No, Marijuana Legalization Didn't Fill Emergency Rooms With Stoned Drivers

By Aaron Brown. He teaches statistics at New York University and at the University of California at San Diego. Excerpts:

"Last October, The Wall Street Journal published an editorial titled "More Marijuana Users Are Crash Dummies."

"How much social and public-health damage will Americans suffer before doing a U-turn on marijuana promotion?" the editorial begins. "A new study finds that more than 40% of drivers who died in car accidents in one U.S. county over the last six years had elevated levels of the drug in their blood.

The "new study" they cited is available only as an abstract and a short press release describing a conference presentation of an unpublished report, with no supporting details. After the Journal editorial appeared, we made several attempts to speak with the lead author, Wright State University professor of surgery Akpofure P. Ekeh, to obtain a copy of the draft study and answer some basic questions. We were unable to reach him. A public information officer at the American College of Surgeons, where Ekeh is a member, told us via email that the study "is a research-in-progress, meaning there is not yet a complete study that I am able to provide.""

"The claim that 40 percent of deceased drivers had elevated levels of marijuana in their blood isn't trustworthy because THC testing is only ordered in some cases, presumably the ones when driver impairment is suspected." 

"Drivers were likely tested because they were suspected of intoxication."

"Also, testing the blood of autopsied drivers doesn't mean they were high while driving. THC in the blood generally indicates that someone has used marijuana in the previous few days. Postmortem THC tests are particularly unreliable."

Another study from the Insurance Institute for Highway Safety did claim to show a difference between pre- and post-legalization of marijuana use by drivers by examining changes in accident rates in five Western states. It found that legalization was associated with a 2.3 percent increase in fatal crash rates.

Here's how the authors presented the data.

 

The blue dots represent seasonally adjusted monthly motor-vehicle fatalities before legalization, the orange dots represent those after legalization, and the dashed lines show the averages before and after legalization.

The three-year average traffic death rate in legalization states was 9.5 percent higher after legalization than before. The pattern was the same in the control states that did not legalize, but they had only a 6.5 percent increase. After some complex adjustments, the authors attributed a 2.3 percent increase to legalization. It looks like a big jump. But that's because the chart presented the data in a misleading way.

I recharted the data and, unlike the authors, I made it into a time series, accounting for changes in the rate of traffic deaths during the study period. This way, you can see the trends, which undercut the authors' thesis.

The blue dots represent seasonally adjusted monthly motor-vehicle fatalities before legalization, the orange dots represent those after legalization, and the dashed lines show the averages before and after legalization.

The three-year average traffic death rate in legalization states was 9.5 percent higher after legalization than before. The pattern was the same in the control states that did not legalize, but they had only a 6.5 percent increase. After some complex adjustments, the authors attributed a 2.3 percent increase to legalization. It looks like a big jump. But that's because the chart presented the data in a misleading way.

I recharted the data and, unlike the authors, I made it into a time series, accounting for changes in the rate of traffic deaths during the study period. This way, you can see the trends, which undercut the authors' thesis.

 

The press release also had no mention of a control, so we have no idea if the drivers' THC-positive rate is higher or lower than for the general population. Scientific studies require a control. It also looked at one county in Ohio, covering data before and after marijuana was legalized there in 2023, and there was no significant change in the ratio of drivers with THC in their blood.

So the study, if it ever does appear, will have nothing to say on the impact of marijuana legalization on driving while high, and it won't present evidence that this practice is on the rise. That didn't stop The Wall Street Journal in its coverage of this yet-to-materialize study from claiming in its subhead that "high-on-pot drivers are contributing to more highway accident deaths."

The most explosive finding about the dangers of legal weed comes from a study by a team of Canadian researchers, who looked at emergency room records in Ontario before and after legalization took effect in October 2018. As CNN summarized it, the study found that "documented marijuana-related traffic accidents that required treatment in an emergency room rose 475% between 2010 and 2021."

Why is the 475 percent claim misleading? For starters, the news coverage didn't mention that we're talking about a very small number of people. During the period when marijuana was legalized and commercialized, 120,569 people showed up in Ontario emergency rooms due to traffic accidents. Just 125 people, or 0.1 percent of the total, "had documented cannabis involvement," according to the clinical judgment of the onsite medical team. Moreover, for every cannabis involvement patient, there were 18 with alcohol impairment. Of the people with cannabis involvement, 42 percent also had alcohol involvement. Cannabis alone does not seem to be the major intoxicant choice to impair driving. 

The tally of 125 people over 20 months works out to about six people per month. Before legalization, there were two people per month showing up at emergency rooms with "cannabis involvement." That's a 200 percent increase, not a 475 percent increase. Why did the authors claim a 475 percent increase? 

Marijuana legalization overlapped with the COVID-19 lockdowns. During the pandemic, people were driving much less, leading to a decline in total car accidents.

The authors wanted to adjust for this unusual situation, so they assumed that if people had been driving normally, there would have been many more marijuana-related accidents. That assumption, along with a few other adjustments, led them to raise the 200 percent increase to 475 percent.

This adjustment isn't valid. You can't compare COVID lockdown data with pre-COVID data because life was so abnormal. School closures in Ontario meant people were driving their kids to school less often, and many were working from home or were unemployed. Since most people who drive while high are less likely to do so while heading to work or taking their kids to school, you would expect an increase in the proportion of drivers on the road with marijuana in their system during the lockdowns, even if the absolute number stayed the same.

Another problem is that the 125 people counted by the researchers weren't necessarily high while driving. Just because they were classified as cannabis users in the E.R. doesn't mean they were under the influence at the time of the accident, or that marijuana caused them to crash their cars.

