Menu Home


I’ve been thinking a lot lately about the use and abuse of illegal drugs and what doing so does not only to the person using/abusing but to the people around them and even to people far away. My wife, a friend, and I went to a comedy show the other night, and the comedian said that the reason people take drugs is “because they work.” He then went on to explain that people use drugs because they’re a way of escaping from the harsh realities of the world.

Of course, the physiology of addiction is much more complicated than just saying one uses drugs to “get away.” One also uses drugs because they trigger pleasure centers in the brain, or they dull pain receptors, or they allow you to sleep when you’re anxious… And the list goes on and on. It’s about two semesters’ worth of theory on drug addiction, and I don’t have the time — nor you the patience — to tell you all about it.

In case you didn’t know, I come from Mexico. A lot of my family is still there. Also in case you didn’t know, there is one hell of a drug war going on down there. By some accounts, there are thousands of people dead or missing as a result of the war. Most of them are or were criminals, but there are plenty of innocent people dead to make it very, very troubling.

They call it a “drug war” because it was triggered when then President Felipe Calderon decided that enough was enough with the drug cartels and he took them on. History will decide if this was a wise choice. However, his approach of taking out the heads of the cartels left the underlings fighting each other and law enforcement and the Mexican Army. Put on top of that the levels of corruption within the law enforcement institutions (and even within army units), and you have one glorious mess.

Every day, I read news of battles between rival gangs, between gangs and law enforcement or the army, even between law enforcement agencies when one takes down the other for corruption. Every day, there are assassinations, murders, kidnappings. And, almost every day, some group takes a rival cartel member and tortures them (or worse) on a video posted online. In that last instance, they seem to have taken a page out of the Al Qaeda handbook, where they try to scare their opponents into submission by doing some horrible things to their captured enemies.

And then, as if all this wasn’t enough, other criminals decided to pile-on and do their worse while hiding in the confusion and lack of accountability brought on by the war. They extort money from businesspeople, they kidnap, and they rob at gunpoint. My hometown of Juarez, across the river from El Paso, Texas, was ranked among the most violent cities for a few years during the Calderon administration. On the other hand, El Paso has consistently been among the safest. This just tells me that there is a lot of impunity and lack of police power in Juarez.

The other thing about Juarez is that it became a “choke point” for the drug trade. As US Customs and Border Enforcement has stepped out its interventions along the border, all of the “bad guys” have stayed on the Mexican side, fighting it out with each other. Things have calmed down a lot in Juarez since one cartel beat the other, but there are still plenty of crimes committed that go unpunished.

And it’s all because of the drugs. The US is, per capita, the largest consumer of illegal drugs in the world. It’s an industry that is almost $200 billion a year! Of course they’re going to kill each other for a bigger piece of that pie.

The most used illegal drug? Marijuana. The most trafficked? Marijuana. The one they’re killing each other in Mexico to bring to the US? Marijuana.

I’ve never used marijuana or any other illegal drug. I’ve drank alcohol. I’ve never smoked. So I’m not going to speak from experience on marijuana. I’m just going to use the evidence.

The evidence is that marijuana is not that bad as a drug. It is impairing. You can’t really operate a vehicle or make rational decisions while you’re high on it, but it’s not going to kill you. In essence, you’re not going to overdose from it and die. Children and teens shouldn’t use it because it does a number on a developing brain. But adults? Responsible adults in the privacy of their homes who are not going to go out and drive or are not taking care of a child and such?

As a public health professional, I would rather people use other coping skills than illegal drugs. But does it make sense to put an adult in jail for using marijuana not while driving, not while taking care of a child, not while operating a train full of people? That is, just for possessing it? And does it make sense to allow the cartels to have access to those billions of dollars?

Sensible drug policy doesn’t have to be an all-or-none game. If marijuana is decriminalized, it can be grown domestically, used by adults 21 and older (like alcohol), and governments at all three levels can tax the hell out of it (like tobacco) in order to get revenue and reduce its use. Will this halt the drug war in Mexico? I don’t know. Drug cartels might switch over to fighting it out over importing more of the other drugs they already bring in, like heroin and cocaine.

Heroin and cocaine are serious drugs (alone and in combination), and I don’t see a way to decriminalize them and treat them like we treat alcohol and tobacco. You can die from an overdose, and overdosing is easy. Intravenous use of heroin brings with it a very high risk of hepatitis B or C, or HIV infection. That said, I’d rather put a person addicted to them in a treatment program rather than jail. (I’d put the dealers and traffickers in jail.) In my opinion, prison should be a place where we send threats to society, not people who are threats to themselves.

