Liberals say addiction is a disease, which is true. But then they say stop punishing them and just give them treatment. What happens? Most addicts and alcoholics say no; that is, when they are being polite. The Amy Winehouse line, They tried to make me go to rehab but I said ‘ no, no, no’  is every addict’s first response to help. So just offering treatment does no good.

Hard-line conservatives want to lock ‘em all up. For some addicts, prison is the best thing; it’s the only time they stay clean. But it’s expensive, and untreated, they get released and wind up in trouble again. Prisons are full of repeat offenders who never get treatment.

The answer is coerced treatment. Use the threat of punishment to keep them in treatment. And the moment they stray, throw them back in jail. We’re already doing this across the country with drug courts, HOPE in Hawaii, and dependency court for addicts who run afoul of Child Protective Services. One of my patients told me the best thing that ever happened to her was CPS taking her daughter away, because it forced her to get clean and stay clean to get her kid back.

Also, most people in jail and prison are substance abusers, and despite what the marijuana lobby wants us to believe, they are almost all there for a real crime they committed while under the influence. So why don’t we turn our jails and prisons in huge treatment programs. We’re already covering room and board. Just add some treatment staff.

Why don’t we do this? Politics. Politics and enabling. Enablers are well-meaning people who help an addict keep using. In the WAshington Post story, the chaplain who convinced the judge to send Amy to treatment instead of prison was enabling. Enablers on the left tend to believe that giving people the help and support they need will work. It doesn’t. Their cry is treatment, not punishment, but treatment alone does not work.

The left is now egged on by the marijuana lobby, a collection of politically savvy groups that represent drug users. Like Amy Winehouse and millions of addicts and alcoholics everywhere, they hate treatment. They just want to get high. It seems crazy to let drug addicts and abusers rewrite the nation’s drug laws, but they now have the left on their side.

And the marijuana lobby hates coercion. Two of the four points of the Marijuana Policy Project’s mission statement say they want only “non-punitive, non-coercive” policies. They want us to believe they will get treatment when they are ready. Anyone who works in the addiction treatment field can tell you they are never ready until something really painful happens, like getting busted or fired. So the left won’t help us get to a sane drug policy.

On the far right, we hear lock ‘em up. But no money for treatment; that’s just coddling them. But that’s not just inhumane, it’s expensive. Society saves at least $12 in criminal justice costs, health care costs and lost economic activity for every $1 spent on treatment.   However, that’s a bit too nuanced for the far right.

We’re caught between the two tea parties. The tea party on the right refuses to pay for prevention and the tea party on the left (the ones who smoke their tea) just wants to abolish drug laws so they can get high in peace.

Centrist politicians are the ones who usually understand coerced treatment, using tough laws and the threat of punishment to get people clean and sober and keep them that way. Unfortunately, in today’s hyper-partisan climate, centrist politicians are practically extinct.

I’ve been asked a few times to explain why I say almost every one of the marijuana cardholders in Arizona is probably a substance abuser faking their illness just to get the pot.

Pain patients are about 55 percent female in one study, and the others just came up with mostly female. That’s close to 50 percent, so let’s just say pain patient should be 50:50 male: female. Then it is like a coin toss. If you toss a coin 100 times, about 50 times it should be heads. If you toss it 100 times and get heads 75 times, something is very wrong.

Now suppose there is a coin that actually does come up heads 75 percent of the time. If you toss it 100 times, you should get heads 75 times.

So now suppose you have a whole pile of 1000 coins. Some of them are the normal ones and some are the ones that come up heads 75 percent of the time. And you want to figure out how many are the normal coins and how many are the 75 percent heads coins.

You can’t tell which an individual coin is by tossing it, but if you toss them all you will have a good idea. If you toss them all and get heads 50 percent of the time, then they are all normal coins. If you toss them all and get heads 75 percent of the time, then they are all the 75 percent coins. If you toss them all and get heads 67.5 percent of the time, then half the coins are normal and half are the 75 percent heads coins.

