Substance Use Disorders

This commentary appeared in USA Today on April 25, 2013.

Believe me, I've heard all the pot jokes, and some of them are true. Public support for legalizing marijuana use is at an all-time high. Some state-level marijuana laws are going up in smoke. And yes, Washington and Colorado are embarking on a historic joint venture.

Puns aside, discussions about marijuana legalization are getting serious. In November, voters in Colorado and Washington made the unprecedented decision to allow commercial production, distribution and possession of marijuana for nonmedical purposes. Not even the Netherlands goes that far.

With voters in Colorado and Washington deciding to legalize marijuana last election season and a recent poll indicating that 52 percent of Americans now support legalizing the use of marijuana—the first such majority in more than 40 years of polling—serious discussions about drug policy abound.

To weigh in on these developments and more, Beau Kilmer, co-director of the RAND Drug Policy Research Center and coauthor of Marijuana Legalization: What Everyone Needs to Know, hosted an “Ask Me Anything” (AMA) session on Reddit this week. Kilmer fielded questions from participants on a variety of drug policy issues.

This commentary appeared on The Huffington Post on February 1, 2013.

The Super Bowl is the promised land for advertising agencies. More than 100 million engaged consumers, even those otherwise uninterested in football, will turn on their TVs Sunday night and watch the commercials and halftime extravaganza.

This year, Beyoncé Knowles-Carter will headline the halftime show as part of a $50 million contract with PepsiCo's Live for Now Campaign. The campaign's most prominent image—scheduled to appear life-size in stores this year—Beyoncé in a scant Pepsi-blue outfit, pushing a shopping cart filled with 12-packs of full-calorie Pepsi. While the public health community was outraged by Beyoncé's deal with Pepsi, American consumers didn't seem to mind. In fact, so many celebrities have done similar endorsements that, as the Atlantic's health editor notes, it would take "a lot of cultural unwinding" for soda endorsements to be frowned upon by the general public.

While we may think that it makes intuitive sense to encourage at-risk youth to seek employment, our findings in recent work funded by the National Institute on Drug Abuse suggest that the opposite could be true.

Employment can build character for many teens, especially as they balance work and school, learn how to manage their paychecks, and are accountable to their employers and coworkers. However, not all teens reap these benefits—and in fact, for some teens, employment can lead to unwanted habits and behaviors.

Beau Kilmer, codirector of the RAND Drug Policy Research Center, discusses the 24/7 Sobriety Project, which requires those arrested for or convicted of alcohol-related offenses to take twice-a-day breathalyzer tests or wear a continuous monitoring bracelet. Those who fail or skip their tests are immediately subject to modest sanctions—typically a day or two in jail.

This commentary appeared on Newsday on September 14, 2012.

New York City's just-approved ban on serving sugar-sweetened beverages larger than 16 ounces, along with the decision by McDonald's to post calories on menu boards nationwide, signal a new era in efforts to control the obesity epidemic. And as we navigate this future, it's worth taking a look at similar campaigns in our country's past.

Two hundred years ago, America was considered a nation of drunkards. Alcohol was the beverage of choice, in part because people didn't have access to potable water or couldn't trust the local water supply. Alcohol was served to all, even children. The tavern was the key social institution in town. Employers gave workers allotments of rum. Abundant corn crops were difficult to ship, so settlers transformed them into abundant supplies of whiskey.

This November, Washington state, Oregon, and Colorado voters will consider ballot measures to legalize the production, distribution, and possession of marijuana for nonmedical purposes. Even if voters pass these measures at the state level, marijuana will still be prohibited by the federal government. How might the federal government react?

Two years ago, California voters rejected Proposition 19, which sought to legalize and regulate the recreational use of marijuana (46.5% voted "yes"). At the time, Attorney General Eric Holder agreed with voters and made clear that the government would "vigorously enforce" the federal laws against marijuana.

School is back in session, and if you're a parent of a high-school student there's a 25 percent chance (PDF) that your child wants to take on the added responsibility of having a part-time job. You're probably proud of your child's decision, and you should be—having a job can instill a sense of work ethic, timeliness, and responsibility that is likely to reap benefits in the future. However, you should also be aware that if your son or daughter is a non-smoker, your child is at increased risk for starting to smoke cigarettes when he or she starts working part-time during the school year.

In 2007, my research in Baltimore found that youth who started working were nine times more likely to start smoking than those who do not. Similar findings have now been shown in Egypt and Taiwan, and in the most recent issue of the Journal of Adolescent Health I comment on a similar finding in the Republic of Korea. I suggest that workplaces across the world that rely on a teenage workforce, like supermarkets and fast food restaurants, need to do a better job protecting young people from starting to smoke. This includes enacting policies to ensure these establishments and the area around them are smoke-free, and for public health researchers to develop interventions geared specifically for young workers and delivered in the places where they work.

Beau Kilmer, senior policy researcher and codirector of the RAND Drug Policy Research Center, discusses what makes marijuana legalization so dramatically different from mere decriminalization.

This excerpt from Marijuana Legalization: What Everyone Needs to Know appeared on Huffington Post on July 12, 2012.

If alcohol is more dangerous than marijuana, what's the logical justification for one being legal and the other illegal?

If we were making laws for a planet whose population had never experienced either marijuana or alcohol, and we had to choose one of the two drugs to make available, there would be a strong case for choosing marijuana, which has lower organic toxicity, lower addictive risk, and a much weaker link with accidents and violence.

But that's not the planet we inhabit. Here on this planet, alcohol has been an ingrained part of many cultures since the Neolithic revolution (which may have been driven in part by the discovery that grain could be brewed into beer). People have used cannabis plant products for thousands of years, but its widespread use as an intoxicant in the United States is a phenomenon of the last hundred years. Even today only about one in sixteen American adults used marijuana at all in the course of a typical year; for alcohol, that figure is more than half.