Some of those 125 people were passengers rather than drivers, which makes the inference that marijuana contributed to the crashes even more dubious. If someone who didn't use marijuana was giving a ride to a friend because he was too stoned to drive, and they still got into an accident, the passenger would have been counted as a patient with "documented cannabis involvement." That tells us nothing about whether marijuana legalization led to more traffic accidents.

Another problem with the dataset is that many of the people were counted because they admitted to the doctor at the E.R. that they were marijuana users. Patients would have been more willing to admit to their drug habit after legalization than before, which further biased the data.

by claims that legalization increases traffic accidents by 2.3 percent. Even if there were solid evidence for that claim, it's laughably inadequate to support a drug war." 

Drug Prohibition and the Waterbed Effect

Jeffrey Miron.

"A key rationale for drug prohibition is the belief that outlawing drugs makes them less available and more expensive, thereby shrinking consumption.

Decades of evidence, however, suggest this impact is modest, partly due to the “waterbed effect:” enforcement efforts aimed at shrinking the market mainly causes it to shift, in various ways, without much impact on its overall size. Just as pushing down on one part of a waterbed merely forces the water somewhere else, rather than reducing the overall quantity.

Two recent news stories provide textbook illustrations. From the Washington Post,

The Trump administration’s deadly military strikes on alleged drug trafficking boats have not reduced the amount of cocaine entering the United States, but they’re prompting criminal organizations to develop new strategies and tactics and undermining traditional investigative methods, according to a previously unreported assessment by the Drug Enforcement Administration, a closed-door congressional briefing and interviews with current and former U.S. and foreign officials.

In a recent assessment reviewed by The Washington Post, DEA analysts found the strikes had failed to affect the supply or price of cocaine in the United States and had led traffickers to diversify beyond go-fast boats and to avoid international waters, opting instead for larger boats and hemming close to coastlines, where U.S. forces are less likely to open fire. In a closed-door briefing last month, Pentagon officials told lawmakers the strikes in international waters off South and Central America had not reduced its purity.

And from the Financial Times,

In the battle for the seas, drug traffickers are often coming out on top — making Europe, in the words of the UN, the new “primary destination” for cocaine. The drug, once the preserve of rich European partygoers, has gone mainstream, with street prices falling by an average of 18 per cent between 2014 and 2024 while the products sold became 44 per cent purer, according to the EU’s drugs agency.

…

As authorities have stepped up interceptions at major ports, traffickers have kept ahead through sophisticated drop-offs at sea, enabled by encrypted communications, powerful speedboats, unmanned submersibles and GPS spoofing, which involves vessels faking their locations.

“You always have to stay up-to-date, because there’s always a new modus operandi,” says Jürgen Ebner, acting chief of Europol, the EU’s law enforcement agency. He warns of a “waterbed effect” — when authorities come down hard in one area it can just push problems somewhere else.

Exactly."

Decriminalization versus Legalization

By Jeffrey Miron.

"A new study argues that recent drug de-criminalizations in Oregon and Washington caused substantial increases in drug overdoses.

Is this plausible? And does it imply that prohibition is better than legalization?

Yes, and no.

Decriminalization means elimination of criminal penalties for drug possession. Legalization means elimination of criminal penalties for production and sale.

Standard economics suggests that decriminalization, by reducing the full price of purchasing drugs, shifts demand outward, implying greater use.

This causes, since production and sale are still illegal, a larger underground market and therefore more of the associated negatives. These include increased violence, because black market participants cannot resolve disputes with courts and lawyers; and additional overdoses, because quality control is difficult in black markets.

Thus the study’s result makes sense. But rather than supporting prohibition, it shows that full legalization – rather than decrim – is the right path. Indeed, if policy legalizes only one side of the market, it should be supply rather than demand. A related point is that legalization must not include too much regulation and taxation; that just re-creates the black market.

A possible qualification is that some decrims seem to have avoided increased violence or overdoses. The likely explanation is that in these instances, policy de-escalated supply side enforcement along with decriminalizing."

Why the black market for marijuana is still flourishing in California

Letter to The WSJ. 

"It’s hardly a surprise that the black market for marijuana is still flourishing in California. The majority of the state’s crop has always been exported out of state, where sales remain illegal. So long as there remains a substantial out-of-state market where marijuana is illegal, black-market sales will persist.

Nevertheless, California Gov. Newsom was right to support legalization as a necessary first step to rolling back prohibition. Legalization has substantially reduced the scale of California’s illegal crop, which used to be measured in millions of plants eradicated per year.

Meanwhile, marijuana felonies have drastically dropped since legalization, more than 80,000 legal jobs have been created, and the state is raking in billions in tax revenue per year. It took decades to stamp out moonshining after alcohol prohibition was repealed, and the same will likely be true for marijuana.

Dale Gieringer

Director, California National Organization for Reform of Marijuana Laws" 

Fewer employers are screening job candidates for marijuana because it would make it tougher to find qualified candidates

See More U.S. Workers Are Testing Positive for Marijuana. Fewer Employers Are Concerned. As cannabis use grows, employers are rethinking pre-hire screens to avoid recruiting challenges by Celia Bernhardt of The WSJ. Excerpts:

"And fewer employers are screening job candidates for marijuana use at all, in part because it would make it tougher to find enough qualified candidates, said Todd Logsdon, a partner at employment law firm Fisher Phillips. 

“I’ve had other employers tell me, ‘If I test for that, I’m not gonna have any applicants,’” Logsdon said. “They’re being very choosy about which role they test for.”

In a 2024 survey of nearly 1,000 employers, the law firm found about half didn’t test for cannabis in the pre-hire process, often for that reason. Among those that did test, 44% said they faced recruiting challenges and nearly a quarter said they were considering loosening the policy.     

Citigroup and many of its Wall Street peers dropped the pre-hire test over the past decade. Retailers like AutoNation and Home Depot have done away with it for most positions as well. Amazon stopped testing for marijuana for most applicants in 2021." 