Well, that is almost exactly our situation. The medical marijuana patients are almost all claiming pain. If they really have pain and only want marijuana for their pain, then a little over 50 percent will be female, or around 45 percent will be male. But adult pot-smokers are 74 percent male, so if they are all just pot-smokers who are faking pain to get weed, then they will be 74 percent male. And if some are genuine and some are faking, then the percent of males will be somewhere between 50 and 74.

Well, in Arizona, 73 percent are male. That means that probably they are just about all faking it.

In Colorado, 68 percent are male. That is 6 away from 74, but 23 away from 45. (24 away from 45 is easier to use, so let’s use that.) If we were doing our coin toss, then 80 percent would be the mostly heads coins and 20 percent the regular coins. But in our case, 68 percent is the number you’d get if 80 percent were faking it and 20 percent really had pain.

That’s why I say most of them are probably faking it.

If you go look at the Arizona DHS website and look at their marijuana statistics, you will see a graph showing that almost all the young people getting medial marijuana are male. As you get older, the numbers come closer together. That graph alone tells you that most of the young people with marijuana cards are doing it to get high, not for any medical reason.

And last May, 71 percent of congressional Democrats voted to eliminate funding used by the Obama Justice Department to raid large-scale medical marijuana operations they believed were providing the drug to recreational users. Only twelve percent of Republicans joined them so the measure failed.

Democrats should think twice before becoming the party of pot. I’m a lifelong, partisan Democrat, but I’ve also spent 25 years as a doctor treating drug abusers, and I know their games. They’re excellent con artists, and there’s good evidence that the marijuana movement has been conning us.

Medical marijuana laws were sold to over a dozen states with promises that they’re only for serious illnesses like cancer. However, once these laws passed, almost all the marijuana patients claimed pain, which is easy to fake and impossible to disprove. In Oregon and Colorado, 94 percent of marijuana cardholders get their pot for pain. In Arizona, it’s 90 percent. Serious illnesses barely register.

Also, research shows that pain patients are mostly female, whereas a recent National Survey on Drug Use and Health found that adult cannabis abusers were 74 percent male. So which one do marijuana patients resemble?

Only two states release data on gender. In Arizona, 73 percent of marijuana cardholders are male. In Colorado, it’s 68 percent. The best explanation for these skewed numbers is that most medical marijuana recipients are drug abusers who are either faking or exaggerating their problems just to get high.

No one should support this subterfuge, but especially not Democrats. It turns us into hypocrites. We fumed when President George W. Bush proposed gutting the Clean Air Act and called it the Clear Skies Initiative. That’s no more dishonest than calling pot “medical” when it almost all goes to recreational use.

Marijuana activists use phony science just like global warming deniers. For years they claimed pot was good for glaucoma, and never apologized when research found pot can actually make glaucoma worse. They still insist weed isn’t addictive despite every addiction medicine society saying it is. They’ve even produced their own flawed scientific studies supposedly proving that medical marijuana laws don’t increase teen use, when almost all the evidence says just the opposite. How can we criticize Republicans for disregarding science and making up facts if people on our side do the same?

Democrats know we need government regulation to protect the public from unhealthy products. However, the marijuana lobby wants us to distrust the FDA and DEA. The whole purpose of medical marijuana laws is to evade the regulatory power of these agencies. We’re the political party that got the FDA to regulate tobacco; from which side of our mouth would we now say the FDA can’t regulate pot?

Marijuana legalization also runs counter to the Democratic commitment to education as the best way to keep our economy strong. States with medical marijuana laws have always had much higher rates of teenage marijuana use, but now the effect is nationwide. Since 2008, teen use in America has increased 40 percent, and heavy teen use (at least 20 times per month) is up 80 percent. The drive to legalize pot is mostly to blame. It sends the message that weed is harmless, even though research clearly shows that marijuana interferes with learning. Teens who smoke pot regularly do worse in school, are twice as likely to drop out, and earn less as adults. Research even shows that teenage marijuana use lowers IQ and the effect appears to be permanent. No other drug, not even alcohol, affects academic performance like marijuana. How can we call education crucial for a competitive America, and then support laws that will blunt the next generation’s ability to compete?

Legalization would even undermine a successful Democratic program. Drug courts were started in 1989 under Dade County State Attorney Janet Reno and written into the 1994 Crime Bill by Senate Judiciary Chairman Joe Biden. President Clinton fought for that bill and it became law despite three-fourths of Republicans voting against it.