We all know how messed-up the mental health system is in this country (and in most of the world). Diseases like addictions are considered taboo, moral failures of the people who become addicted. The kid who uses marijuana in high school and can’t cope with reality later on because their brain chemistry has been forever altered is not worthy of care, according to many in power, because they brought this on to themselves. If only they would have made the right choice, right? But what if no one was there to help them make the right choice? I was a teenager once, and I remember making the most stupidest of choices because I lacked the prefrontal cortex to govern my actions and make me aware of the possible consequences.

Unfortunately, there will be plenty of people who will read this and think that I have gone “soft” and that I’m advocating for a free-for-all on drug use. I’m not. I’m saying that we can be rational about marijuana, the most commonly used drug in this country and whose trade is causing thousands of deaths in other countries. We can treat it like alcohol and tobacco because — although it’s more psychoactive than alcohol and tobacco — the evidence tells us that it’s no more harmful. Yes, you do become physically addicted, and, yes, you do increase your chances of lung cancer if you smoke it. But this is true of tobacco. Allowing responsible adults to use it in the privacy of their homes is the rational thing to do. And, when it comes to the harder drugs, the ones that can and do kill their abusers, let’s put them in treatment instead of in jail. The jails are crowded enough as it is, and most people who are addicted are more a danger to themselves than to others.

But I can hear the naysayers now using slippery-slope arguments and anecdotal evidence. They’ll say that marijuana is a gateway drug that leads to harder drugs. For some people it is, especially teenagers who cannot cope with the world in a healthier way and use marijuana not as a recreational activity but as a coping mechanism. They’ll say that other drugs will be decriminalized. That’s only true if we are not rational about what we’re doing. They’ll say that there are plenty of crimes committed by addicts in order to get money to buy drugs. You know why that is so? Because we make drug treatment so inaccessible that they have no other choice but to continue to be addicted! Because it’s easier to rob someone and buy another hit than to be reached out to and be offered help.

The thing about addictions is that addicts will do whatever they deem necessary to feed the addiction, and they will pay through the nose to do so. We can allow the criminal organizations to be the ones providing the drugs, or we can allow it to be a business that is taxed and regulated and, thus, won’t sell drugs to children or others who may be hurt by them. We can offer the addict help to get rid of the addiction, or we can allow them to continue to be addicted and continue to make poor and even criminal decisions. It’s our choice, and it is time we grow up and have an honest conversation about it.

Categories: Blog

Tagged as:

René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.

1 reply

  1. Regrettably, that won’t happen. We have the far right, who insist on blaming the victim, be it the victim of addiction, a victim of mental illness or even in many cases, a victim of rape.
    Some will further heap on the pile of “justifications” religious nonsense, nonsense because we are allegedly a secular nation, not a religious ruled one.

    Still, I agree that regulation of marijuana would work and bring both revenue and end much of the wild west nonsense that goes on in both US inner city streets and in Mexico, at least for a time, as the organizations adjust to the new environmental conditions.
    We do regulate tobacco and alcohol, we tax the living hell out of them as well. In the Commonwealth of Pennsylvania, there is a total of 100% duty on all alcoholic products, a greater amount taxed on tobacco and that is on top of federal taxes.
    We restrict these products from children. Do some still acquire them? Yes. They also acquire firearms on occasion as well. Doesn’t make it legal, it’s just a fact of life that some will acquire things that they should not have, due to a lack of mental maturity.

    Let us have a brief history lesson about alcohol. Why did George Washington send the US Army to quell the Whiskey Rebellion? Alcohol taxation funded the majority of the US government.
    There was no income tax until prohibition was in the works. To replace the lost taxation revenue from alcohol, income tax was enacted. Again, even then, the majority of federal money came from alcohol taxation. It was replaced with an income tax and strangely, income tax was never repealed when alcohol was legal again and tax as it once was.
    OK, not so strangely.
    Yet, we refuse to control marijuana in the same way as alcohol, hence, we permit lawlessness and refuse to relive ourselves of part of our tax burden.
    All over a plant.
    A plant that one can grow for fiber in nearly every nation in the world, save ours. For, even fiber cultivars, which have nearly no THC content, are also illegal in the US.
    For me, that is the only use I have for marijuana, as fiber. But then, I never got into smoking it. I do smoke tobacco and drink alcohol.
    Today, my recreational drug of choice is ibuprofen. For, there is nothing more entertaining than to be able to move about without pain.
    For escape, I can go camping, I can go to the beach in the summer, I can watch a movie or even play a video game.
    Though, the ultimate escape is playing with my grandchildren. 😀


%d bloggers like this: