Citation

Adinoff B, Cooper ZD. Am. J. Drug Alcohol Abuse 2019; 45(6): 707-712.

Affiliation

Department of Psychiatry, University of Colorado School of Medicine, Denver, CO, USA.

Copyright

(Copyright © 2019, Informa - Taylor and Francis Group)

DOI

10.1080/00952990.2019.1680683

PMID

31755837

Abstract

The use of psychoactive substances, including cannabis, has accompanied the development of civilization (1). (In the context of this paper, “psychoactive substances” refers specifically to substances that produce pleasurable and rewarding effects). For millennium, many of these substances have been widely used as medicinals, in religious ceremonies, and as recreational intoxicants. Their misuse (use that results in problems related to intoxication or excessive consumption), however, has historically been viewed as a moral failing, a character defect, a disruption in cognition, coping, or stress tolerance, and/or a problem within the social-cultural-legal milieu (e.g., the availability of an irresistible euphoriant). Of particular relevance to the past century, there has been an ongoing struggle between perceiving the use of psychoactive substances as socially acceptable and legal (e.g., alcohol, nicotine and caffeine in the West, khat in many Horn of Africa and Arabian Peninsula countries, and coca in some South American countries), as dangerous or sinful in any amount and necessitating punishment from law enforcement (the temperance perspective), and/or, when used in an addictive manner, as a medical illness requiring treatment (the brain disease perspective) (2). The predominant approach employed in response to the use of a specific substance in any given jurisdiction has typically shown little correlation with a substance’s intoxicating effect or its harm to the individual or society (3). Rather, legal status of a substance has been product of a region’s societal-cultural-religious-historical preferences and perceptions (1), substance-related societal disruptions (4), economic concerns (5,6), and political expediency (7).

In many countries, particularly in the Western world, the balance between the temperance model (with its concomitant legal constraints) and the medical model has been particularly fraught over the past century (4). In the United States, for instance, the Smoking Opium Exclusion Act in 1909 banned the possession, importation and use of opium for smoking and the 1914 Harrison Narcotics Act (8) restricted the manufacture and sale of cannabis, cocaine, heroin, and morphine. In 1919, the 18th Amendment to the U.S. Constitution was ratified, banning the manufacture, transportation or sale of alcohol (but not its use) ...


Keyword: Cannabis impaired driving; alcohol impaired driving;

Language: en

Keywords

Marijuana; harm reduction; medical marijuana; prohibition