Drug courts use coercion, the threat of jail, to keep addicts in treatment. And it works. By combining tough drug laws with coerced treatment, drug courts have turned thousands of criminal addicts into clean and sober law-abiding citizens.

However, the pro-legalization Marijuana Policy Project opposes coerced treatment. That’s not surprising. They represent drug users, who just want to be left alone to get high. But if we side with them, we’re undercutting the Democratic answer to substance abuse.

Groups that want to legalize pot have coalesced into a powerful marijuana lobby, intent on pulling the nation in their direction. In effect, we now have two tea parties in this country. On the left they smoke their tea; on the right they throw it in the Boston harbor. Both tea parties distrust government, disregard science, and make selfish demands that would undermine the public good. What’s different, and what Democrats can be proud of, is that while Republicans have completely caved to their tea party, several Democrats, including the President, are standing up to ours. And protecting the long-held principles of the Democratic Party.

A shorter version of this post appeared as an op-ed in the New York Times on November 8, 2012.

Arizona’s “medical marijuana” law passed in November 2010 by just over 4000 votes, 0.2% of all votes cast. I opposed it because it’s not really about medical marijuana, it’s designed so almost all the marijuana goes to recreational users. Had it been an honest medical marijuana law that gave most of the marijuana to genuinely ill people who would be helped by it, I never would have opposed it. There are real instances in which cannabinoids can provide relief of symptoms. Now that it has passed, we should make sure the law provides medical marijuana, not recreational marijuana.

First of all, marijuana for medical use should never be dispensed in a form that can be smoked. Marijuana can be made into capsules or suppositories or cooked into food, but marijuana smoke contains dozens of carcinogens. Preliminary research shows that smoking marijuana can increase the risk for respiratory problems and several types of cancer–lung, head and neck, testicular and bladder. This post reviews much of the research. The medical profession and others in public health have made a huge effort for several decades to eliminate the smoking of tobacco because it’s such a serious health hazard, and doctors should not recommend any substance to be smoked.

Following the adage, “First, do no harm,” doctors should always prescribe medications by the least harmful route of administration. And, in fact, we always try to give medications orally. For people whose illness makes it hard to take a pill or to keep one down, we have skin patches and suppositories. The last resort is injecting medicine. But there is no precedent for a medication that is smoked. To my knowledge, there is no medicine prescribed today that is smoked,  and for good reason. Smoking causes cancer and lung damage. And there is no need for a medication that is smoked; there is nothing that smoking accomplishes from a medical point of view that can’t be accomplished by safer routes of administration.  Arizona, and other states with medical marijuana laws, should forbid the dispensing of medical marijuana in any form that can be easily smoked.

Here’s some of the research on problems caused by smoking:

Research has shown that marijuana smokers have several respiratory tract changes, including lesions that are considered pre-cancerous. So far there is no evidence of emphysema, but smoking marijuana does cause problems with airflow obstruction.

There are a small number of studies of cancer in marijuana smokers, some positive, some negative.   Negative studies are quite common in research, and all they mean is this particular study did not find this particular result. Negative studies are not proof unless it happens repeatedly and there are no positive studies. However, many pro-marijuana websites and media outlets have taken a single negative study and claimed marijuana does not cause cancer. There are also articles designed to look scientific that make this claim.  This is an incorrect reading of the research.

Two studies did show no increase in cancer in marijuana users, but both studies have been criticized for bias. One large study (Tashkin 2006) of 1200 people with head, neck and lung cancer showed no increase in cancer in marijuana smokers. Tashkin was the same researcher who had previously found that marijuana caused pre-cancerous changes in the respiratory tract, so he was surprised to find no increased cancer risk.  That large study has been criticized for selection bias—marijuana users in the control group were more likely to also smoke cigarette than the marijuana users in the group with cancer. The authors admitted selection bias possibly explained their negative findings.

One other study published in the American Journal of Public Health in 1997 (Sidney et al) that found marijuana smokers had no increase in cancer has been criticized for using subjects who were too young, so cancers would not have had time to develop.

