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Amina Srna: It's The Brian Lehrer Show on WNYC. I'm producer, Amina Srna, filling in for Brian today. Welcome back, everyone. When states began legalizing recreational marijuana, it was supposed to be a win-win. The black market would shrink, tax revenue would pour in, criminal justice reform would take a major step forward, and cannabis become a safer, more regulated product. More than a decade later, my next guest argues that win-win hasn't materialized.

A recent article in The Atlantic argues that legal weed hasn't lived up to its promises. The piece points to a sharp rise in daily cannabis use, particularly with the spread of high-potency products that differ significantly from what was on the market decades ago. It raises concerns about public health, profit motives, and questions whether the criminal justice benefits have been as far-reaching as some advocates predicted.

Joining me now, Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University, author of Addiction: A Very Short Introduction, and a member of the Stanford Network on Addiction Policy. His piece in The Atlantic, co-authored with Jonathan Caulkins, is Legal Weed Didn't Deliver on Its Promises. He'll unpack his argument and talk about where he feels legalization may have gone wrong. Professor Humphreys, welcome to WNYC.

Professor Keith Humphreys: Thanks very much for having me.

Amina Srna: You and your co-author on this article, Jonathan Caulkins, write that the promises of marijuana legalization "have turned out to be overstated or simply wrong." What were the biggest expectations and how do you think the reality has fallen short?

Professor Humphreys: Probably helpful to say where the point of view we're coming from is not to say we should or shouldn't legalize. We have. That's reality. The question is, how do you make it work better? You think like the person we'd be addressing like I have many friends in New York who support legalization and thought they were going to get regulated businesses that were licensed and paid their taxes and were good employers and all that and are now living in a neighborhood that smells like weed all the time.

Everybody's unlicensed. They're not paying their taxes and they're feeling like, "Hey, I support legalization, but not like this." A lot of people feel that way. What Jonathan and I are pointing out is that's probably why this last election cycle in multiple states, recreational legalization failed for the first time, is that it's not working well enough for those who have already done it.

If you support legalization, the smart thing is to say, "Okay. Well, we have it now in 23 states. What would make it work better? What would make it so that the average person who voted for it a year in says, 'This was a good deal and I got what I wanted. I got the taxes. I got the safety. I got less criminal justice involvement in people's lives, but I don't have lots of people addicted to cannabis or neighborhoods falling apart.'" That was the spirit in which we wrote.

Amina Srna: We'll get through all of your points in the piece, but let's start with your focus on the rise in daily or near-daily cannabis use as one of the most concerning trends according to your article. What does the data show about how common heavy use has become and why do you see it as a problem?

Professor Humphreys: This is something that's very shocking if you're my age. 20, 30 years ago, a typical cannabis would have the principal intoxicant called THC. It might have been 3%, 4%, 5% of the plant. Today, typical product in a legal market is about 20% THC, so that's a lot stronger. Second, the typical user 30 years ago was using on average about once a week. Now, slightly over 40% of users use every day or almost every day.

That's just a different kind of thing. To use a stronger drug every day or almost every day is different than using a weaker drug once a week. The ratio between the average consumption is about 70:1. As a result, we have a lot of people getting a lot of exposure to THC. We don't fully know honestly what that does, particularly when it happens in adolescence.

We have some indications that people developing mental health problems, developing academic problems, and so on, and that should be a concern. Not to make us jump in and arrest a bunch of people, nothing like that. To say, "Hey, this is now a public health issue," if this were about alcohol or cigarettes, we would be thinking about public health. We need to think about that now with cannabis because it's a legal industry like the alcohol industry and like the tobacco industry.

Amina Srna: Listeners, we want to hear from you. Has marijuana legalization changed your community for better or worse? Have you seen the kinds of public health or safety concerns raised in The Atlantic article, many of which we still have to get through, or do you think the benefits of legalization outweigh the drawbacks? How has it changed the way that you use cannabis if you're a regular cannabis user or an occasional cannabis user? Give us a call now at 212-433-WNYC. That's 212-433-9692. You can also text that number. Professor Humphreys, what are the main health risks of frequent cannabis use, particularly when compared to substances like alcohol or tobacco?

