Twenty-four states and the District of Columbia allow for the medical use of marijuana. Currently, four states have approved the legalization, taxation, and regulation of small amounts of marijuana for personal use. Other states have decriminalized the possession of small amounts of marijuana. In 2016, a number of other states will address the legalization or decriminalization of marijuana on the ballot in November.
Nonetheless, at the time of this writing, according to federal statutes, possession of marijuana remains a criminal offense. The United States Drug Enforcement Administration continues to list marijuana as a Schedule I controlled substance, meaning that according to the federal government, it has no medicinal use and cannot be purchased legally by private citizens or dispensed by medical personal under any conditions. In fact, marijuana is classified in the same category as heroin. The current executive administration has maintained a hands-off policy regarding enforcing federal marijuana statutes in states where marijuana has been legalized or decriminalized; however, there is no guarantee that future administrations will do the same if the federal statutes are not altered.
The criminal justice policy initiated by the United States regarding possession of marijuana has resulted in a number of individuals who have probable drug abuse or substance use disorders experiencing harsh sanctions as opposed to receiving needed supports and treatment for their issues. These types of policies certainly hamper the substance use disorder treatment industry’s ability to provide support to individuals who are sanctioned or incarcerated with what are most likely relatively minor legal transgressions and more likely represent issues with substance use disorders.
Legalization and Treatment
Colorado and Washington have legalized marijuana and model their approach to its sale and distribution after the regulation of liquor sales in those states. There is a concerted attempt by both states to make sure that individuals under the age of 21 cannot buy marijuana, and that businesses that sell marijuana should only be selling marijuana products and not be selling other commodities to limit underage traffic in these businesses. Businesses can get around this by formally having two businesses under the same roof, such that one business only markets marijuana products and the other markets something else. Colorado and Washington can serve as examples of how legalization affects the treatment industry.
The available data indicates that generalizations regarding how the state and federal government approach the issue of substance use disorders (e.g., criminal justice versus legalization and decriminalization) will affect many of the issues regarding treatment. Exactly how changing policies will affect treatment providers cannot be fully determined at this time. However, it can be hypothesized that:
- Legalization will most likely result in an increase of the diagnoses made for individuals with substance use disorders, and this will increase the burden of treatment in the substance use disorder treatment industry.
- Legalization may result in an earlier identification of substance use disorders in individuals and in fewer individuals with substance use disorders being incarcerated for their behavior unless they also break other laws.
- Legalization may have actually a negative effect on keeping potential substances of abuse out of the hands of younger individuals.
- It is uncertain how legalization or decriminalization of drugs will result in more state and federal aid being appropriated toward the treatment of substance use disorders. It can be speculated that legalization may result in the development of more state-sponsored substance use disorder treatment programs, as many proponents of legalization also support the notion that certain percentages of tax revenues accumulated from the sale and distribution of newly legalized drugs should be appropriated to formalized treatment programs. If legalization remains associated with rising proportions of the population using specific drugs, such a move would appear to be appropriate.
- A number of states will most likely address the legalization of marijuana in 2016. Many of the questions regarding how legalization will affect the policies of treatment providers may be answered within the next two or three years.