This article shows how competitive labor markets are. If employers had the power they could keep screening for marijuana use. 

Should we recriminalize marijuana?

By Tyler Cowen.

"The present and also future of mankind is a world where reasonably high levels of self-discipline are needed to do well. The journalist Daniel Akst pointed this out in his 2011 book Temptation: Finding Self-Control in an Age of Excess, and we are now living it full force.

I would rather cope with that world than face the full nanny state, backed by modern, AI-intensified surveillance techniques to boot. Concentrating more power in political authorities hardly solves the basic problem. If marijuana and sports gambling can manipulate weak individuals, so can unscrupulous political leaders. A greater realization of individual weakness does not translate into a case for more government action; if anything, it suggests the opposite. Better to allow our social problems to fester in a more decentralized fashion, rather than reinforce our social pathologies through a manipulative and dysfunctional leader at the very top.

In the longer term, we may need to look to medications, such as GLP-1 drugs and their offshoots, which seem to curb some forms of addictive behavior beyond the appetite for food. Alternatively, some individuals may choose self-surveillance, with self-imposed penalties for bad or addictive behavior. Perhaps your AI, or a hired third party, docks your bank account every time you puff on a joint. I am not convinced such services ever will become popular, but that should be taken seriously as an indicator of what people really want to do. We can at least give them better options for self-constraint. If they rarely choose such options, then perhaps for many of those people, marijuana consumption is not a matter of weakness but a very well-established preference, whether we like it or not…

In short, it is time to realize that paternalism is far less workable than in times past. Our government does not have the credibility, the control over information, or the control over our lives to pull it off.

I do understand that is in some significant ways bad news, as voluntary choice is overwhelming some of us with bad outcomes.

My response is to start by accepting some steps backward, holding paternalist tyranny at bay, and hoping some longer-run cultural and technological adjustments will make this all more workable.

If you have a better solution, I would love to hear it."

The Least Surprising Headline Ever: 'Blowing Up Boats Hasn't Slowed Cocaine Traffic to U.S.'

After nine months of murdering suspected cocaine smugglers, the Trump administration has no evidence that the strategy is working as advertised.

By Jacob Sullum of Reason. 

"Since September 2, the U.S. military has attacked suspected drug boats in the Caribbean and the Eastern Pacific 59 times, killing 196 people. According to President Donald Trump's mysterious math, that means this campaign of carnage has prevented around 1.5 million drug-related deaths in the United States—more than 20 times the total number recorded in the year before Trump started treating suspected cocaine smugglers as "combatants" who can be killed at will, from a distance and in cold blood.

Back on planet Earth, there is no reason to think the boat strikes have prevented any deaths at all. That could only happen if blowing up smugglers—as opposed to the previous practice of intercepting them, arresting them, and seizing their cargo, which Trump says was "totally ineffective"—reduced the supply of cocaine available to American consumers. Given more than a century of failed attempts to "stop the flow" of illegal intoxicants, that never seemed likely. And nearly nine months after Trump launched his new, deadlier version of the war on drugs, there is no evidence that it is more effective than the traditional tactics he derides as insufficiently homicidal.

"Blowing Up Boats Hasn't Slowed Cocaine Traffic to U.S.," The New York Times says in what surely qualifies as one of the least surprising headlines ever. That conclusion is based on several indicators, none of which is moving in the direction you would expect if Trump's strategy were working as advertised.

One sign of success would be a decline in the amount of cocaine seized at the border, since that number represents a percentage of the total supply, and it is unlikely that the percentage changed much between the first eight months of Trump's second term and the eight months after he started murdering alleged cocaine smugglers. But according to data reported by U.S. Customs and Border Protection (CBP), cocaine seizures have gone up, not down. From January through August 2025, CBP seized about 43,300 pounds of cocaine. From September 2025 through April 2026, it seized about 47,800 pounds.

If Trump were putting a significant dent in the cocaine supply (or, more plausibly, imposing new costs that traffickers felt compelled to recoup by charging more), you would expect retail prices to rise. But according to University of North Carolina drug researcher Nabaruun Dasgupta, the Times says, "street prices for cocaine remain between $60 [and] $100 per gram in many U.S. cities, about where they were before the boat strikes began."

Pressure from the boat strikes might also be reflected in adulteration of cocaine with cheaper substances such as levamisole and lidocaine. But Dasgupta reports that "the average number of such substances in cocaine samples ranges from 1.3 to 1.5 in 2026, after the boat strikes began, compared with a range of 1.4 to 1.6 for much of 2025."

A reduced supply of cocaine also should be reflected in the substances detected after drug-related deaths. But according to provisional estimates from the Centers for Disease Control and Prevention (CDC), deaths involving cocaine fell slightly in early 2025 but remained flat during the four months after the boat strikes began. Cocaine was detected in 27.9 percent of total drug fatalities last year, up slightly from 27.5 percent in 2024.

Attributing all those deaths to cocaine is highly problematic, since the vast majority of the cases involve combinations of drugs. From January 2021 through June 2024, according to a 2025 CDC study, four-fifths of "cocaine-involved overdose deaths" also involved opioids, which pose a much bigger overdose risk. That may explain why Trump, in his eagerness to brag that he is saving lives by killing people, conflates cocaine with fentanyl.

Although Trump's bloodthirsty strategy has not affected the amount of cocaine available in the United States, it does seem to have driven changes in smuggling patterns. According to the experts consulted by the Times, traffickers have shifted from the small speedboats targeted by Trump to overland routes through Central America and shipments concealed in cargo on larger vessels.