Professor Humphreys: There's good news and bad news. To compare one different to what you asked is at least you don't die like people die from fentanyl. You can overdose in cannabis, but it's just more of a toxic experience. Death is incredibly rare unless you get behind the wheel of a car, so that's great.

Amina Srna: Or even alcohol and tobacco being far more deadly and legal.

Professor Humphreys: Yes, alcohol. Again, we're not arguing about whether cannabis is legal or not. It is legal.

Amina Srna: Right.

Professor Humphreys: Let's not get stuck in the past. Certainly, what you see for people who are really heavy users all day or almost every day, problems with concentration, memory, school performance, work performance, driving ability, and greater number of accidents, and also worse mental health. It's particularly true for people when they're using when they're young because the brain is developing when we're young. Most of the drug problems people develop across all drugs tend to be in the adolescent years, not in the adult years.

This is something we point out is a fear about legalization that didn't happen is youth use is only up slightly about 3%. That's good. A lot of people said as soon as it's legalized, then teenagers will be using at much higher rates. They aren't. That is great, but the downside is that those who are using, what they're using is just a heck of a lot stronger than what their parents or their grandparents used. We honestly don't know what that does because all our longitudinal studies, what happens over 20, 30 years are based on the weak cannabis a long time ago. We will find out as we go what all the effects are on this generation.

Amina Srna: You're speaking just there about the usage not particularly increasing in teens and young adults, but the category that I believe you did pinpoint was adults. Is it 35 and older?

Professor Humphreys: Yes, right. It's older people and then there's also really large growth among adult women in using cannabis. In some sense, following what has happened with alcohol, where women's alcohol consumption has gone up over the last 20 years really sharply. Men and women used to be much more different in substance use in general than they are today. Again, we will find out the effects of this as we go along. We certainly want to think about public health again just as we would with any other legal industry that sold a product that many people enjoy and also causes other people problems.

Amina Srna: You earlier mentioned fentanyl and opioids and you write, "Based on weak scientific evidence, many advocates likewise promised that legal cannabis would lead people to use fewer opioids." What does the research actually show? Has legalization helped curb opioid addiction and overdoses or was that claim overstated from the start?

Professor Humphreys: Yes, so Weedmaps, we note the company put up billboards in states saying a 25% drop in opioid overdoses. Thank God, opioid overdoses did go down this year, but cannabis use, of course, has been soaring for more than a decade. That's not the reason why. That was a very optimistic promise. A similar optimistic promise was that it would reduce drinking. We see no evidence of that either. If that had happened, either of those things, it would have been a pretty good trade-off. We don't see those benefits. We have to cope with the reality as we know it now and not expect that to happen.

Amina Srna: This is The Brian Lehrer Show on WNYC. If you're just joining us, I'm Amina Srna. My guest is Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University, whose latest article in The Atlantic has this headline, Legal Weed Didn't Deliver on Its Promises. Continuing on the idea of promises, delivered or not, legalization was supposed to reduce criminal justice harms. Have we actually seen meaningful reductions in marijuana-related arrests and prosecutions, especially in communities that were most affected by the war on drugs?

Professor Humphreys: Absolutely. Huge drops in arrest, which Jonathan and I think is great actually. No point ruining the lives of putting someone in a cage because they smoked cannabis. I've always thought was crazy and I'm glad we're doing that a lot less, although that is actually accomplished by what's called decriminalization. In other words, on the side of users, you just say, "This is no longer a criminal offense." We did that in California before legalization. That eliminated something like 86% of our arrests.

By the time legalization comes in, you can't eat that lunch again because the arrests are already gone. What legalization is about is more about the industry rather than just recriminalizing use. That is the companies that make it, how it's advertised. Do you have to be licensed? Do you have to label the product, all those sorts of things? I think that's where the debate is. I don't think Americans want people arrested for cannabis use. I never have. I think that's the consensus. At this point, it's really just about the industry, not the user, I think is where the debate is.

