4 ms·

Is there any thorough study about this being a gateway drug to other nastier ones or not? That would be much more expensive. I see SF and I don’t like it.

by szundi 2y ago

Der_Einzige 2y ago
[flagged]
toomuchtodo 2y ago
In the United States, cannabis is legal in 38 of 50 states for medical use and 24 states for recreational use [1]. I believe this to be a robust natural experiment, demonstrating that the negative impact (which does exist, but appears to be minor, according to the right leaning Cato Institute [2]) can be balanced against the previous harm of prosecuting users of this drug. Public support for legalization remains high [3]. This doesn't mean we don't chase after the harm of cannabis use to solve for the second order effects; it means we do that instead of chasing citizens with police for a drug that is demonstrably less harmful than alcohol [4]. Importantly, the GLP-1 drug class is now available, which may provide material improvement in addiction therapy at scale [5] while cannabis for pain management appears to be a favorable substitute for opioids: "Prescription drug overdoses are the leading cause of accidental death in the United States. Alternatives to opioids for the treatment of pain are necessary to address this issue. Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain. The current study examined the use of cannabis as a substitute for opioid-based pain medication by collecting survey data from 2897 medical cannabis patients. Thirty-four percent of the sample reported using opioid-based pain medication in the past 6 months. Respondents overwhelmingly reported that cannabis provided relief on par with their other medications, but without the unwanted side effects. Ninety-seven percent of the sample “strongly agreed/agreed” that they are able to decrease the amount of opiates they consume when they also use cannabis, and 81% “strongly agreed/agreed” that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids. Results were similar for those using cannabis with nonopioid-based pain medications." [6] TLDR More healthcare and social service access, less policing for this specific drug. [1] https://en.wikipedia.org/wiki/Legality_of_cannabis_by_U.S._jurisdiction https://en.wikipedia.org/wiki/Legality_of_cannabis_by_U.S._j... [2] https://www.cato.org/policy-analysis/effect-state-marijuana-legalizations-2021-update https://www.cato.org/policy-analysis/effect-state-marijuana-... [3] https://www.pewresearch.org/politics/2024/03/26/most-americans-favor-legalizing-marijuana-for-medical-recreational-use/ https://www.pewresearch.org/politics/2024/03/26/most-america... [4] https://www.economist.com/graphic-detail/2019/06/25/what-is-the-most-dangerous-drug https://www.economist.com/graphic-detail/2019/06/25/what-is-... [5] https://recursiveadaptation.com/p/the-growing-scientific-case-for-using https://recursiveadaptation.com/p/the-growing-scientific-cas... [6] https://pmc.ncbi.nlm.nih.gov/articles/PMC5569620/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5569620/
abeppu 2y ago
But in SF, and a bunch of other places that have a lot of visible drug use, I think the "gateway drug" has often been legally prescribed opioids. You could be prescribed opioids for any number of legitimate reasons (injury, post surgery, whatever), get hooked, and the addictive wiring in your brain pushes you into a spiral. Whereas most of the people I know who use marijuana use either just marijuana, or dabble in some psychedelics. I think if you're worried about people getting addicted to "nastier" drugs, multiple valuable steps to focus on are: - we need predictive tools for health care providers to consult before they prescribe opioids to evaluate whether someone is more or less likely to develop a habit around their use, and better alternatives - we need better routine support for people getting off of opioids, rather than just "take this for x days, possibly with a refill, then stop". - we should have a better integrated medical information system so all healthcare providers who interact with a patient can see their full medical history including all prescriptions. Take opportunities away from "drug-seeking patients" that go into a new clinic with complaints about a recent back injury or whatever.
bryanlarsen 2y ago
In terms of the effects on other drugs, it's quite clear anecdotally that marijuana usage displaces tobacco and alcohol usage.
lithos 2y ago
In recent times is a combination of work injury (stress fighting insurance, legal system, and work), combined with opiods getting massively deregulated (with massive lobbying to hospital administrators to over prescribe afterwards). In my opinion this is the ripe field that allowed antivax stuff to grow and stop being mutually ridiculed by just about everyone in the US. (The hate and observations of how "antihuman" pharmaceutical companies are)

Is there any thorough study about this being a gateway drug to other nastier ones or not? That would be much more expensive. I see SF and I don’t like it.

by szundi 2y ago

Is there any thorough study about this being a gateway drug to other nastier ones or not? That would be much more expensive. I see SF and I don’t like it.