"These operations raise serious concerns about effectiveness," Sen. Mark Kelly (D–Ariz.) noted during a Senate Armed Services Committee hearing in March. "These repeated boat strikes suggest a tactical approach that may be generating headlines, but it's far less clear that they are producing durable security outcomes. To me, this operation looks like a cycle of reactive strikes with limited long-term impact." Kelly asked Gen. Francis L. Donovan, who oversees the boat strikes as head of the U.S. Southern Command, "what evidence" he had that "this campaign is actually degrading cartel operations rather than simply destroying some low-level assets," "killing some people," and "displacing some trafficking routes."

Donovan candidly admitted that "I couldn't provide you [with] measures of effectiveness for the current effort." Although "we've seen changes in the narco-traffickers' patterns," he said, "the boat strikes aren't the answer."

Someone should tell the president. Or maybe the secretary of defense. The boat strikes are a "highly effective" way to "stop lethal drugs," Pete Hegseth insisted on X in November. Then again, he also claimed that summary execution of criminal suspects is "lawful under both U.S. and international law"—an equally implausible proposition.

"They're not moving the needle at all," Adam Isacson, director of defense oversight at the Washington Office on Latin America, told the Times. "Is that worth killing all these people?" 

The U.S. Indicts a Mexican Governor

Charges made in New York mean President Sheinbaum will have to choose a side

By Mary Anastasia O’Grady. Excerpts:

"Mexican civil-society groups have long accused the political class of aiding and abetting cartels. Activists, family members whose loved ones are among the 130,000 gone missing since 2006, and journalists are some of the brave Mexicans who have tried to raise the consciousness of their nation about what they allege is a link between the gangsters who terrorize them and the state. It’s dangerous work."

"For more than a decade, the Cartel, under the rule of the Chapitos Leaders, and, before them El Chapo and El Mayo, has paid cash bribes to public officials at each level of the government, in exchange for protection of the Cartel’s drug trafficking operations. These corrupt government and law enforcement officials, including the defendants, are essential to the Cartel’s drug trafficking operations.”" 

Can You Make the Case for the Drug War by Pointing out a Bad Effect of the Drug War?

By David R Henderson.

"Earlier this week, I was discussing the drug war with a free-market, very libertarian economist. I was opposing it. He said that although he used to favor legalizing drugs, he no longer does. What changed his mind? The horrible consequences of fentanyl in Oregon.

He pointed to the deaths that had occurred because fentanyl was relatively easy to obtain on the street. I responded that you can’t judge the effects of making something legal by pointing to a case where they’re illegal and just assuming that the effects of making them legal would be the same as the effects of keeping them illegal.

First, fentanyl is illegal, even in Oregon, and was illegal even before the legislature reversed some decisions in 2024. Second, the very fact that it’s sold on the street rather than in pharmacies or even Walmart is due to its illegality. If it were truly legal, consumers would know more about what they’re getting and would, therefore, be less likely to overdose.

A good way to see that is to look back to the Prohibition era. Very few people would say that the fact that people could easily get booze in speakeasies meant that producing and selling liquor were legal. They weren’t. Also, because liquor was illegal, you didn’t always know what you were getting. Producers had less incentive than otherwise to establish brand names and advertise. When the production and sale of liquor were legalized in 1933 (thanks, FDR, for one of the few good things you contributed to), deaths from alcohol poisoning fell. It’s reasonable to expect similar consequences from completely legalizing fentanyl."

The Economics of Illegal Drugs

As a teenager I saw the war on drugs up close. Then I studied it as an economist and saw it differently

By Roland Fryer. Excerpts:

"When demand for a drug is inelastic—meaning users don’t reduce consumption much even as prices rise—supply-side enforcement doesn’t starve traffickers. It enriches them."

"When enforcement raises costs, the street price goes up. If demand is elastic, consumers cut back, total spending falls, and less money flows to traffickers. But if demand is inelastic, as decades of evidence suggest it is for hard drugs, consumers cut back only modestly, total spending increases, and more money flows into the drug trade."

"legalize and tax. When demand is sufficiently inelastic, an excise tax on a legalized drug . . . reduces consumption more than any “war” on the drug. With legalization, producers prefer paying the tax to going underground, and enforcement costs collapse."

"in the 1980s and ’90s. With the rise of crack, homicide rates doubled among black males 14 to 17 while fetal deaths among blacks sharply increased. Yet even as crack use persisted at 60% to 75% of its peak level through 2000, the violence almost disappeared. The initial violence was driven not by drug use but by the struggle to establish property rights in illegal markets. Once those rights were established and crack prices fell, the violence subsided."

"Portugal and Switzerland represent partial steps: decriminalizing use while keeping supply illegal, or medicalizing supply for the most dependent users."

"Portugal decriminalized all drugs in 2001 and redirected resources to treatment. Annual drug-related deaths fell from 76 to 16 by 2012; HIV infections among users fell more than 90%; drug use didn’t spike."

"Switzerland began prescribing pharmaceutical-grade heroin to its hardest cases in the 1990s. Muggings by participants dropped 70%; opioid-related criminal cases nationally declined from 20,000 a year to 5,000."

"cocaine retails at 262 times its farm gate price—a markup attributable to the risk premium of illegality."

"addicts respond far more to permanent price changes than to temporary ones."

"In November 2025, the Congressional Budget Office’s director testified that he had no evidence the interdiction campaign has affected drug use or prices in the U.S. A classic RAND Corp. study found decades ago that treatment is 23 times as cost-effective as source-country control and 10 times as cost-effective as interdiction."  

When drugs are legal, private and public mechanisms for quality control (reputation, tort liability) limit the risk of accidental overdoses

See Marijuana versus Fentanyl by Jeffrey Miron and J. Glazer.

"The Trump administration recently initiated rulemaking to reschedule marijuana from Schedule I to Schedule III. Drugs in Schedule I are deemed to have no accepted medical purpose and high potential for abuse, while those in Schedule III (e.g., ketamine, anabolic steroids) are categorized as having “moderate to low potential for physical and psychological dependence.”

