Surgeon General’s Marijuana Warning Omits Crucial Context

advisory on marijuana, Dr. Jerome Adams, the surgeon general, put a new spin on long-standing admonitions about the drug.

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“Marijuana has a unique impact on the developing brain. It can prime your brain for addiction to other substances,” Adams said at a Washington, D.C., substance abuse conference held late in August and sponsored by Oxford House, a recovery center network.

This is a reiteration of the old “gateway” argument: the idea that marijuana is frequently an entree to using other, harder drugs. And the surgeon general’s emphasis comes just as many states are loosening restrictions around its medicinal and adult recreational use.

But marijuana research is limited, and this particular hypothesis is fairly controversial. We decided to put Adams’ claim to the test. Is his central thesis ⁠— marijuana has a “unique impact” on developing brains and can “prime your brain for addiction” ⁠— accurate?

We contacted the surgeon general’s office, which directed us to statements from the National Institute on Drug Abuse. NIDA noted that marijuana may have a gateway effect, but that most people who use the drug don’t progress to other, harder substances; and that alcohol and nicotine appear to have a similar impact. But the surgeon general’s office was also unequivocal on a related point: “From a public health perspective, no amount of drug use is safe for the developing brain.”

So how fair is Adams’ statement? When we interviewed experts, the responses were all over the map ⁠— reflecting just how contested this issue is and how difficult it is to speak definitively about marijuana’s impact.

remarks at Oxford House World Convention, Aug. 30, 2019

National Academies of Sciences, Engineering, and Medicine, “The Health Effects of Cannabis and Cannabinoids,” January 2017

National Institutes of Health, “Is Marijuana A Gateway Drug?” September 2019

Office of the Surgeon General, “U.S. Surgeon General’s Advisory: Marijuana Use and the Developing Brain,” August 29, 2019

Email Interview with Jonathan Caulkins, H. Guyford Stever Professor of Operations Research at Carnegie Mellon University Heinz School of Public Policy and Management, Oct. 29, 2019

Email Interview with Joshua Isen, assistant professor of psychology at the University of South Alabama, Oct. 30, 2019

Email Interview with Hugh Garavan, professor of psychiatry and psychology at the University of Vermont, Oct. 29, 2019

Email Interview with Sue Sisley, psychiatrist and marijuana researcher, Oct. 29, 2019

Telephone Interview with Susan Weiss, director of division of extramural research and scientific adviser to the director of the National Institute for Drugs and Alcohol, Oct. 30, 2019

Email interview with the Office of the Surgeon General, Nov. 1, 2019