Amina Srna: You argue that few people were in prison solely for marijuana possession.

Professor Humphreys: Right, yes. I remember very smart Stanford students telling me, half the people who are NGO are there for cannabis or even more. It actually was about 2% of people in the prison system were there for any cannabis offense, all the way up to trafficking, and so on. There are certainly many people who commit other crimes who also use cannabis or in prison, but that was never the reason why. There's no way cannabis legalization could have that big an impact on our prison system because it never really did.

Amina Srna: We remember before legalization in New York, cannabis was sometimes used as a pretext for broader policing and criminalization.

Professor Humphreys: Oh, absolutely. New York actually was, I would say, the capital of way too many arrests for cannabis. Those can be very damaging, of course, but you can get rid of those again with decriminalizing use for the user and leave them out of it. That still leaves you the question of, "Well, if we're going to have an industry and we have one in New York, what kind of shape do we want it to be?"

I think it's important not to let industry off the hook to say, "You aren't paying your taxes," and say, "Well, we shouldn't arrest people for use." It's like, "That's not the question. We're not going to do that." We still think if you run a business, you should have to pay taxes. We don't let other industries off on that basis. That's why it's important to keep those issues separate. There's nothing stopping us from saying, "Leave users alone, but we want the industry to behave itself." We can have both those things.

Amina Srna: Let's go to a caller. Wilson in Brooklyn, hi, you're on WNYC.

Wilson: Hi. Thank you so much for taking my call. Yes, I just want to respond and just make a comment. The reason why there's not the research that we need is because of the federal US government and the way that cannabis has been classed and that research wasn't allowed, so there's that. Also, as far as my experience, there is a licensed dispensary in my neighborhood. They're great.

I don't think anything's really changed with legality or illegality. You would always walk around the city and smell marijuana before it was legal. Me personally, I just don't think the legalization has affected things that much. Also too, and I'm glad that you all made that point, the fact that there are less arrests and people's lives are not being destroyed because of it. I think that's really the most important thing, so thank you.

Amina Srna: Thank you so much for your call, Wilson. We appreciate you. Professor Humphreys, any reactions to Wilson?

Professor Humphreys: Oh, I totally agree on the research front. I've said for years that when any drug is actually in Schedule I, people should still be able to study it. That's very hard to do. Schedule I, meaning it's the toughest, most controlled. We would learn a lot more, not just about harms but also potentially about benefits if we could do that research. As I said, I agree on the arrest. All I'm saying is we can have our cake and eat it too. In other words, we cannot arrest users and, at the same time, have an industry that pays taxes, labels products accurately, and protects public health. I think that's not really the choice that we have. We can have more than one good thing.

Amina Srna: Professor, you'd spoken earlier in our conversation about the increased potency of cannabis products. We have a caller that I believe disagrees with that. Maury in Carroll Gardens. Hi, you're on WNYC.

Maury: Hi there. Hi. Thanks for taking my call. As I told the screener, I have been smoking cannabis, this is very important, first of all, since I was 20. I did not start as a teenager and I do not think teenagers should smoke. After I started smoking at 20, it was [unintelligible 00:15:08]. I've been smoking ever since. I'm now 62 years old. I have not noticed any increase.

I would love to be able to find a dispensary that did have something that was far more powerful than it used to be back in the '80s. That's just personally not my experience. As I said, I smoked every day for many years. I understand what the professor is saying as far as the percentages. Experientially, it's just not the case for me or really for anybody else that I know who is a regular smoker.

Amina Srna: Thanks for your call, Maury. I wanted to ask you if it's not too personal.

Maury: Of course.

Amina Srna: Since you mentioned dispensaries, do you typically buy your products in the few licensed dispensaries we have in New York City?

Maury: Well, actually, I do not. I was away in Massachusetts and turns out the prices are far less expensive, half the price. It's about $120 an ounce up there versus about $250 down here. I would just buy a quantity of that and bring it home. Otherwise, that's from my primary source. Before then and before it became legal here, which I'm absolutely delighted about, I would buy from a private source.