There are several research studies showing increased cancer rates in marijuana smokers.

A New Zealand study published in the European Respiratory Journal in 2008 looked at 79 patients with lung cancer and found the risk of lung cancer increased by 8 percent for every joint-year (averaging one joint daily for one year) and 7 percent for every pack-year (averaging one pack of cigarettes daily for one year), leading them to conclude that smoking marijuana posed the same lung cancer risk as smoking cigarettes.

Three North African case studies showed a very strong link between marijuana smoking and lung cancer, but none of these studies controlled for tobacco use, so these results are questionable.

A 2009 study done at the Fred Hutchinson Cancer Research Center in Seattle and published in the journal Cancer found that men who smoked marijuana once a week had twice the risk of testicular cancer when compared to men who never used marijuana, and marijuana was most strongly linked to nonseminoma, the most aggressive form of testicular cancer.

Research published in the journal Urology in 2006 showed increased rates of bladder cancer in marijuana smokers. They also found that marijuana-smoking patients were younger at the time of diagnosis than most patients with bladder cancer. Cigarette smoking is a major risk factor for bladder cancer, but the researchers concluded that smoking marijuana may be as bad or worse than cigarette smoking as
a risk factor for bladder cancer.

In 1999, a study published in the journal Cancer Epidemiology found that squamous cell carcinoma of the head and neck increased with marijuana use and there was a strong dose-response curve, the heavier marijuana users had higher rates of cancer. However, in 2004, a study published in Cancer Research found no association between marijuana user and squamous cell carcinoma.

This is not a complete list of studies, and there aren’t many. So it is not enough to draw definitive conclusions on marijuana and cancer. However, the evidence that marijuana smoking is linked to cancer is far more substantial than the research supporting marijuana as treatment for many of the disorders listed in Arizona’s new medical marijuana law.  Also, remember, it took decades of heavy tobacco use by large swaths of the population before we had a definitive link between tobacco smoking and cancer. Meanwhile, cigarette smoking killed Franklin Roosevelt, Humphrey Bogart, Edward R. Murrow, and tens of thousands more. The rule in the field of medicine is when in doubt, err on the side of caution. Caution says if preliminary evidence shows that marijuana smoking probably causes cancer, treat it as if it definitely does.

On several pro-marijuana websites I found the claim that there is no direct evidence linking marijuana smoking to lung cancer in humans. That is exactly what the tobacco industry said for decades after the first studies came out linking cigarette smoking with lung cancer. What they said was technically true; until recently we did not know for certain the exact mechanism by which smoking caused cancer. However, the statistical evidence was overwhelming, so the tobacco industry was being completely disingenuous and so are the pro-marijuana groups who say marijuana doesn’t cause cancer. Anyone who claims that marijuana does not cause cancer is ignoring the research.

Also, in November 2010 an article printed in the European Journal of Immunology described a possible mechanism by which smoking marijuana causes cancer and the research supporting this possible mechanism. If further studies support these findings, then we will have direct evidence linking marijuana smoking to cancer in humans.

Anyone who goes on the internet will find the pro-marijuana groups misrepresenting research. What they almost always do is take one study or one bit of information and run with it as if that were the whole story. That’s how Arizona ended up with a law that says marijuana is good for glaucoma even though the Glaucoma Foundation warns patients not to use marijuana because it could make their symptoms worse.

The American Cancer Society points out on its website that it’s hard to study marijuana and cancer because so many marijuana users also smoke cigarettes and because it’s hard to study illegal drugs. British cancer researchers noticed the same problem.

However, one part of the research is very clear. We know for certain that marijuana smoke contains many of the same carcinogens as tobacco smoke, produces more tar than tobacco, and that the way people smoke marijuana (down to the roach, unfiltered, inhaling deeply, holding it in) delivers more tar to the lungs than the way people smoke tobacco.

California’s Office of Environmental Health Hazard Assessment ruled in 2009 that marijuana smoke is carcinogenic. They are not calling the marijuana plant a carcinogen, just the smoke. That seems right; the research shows a link between smoking marijuana and several types of cancer also commonly caused by smoking tobacco. There is no evidence that ingesting marijuana by other methods causes cancer.

