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REEFER MADNESS.

Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence, by Alex Berenson. Free Press, 272 pages, $26

REGARDING MARIJUANAS LEGAL STATUS, America is now a house divided. On one side stands the federal government's 1970 Controlled Substances Act (CSA), which classifies marijuana as a prohibited Schedule I drug with a high abuse potential and no approved therapeutic uses. Additionally, 17 states have neither broadly decriminalized marijuana nor legalized it for either recreational or medical uses. On the other side are the 11 states and the District of Columbia that have legalized marijuana for recreational purposes. Another 22 states have either decriminalized marijuana or legalized it for medical uses or both.

Can this house divided stand much longer? The conflict between the CSA and 33 states (at last count) is a federalism Pandora's Box. For instance, federal "know your customer" laws require banks to red-flag deposits derived from illegal trade. The CSA outlaws marijuana sales. So, when bank officials accept monies they know come from selling or taxing cannabis, are they money laundering?

What about the locally licensed marijuana merchants and state government taxmen themselves?

In 1996 California became the first state to legalize marijuana for medical use. Sixteen years later, Colorado and Washington State became the first to legalize it for recreational use. Behind the war for marijuana were billionaire George Soros and several other rich businessmen, who financed the politicking, media-messaging, and coalition-building that united anti-drug war activists, left-wing radicals, and free-market conservatives. Their savvy, nonstop, hearts-and-minds campaign now finds two-thirds of Americans supporting legalization. Additionally, a 2017 Yahoo News/ Marist poll showed that 52% of Americans have tried pot, 22% use it currently but rarely, and 14% use it at least once or twice a month.

ALEX BERENSON WOULD URGE US ALL to look hard before we leap any farther toward legalizing marijuana. In Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence, he pleads: "The United States should not legalize cannabis nationally; it should move to discourage more states from legalizing, and it should consider pressuring those that have already done so to reverse course."

A former investigative reporter for the New York Times, Berenson is an award-winning spy novelist whose wife, a psychiatrist, specializes in evaluating mentally ill criminals. He wastes no time dramatizing his core reason for insisting that legalization is not worth the risk: psychoses triggered or worsened by pot use and resulting in murder and mayhem. Tell Your Children opens with a terrifying tale about a low-income, 37-year-old paranoid schizophrenic Australian who stabbed her own seven children and a niece to death after becoming a heavy marijuana user. He closes with a horror story about a 26-year-old man who stabbed 19 people to death at a Japanese nursing home after being "hospitalized less than five months earlier for cannabis psychosis."

WISELY, BERENSON ASSEMBLES HIS anti-legalization brief not only by multiplying anecdotes and excerpting interviews he conducted, but also by summarizing numerous scientific studies. Unfortunately, his book has no footnotes, endnotes, bibliography, or subject index. Too often, the mystery writer leaves his reader pining for clues about exactly where he got certain facts, figures, or findings. Still, his in-text references to studies usually allow the diligent reader to find them.

For example, Berenson writes, "Cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk." That's a direct quote from The Health Effects of Cannabis and Cannabinoids, published by the National Academy of Sciences (NAS) in 2017. But Berenson, who seems like a sincere soul, ignores the NAS report's caveats and qualifications regarding the cannabis-psychosis connection. The conclusion he quotes rests on just five studies, published between 2007 and 2016, whose limitations include "self-report for cannabis use," research design issues, a "lack of information on the frequency of use," and others. And there are "ecologic data" indicating that, "in certain societies, the incidence of schizophrenia has remained stable over the past 50 years despite the introduction of cannabis into those settings."

Which way do the causal arrows fly among and between substance use (marijuana and other), mental illness (psychosis and other), and other risk factors (genetic and other) that might predispose one to be a substance-using psychotic? On this "comorbidity" question, the NAS report is expressly agnostic, as is the Centers for Disease Control (CDC) online statement, which advises that marijuana is correlated with "anxiety, depression, and schizophrenia, but scientists don't yet know whether it directly causes these diseases." And, in its June 2018 "Drug Facts" research bulletin, the National Institute on Drug Abuse, an agency not known for hiding bad news about narcotics, states that while "[l]ong-term marijuana use has been linked" to "worsening symptoms in patients" with schizophrenia and "other mental health" diseases, "study findings have been mixed."

In other words, neither Berenson's claims about cannabis and psychosis, nor those about cannabis-induced violence, are well supported. For instance, he asserts that the link between marijuana and violence is "[i]n many cases" stronger than the link between alcohol and violence. In fact, pot is a distant second to booze when it comes to violence. Drunkenness figures in about half of all violent crimes (homicide, aggravated assault, sexual assault, intimate partner violence, and child abuse).

As discussed in "The Neural Correlates of Alcohol-Related Aggression," a 2018 study published in Cognitive, Affective, & Behavioral Neuroscience, the jury is starting to come in regarding how boozing buzzes the prefrontal cortex and contributes to aggression.

CRIME AND PUBLIC POLICY IS A SERIES featuring the latest and best policy-relevant research by leading crime analysts, edited by the late, great conservative intellectual, anti-legalization hard-liner, and my own mentor and friend, James Q. Wilson. The 2011 edition's chapter on drugs and crime concluded that "the cannabis market causes little violence," adding that, "since cannabis intoxication does not lead to aggression, legalizing cannabis would not be likely to cause much additional pharmacologic crime." The 2016 edition of Marijuana Legalization: What Everyone Needs to Know concluded the same. Berenson praises Marijuana Legalization as "a balanced look" at legalization, but asserts that "it understates the violence risk." I can't see how.