Amina Srna: Well, thank you so much for your call, Maury. We really appreciate it. Professor Humphreys, how do you want to respond to Maury? There's a couple of things in there that are kind of interesting and I think speak to your piece.

Professor Humphreys: Yes, we're all experts on our own experience. I believe that is Maury's experience with cannabis markets. Where we know about the market as a whole, not just any individual's experience, there's actually a very good evidence in that. You could look through High Times magazine and the winner of the Cannabis Cup year after year after year.

That has gone up and up and up, or you can look at almost any legalization state's public data because the drugs are tested and see the potency going up over millions of transactions across millions of people. It's really not about one person's story, but the evidence on it is really clear that potency has increased dramatically. I understand that maybe individual haven't experienced it. As a whole, there's really no doubt that that's been the national trend.

Amina Srna: I believe this is also in your piece. When someone enters a dispensary, whether it's a licensed dispensary or what I think we refer to now as a gray market dispensary, not quite licensed, but obviously selling a legal product, can the labels on products really be trusted?

Professor Humphreys: Yes, unfortunately, often not. There's been multiple published audit studies showing that labels are often really wrong. Sometimes they're wrong in part. Sometimes they're wrong entirely. In part would be something like maybe it's a cookie, but it's not mixed all the way through. Half of it is twice as strong as the label says and the other half is just a cookie. Other things are just completely labeled wrong. I think it's pretty hard for anyone to say, "Things shouldn't be accurately labeled." Yes, of course, they should be accurately labeled. We expect that for food. We expect that for alcohol. We ought to be able to expect that in the cannabis industry.

Amina Srna: Just to clarify. When we're talking about labels, typically, what we're referring to is percentage of THC.

Professor Humphreys: THC, and also what else is in it. There's other things. There's CBD, there's terpenes, and so on. It's generally accepted. We have a right to know what it is we put into our bodies. I think that's a reasonable thing to ask for. We often haven't gotten it. Our view is like, "Well, if we're going to make legalization work, that seems like a fairly basic thing that everyone, however they feel about legalization, should agree." Yes, public health department should be making sure that happens. Mostly, they haven't.

Amina Srna: Let's go to another call. Olivia in Hauppauge, Long Island. Hi, you're on WNYC.

Olivia: Hi. Thanks for taking my call. I wanted to make a point and ask a question. The point is that I am concerned about there being more responsibility in just the culture surrounding having general public cannabis use because I'm for it being legalized, but I see on the other side, so many people have concerns where, "Okay, we've had cigarettes in our culture for over 100 years. We've had drinking in our culture."

We've known that it's illegal to drink and drive since the 1960s, but this is a new step, a shift in our culture. I don't know that I see the responsibility there yet in simply how people are approaching this, talking about it. My own personal experience, I've had multiple coworkers at different jobs who show up to work high. They'll say things like, "I take marijuana for anxiety," but they don't have a prescription from their doctor to use it for that purpose.

Even if that's true, I feel like not having a legal thing or a prescription from your doctor, I think that takes away, one, from people who really do suffer from severe anxiety because you could be using that term loosely and not even have a diagnosis. Then, two, I think it takes away from cannabis becoming more of a thing that can be a real help to people who do need it. I just see responsibility as something that we need to have in our culture more about the use of the drug.

That goes to driving. Too many people drive high. I don't think they take it as seriously as driving drunk. Then my question goes to, how many studies have been done on the effects of smoke in your lungs, whether it's from marijuana or from a cigarette? What is the difference in the effects of smoke on your lungs? My understanding is smoke is the same no matter what it is. If you're inhaling it, it's bad for you. If there's more research on that, I would love to hear about that. Thank you.

Amina Srna: Thank you so much for your call, Olivia. Professor Humphreys, I'm not sure that that came up in your piece per se, but I wonder if you would know the answer to Olivia's question on cigarette smoking.