Smoking marijuana is also linked to respiratory problems. Research shows that marijuana smokers have decreased respiratory function, increased airflow obstruction, and fewer of the anti-oxidants that protect against cancer and heart disease.

In summary, smoking marijuana has been implicated in several health problems including cancer. Not definitively, but enough evidence to make it likely. So no doctor should be recommending marijuana in a form that can be smoked. And states with medical marijuana laws, including Arizona, should not allow such a potentially dangerous route of administration.

Marijuana can be mixed into food, formed into a suppository, or cooked in vegetable oil or butter and put into a capsule. Dispensaries should only be allowed to dispense marijuana in these forms, and they should not be allowed to sell marijuana in a form that can be smoked.

Marijuana users have responded to the harm of smoking by developing vaporizers so they can continue to inhale cannabinoids without the dangers of smoking.  However, the reason for vaporizing marijuana is still to get a quick high, just like smoking it. It still offers no medical advantage over taking cannabis orally or rectally, and it allows marijuana to be dispensed in the same form that can be smoked, allowing diversion. Besides, the vaporized product has not, to my knowledge, been tested for carcinogens.

So I strongly suggest the following addition to Arizona Department of Health regulation R9-17-311, and I recommend similar laws for every state with a medical marijuana law:

7. Marijuana may not be dispensed in its raw form or in any form that can easily be used by smoking it. Marijuana should only be dispensed in forms that can be taken orally, such as in foods or mixed with oil or butter and made into capsules, or rectally, as in suppositories. The dispensary will keep records listing the form in which the marijuana is dispensed.  Marijuana for medical use cannot be transported in its raw form. It must be turned into a dispensable form within 100 feet of the place where it is grown.

All marijuana dispensaries must post a warning that can be easily seen by anyone purchasing medical marijuana. The warning states: “Marijuana smoke contains known carcinogens and has been determined to be carcinogenic by ADHS.  Medical marijuana can only be dispensed in forms that are taken orally or rectally. Smoking marijuana obtained for medical use is considered illegal diversion and can be prosecuted. Possessing raw marijuana and smoking marijuana are still illegal under Arizona law.”

The rule against transporting marijuana in its raw form will also help law enforcement because, in other states with medical marijuana laws, it is a common practice for drug dealers to get marijuana cards so they can claim the marijuana they are carrying around is for medical use.

The known carcinogen statement is taken from California’s Office of Environmental Health Hazard Assessment.

Arizona physicians, other health care providers and all concerned citizens who agree that smoked marijuana should remain illegal should go to the Department of Health Services website before January 7, 2011 and register their opinion on the Electronic Comment Form. Also, please read the proposed regulations and give feedback on that as well. They will be getting huge numbers of comments from people who want to divert marijuana to recreational use. They need to hear from the rest of us as well.

Here are Seven Reasons to oppose medical marijuana…

1) Most of the marijuana will go to drug abusers; less than 3 percent will go to the seriously ill.

2) Prop 203 will increase teenage marijuana use, and it will hurt them academically.

3) Prop 203 will increase DUIs and traffic fatalities.

4) Almost all the marijuana is prescribed by pot doctors who hand out marijuana cards all day to anyone with $150. This is not a real doctor-patient relationship.

5) Prop 203 gives pot-smokers unheard of impunity with employers and the law. It will be hard to prosecute them for DUI or discipline them for coming to work stoned.

6) The Marijuana Policy Project claims prisons are full of innocent people who did nothing but smoke marijuana, and that is completely untrue.

7) Marijuana is actually harmful for people with glaucoma and other diseases they keep saying it helps.  This whole thing is being pushed by pot-smokers, not doctors or people with serious illness.

There’s a post on each of these.

The group opposing Propositon 203 is KeepAZDrugFree.  I can be reached at DrGogek@gmail.com.

