"Capitol Watch: Pot heats up" (The Citizen website, Nov. 24) shows we need a state run monopoly if cannabis is to be legalized, so profits can mitigate public health damage, not private corporate profits. The Onondaga County Medical Society unanimously passed such a resolution with cannabis legalization seemingly imminent.
Eight states currently have legalized recreational marijuana, sold by for-profit companies. Tort law regarding injuries from a defective product has specifically excluded producer/sellers of addictive drugs. Income from tobacco in the United States is $124 billion/year and costs to taxpayers are $300 billion, including $170 billion in direct medical care, income from alcohol is $223 billion and costs taxpayers are $249 billion (Sacks et al, 2015), including $1.7 billion in medical costs to New York state.
For-profit sales of addictive drugs encourages development of drug delivery innovations and recruiting children to use the drugs. In 2016 one in four students in grades six through 12 were vaping nicotine with e-cigarettes. Of those, one in four middle school students and one in three high school students, were also vaping cannabis (Trivers et al, 2018). The frightening consequence is a significant minority of children leaving high school already addicted to two drugs using the lung as the route of administration.
The cost of providing medical care for complications of marijuana use are likely to be approximately equal to the income derived from sales of marijuana. Cannabis use produces psychosis in vulnerable persons (Bagot & Chang, 2018). The main burden will be doubling the cost of schizophrenia, currently $156 billion in the U.S. (Miller, 2016). Other costs are expected to be the care for in utero exposure complications, vascular complications such as stroke and myocardial infarction, hyperemesis, the pulmonary damage caused by using the lung to get marijuana to the brain, more addiction due to wider availability, accidents caused by intoxication, increased emergency visits for emotional complications of intoxication such as panic.
We know public health measures, such as sales of addictive drugs by a state monopoly, have been successful. For example, all alcohol in Ontario, Canada, is sold by a state monopoly, and they plan to do the same with cannabis.
The state of New York should sell marijuana rather than allow private companies to sell marijuana legally. This approach will contain, regulate and discourage use, and provide addiction treatment at point of sale. Suggested site of sale is the public health department of each New York State County. All revenues will accrue to the state to fully compensate citizens of New York State for the direct and indirect costs of legalizing an addictive drug.
MaryAnn Millar, Dr. Brian Johnson and Dr. Sunny Aslam
MaryAnn Millar is president, Dr. Brian Johnson is immediate past president, and Dr. Sunny Aslam is on the executive committee of the Onondaga County Medical Society.