Cannabis prohibitionist bureaucrats have always argued that marijuana is a gateway drug leading to abuse of hard drugs. This fiction should have been put to rest with the 1999 Institute of Medicine report, Marijuana and Medicine: Assessing the Science Base. Now, with nearly 15 years more medical cannabis experience in the country, it turns out that cannabis may be an excellent exit gateway or reverse gateway drug, useful in helping people reduce and avoid use of dangerous drugs such as narcotics and alcohol.
Cannabis offers many advantages to people wishing to quit dangerous drugs. Foremost, cannabis is one of the safest drugs in existence, one of the very few that can not cause death. Aspirin can and does kill. Even drinking too much water can be fatal. There is no lethal dose of cannabis. As DEA administrative law judge Francis Young noted in 1988,
“In strict medical terms marijuana is far safer than many foods we commonly consume. For example, eating 10 raw potatoes can result in a toxic response. By comparison, it is physically impossible to eat enough marijuana to induce death. Marijuana in its natural form is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within the supervised routine of medical care.” This is perhaps the last time any truth has come out of the DEA regarding cannabis. Judge Young also declared that to not reschedule cannabis down from Schedule I would be, “cruel, arbitrary and capricious,” the exact behavior of the DEA in the ensuing 25 years.
As a candidate for a safer substitute drug, cannabis excels also in the area of lack harms against others. Cannabis reduces violence, especially in contrast to alcohol. The main area where cannabis use causes hardship to family and community is when the cannabis consumer run afoul of the war on drugs and is arrested and perhaps imprisoned. These harms are from the persecution of the drug consumer by the forces of prohibition, not from the mild effects of cannabis itself. Cannabis has little additive potential with few withdrawal symptoms when unavailable. Unlike some addictive drugs, lack of cannabis does not cause compelling need.
The third reason cannabis serves well as a substitute for dangerous drugs is the positive effects of the mild euphoria cannabis use can provide. The “high” associated with cannabis is uplifting, not debilitating. If a person is using drugs to escape a negative mental or emotional state, the feelings of well-being produced by cannabis use are therapeutically useful and appropriate. As a matter of fact, the introduction of pharmaceutical drugs which had the opposite effect of the cannabis high (cannabinoid antagonists such as rimonabant) were blocked in 2006 by the negative and suicidal reactions to the psychological “low” the drug produced. Indeed, it may well be that many people predisposed to using dangerous drugs are cannabinoid deficient, either with minimal levels of natural cannabinoids such as anandamide, or suffering from insufficient cannabinoid receptors. In such cases, cannabis use would serve a homeostatic role, restoring this imbalance.
Another reason cannabis is being used as a substitute for dangerous drugs is its ability to relieve pain. Pain relief is the main reason for most doctor’s visits. The opioids most available as pharmaceuticals come with a host of adverse effects including, “respiratory depression, sedation, sleep disturbance, cognitive and psychomotor impairment, delirium, hallucinations, seizures, hyperalgesia, constipation, nausea, and vomiting.” Opioid drugs can kill by stopping breathing; cannabis can not. For some types of pain, especially neuropathic pain, caused by damage to nerves from conditions such as diabetes, the opioid drugs provide little pain relief. Cannabis is very effective in reducing neuropathic pain. It also makes for an excellent adjunct pain therapy for use in conjunction with other pain drugs, allowing these dangerous substances to be used in lesser amounts.
The American federal government blocks nearly all research into the medicinal use of cannabis, but with more US states asserting medical exemptions, we can increasingly expect more Americans to substitute safer cannabis for dangerous drugs.