Likewise, he cites as "definitive" a 2009 article on schizophrenia and violence in PLOS Medicine by Seena Fazel, an Oxford University forensic psychiatry professor. But in that article Fazel and his co-authors stress that their overall estimates are based on disparate findings from diversely designed studies. They note that when siblings are used as control groups, "the risk increase" for violence is "significantly less pronounced." They conclude, far from definitively, that "how substance abuse mediates violent offending needs further study."

I could find nothing in Fazel's fascinating work or related studies to undergird Berenson's claim that marijuana is "a supercharger for sudden, extreme violence." To conclude otherwise, I'd have to believe that the maximum-security prison officials by the hundreds whom I studied for more than a decade were misreading their own experience managing violent criminals when they worried much more about contraband booze than smuggled-in weed.

STILL, BERENSON DESERVES DECENT marks on several counts. With the help of Sanford Gordon, my own former Princeton graduate student and now a top social science scholar, he deflates the claim that medical cannabis is a solution to the opioid overdose epidemic. (Earlier this year, Gordon co-authored a Proceedings of the National Academy of Sciences study reinforcing the tentative findings that are previewed in Tell Your Children.)

In addition, Berenson is right "that occasional use of marijuana by people over 25 is generally safe" and that levels of tetrahydro-cannabinol (THC) in marijuana have increased over the past few decades. He wisely warns about higher-potency pot and a coming cannabis industry that can maximize profits by turning customers into addicts.

To his great credit, Berenson reached out to pro-legalization leaders. The one he deems "more responsible for the legalization of cannabis in the United States than anyone else" is Ethan Nadelmann, the former Princeton professor who founded the Soros-seeded Drug Policy Alliance (DPA) and whom Rolling Stone magazine touted in 2013 as America's "real drug czar." "I like Ethan Nadelmann," he confesses, noting that Nadelmann "didn't join the legalization movement to get rich--or high."

Well, I don't like Nadelmann ... I love him. For nearly 40 years he has been among my dearest friends. He remained so even during the two decades that I strongly opposed de criminalization as a threat to public health and safety, and despite my never trying pot (unless you count not holding my breath through rock concerts). In a 1999 Reason magazine article, "Prison Conversion," Jacob Sullum summarized how my own research on the alcohol-crime nexus and "drug-only offenders," mixed with religious stirrings and Nadelmann's influence, had changed my views. But I still also count among my friends several largely unreconstructed drug warriors, including John Walters, the wonderful public servant who served as federal drug czar when I was on George W. Bush's White House staff, and with whom I had worked earlier on many projects.

In an extensive sit-down interview with Walters, Berenson waxed eloquent regarding his conviction that children and "vulnerable adults" are victimized when marijuana is ubiquitous. "That risk," he concludes in his final pages, "is the reason" most nations remain "wary of marijuana." He asks: "Why on earth would we want to encourage people to use this drug?"

WE DON'T--NOT HIM, NOT WALTERS, and not Nadelmann. The real question is: What marijuana public law regime is most likely to achieve the greatest good and minimize the most harm for the greatest number? The best (or least bad) policy must accommodate a national population that includes: security-first folks like me who tell their children to eschew all illicit drugs; freedom-loving folks like Nadelmann who are more open to achieving altered states; and those who tell their own children and others that if they use marijuana at all they must strive to use it responsibly.

Berenson opposes repealing the CSA and extending state-level legalizing, but he also opposes rolling back decriminalization laws, calling them a "reasonable compromise," Nor does he want to put anybody in jail for using pot, adding that if people "want to use in the privacy of their own homes, so be it." But that "so be it" seems devilishly hard to reconcile with the 220-plus pages that precede it. Can the supposed epidemic of cannabis-psychosis-induced murder and mayhem be somehow mitigated if people use pot only in the privacy of their own homes--homes that, presumably, they will exit at some point?

Still, he's right that today "we are in the worst of all possible worlds," with marijuana "legal in some states, illegal in others," and outlawed outright by the federal government. So, what to do?

Let's start by cultivating common ground on laws and taxing schemes that favor local marijuana dispensaries and keep big pharma-type enterprises from doing with pot what they've done since the 1990s with opioids and other prescription pain killers: lie, get people hooked, lobby, and fiddle while people die. Ditto for regulating marijuana production, distribution, and sales (especially THC potency levels). We should discourage smoking anything in public or private places (fewer joints, bongs, and blunts relative to edibles and drinkables). Top medical researchers need to do an even deeper dive into the health effects of cannabis and cannabinoids. Finally, longitudinal studies tracking how, and whether, laws legalizing cannabis have affected public health and safety will provide essential clarity.

BUT FIRST, LET'S STOP DEBATING MARIJUANA legalization as if any one side possesses the empirical and moral truth, wholly and unequivocally. Sir Isaiah Berlin had a term for people who insist that "the truth" is a knowable, single, harmonious whole, such that to possess it is to be spared the need to weigh competing facts, choose between competing values, cope with uncertainties, or tolerate people who think and live otherwise. Berlin baptized them "monists," as opposed to "pluralists."

Going forward, we need fewer marijuana monists and more pot pluralists. For all its problems, Tell Your Children is a well-motivated attempt to rebut "dangerous myths about cannabis" and be a "bullhorn" for those who "have so much trouble being heard." I suspect, however, that Berenson knows "the truth" about marijuana to be less certain, singular, and settled than he has rendered it. Indeed, I spy here a pluralist in monists clothing. It will be no mystery to me if his position on marijuana evolves more than a little in the coming years.

John J. Dilulio, Jr., is the Frederic Fox Leadership Professor of Politics, Religion, and Civil Society at the University of Pennsylvania.

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Author:Dilulio, John J., Jr.
Publication:Claremont Review of Books
Date:Sep 22, 2019
Words:2098
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