Parallel to the presidential elections in 2012, the two American states - Colorado and Washington - have voted for the legalization of recreational marijuana. The inhabitants of these western states were in favor of the free sales, possession, and cultivation of marijuana under state control and taxation. The current situation is unique in several ways. Firstly, it is the first case of unconditional legalization of cannabis since the time of large-scale bans in the beginning of the 20th century. Secondly, the new legislation of Colorado and Washington directly contradicts the federal one. At the same time, medical marijuana has already been legalized in many parts of the US. This paper provides a brief analysis of the influence of marijuana legalization on the work of professionals in a medical sphere (nurses), as well as the overall influence of the drug legalization on the United States and its citizens.
The use of marijuana for medical and/or recreational purposes has been an issue for public and political discussions for quite a while. After strict bans on the drug, the legislation of some states began allowing the use of medical marijuana. Meanwhile four states (Alaska, Oregon, Colorado, and Washington) have de-criminalized both medical and non-medical possession and sales of cannabis. The situation is complicated by the fact that, according to the federal law of the United States, it is still illegal to conduct any operations with marijuana (sell, use, grow, and buy). Therefore, the twenty-three US states and Washington DC, which have to some extend legalized cannabis, are contradicting the federal legislation.
In the US, the process of marijuana de-criminalization began with the introduction of medical marijuana. It is interesting that a public opinion has always had more influence on the state legislation than the actual medical data. It means that even if some other drugs show better results than medical marijuana, but the public supports cannabis de-criminalization. As a result, marijuana will become legalized, to some extent. Currently, the majority of the US population is supporting the legalization of marijuana; and the drug is commonly used throughout the country despite its different legal status (Schoenly and Knox). According to Marcoux, Larrat and Vogenberg, “the 2011 National Survey on Drug Use and Health (NSDUH) reported that approximately 18.1 million individuals 12 years of age or older had used the drug in the month prior to the survey” (616). Marijuana is the most widely used drug in the United States. On one hand, this fact might seem scary, but, on the other one, the legalization of marijuana might in fact have a positive impact on the society.
As a main form of marijuana legalization in the United States is medical, it is not surprising that doctors and other medical sphere employees are those ones most influenced by the cannabis legislation. One of the basic rules on marijuana in the medical practice has for a long time been that doctors are not allowed prescribing the drug. They rather recommend or advise consideration of the appropriate therapy (Marcoux, Larrat, and Vogenberg). Thanks to the 2002-year decision of the US Court of Appeals, the First Amendment allows physicians to discuss and recommend medical use of marijuana to their patients without any negative legal consequences.
In 2008, the Board of Directors of the American Nurses Association (American Nurses Association) has issued an official statement in the support of the use of medical marijuana by patients. This statement has explained the ANA’s official position on the therapeutic use of marijuana and supported the patients’ access to the drug. The ANA has stated that cannabis has proven to be effective in treating various symptoms and conditions; thus, the organization has made 5 statements. They have defined its attitudes towards the use of medical marijuana and the requirements connected with it. These are such ones as: education of nurses and other practitioners on the use of medical marijuana; protection of the patients from penalties; protection of healthcare practitioners who prescribe, dispense, or administer the drug, according to the state regulations; reclassification of cannabis into a less restrictive drug category; and the official confirmation of the therapeutic effects of the drug (American Nurses Association).
The question of the recommendation of medical marijuana by healthcare practitioners was raised again in 2013, when a nurse recommended the drug for a couple of young kids (Davies). A Seattle-based nurse practitioner recommended medical marijuana to two children, aged four and six, which resulted in a lawsuit (Davies). This case has once again raised the discussion around the use of cannabis for medical purposes; this time – in a case of children. While some practitioners state the unknown consequences of the marijuana use for kids; others support the treatment of such diseases as epilepsy, cerebral palsy, and pain with non-psychoactive forms of cannabis. This discussion reminds of one of the issues being commonly forgotten in the cannabis arguments. Marijuana can be used in more ways than just smoking. The non-intoxicating forms of cannabis that do not have the effect of the drug can still have health benefits for people. Therefore, these types of marijuana use should be also distinguished in the debates. At the same time, this case shows that despite the legalization of marijuana, nurse practitioners still need to approach the issue of cannabis recommendations with care and responsibility. Despite the new legislation, not all patients are supportive of marijuana legalization. It means that its prescription (same as any other medicine) needs a solid argumentation and explanation to a patient. As the case of Seattle nurse has shown, for some groups of population, medical marijuana is still the last resort. By many of them, it is perceived as an addictive substance; and the consequences of its use seem to be if not negative then just unclear.