Opinions vary as to whether this rescheduling will have a major impact on the marijuana market, since Schedule III still gives the federal government considerable control. But the change unquestionably weakens federal marijuana prohibition.

A further question is why federal policy treats marijuana so differently than opioids like fentanyl. Conventional wisdom assumes that opioids are more dangerous than MJ and that stricter government control is desirable for more dangerous substances.

In fact, the right approach for all drugs is the same: legalization. The history of marijuana versus opioid policy supports this view.

Since the 1970s, U.S. marijuana policy has moved away from strict prohibition, starting with state-level decriminalization, medicalization, and legalization, followed now by partial federal relaxation. Despite debate over the effects of marijuana on psychological health, the evidence does not suggest that rescheduling would result in material increases in violence or other social harm. By contrast, policy toward fentanyl and other opioids has moved toward more aggressive prohibition and enforcement over the past several decades. During that period, opiate overdose deaths have soared.

This contrast highlights a core libertarian point. When drugs are legal, private and public mechanisms for quality control (reputation, tort liability) limit the risk of accidental overdoses. Under prohibition, these mechanisms do not operate, so quality control (e.g., accurate potency labels) declines. Similarly, under legalization, market participants resolve disagreements with non-violent mechanisms like courts and arbitration; under prohibition, they resort to violence.

The lesson from marijuana is therefore not that drugs are harmless but that criminal enforcement makes their harms worse. If policymakers are serious about reducing drug-related deaths and violence, the divergence between marijuana and opioid policy should give them pause."

The Medical Case for Rescheduling Cannabis

Dr. Peter Grinspoon replies to the editorial board

Letter to The WSJ. 

"Your editorial “Trump Goes for the Stoner Vote” (Dec. 20) misses some important aspects of cannabis use in the U.S. Among them: There is no evidence that teenage use has risen with legalization. Dispensaries are extremely careful in checking identification, and smoking simply isn’t as cool when grandma is a taking a puff or two for her arthritis.

The medical review you cite, which claims “no medical benefit” to use, is one study among thousands. It was performed by researchers who, to my understanding, haven’t treated a single medical cannabis patient to alleviate symptoms. The doctors who directly help patients use cannabis have a different vantage. There is abundant evidence for the efficacy of medical cannabis for most, if not all, of the claims patients make. The 2017 report by the National Academies of Science, Engineering and Medicine concluded there was “conclusive” evidence of effectiveness in treating chronic pain and other conditions.

Cannabis doubtless has several potential harms, and certain people should stay away from it—e.g., teens, pregnant women, those with a history of psychosis. We don’t want an unregulated industry running amok, either, as we experienced with tobacco and alcohol. Yet cannabis is less dangerous than both substances—both of which are excluded from the Controlled Substance Act and contribute to hundreds of thousands of deaths per year. We shouldn’t treat cannabis any different.

As a physician, I suggest we primarily look at how we can reduce patients’ suffering. With education and careful regulation we can avoid or minimize many of the harms associated with cannabis use, which is already helping Americans with intractable chronic pain, nausea, anxiety and insomnia. A majority of Americans support legal access to medical cannabis—so a baby step in this direction, rescheduling cannabis into a less restrictive category, is a step in the right direction.

Dr. Peter Grinspoon

Harvard Medical School"

 

 

Nothing Fails Like Prohibition

By David R Henderson. Excerpts:

"First, is killing people carrying the drugs, rather than arresting them, justified? Second, should those drugs be illegal or should we instead allow a free market in drugs with restrictions on purchases by minors?"

"My answer is that the drugs should be legal for adults. If my answer is correct, then I have also answered the first question. If drugs should be legal, then there is no justification for killing people who transport them."

"The main principle is freedom. Because we own our bodies, we should be free to ingest whatever we wish, even if it can be harmful. But the drug war doesn’t destroy just our freedom to consume what we want. Fighting the drug war has led the government to restrict many of our other freedoms.

The pragmatic reason for legalizing drugs is that criminalizing the industry has caused many harms. Our experience with prohibition of alcohol for thirteen years has a lot to teach us, if only we’re willing to learn. Prohibition worked in the narrow sense of reducing consumption of alcohol but caused horrible side effects. It shifted alcohol production and distribution away from law-abiding citizens to hardened criminals; it reduced respect for the law; and it caused many deaths. Drug prohibition does the same. If drugs were legalized, they would be sold by law-abiding people who have an incentive to care about quality. Organized crime would exit the industry. And the deaths from gang wars, which often include deaths of completely innocent people, would end. Would legalization be problem-free? No. But the problems would tend to be for those who use drugs, not for those who are innocent victims."

"before the Harrison Narcotic Tax Act of 1914, marijuana, cocaine, and heroin were all legal. Some of these drugs were widely used. Yet there was no drug epidemic with these drugs. Second, most people favor allowing activities that are much riskier than the consumption of drugs. Google “the fatality rate in climbing K2” and you’ll learn that historically, fatalities have been about 23 to 25 percent of successful climbs of that peak. Yet the vast majority of people seem to accept that climbers have a right to take this risk." 

Why Treat Weed Differently?

Public policy shouldn’t infantilize people simply because minors might misuse a product, writes Dr. Jeffrey Singer.

Letter to The WSJ.

"It’s no surprise that adolescents can have serious psychiatric reactions to high-dose THC or otherwise suffer from severe nausea and vomiting (“Potheads Head for the ER,” Review & Outlook, Dec. 10). Clinicians have been aware of these risks associated with cannabis use for years.

They’ve also long known that alcohol can trigger acute hallucinations and psychotic reactions. Anyone who’s been to a college party also knows how easily excessive drinking leads to uncontrollable vomiting. Studies consistently show that college-age drinkers face sharply higher risks of alcohol-related injuries, car crashes and sexual or physical assault than older users.