Proposition 203 is basically dishonest. The ballot says it’s for “terminally or seriously ill patients,” but in other states that passed similar laws, anyone can get pot, and hardly any goes to the seriously ill. In Montana 3 percent of the medical marijuana patients

Marijuana dispensary in California, where three-fourths of all medical marijuana patients are under age 40. Does he look seriously ill?

have cancer, AIDS or glaucoma–the serious diseases the marijuana is supposedly for. In San Diego, it’s only 2 percent.  Drug abusers, teenagers, college students, people with no serious medical problems at all—that’s who these laws protect and that’s who smokes almost all of the medical marijuana, not people with serious illnesses. News stories by the Associated Press (Medical Marijuana Facing a Backlash) and the New York Times (When Capitalism Meets Cannabis) have documented this problem in Montana and Colorado.  What the proposition seems to say and what really happens are completely different.

For example, Prop 203 limits marijuana to people with very specific medical conditions, and lists cancer, AIDS,  multiple sclerosis—disorders that are extremely debilitating and hard to fake. It’s easy to prove whether or not someone has cancer. But the list of

The Arizona Republic said the medical argument is a smokescreen. Prop 203 is a backdoor route to legalization.

approved medical conditions also includes “severe and intractable pain.” That one’s totally subjective. Anyone can fake pain and it’s impossible to disprove. And anything can be severe and intractable pain—a twisted ankle, a bad back, a skateboarding injury. One woman got marijuana because her high heels hurt. So it’s a perfect loophole for drug abusers.

That might be okay if only a tiny amount of marijuana went through this loophole while most of it went to genuinely sick people who needed it. But what’s happening in states with these laws is almost all the pot is smoked by drug abusers and genuine medical use is a rarity. In the New York Times article (When Capitalism Meets Cannabis) the reporter spent 3 days in several marijuana dispensaries, and most of the patients he saw were under age 30. Everyone he interviewed had a diagnosis of severe pain. And in the city he visited, at one point all the marijuana dispensaries were on college campuses. In Montana, 90 percent of cardholders have a diagnosis of “chronic pain,” and only 3 percent have serious illness.

According to the Justice Department’s 2008 Marijuana Sourcebook (page 20), in San Diego County, three-fourths of the “medical marijuana” patients are under age 40, and 12 percent are under 21. This is not the age group that should have the most serious health problems.

The demand for medical marijuana doesn't come from doctors or from the seriously ill.

So don’t buy the story that Prop 203 is about people with cancer and other serious illnesses. The real story about Prop 203 is that it’s a back door route to legalization, and almost all the marijuana will go to people with no significant health problems at all.

Some people say, what’s it matter, as long as that 2 percent is helped. The answer is that, despite what pot-smokers would have us believe, marijuana is harmful. The next 2 posts tell you how harmful medical marijuana laws are, and why it’s really bad for Arizona to pass a law that will give 98 percent of the medical marijuana to people with no medical need.

To join or learn about the group opposing Proposition 203, go to KeepAZDrugFree.com

Research shows that teenagers who smoke pot frequently have difficulty with  memory, attention and problem-solving, find it harder to learn, get lower grades, and are less likely to finish high school or college. Once they’ve finished or left school, they have higher job turnover, less satisfying careers and earn less money than non-pot-smoking peers. No parent wants this for their children. Medical marijuana laws increase teenage marijuana use, so all these problems become more common.

By 2006, 20 percent more teenagers were smoking pot in medical marijuana states (ProCon.org) By 2008 the difference was 30 percent. (SAMHSA)

Most teens are actually pretty smart about drugs, using the ones they consider to be safe and avoiding the ones they believe to be harmful. That’s why cigarette smoking and binge drinking have decreased sharply among teens.  Teenage marijuana use also showed an overall decrease between 1999 and 2006 as teens recognized the very real problems it can cause. But the decrease has been far less in states with medical marijuana laws. In medical marijuana states, teen use dropped by 5 percent in 7 years, whereas in non-medical marijuana states it dropped 14 percent.

By the way, some pro-marijuana advocates use only half this statistic, pointing out that teenage marijuana use is decreasing in medical marijuana states and claiming that proves medical marijuana laws don’t increase teen pot use. What they’re not mentioning is that teen marijuana use has decreased everywhere, and is decreasing three times as fast in states without medical marijuana laws.

If teens know the problems pot can cause, they are less likely to use it.