Despite the official ANA statement, currently among nurses there is no unified opinion on the legalization of marijuana. Opinions are usually based on the belief whether cannabis is harmful to the human health or not. As there is no final conclusion on the issue, both points of view have a right for existence. A part of the US nurses believes that medical marijuana is harmful for patients (Schoenly and Knox). Their arguments are the following: with the legalization of cannabis, its use will increase. Thus, there will the number of respiratory diseases. Legalization increases the availability of this drug to masses, and the numbers of addicts will grow. Marijuana is the drug most commonly used while driving, thus, there is a chance for the increase of driving accidents (Schoenly and Knox). The proponents of marijuana legalization, in their turn, use the following arguments: legalization of the drug allows regulating all the marijuana-related processes. It allows restricting drug use by children, controlling the quality of the drug, getting revenues from marijuana taxation, etc. Cannabis has been used for medical and recreational purposes for hundreds of years by different civilizations; and legalization of the drug decreases drug-related crimes in communities (Schoenly and Knox).
De-criminalization and legalization of marijuana gives a possibility to control not only the drug flow, but also establish various marijuana-related legislations. For example, some states that have legalized cannabis (California, Massachusetts, Minnesota, Oregon, and Washington) have the legislation of the use of marijuana by employees. They allow employers to legally restrict the use of cannabis on their premises during working hours (Marcoux, Larrat and Vogenberg). At the same time, the federal legislation, which clearly defines the consequences of marijuana possession, has nothing to say on the consequences of the worksite use of the drug. Therefore, the legalization of marijuana, in fact, gives a possibility to establish a more complex control over the use of the drug.
The relationship between legalization of recreational marijuana and workplace is still very complex. Even in Colorado, where non-medical use of cannabis has already been legalized, thus, its use cannot be considered an illegal activity; employees are still allowed to fire someone using the drug. Colorado’s laws allow employees to maintain a drug-free environment, which, consequently, gives them a legal right to fire for the use of marijuana at a workplace (Wengert). Taking into consideration the fact that the drug stays in one’s system for a long period of time, people leaving in states with legalized marijuana should still carefully think about consequences while using the drug.
A good example of the influence of marijuana of the community and ordinary citizens is presented in the analysis of cannabis legalization in Colorado, made by Katie Rucke. Although the review was made only six months after the law on legalization had passed, some tendencies have already been defined. Firstly, the crime rate was down more than 10 percent since 2013, while the violent crime rate has decreased by 5% (Rucke). These statistics show that on an everyday basis a lot of attention is paid to marijuana-related crimes. They, consequently, decrease the possibilities of law enforcement to tackle other types of crimes. After the legalization of marijuana police officers have gained more time and possibilities to tackle more complex crimes. Secondly, with the decrease of cannabis-related arrests many fewer people had to deal with Colorado judicial system. The significant decrease of marijuana possession cases processed in the court the state expenditures in these spheres have decreased. According to the predictions of Colorado officials, the state could save $10 million (the least one) on the decrease of court-related expenditures (Rucke). Next, as it was expected, the legalization of marijuana industry brought significant revenues to the state of Colorado, with around $20 million in fees and taxes over 6 months. This money is spent on marijuana-regulation offices and educational campaigns on the use of the drug.
The issue of marijuana legalization is one of the most common topics for a discussion. After a long period of the cannabis ban, the United States began to de-criminalize the substance. Currently, it is legal for medical service in twenty-three states; and some of them have even legalized marijuana for recreational purposes. At the same time, the federal legislation still prohibits any cannabis-related operations. In these still unstable conditions, nurses should be careful while recommending marijuana as medicine. Careful examinations should be conducted in order to define the most suitable drug. In some cases (for example, with children) one might need to explain in details the need for marijuana use and its consequences for the patient’s health. Although the legalization of cannabis made it easier for nurses and other healthcare practitioners work with the drug, it still has to be approached with care and special attention. At the same time, the legalization of marijuana is making a positive change in the state affairs. As the case of Colorado has shown, recreational marijuana has led to a crime decrease, as well as it has created a new sphere for state profits. Still, citizens, same as nurses, need to have a responsible approach to marijuana. It, same as alcohol or any other drugs, can lead to negative consequences in a case of abuse.