Yet no serious person suggests revisiting prohibition. We trust adults to weigh the risks and benefits of drinking, and we rely on age restrictions and enforcement, not broad bans, to keep alcohol out of minors’ hands.

Why should we treat cannabis differently? All drugs carry some risk, but the harms of adolescent use don’t justify laws that strip adults of their right to consumption. Public policy shouldn’t infantilize people simply because minors might misuse a product. We don’t ban alcohol, driving or ordinary household chemicals on that basis, and we shouldn’t apply a more paternalistic standard to cannabis.

Jeffrey A. Singer, M.D.

Cato Institute"

Prohibitions Increase Violence

Jeffrey Miron and Jonah Karafiol. 

"Since September 2025, the U.S. has carried out five lethal strikes on small boats off the coast of Venezuela, leaving 27 people dead as of October 14. Even granting the government’s account—that these were traffickers and the strikes were effective interdictions—the policy question remains: does escalating force in prohibited markets reduce violence?

In short: no.

When prohibition forces a widely demanded product underground, participants still engage in purchase and sale. And, with no legal avenue to resolve disputes over territory, quality, and debts, buyers and sellers often turn to violence.

Empirical evidence supports such a conclusion. A 1999 study covering roughly a century of US homicide data finds that stronger enforcement of alcohol and drug prohibitions corresponds to higher homicide rates.

Especially problematic is the kingpin approach, in which authorities “decapitate” cartels via short-run seizures, arrests, or assassinations. A 2018 study finds that after these “successes,” homicides increase in the affected municipalities and spill over to nearby areas. Likewise, a 2015 study of organizational “beheadings” shows removing bosses destabilizes protection rackets and boosts killings rather than pacifying markets. In these cases removals create power vacuums, dissolve informal agreements, and increase uncertainty over territory and payments. Consequently, the expected return to preemptive violence rises, and competing factions test boundaries until a new equilibrium emerges.

Thus, by pushing high-demand markets underground, prohibition replaces contracts with retaliation, selects for firms best at coercion, and turns “enforcement wins” into violent reshuffling. If the aim is fewer homicides and less cartel power, the better path is to repeal drug prohibition, rather than promote militarization."

Prohibitions Increase Violence

By Jeffrey Miron.

"Since September 2025, the US has carried out five lethal strikes on small boats off the coast of Venezuela, leaving 27 people dead as of October 14. Even granting the government’s account—that these were traffickers and the strikes were effective interdictions—the policy question remains: does escalating force in prohibited markets reduce violence?

In short: no.

When prohibition forces a widely demanded product underground, participants still engage in the purchase and sale of it. And, with no legal avenue to resolve disputes over territory, quality, and debts, buyers and sellers often turn to violence.

Empirical evidence supports such a conclusion. A 1999 study covering roughly a century of US homicide data finds that stronger enforcement of alcohol and drug prohibitions corresponds to higher homicide rates.

Especially problematic is the kingpin approach, in which authorities “decapitate” cartels via short-run seizures, arrests, or assassinations. A 2018 study finds that after these “successes,” homicides increase in the affected municipalities and spill over to nearby areas. Likewise, a 2015 study of organizational “beheadings” shows removing bosses destabilizes protection rackets and boosts killings rather than pacifying markets. In these cases, removals create power vacuums, dissolve informal agreements, and increase uncertainty over territory and payments. Consequently, the expected return to preemptive violence rises, and competing factions test boundaries until a new equilibrium emerges.

Thus, by pushing high-demand markets underground, prohibition replaces contracts with retaliation, selects for firms best at coercion, and turns “enforcement wins” into violent reshuffling. If the aim is fewer homicides and less cartel power, the better path is to repeal drug prohibition rather than promote militarization."

Mexico’s Cartels Are Exporting Their Bloody Rivalry to Ecuador and Beyond

The two most powerful drug rings are locked in a turf war over control of a key South American smuggling route. The bodies are piling up.

By Ryan Dubé of The WSJ. Excerpts:

"Corruption flourished as drug traffickers bought off judges, politicians and state security officials, prosecutors said. “They realized that the weak spot in the region was Ecuador,” said Fausto Salinas, former head of Ecuador’s police. 

Sinaloa joined with Telmo Castro, an Ecuadorean army captain who used military vehicles to transport cocaine from the border with Colombia to the Ecuadorean coast, according to Ecuadorean police. Mexican pilots picked up the drugs at clandestine runways.

Castro earned about $600,000 a load, Jorge Cifuentes, a Colombian who was one of Sinaloa’s top cocaine suppliers, said during the 2018 U.S. trial of Sinaloa boss Joaquín “El Chapo” Guzmán. Castro was killed in prison in 2019."

"The Choneros took over the route when Prado was arrested in Colombia in 2017. He was extradited to the U.S., where he pleaded guilty in 2018 to drug smuggling. In his absence, the Choneros expanded their work for Sinaloa across coastal Ecuador."

"'In 2022, traffic officials in Manta pulled over a black Chevrolet Tahoe carrying $7 million in drug money. The officials kept the cash and released the driver, a Mexican Jalisco member." 

"Macías oversaw the Choneros from prison. Armed inmates protected him as he moved among amenities including a private gym and a pool with ducks."

Did Oregon’s Drug Decriminalization Increase Crime or Overdoses? —Separating Short-term Spikes from Long-term Trends

By Jeffrey A. Singer of Cato.

"Earlier this month, in a Wall Street Journal op-ed, Charles Fain Lehman highlighted a working paper released on July 30 by criminologists (Boehme et al.) from the University of South Carolina and the University of Nebraska that examined the effects of short-term drug decriminalization in Oregon and Washington on arrest and crime rates.

