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Column: Legalize recreational marijuana to protect adult users, keiki

Mark Rothstein
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Mark Rothstein

JAMM AQUINO / 2019
                                Brian Goldstein, CEO of Noa Botanicals, points to a bud on a cannabis plant at the company’s growing and production facilities in Kunia. State lawmakers are once again considering legislation to remove prohibitions on recreational adult-use cannabis.
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JAMM AQUINO / 2019

Brian Goldstein, CEO of Noa Botanicals, points to a bud on a cannabis plant at the company’s growing and production facilities in Kunia. State lawmakers are once again considering legislation to remove prohibitions on recreational adult-use cannabis.

Mark Rothstein
JAMM AQUINO / 2019
                                Brian Goldstein, CEO of Noa Botanicals, points to a bud on a cannabis plant at the company’s growing and production facilities in Kunia. State lawmakers are once again considering legislation to remove prohibitions on recreational adult-use cannabis.

For many years, opponents of cannabis legalization have promoted and exaggerated the potential for harm and have spread misinformation about cannabis’ impact on society. As a licensed physician since 1974 and medical director of Green Aloha Ltd., one of the existing eight legal medical cannabis license holders in Hawaii, I have seen the benefits of cannabis and the downfalls of prohibition. And I am a strong proponent of cannabis legalization and regulation bills House Bill 1246 and Senate Bill 1613.

There is no medication, commercial product, substance, or even food that is completely without any adverse effects. Cannabis is no different.

There are some people that should not use cannabis and may be at greater risks of significant adverse effects. But we do not ban peanuts because 0.5% of adults have peanut allergies. We do not ban alcohol because almost 11% of adults abuse alcohol. We don’t even ban tobacco products though we know it can cause lung cancer.

A responsible society places age limitations, licensing restrictions, labels about proper dosing and content, and educational and warning information about these products. This is exactly what SB 1613 does.

A century ago, a constitutional amendment was passed to enable the “noble experiment” of alcohol prohibition. But within 13 years the country had realized that prohibition didn’t work. It resulted in thousands of deaths from tainted liquor, grew organized crime and made us a nation of hypocrites. Cannabis prohibition is just as big a folly.

Much of the opposition to SB 1613 is not based in fact and is purely hyperbolic and anecdotal. For example, while prohibitionists remark that legalizing cannabis will increase the use of other drugs, there is no consensus of causality that cannabis is a “gateway” drug.

Legalizing adult-use cannabis at the state level “does not increase other substance use disorders or use of illicit drugs among adults and, in fact, may reduce alcohol-related problems,” according to recent Colorado University at Boulder research.

As support for legalization increases, there are concerns that this will encourage youth marijuana use.

However, the data is clear that adult-use cannabis legalization laws are not linked with increased cannabis use in adolescence. In fact, the data suggests the opposite. Twenty-four states have legalized adult-use cannabis, and in 19 of the 21 states with before-and-after data, government surveys reported a decrease in high schoolers’ marijuana use rates post-legalization.

Another common argument against legalization is that cannabis products have increased in potency. While this is definitely true, people have different tolerances and different rates of metabolic degradation of substances. Cannabis products have a wide range of potency.

Likewise, almost every pharmaceutical medication comes in varying dosages. Alcohol products also vary in potency. It should not be surprising or problematic that the products sold in retail cannabis stores have a varying degree of the active ingredient (THC). The higher-potency argument of modern cannabis is actually an argument in favor of SB 1613 as it requires third-party testing, dosage limits and labeling of the entities that it licenses. The illicit market has no such constraints.

Passage of SB 1613 will reduce the influence of the illicit market. The law will extend the present medical cannabis rule requiring a government issued ID to legally purchase cannabis, preventing those under 21 years old from purchasing cannabis at licensed retail stores.

It would also require proper testing for potency and contaminants to all future legal license holders. Enforcement of this law will be necessary to truly accomplish the goal of reducing adolescent use and protecting adult consumers.

Cannabis use is ubiquitous in Hawaii as it is elsewhere in this world. If the Legislature really wants to protect the people (and specifically the keiki) of Hawaii, it will pass SB 1613.

There is no constitutional process for voter initiatives or referendums in Hawaii. Our only pathway is through the legislative process.

I implore our Senate and House of Representatives to replace cannabis prohibition with legalization for adults coupled with education, sensible regulations and investment in our communities.


Mark Rothstein, M.D., is medical director of Green Aloha Ltd.


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