Opinion: Opt out of marijuana sales

The Tompkins County Medical Society wishes to provide our perspective against the development of recreational marijuana/cannabis industry in Tompkins County. We present 3 arguments against recreational marijuana/cannabis: 1) the overstated tax benefits, 2) the real and under-estimated negative consequences from using marijuana/cannabis, and 3) the effect of cannabis on central NY workers to compete in the global marketplace.

The Overstated Tax Benefits

The most common suggested benefit is a large tax windfall from cannabis sales. Let’s look at other legal addictive substances — alcohol and nicotine — which in fact have total societal costs that far exceed tax revenues.

The true financial cost of alcohol use in the USA, when accounting for healthcare, lost productivity, motor vehicle accidents, etc., is estimated at $249B per year (cdc.gov/alcohol/features/excessive-drinking.html). This annual cost compares to net annual sales of $222B in 2020 (t.ly/Ixbs).

Thus, for alcohol, total sales tax comes nowhere near to covering the $249B in societal costs of alcohol consumption.

Experience with tobacco is similar. The societal cost of tobacco has been estimated to be $300B per year in 2010 (pubmed.ncbi.nlm.nih.gov/24455788/), versus annual sales of $50B [now] (pubmed.ncbi.nlm.nih.gov/29739530/).

What reason is there to believe that cannabis will be different? In a full accounting of the predictable medical and other costs of any vice, the community costs of legalization and retail development are almost certain to be more than the potential tax revenue.

The Understated Harms

Have we learned nothing from the opioid crisis? With OxyContin, Purdue Pharmaceutical overstated the benefits and widely understated the risks of their product. Is that different from the current state of the cannabis industry overstating the benefits and downplaying the risks?

A recent study in the Journal of the American Medical Association (JAMA) looked at traffic deaths in Colorado and estimated that legalization causes 75 additional deaths per year (pubmed.ncbi.nlm.nih.gov/32568378/). Another recent study in JAMA found that if all 50 states were to legalize marijuana there would be an expected increase of 6,800 traffic fatalities per year (pubmed.ncbi.nlm.nih.gov/32568359/). Do we want that here?

Cannabis use increases the incidence of psychosis, and of schizophrenia 2- to 4-fold. Schizophrenia typically develops in late teens and young adults. A Yale study found no benefit of CBD in reduction of psychosis symptoms (tinyurl.com/y253xmk6). A 2021 study in Denmark found a causal relationship between cannabis use and a 3- to 4-fold increase in the risk of developing schizophrenia among marijuana users from 1995 to the present. The authors proposed that this increased risk was due to the increasing potency of marijuana over this period (tinyurl.com/y43jn4gl).

Second-hand marijuana smoke increases upper respiratory infections in children by 30% (nature.com/articles/s41390-021-01641-0).

Maternal use of cannabis during pregnancy leads to decreased birth weight and an increase in childhood anxiety, aggression, and hyperactivity (pubmed.ncbi.nlm.nih.gov/34782458/). Further, a 2020 study demonstrated that women in states where marijuana was legalized were 3 times more likely to report concurrent cannabis and tobacco use during pregnancy (pubmed.ncbi.nlm.nih.gov/34449272/).

Macroeconomic Considerations

As we seek to position central NY in the modern global economy, based on knowledge, innovation, the ability to learn, and a focused motivation and drive, what effect will cannabis have on our work force?

Overwhelming data show that cannabis products produce the exact opposite of the traits needed for success in the global economy. Cannabis use, just one time, reduces learning, attentiveness, and impairs memory for more than a week. Daily or near-daily users function at reduced mental capacity most or all the time (tinyurl.com/nckn8wj).

Negative cognitive impacts are not limited to youth, as the large CARDIA study demonstrated that, among current marijuana users, cumulative lifetime use of marijuana was associated with decline in verbal memory, processing speed and executive function (pubmed.ncbi.nlm.nih.gov/26831916/).

Conclusion

Given these notable negatives from the use of cannabis products, negatives that impact both the individual as well as the broader community, where are the collective benefits to our community?

We absolutely believe in decriminalization of possession. We also believe that cannabis should be changed from Schedule I to Schedule II, so that high-quality research can be done to clarify what constituents in cannabis have medicinal purposes in a purified and dose-controlled form — like all other FDA-approved medications.

We think legalization of cannabis just because people wanted to get high, without due diligence to understand the personal and societal risks, was a mistake, but that is done and over and now NY law. Tompkins County communities should not compound Albany’s mistake by supporting local product development and sale until more is known about the risks and costs to individuals and to society.