In November 2020, Oregon voters approved Measure 110, a ballot initiative that decriminalized drug possession and increased funding for harm reduction programs. The measure took effect in February 2021. Later that month, the Washington State Supreme Court declared the state statute criminalizing narcotics possession was unconstitutional. Washington lawmakers recriminalized illicit drug possession three months later, classifying it as a misdemeanor rather than a felony. Oregon lawmakers recriminalized drug possession in mid-2024, making possession a misdemeanor carrying up to six months in jail.

It’s important to note that decriminalization is not the ideal policy reform. Ending the practice of imprisoning people for possessing or using substances the government disapproves of—and saddling them with felony records—is a big step forward, but it keeps prohibition in place. People must still buy from the black market, where there’s no guarantee of purity, dosage, or even the true identity of a substance. As a result, decriminalization alone is unlikely to reduce the risk of overdose deaths. Decriminalization also doesn’t remove the criminal element from drug markets, where dealers resolve their disputes with violence rather than with lawyers. 

A more effective reform would be to end prohibition and regulate drugs the same way we do alcohol.

Boehme et al. examined daily crime and arrest rates for various offenses in Oregon and Washington from 2019 through 2022, using the FBI’s National Incident-Based Reporting System data from 23 states. They applied two separate approaches—estimating two-way difference-in-differences models and constructing a synthetic control model—to assess the impact of decriminalization on crime. Their results showed that “at the state level, Oregon and Washington experienced significant increases in most serious violent and property crime,” driven mainly by Portland and Seattle. These results, however, do not tell us the mechanism by which decriminalization caused these changes—a key point missing from Lehman’s column. 

The researchers suggested several possible reasons for their findings, including weakening social cohesion, failing to jail chronic offenders, and broader “de-policing.” Boehme et al. is a working paper, so the authors still have time to include some of these variables in the statistical models of their next version.

Lehman also noted that drug overdoses spiked during the same period. In a letter to the Wall Street Journal’s editor, I challenged the notion—implied though not stated outright—that ending penalties for possession directly drove increases in crime and overdoses. It is implausible to think drug users suddenly turn to violent or property crime simply because they face no penalty for possession. Portugal’s 2001 decriminalization and the Czech Republic’s 2010 reform saw no such rise. And a 2024 Journal of the American Medical Association study by researchers at Brown University and RTI International (Zoorob et al.) showed that once fentanyl’s staggered arrival across the country was factored in—the Pacific Northwest was hit around 2019–2020—the apparent link between decriminalization and overdose deaths disappeared. The real driver was the rapidly shifting drug supply.

On August 11, researchers at Portland State University (PSU) published a final project report, funded by the National Institute of Justice, titled Examining the Multifaceted Impacts of Drug Decriminalization on Public Safety, Law Enforcement, and Prosecutorial Discretion. Focusing solely on Oregon, it covers a much longer period (2008 to 2024) and relies on extensive secondary data obtained through information-sharing agreements with agency partners. Researchers supplemented this dataset with additional information from multiple sources to provide a baseline for their complex analyses. They examined three Oregon interventions that may have influenced crime data: the 2013 reduction in mandatory minimums for cannabis offenses and increased use of probation for drug possession, the 2017 downgrade of drug possession to a misdemeanor, and the 2021 enactment of Measure 110. The report also considers changes before and after the COVID-19 lockdowns and the fentanyl wave beginning in 2019, drawing on Zoorob et al. to provide context. While the report offers a valuable historical perspective, it primarily presents descriptive data.

According to the report’s key conclusions (page 12):

Oregon’s drug policy shifts, including defelonization (2017) and decriminalization (2021), had no significant, sustained effects on property or violent crime rates. Property crime saw a brief increase after Measure 110 but returned to pre-pandemic levels, while violent crime remained stable. The rise in overdose deaths was driven primarily by the COVID-19 pandemic and the proliferation of fentanyl, rather than specific drug policy changes. These outcomes underscore the importance of accessible behavioral health services, economic stability, and social support in mitigating the impacts of substance use and enhancing public health.

While the PSU and Zoorob et al. studies do not rely on causal inference methods, they do identify additional variables related to policing, fentanyl prevalence, or COVID-19 that researchers could use in future synthetic controls. Boehme et al. should consider them for the next version of their working paper. This underscores the role of harm reduction programs and accessible addiction treatment in addressing substance use. Analysts and commentators should avoid automatically blaming decriminalization when crime or overdoses increase and instead examine the broader context carefully."

Trump’s New Tax Is in the Mail

The abolition of the de minimis exemption means you’ll soon be paying more for everything you buy from abroad

By Phillip W. Magness and Alberto Mingardi. Excerpts:

"the White House is trying to justify its order by saying the de minimis exemption is abused to send fentanyl and other synthetic opioids undetected. The vast majority of fentanyl smuggled into the U.S. comes from one country: Mexico. But Mr. Trump is ending the de minimis exemption for packages from all countries. Although fentanyl is a deadly drug, there’s no evidence that taxing worldwide e-commerce will stop drugs from entering the U.S."

"The European Union has been targeting Temu and Shein, another low-cost Chinese platform, under the guise of “consumer protection.” The EU alleges that these platforms distribute “illegal” goods. But, in many cases, “illegality” means little more than failing to meet the EU’s notoriously complex product-labeling regulations or falling short of its Byzantine labor and environmental rules." 

Charles Fain Lehman’s War on Weed

By Jeffrey A. Singer of Cato. 

"Charles Fain Lehman of the Manhattan Institute is no fan of cannabis legalization. On July 2, 2025, he took to the Wall Street Journal opinion pages to argue that it would be disastrous for the Trump administration to move cannabis from Schedule I (“drugs with no currently accepted medical use and high potential for abuse”) to Schedule III (“drugs with a moderate to low potential for physical and psychological dependence”) on the Drug Enforcement Administration’s schedule of controlled substances. Other Schedule III drugs include ketamine, anabolic steroids, and acetaminophen with codeine (e.g., Tylenol #3).