Der_Einzige 2y ago

[flagged]

toomuchtodo 2y ago

In the United States, cannabis is legal in 38 of 50 states for medical use and 24 states for recreational use [1]. I believe this to be a robust natural experiment, demonstrating that the negative impact (which does exist, but appears to be minor, according to the right leaning Cato Institute [2]) can be balanced against the previous harm of prosecuting users of this drug. Public support for legalization remains high [3]. This doesn't mean we don't chase after the harm of cannabis use to solve for the second order effects; it means we do that instead of chasing citizens with police for a drug that is demonstrably less harmful than alcohol [4]. Importantly, the GLP-1 drug class is now available, which may provide material improvement in addiction therapy at scale [5] while cannabis for pain management appears to be a favorable substitute for opioids: "Prescription drug overdoses are the leading cause of accidental death in the United States. Alternatives to opioids for the treatment of pain are necessary to address this issue. Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain. The current study examined the use of cannabis as a substitute for opioid-based pain medication by collecting survey data from 2897 medical cannabis patients. Thirty-four percent of the sample reported using opioid-based pain medication in the past 6 months. Respondents overwhelmingly reported that cannabis provided relief on par with their other medications, but without the unwanted side effects. Ninety-seven percent of the sample “strongly agreed/agreed” that they are able to decrease the amount of opiates they consume when they also use cannabis, and 81% “strongly agreed/agreed” that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids. Results were similar for those using cannabis with nonopioid-based pain medications." [6] TLDR More healthcare and social service access, less policing for this specific drug. [1] https://en.wikipedia.org/wiki/Legality_of_cannabis_by_U.S._jurisdiction https://en.wikipedia.org/wiki/Legality_of_cannabis_by_U.S._j... [2] https://www.cato.org/policy-analysis/effect-state-marijuana-legalizations-2021-update https://www.cato.org/policy-analysis/effect-state-marijuana-... [3] https://www.pewresearch.org/politics/2024/03/26/most-americans-favor-legalizing-marijuana-for-medical-recreational-use/ https://www.pewresearch.org/politics/2024/03/26/most-america... [4] https://www.economist.com/graphic-detail/2019/06/25/what-is-the-most-dangerous-drug https://www.economist.com/graphic-detail/2019/06/25/what-is-... [5] https://recursiveadaptation.com/p/the-growing-scientific-case-for-using https://recursiveadaptation.com/p/the-growing-scientific-cas... [6] https://pmc.ncbi.nlm.nih.gov/articles/PMC5569620/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5569620/

abeppu 2y ago

But in SF, and a bunch of other places that have a lot of visible drug use, I think the "gateway drug" has often been legally prescribed opioids. You could be prescribed opioids for any number of legitimate reasons (injury, post surgery, whatever), get hooked, and the addictive wiring in your brain pushes you into a spiral. Whereas most of the people I know who use marijuana use either just marijuana, or dabble in some psychedelics. I think if you're worried about people getting addicted to "nastier" drugs, multiple valuable steps to focus on are: - we need predictive tools for health care providers to consult before they prescribe opioids to evaluate whether someone is more or less likely to develop a habit around their use, and better alternatives - we need better routine support for people getting off of opioids, rather than just "take this for x days, possibly with a refill, then stop". - we should have a better integrated medical information system so all healthcare providers who interact with a patient can see their full medical history including all prescriptions. Take opportunities away from "drug-seeking patients" that go into a new clinic with complaints about a recent back injury or whatever.

bryanlarsen 2y ago

In terms of the effects on other drugs, it's quite clear anecdotally that marijuana usage displaces tobacco and alcohol usage.

lithos 2y ago

In recent times is a combination of work injury (stress fighting insurance, legal system, and work), combined with opiods getting massively deregulated (with massive lobbying to hospital administrators to over prescribe afterwards). In my opinion this is the ripe field that allowed antivax stuff to grow and stop being mutually ridiculed by just about everyone in the US. (The hate and observations of how "antihuman" pharmaceutical companies are)