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What Do We Know About Marijuana's Safety? Not Enough, Says Malcolm Gladwell

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A budding mature marijuana plant. (Jesse Costa/WBUR)
A budding mature marijuana plant. (Jesse Costa/WBUR)

Recreational marijuana is now legal in 10 states and Washington, D.C., and it's bringing in billions in revenue. But when it comes to science about its safety, medicinal properties or even its benefits, we're still largely in the dark, says New Yorker writer and author Malcolm Gladwell.

Here & Now's Robin Young talks with Gladwell (@Gladwell) about his new article on the subject, which explores what's known about the drug and why he thinks it's critical to spend some time and money on learning more.

"For years and years and years, people who were advocating for the decriminalization of marijuana correctly pointed out that you can't study the drug, you can't understand it, unless you make it legal," Gladwell says. "We're now making it legal, and we have the opportunity to study it properly. But it strikes me that in some cases, we're not doing that. We're kind of jumping ahead of ourselves."

Interview Highlights

On how marijuana has become more potent over the years

"That's puzzle No. 1, which is, the kind of marijuana that people of my generation smoked 20 years ago probably had one-fifth of the THC levels that the marijuana that's being sold now has. And in some forms, the THC levels of marijuana are even higher, like in some of the oils and things. And we don't really know a lot about what it means to crank up the active ingredient that high. It's not necessarily a bad thing. But we knew very little going in to begin with, and we know even less about the new kinds of high-potency marijuana that are being sold in many cases."

"Before any drug gets permitted to go on the market, basic questions have to be answered about its safety and efficacy. We don't know relatively basic questions about marijuana."

Malcolm Gladwell

On not much light being shed by a 400-page report on marijuana's health effects published by the National Academy of Medicine in 2017

"Before any drug gets permitted to go on the market, basic questions have to be answered about its safety and efficacy. We don't know relatively basic questions about marijuana. A really simple one is, is it safe for a pregnant woman to smoke high-potency marijuana? Another good question would be: what happens to people when they're high and they drive? Particularly, when they're high on the newer strains of marijuana? Maybe they're fine. But having just been through a pretty disastrous, 100-year-long experience with drinking and driving, we'd want to get our ducks in a row before we introduce another drug into the mix. Or, what age can someone safely start to smoke marijuana? What do we know about those crucial adolescent years? The answer is not a lot, and that's what the National Academy of Medicine report was all about. It was just saying, 'Here's what we don't know, and it's more than you'd think.' "

On Alex Berenson, who wrote the book "Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence"

"Alex Berenson is a former New York Times reporter who mostly writes thrillers now, but his wife is a psychiatrist who deals with pretty troubled cases, and she got him interested in this question of what the potential dark side of marijuana might be. And he has written a book, which I think it's fair to describe as an alarmist manifesto about the worst-case scenario for marijuana. Do I agree with Alex Berenson in totality? No. But I do think that when you don't know a lot, you have to know what the parameters of the risks are. He points us to a bunch of interesting questions, like, 'We know there is a link between smoking marijuana for prolonged periods and an increased risk of mental illness.'

"So they're talking about relatively prolonged use in a very specific and relatively small subset of the using population. Nonetheless, it is a real risk, and the data that we have so far does appear to support that connection. Berenson is really concerned about that, and I think that is clearly an area where we'd like to know more. It's not a trivial matter. We do know that cases of schizophrenia in countries that have seen increases in marijuana smoking in recent years have risen dramatically — particularly in this country. We'd like to know how much of that, if any, is attributable to increased marijuana use."

On the path forward for developing a better understanding of marijuana

"I think there is a kind of clear path to a middle ground here, which is, people who are advocates for marijuana have got to get together with the scientific establishment, and sit down and say, 'What are the kinds of questions that we need to answer before we can safely go ahead?' The overall cause of decriminalization is essential — I think everyone is in agreement on that. The status quo that we had for the last X number of decades was disastrous. The question is, what is the most appropriate form that legalization ought to take, and how much of a regulatory burden ought the advocates of marijuana use be required to carry?"


Karyn Miller-Medzon produced this interview and edited it for broadcast with Todd Mundt. Jack Mitchell adapted it for the web.

This segment aired on January 28, 2019.

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