In a 2006 ranking of states based on the percentage of teens who used marijuana over the past month, medical marijuana states came out on top.  The 3 states with the highest rates of teen pot use were all states with medical marijuana laws. At the time there were only ten states with medical marijuana laws, but half of the top ten were medical marijuana states. Maine went from 28th to first in the nation in just a few years after passing a medical marijuana law.

Between 1999 and 2006, teenage pot use was 20 percent higher in medical marijuana states. But in 2007-2008 the gap increased to 30 percent, and the downward trend in teen marijuana use bottomed out, especially in states with medical marijuana laws. This is all from the SAMHSA National Household Drug Use Survey. In 2009, teenage marijuana use increased, and most likely teenage marijuana use is increasing in states with medical marijuana laws and decreasing in states without these laws.

Marijuana vending machines in California send the message that pot is as harmless as candy

One reason teenagers smoke more pot in states with medical marijuana laws is that they begin to see pot as a benign medication for everyday aches and pains rather than as a harmful, addictive drug.  Also, medical marijuana laws, especially loosely-written ones like Prop 203, make marijuana more available for everyone. In an NPR story earlier this year, teenagers in California were quoted saying marijuana is always available, either from dispensaries or from friends who have medical marijuana cards. When a drug is more available and seen as safe, more people use it, especially teens.

Parents should know that one of the main results if this proposition becomes law is that their children are much more likely to have friends who smoke pot and more likely to smoke pot themselves. And if they do smoke pot, they will probably start at an earlier age and smoke it more often.

Medical marijuana laws also teach kids dishonesty. When they see drug abusers and doctors gaming the system, and getting away with it, they think that’s what normal people do.

To join or learn about the group opposing Proposition 203, go to KeepAZDrugFree.com

Marijuana is the culprit in one-third of Montana's DUI traffic fatalities. If more people smoke pot, it could even overtake alcohol.

A research study by the University of Auckland compared a random sample of drivers with people who had either been killed or hospitalized by car accidents. Regular and heavy pot-smokers were 9.5 times more likely to get into a serious accident as non-users. Another study looked at patients in a hospital trauma unit who had been in car or motorcycle accidents. Fifteen percent had been using marijuana alone and an additional 17 percent had both THC and alcohol in their blood streams.  A study published in the New England Journal of Medicine looked only at impaired drivers who were not using alcohol. They found that 45 percent of people stopped for reckless driving tested positive for marijuana.  A significant percent of impaired drivers and serious accidents, including fatal accidents, are caused by marijuana.

Part of the problem is that so many people drive stoned. One study found that 16 percent of adolescents drove within one hour after smoking pot. Also, while there’s been a huge education campaign against drunk driving, the pro-marijuana groups often insist that marijuana makes people safer drivers.

Marijuana advocates often insist that marijuana never killed anyone. One look at the stoned driving statistics should make it clear that’s not true. They also frequently argue that marijuana is safer than alcohol. But judging by these statistics, it’s possible that the main reason alcohol kills more people on the highway is because it is more widely available, not because it is more inherently dangerous. Laws that make marijuana more widely available could even the gap between the two drugs.

In fact, that has happened. When Montana first passed its law, very few people were prescribed, or recommended, medical marijuana. Then marijuana caravans began criss-crossing the state, bringing with them pot doctors who made all their money handing out marijuana cards. In less than a year, the number of “medical marijuana” users increased 5-fold. And shortly after that, according to Montana narcotics chief Mark Long, marijuana DUIs skyrocketed as did the number of fatal car accidents where one of the drivers had marijuana in his blood stream. In two years, the number of fatal car accidents caused by marijuana increased 25 percent. In Montana, marijuana now causes half as many traffic fatalities as alcohol, and the gap is narrowing.

In California, the number of fatal car crashes caused by marijuana doubled in the five years after they passed their medical marijuana law. Marijuana is just as deadly behind the wheel as alcohol, and if marijuana use increases it could overtake alcohol as the deadliest drug on the road.

If Prop 203 passes, Arizona will see a similar increase in deadly car crashes.

To join or learn about the group opposing Proposition 203, go to KeepAZDrugFree.com

If it's just for serious illness, why is this doctor advertising where young people hang out?