Professor Humphreys: Yes, smoke. Inhaling hot smoke is not good for the lungs. It increases the risk of respiratory problems. That's true like wood smoke too. I don't want to overstate it relative to cigarettes. People blow out and consume much more smoke in daily cigarettes because you just smoke a lot more volume than you do with cannabis. It is a risk, but it's not at the level of tobacco risk. I do want to emphasize the point Olivia said. I think it's really smart about culture.

How most of us learn about substances is not through the law and not through school. It's about what the people around us tell us and the experiences they share and what families say and what friends say and so on. I think we do need to get to the point. In the service of trying to legalize, many people said, "There are no harms here." Now, it is legal. I think we need to stop saying that. There are some harms here. Yes, there are some benefits, but there are some harms.

To the extent, we at least are aware of those risks of driving, which is one where we do have a lot of problems, then they're less likely to end up being a problem. The best way for cannabis to become a trouble for us is if we tell ourselves there's no way it could become a trouble. If we're aware that it can have negative effects and we think about that and we say that to our friends and the people we care about, then we're more likely that as we absorb this drug into our culture, the harms will be less.

Amina Srna: As you're speaking about some beneficial properties, one listener texts, "Your conversation also ignores the millions of patients with cancer, seizures, PTSD, et cetera, who have attributed cannabis to saving their lives." Again, bringing up that cannabis can be prescribed medicinally by doctors. It's a part of the same conversation, but it's different from your argument in the piece.

Professor Humphreys: Yes, we were focused on the recreational market.

Amina Srna: Exactly.

Professor Humphreys: As I said before, I think it was Wilson, the previous caller, yes, I think it's good. We should research the plant. We are researching the plant and find out potentially. That's great. We were looking more at the recreational market, the part of cannabis that's like the alcohol industry.

Amina Srna: I want to take a personal experience that I think echoes some of the things that you speak about in your piece. Let's go to Juliana in Brooklyn. Hi, Juliana. Thank you so much for calling in.

Juliana: Hi, thanks for taking my call. I'm in my mid-40s. I'm a mom. I probably fit squarely in one of those demographics of cannabis users. I traded alcohol for cannabis, which we call California sober, about three and a half years ago. My concern is that it has absolutely helped my sleep. It's had a number of benefits. I feel more present with my children if I'm around them. My sleep is better. My anxiety levels have definitely decreased. It's certainly better than alcohol for me overall.

What I'm noticing is that we're undertalking about the physiological impacts, the physical impacts on your health. I don't even smoke it. I only consume edibles. My resting heart rate, I've recently noticed, is drastically reduced. My breathing can be labored. As I google this, and I'm actually seeing a cardiologist about this, this is a real concern. This is highly potent. I'm buying all of my marijuana from Massachusetts. This is cannabis that's in legal dispensaries.

I'm concerned that we're under-researching some of these physical-- This is serious stuff. If it's impacting your heart and your lungs and you're not even smoking it, this is something we need to speak about, not just the mental impacts of less motivation or potential spontaneous psychosis, which I know we speak about is a very extreme circumstance. I'm wondering if you have any research around the cardiac impacts of the plant, not just smoking.

Amina Srna: Juliana, thank you so much for your call. Professor Humphreys, I'll just add another listener text pretty similarly, "I was a heavy smoker all day for 20 years, quit smoking in December. Now, I eat a 10-milligram gummy every night after work. My lungs feel better. What are the negative effects of eating?" I think both Juliana here and the texter are referring to edibles.

Professor Humphreys: Yes. Well, first, to say quitting smoking is really good for you. That's not something to be underestimated. There's probably few things anybody can do with their health if you're smoking a pack a day to quit. You could be ahead on net even if you have some risk from the consumption. We don't know a heck of a lot about the edibles. It's another thing that happens with legalization is you get a lot of product differentiation.

Now, for people who like it, that's great. It's like having, "Here's another type of wine I could try." For scientists, and I know we're all fuddy-duddies, it's just tougher because, now, we have to do all these different studies of all these different things. There's gummies and there's edibles and there's shatter and there's dab. Then there's the different strength flowers and so on. We don't know a heck of a lot about what these are going to do.

