Thread by @MyHarmReduction

As a researcher, a social worker, and legalization advocate, I have a lot of problems with this article: theatlantic.com/health/archive…

First of all, this piece reiterates the myth that legalizers somehow don't think cannabis/marijuana use can be harmful. No one has ever said that. However, we DO say that the harms of prohibition and its collateral effects are why legalization is important.

Second of all, legalizers are not a monolith. There are absolutely problematic players advocating for policy reform- we live in a capitalist society with no publicly funded campaign system. Special interest money influences all legislation in US. Marijuana policy is no exception.

Third of all, frequency of use does not always equal harm. In fact, frequency of use isn't even a diagnostic criterion of a substance use disorder (think of caffeine, agonist txs). Use despite negative consequences determines SUD.

I would like to highlight a poster presented at @CPDD18 which disputes that frequency of use = more cannabis use disorder prevalence. Check out this poster by @Columbia researchers showing rates of CUD declined among daily users since '02.

Here is a link to a published paper which also suggests that rates of CUD among frequent users has been on the decline. This is by researchers at @RANDCorporation doi.org/10.1016/j.drug…

Lastly, people who develop substance use disorders (on ANY substance) often are struggling with other issues. SUDs have little to do w the substances themselves, but on the person's unique bio-psycho-social context. Exposure doesn't create addiction.

If someone is developing a SUD, it is often due to other pre-existing or co-occurring issues/concerns- such a mental health concerns, trauma, boredom, relationship issues, employment issues, lack of support, and others. Not everyone is vulnerable to SUD due to use alone.

Pieces like this irresponsibly pin the blame on the drug exposure/use rather than the likelihood that individuals who develop these SUDs had other concerns at the time which escalated use beyond/in spite of negative consequences.

Journalists. Please do better.

Also- shoutout to my @DrugPolicyOrg colleague Jolene Forman for her important quote!