Prop 203 says only licensed physicians can write marijuana recommendations. That sounds good because we assume doctors will only use it to treat genuinely sick people. But instead what happens is a handful of doctors set up practices where they get rich seeing 50 – 100 people a day, handing out marijuana cards to anyone with $150. Check out the website www.potdoc.com, for an example of one of these marijuana doctors.

In Colorado, the doctor who writes the most prescriptions sees people for 5 minute appointments. In Montana, traveling marijuana caravans take pot doctors from town to town, handing out marijuana cards.

In some offices, the secretary fills out the card before the "patient" even sees the doctor.

This should be illegal. If a doctor openly prescribed Xanax for everyone or Oxycontin for everyone, the licensing board would yank his license and he’d probably go to jail. But Prop 203 protects these marijuana doctors so the licensing board can’t touch them.

Prop 203 is sponsored by the Marijuana Policy Project (MPP), a group devoted to legalizing pot. It says so right on their website.  And they’re knowingly pushing this law that is full of loopholes.

If they were serious about medical marijuana, they could propose a much stricter law that actually gave most of the marijuana to terminally and seriously ill people. They could have based Prop 203 on New Mexico’s more carefully-written law that requires second opinions to make sure people really have the illnesses they claim. Colorado changed their law to require a long-standing doctor-patient relationship, instead of 5 minutes. Prop 203 has neither of these protections.

Prop 203 ties the licensing board's hands, and lets unethical doctors become drug dealers.

People who represent the Marijuana Policy Project says Arizona’s law is improved, that they learned from their mistakes in other states. But the pot doctor loophole is still in Arizona’s law. Colorado’s legislature is trying to get rid of the pot doc loophole, but once a referendum is passed in Arizona, state law makes it extremely difficult for our legislature to fix it.

Why is this man smiling? Dr Jean Tallyrand made $10 million in 5 years prescribing marijuana.

Because of this loophole, Prop 203 will effectively legalize marijuana for everyone. Every drug addict in the state will know exactly who these doctors are, and they’ll have waiting rooms full of people in their twenties and thirties. Is that a legitimate medical practice?

To join or learn about the group opposing Proposition 203, go to KeepAZDrugFree.com

If Prop 203 passes, the courts will have to define too stoned to go to work. Expect a long, drawn-out battle.

That might sound reasonable. After all, marijuana can show up in the bloodstream several days after use. The problem is, there is no standard for what constitutes “insufficient concentration to cause impairment.” Prop 203 doesn’t say who sets the standard, so it will probably fall to the legislature or Department of Health Services. But expect lots of lobbying and lawsuits until a standard is established. And until a standard is established, pot-smokers can drive stoned or go to work stoned with impunity. Whether they’re surgeons,

Until the courts decide, no one can be fired or even sent home for coming to work high.

truck drivers, crane operators or teachers, they’re protected even if they go to work high. Drug-free workplace rules will not apply.

Every landlord's nightmare becomes a tenant's right under Prop 203.

The law also says no landlord may refuse someone as a tenant for being a cardholder, even if the card-holder lives 25 miles from the nearest dispensary and is allowed to grow marijuana in hishome. In Colorado, people who grow their own are re-wiring houses and starting fires, but the law protects them. They can’t be evicted or even charged an extra damage deposit like pet-owners are.

Prop 203 protects the drug-abusing parent, but not the child.

Child visitation can’t be denied because someone is a cardholder. Even if the parent is a drug addict whose child was taken by CPS because he abused the child whenever he was on drugs, that parent can still show up for visitation stoned.

In Montana, nearly 10 percent of criminals on probation and parole have marijuana cards, and they usually got them after they were arrested. This allows them to smoke pot even if they’re drug addicts, and  judges or drug courts have ordered them to stay clean and sober.

Instead of “stoned,” substitute the words “drunk” or “high on oxycontin,” and these people could be prosecuted, fired, evicted, denied visitation or ordered to stay drug-free on parole. But Prop 203 gives pot-smokers unheard of protection. Even strict libertarians and others who support legalization find this unfair. There should still be consequences for people who don’t control their behavior.

To join or learn about the group opposing Proposition 203, go to KeepAZDrugFree.com