I have to agree with the caller that it is a strong drug. It is way stronger than it used to be. It's entirely plausible. It'll have lots of effects on different systems in the body. We don't understand those very well. We should definitely be studying them. Also, everybody who's using them should just be aware of that. You're taking a really strong drug and maybe there are some good effects. Very commonly, strong drugs can also have some toxic effects. Just be aware that there's probably no free lunch here.

Amina Srna: Your article focuses a lot on legalization, but also the industry itself. One of the unfulfilled promises is you mentioned tax revenues haven't been as transformative as some have predicted. States, did they simply overpromise before legalization or is the cannabis industry itself underperforming?

Professor Humphreys: That's a great question. Advocates definitely overpromised the tax revenue on the assumption that most of us knew was wrong, that the price of cannabis wouldn't change once it was legalized. There's a reason we call it weed. It's easy to grow, right? It really, in a free market, would probably sell for about the same as Lipton tea. It was selling for $400 an ounce for at least the cannabis sativa.

That meant that once it was legal, that price collapsed. States were saying, "Well, we'll take 10%. We'll take 20%." All of a sudden, 10% or 20% wasn't that much money. That was the fundamental thing, not taking the price collapse into the calculations. Then that also meant, because the price collapsed, a lot of companies went bankrupt. Bankrupt companies don't pay taxes.

The last thing is we have a lot of tax evasion. These unlicensed shops, which are all over New York, all over a lot of cities, are not paying their taxes. They're just basically stealing from the public. Enforcement needs to be more serious about that just like they would an unlicensed liquor store. They would close down. They need to close down unlicensed cannabis outlets that aren't paying their taxes. That's not fair to the public.

Amina Srna: If legalization as it stands isn't working out as planned as you've said a few times during our conversation, the cat is out of the bag.

Professor Humphreys: Yes.

Amina Srna: We're not going to go back probably. What do you think is a wiser policy approach? What would that look like? What would it take to get things right? I think you offer four specific suggestions actually.

Professor Humphreys: Right, yes. We say, "Look, legalization is here to stay. Let's try to make it work better." One of them is we could do more to provide some protections to the cottage industries, the small producers, relative to the megacorps. The thing is really big companies often acquire substantial extra political power and usually can capture regulators and get things written their own way, whereas cottage producers don't have that.

We also could correct the farm bill, which may seem like an obscure thing, but the way we regulated hemp had enough loopholes in it that has produced totally unregulated gas station weed throughout a lot of states where it's otherwise illegal, that has no rules at all for labeling, for contents, for pesticides, or anything. That needs to be closed. Then finally, we think public health and public safety need to get back in the game.

My friends in public health, they don't want to say anything about cannabis because they think, "I don't want to be a blue-haired mom from the 1980s or something." Hey, it's legal now. It's like alcohol. It's like tobacco. If the tobacco industry advertised and was dishonest, you would say something. You got to do that about cannabis. It's a legal industry too. Same with public safety.

In California and on the West Coast, we've had massive illegal growth. Some of it was human trafficking involved. Really horrible stuff. Getting police motivated. Look, just because there's a legal industry doesn't mean you don't do anything. You still need to stop the illegal actors. Otherwise, the legal industry can't work. If I set up Keith's Quickie thoracic surgery shop, come on in, low prices, I would be arrested.

Why? Because we want people to know when they go to a thoracic surgeon, it's a licensed, trained person. Enforcement makes legal licensed markets work. We need to have the police do their work against the illegal people so that the legal people who are doing things right and playing by the rules are able to be successful. That's how you make a legal market work.

Amina Srna: We won't even open up the can of worms about the fact that you could just drive across a state border depending on where you live and go purchase from a legal state. That's a conversation for next time, I'm sure. We will have to leave it there for now. Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University, is author of Addiction: A Very Short Introduction and a member of the Stanford Network on Addiction Policy. His piece in The Atlantic, co-authored with Jonathan Caulkins, is Legal Weed Didn't Deliver on Its Promises. Thank you so much for your time today. We really appreciate it.

Professor Humphreys: Thanks for having me.

 

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