc0707784. http://www.ncbi.nlm.nih.gov/pubmed/18403778 In: http://en.wikipedia.org/wiki/Cannabis_(drug)#cite_note-pmid18403778-81

¹⁵³ In the state of Washington, where recreational cannabis is legal, out-of-state residents are allowed to purchase cannabis, but it must be consumed in Washington. (Steinmetz K (2014) ‘Everything You Need to Know About Buying Legal Weed in Washington State’ TIME, July 8, http://time.com/2955024/washington-where-to-buy-pot/)

¹⁵⁴ Ingold J (12/18/2014 01:12:07 PM) ‘Nebraska and Oklahoma sue Colorado over marijuana legalization.’ The Denver Post. http://www.denverpost.com/news/ci_27163543/nebraska-and-oklahoma-sue-colorado-over-marijuana-legalization

¹⁵⁵ Some authorities in Nebraska, Oklahoma and Kansas (which are non-legalized cannabis states bordering Colorado where cannabis is legal) have reported an uptick in marijuana-related busts, different police in those states and others say they haven't seen any new issues arise. (Ferner M (05/28/2014 6:27 pm EDT Updated: 05/28/2014 6:59 pm EDT) ‘Keep Your Legal Weed In Colorado, Say Cops In Neighboring States.’ Huffingtonpost.Com http://www.huffingtonpost.com/2014/05/28/colorado-marijuana_n_5405422.html)

¹⁵⁶ Ingold J (02/28/2012 01:00:00 AM MST61) ‘Colorado post offices see increase in marijuana packages’ The Denver Post. http://www.denverpost.com/search/ci_20058373

¹⁵⁷ It may be useful to remember that American car-maker General Motors had to recall over 28 million cars and take a charge of $1.2 billion because it did not want to spend the dime (US$ 0.10) it would have cost to install the correct ignition switches when the cars were first manufactured. http://en.wikipedia.org/wiki/2014_General_Motors_recall

¹⁵⁸ http://en.wikipedia.org/wiki/Homo_Ludens_%28book%29 ¹⁵⁹ http://en.wikipedia.org/wiki/Johan_Huizinga

¹⁵⁹ http://en.wikipedia.org/wiki/Johan_Huizinga

Additional information

Notes on contributors

Manuella Adrian

Manuella Adrian, M. Sc. Hyg., US, researcher, writer, academician, manager. Her main research interests have included trying to find answers to questions that had not been investigated before, mainly because there was no data and no readily available means of acquiring the requisite material. And if one did get the data, how should one approach it? How should one think about it? How should one conceptualize it so that it could yield its information to us in answer our question? What if it could answer a better question in a better way than we had first thought of? That is what researchers do. We come up with questions, concepts, data, research designs, and ways to make sure that we have not forgotten anything. Or anything truly important that will invalidate what we think we have discovered. It is a giant puzzle full of facts and factoids, truthiness and jumbles of seemingly unconnected events. And our job is to find the pattern inherent in it so that we can figure out the next move in the game and have a decent chance of getting it right. For the opportunity to try to solve interesting questions, my thanks to Stanley Einstein, PhD (who came up with interesting questions), Brian Ferguson, PhD (who always could see beyond the obvious), Howard L (for emergency electro-computing life support and resurrection), Kevin Thomas, JD Esq. (whose comment-in-passing inspired this paper). And to all my colleagues on the editorial board of Substance Use and Misuse, and in the readership, whether we know each other personally, by reputation or as a name on an article or in a footnote, or even if we don't know each other at all.