Dr Ray Baker, as chair of the Committee on Addiction Medicine, argues forcefully against the legalization, decriminalization, and medicalization of marijuana in “More reefer madness” [BCMJ 2001;43(6):362].
Dr Baker states, “Its addictive potential is about the same as alcohol; 8% to 15% of adults who smoke it will develop addiction or dependence.” He goes on to state, “Contrary to current myth, prohibition did work, in that there was a dramatic reduction of documented alcohol-related morbidity and mortality during the prohibition years.”
If prohibition was so effective, and there is no reason to question Dr Baker’s statement, why then was it abolished? Not because of Winston S. Churchill’s sentiments, who, when he dined with John Diefenbaker, noted that the latter refused alcohol.
“Are you one of these prohibitionists?” inquired Churchill.
“No,” replied Diefenbaker, “I am a teetotaller.”
“That is better,” said Churchill with a twinkle, “for then you deprive only yourself and not others.” Prohibition was ended because of the burgeoning incidence of organized crime, the profits of which were used to finance further criminal activity. It was recognized that the damage to society from prohibition was greater than the evils of corruption and vice.
To legalize the growing and use of marijuana is not at present a probability; however, to have made both users and growers criminals has encouraged blackmail, extortion, and violence and has fostered the Asian gangs, biker gangs, and drug bosses as surely as prohibition of alcohol created big city gangsters supported by criminal gunmen who did not hesitate to murder, and against whom the forces of law and order seemed helpless. Whilst alcohol and cigarettes may have grave ill effects, society has chosen to accept them as the lesser evils, and it seems a similar path will occur with marijuana, not all at once, but as a progression from decriminalization to regulation and controlled availability from growers and manufacturers, the quality of whose product is predictable and taxable.
Prohibition was not solely an American phenomenon, for, in addition to the USA, Finland, Norway, and Iceland experimented with forbidding intoxicating liquors and, in Canada, Prince Edward Island adopted prohibition from 1900 to 1947. In Canada and the USA, alcohol was banned on First Nations reserves years after it was freely available to others. The walls surrounding homosexuality, race, gender, and physical handicap have been breached by the battering ram and trebuchet of public opinion. Will the fortress surrounding marijuana be the next to fall, guarded as it is by so many vested interests?
—H.E. Woolley, MD
Prince Edward Island was not the only Canadian province to use prohibition; it was enacted in PEI and Nova Scotia before the First World War and in the remaining provinces during the war. Provinces lifted the ban at various times (Quebec, 1919; BC, 1920; Manitoba and Alberta, 1923; Saskatchewan, 1924; Ontario, 1927).—Ed.
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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
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