I have argued here and here that reclassifying cannabis as a Schedule III drug would still mean that cannabis remains federally illegal until the Food and Drug Administration allows pharmaceutical companies to market cannabis and cannabis products as medications—an event unlikely to happen anytime soon. Even then, people would need a prescription from a licensed health care practitioner to obtain it.

Rescheduling cannabis will make it easier for researchers to conduct high-quality studies on the plant’s medicinal uses. It will also simplify the process for cannabis retailers to take federal tax deductions, which the law currently prohibits. Lehman opposes this change, fearing it will enable retailers in the 24 states and the District of Columbia where recreational cannabis is legal to conduct their businesses more freely.

To build his case, Lehman makes many alarming and questionable claims about cannabis’ harmful effects—a more academic and sophisticated version of “Reefer Madness.”

He claims that cannabis legalization has led to higher cannabis addiction rates (cannabis use disorder, or CUD), referencing a 2023 review of nine research articles published between 2016 and 2022 to investigate whether there is a connection between cannabis legalization and CUD. However, the review authors found, “There was no significant association between legalization and CUD treatment admissions, and CUD admissions decreased overall during the study periods.”

Lehman could have cited—but didn’t—a prospective cohort study of over 1,400 adults in Ontario, Canada, from September 2018 (one month before cannabis became legal across Canada) to October 2023, published in the Journal of the American Medical Association in April 2025. Some participants were cannabis consumers before legalization, while others began using cannabis post-legalization.

During the study period, frequent cannabis users reduced their consumption after legalization, while former non-users were more likely to increase their use. Misuse declined among current users, but it slightly increased among new users—an unsurprising trend, given that they were starting from a zero baseline.

Researchers also observed significant changes in product preferences. Consumers decreased their use of dried flowers, concentrates, oils, tinctures, topicals, and hashish, while increasing their use of edibles, liquids, and vape cartridges—a shift that could reduce pulmonary health risks.

Overall, the study indicated that legalization hasn’t led to the feared health harms and may actually promote safer use and harm reduction.

Lehman wrote, “Due to legalization, today’s pot is far more potent than it was years ago.” On the contrary, prohibition is the reason THC levels have increased. Readers of my blog posts are aware of the iron law of prohibition: “the harder the enforcement, the harder the drug.” Data show the average THC content in seized marijuana has been rising since at least the 1990s. This trend predates any state-level legalization and reflects black-market dynamics, where higher potency yields greater profits. Besides, just as liquor stores offer light beer alongside hard liquor, legal cannabis shops sell weed in potencies ranging from mild to high-strength.

Lehman cites a 2024 systematic review of 64 articles to argue that teenage cannabis use has increased in states that have legalized cannabis. The reviewers concluded, “recreational cannabis laws were associated with a modest but significant higher odds of past-month cannabis use.” However, data from the University of Michigan’s 2025 Monitoring the Future Survey show a decline in teen cannabis use in 19 of the 21 states with available pre- and post-legalization statistics. Legal cannabis retailers, like liquor stores, enforce age restrictions. Black market dealers do not. And no reasonable legalization advocate supports legalizing for minors or opposes age restrictions.

Lehman cites research indicating that cannabis, especially in adolescents and young adults, may hinder cognitive development, leading to lower IQ scores, and could increase the risk of heart attacks and strokes in adults. However, multiple studies on twins found no evidence to support claims that cannabis can affect IQ or intelligence in developing youth. There is moderate but inconclusive evidence that cannabis use may contribute to the risk of psychosis and schizophrenia in adolescents, but again, nobody is advocating legalization for minors. An extensive systematic review and meta-analysis in 2023 found that cannabis use does not significantly raise the risk of heart attack or stroke.

Lehman attempts to frighten property owners by citing reports that the opening of legal cannabis dispensaries may reduce property values in nearby neighborhoods. However, this concern is not unique to cannabis. Critics have pointed to studies linking various types of legal businesses—including liquor stores, fast-food restaurants, adult entertainment venues, and even Walmart stores—with declines in property values, higher crime rates, and more social problems in surrounding areas. NIMBY activists often use such research to advocate for stricter zoning laws, which worsen the housing affordability crisis. This is no reason to single out cannabis dispensaries as illegitimate.

Finally, Mr. Lehman writes, “legalization hasn’t even killed the black market.” Yet he surely knows that high taxes and licensing regulations in some states make legal weed less competitive than cheaper black market options. This explains why states with lighter rules, like Washington, have been more successful at reducing the black market than states with strict regulations, such as California and New York.

Importantly, even if cannabis use does carry serious physical and mental health risks, many legal substances that adults consume can also pose health and well-being risks for some individuals, depending on how much and how long they use them.

As I write in my book, Your Body, Your Health Care:

To British philosopher John Stuart Mill, only the affected individual is best qualified to judge whether a risk is worth taking because no other person cares more about that individual’s best interest. Even if patients make the wrong decisions, Mill maintained that society should regard them as if they are the experts about what is in their best interests because they have insights into their own priorities for well-being and happiness that no other person can have. Mill argued against the government blocking people from purchasing certain drugs unless they obtained a physician’s prescription, arguing that it interferes with patients’ choices and may make certain drugs more expensive or more difficult for them to get.

In a free society, adults make their own decisions based on their assessments of the risks and benefits. The government has no right to override those choices. It is no more moral for the government to decide if using cannabis is too risky for adults than it is to regulate how much sugary or ultra-processed food they can consume. Ultimately, the question isn’t whether cannabis is entirely safe—it’s whether we trust adults to make their own choices or believe the government should decide for them.

While Charles Fain Lehman highlights potential risks, evidence from states where it is legal shows that adults can handle those risks responsibly, making federal prohibition both scientifically unsupported and morally indefensible."