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Few individuals have as much influence on drug policy in the United States as Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), whose tenure at the head of the federal government’s top drug research institution started in 2003. In a new interview, Dr. Volkow came to admit that she was wrong about her expectations relating to the legalization of marijuana and that pro-legalization advocates were in the right.
“People were saying that if you legalize marijuana, you’re going to see this explosion in adolescent use, and I think you were part of that group saying that. I was more right than you were,” Ethan Nadelmann, founder of Drug Policy Alliance and pro-marijuana activist, challenged Volkow on his show.
Volkow acquiesced, admitting, “I was expecting the use of marijuana among adolescents to go up, but overall, it hasn’t.” As Nadelmann rightfully points out, marijuana has been easily accessible to teenagers for decades, even when it is fully illegal, with surveys showing that roughly 80% of high school seniors have had easy access to it during prohibition. Teenagers who want to get high will get high, and the law is not going to stop them; what might stop them is the fact that cannabis supplies are moved out of the hands of illegal dealers and into the hands of lawful dispensaries turning away underaged customers after legalization.
One central tenet of prohibitionist policy is the belief that legalizing marijuana would lead to an increase in usage, but also fear that it would mean more impaired drivers on the roads, more addicts among the youth, more crimes across the state and more drug-related injuries and deaths. The exact opposite is true, as practically every study on the topic points out. “Researchers are identifying policies across the states as to how they are legalizing marijuana,” says Volkow. “As you look through the states, you see that the adverse effects of marijuana use are much worse in some states, whereas states that have legalized it actually have better outcomes.”
Legalization allows medical professionals to take care of addicts, it allows professionals and corporations to take over the distribution of marijuana in a lawful manner, it allows the state and medical communities to address the negative consequences of marijuana use instead of keeping it shamefully hidden lest users be locked up in prison for it.
U.S. Policy Does Not Listen to Science
The central point of Volkow’s message is the divergence between scientific knowledge and how it is applied in policies across the United States.
Imprisonment is widely used as a repressive measure against drug users, which science teaches us is not just wrong: It is the polar opposite of the measures that should be taken to improve outcomes for everyone. “Imprisonment has consequences in the brain,” Volkow explains. “It actually increases the risk of taking drugs, and now, even more than before, it also increases the chances of overdosing and dying. We [NIDA] are working to provide alternative models that will ensure that people, if they end up in prison, can get treatment, that they get support, but also how one can intervene to avoid that incarceration. Research shows that, when you have a relative, a father or a mother that ends up in jail, the risk of the child having a substance use disorder is much greater.”
Volkow relates that she tries to bring up the negative, devastating consequences of imprisoning drug users to Congress, because she feels “very very strongly” about the harm caused by the War on Drugs on communities and individuals. “In fact, one of the reasons why I took this position was because I say we can develop the science in such a way that that policy changes.
“There are structural systems that promote certain behaviors,” she says regarding systemic factors that push people to consume drugs or which turn substance consumption harmful. “Science alone is not enough to change those policies. The question that I always ask is: ‘Why is it that science cannot change policies that would get rid of the structural characteristics that are leading to these inequalities?’”
Why, indeed, does the United States continue to double down on a repressive prohibitionist policy that has been thoroughly demonstrated not to work to reduce harm or protect people? That’s because causing more harm, in itself, is the whole purpose. The Drug Enforcement Administration (DEA) chose to ignore their own judge’s ruling that marijuana should be removed from the Schedule I, which it shares with heroin. Somehow, it is the police arm of the DEA that is in charge of making science- and fact-based decisions regarding policy, rather than a scientific body. To nobody’s surprise, the DEA chooses to do the thing that will be most harmful to certain communities—communities of color, LGBTQ+ people, immigrants, poor people … Communities where marijuana arrests are dramatically higher than among white, wealthy Americans despite the same rate of marijuana use.
Volkow agrees that criminalization of marijuana is wrong, adding that, “hopefully, science will serve to change policies, reduce the stigma and change the notion of criminalizing people to that of treating and helping people and preventing them from relapsing.”
This is a nice sentiment, but it is not reflective of the reality within which her institute exists. As Ethan Nadelmann very justly words it, “You’ve never been a fan of the War on Drugs, but here, you’ve been operating in a political context in which punitive prohibitionist policies, mass arrests and the heavy racial biases that go with all of that has been pervasive.” As he points out, even scientists and well-minded individuals among the authorities, such as War on Drugs-sceptic Volkow, rarely focus on the harm caused by drug repression rather than by the drugs themselves, even though prohibition is at the source of many issues that people wrongly conflate with drug use.
