Marijuana use and perception of harm

Jan 21 2010 Published by under Cannabis, Drug Abuse Science, Public Health

A recent alert from the Center for Substance Abuse Research (CESAR) presents an interesting juxtaposition of data from the Monitoring the Future study. It pits the rates of past-30-day marijuana smoking against the perception of harm with regular use in the US high-school senior population.

CESAR-MJ-extraction2010.jpg
Adapted by CESAR from University of Michigan, "Teen Marijuana Use Tilts Up, While Some Drugs Decline in Use," Press Release, 12/14/09. Available online.

Since it has been a little while since I presented data such as these, I'll point to the obvious.
-The apparent co-registration of perception of harm with use rates. This does not, by any means, give us causality and one can (and I'm sure the comments will) argue it either way. Me, I find it hard to escape the logic that if you convince people a drug is risky (by whatever means) you are going to reduce use rates. The opposite argument, that familiarity breeds contempt (for the notion of risk) is less compelling to me.
-There was a long and sustained decrease in illicit drug use during the 80s. These data are reflective of trends for other drugs of abuse. My readers know that I tentatively assign this to the Just-Say-No, DARE, etc drumbeat of drugs-R-bad-m'kay. I just can't think of any other things that explain such broad, US-wide effects which persisted for a decade.
-I still do not understand what happened in the early 90s. These trends for marijuana and for this age group are echoed generally in the other age ranges and other drug categories. I jokingly blame dope-rap and think vaguely about cohorts who are the offspring of drug-lovin' Boomer parents but there is really nothing in firm focus here.

36 responses so far

  • Isabel says:

    "-There was a long and sustained decrease in illicit drug use during the 80s. These data are reflective of trends for other drugs of abuse."
    such as prescription drugs?

  • DrugMonkey says:

    such as prescription drugs?
    nonmedical use of prescription psychoactive drugs follows similar trends, yes. your point? do you have an answer as to why this should have emerged other than the propaganda message you apparently despise?

  • Isabel says:

    Well, I just heard about an increase on the news. Do you have data that prescription use is decreasing? What about drinking?
    I was obviously wondering if they had substituted illicit use with prescription use. Perhaps I am wrong, but it would be interesting to see them all on the same graph.
    Also, kids today are less rebellious in general.

  • MissouriMule says:

    is the decline in use related to increasing average population age (we was goofy in the '60's but we got better....well different anyway).

  • DrugMonkey says:

    Well, I just heard about an increase on the news. Do you have data that prescription use is decreasing? What about drinking?
    A, numero Uno, I put the links to the MtF data for a reason. They make up lots of figures on their website and the reports are easily navigable pdf's if you look at the TOC / Bookmarks pane. You don't have to take my characterization for it, you can look for yourself.
    with that said, I referred to a general decrease through the eighties, increase after the early 90s. Common trend for many drugs.
    The large increase nonmedical use of prescription drugs of late is in large part due to the opiates*. I don't think the history goes back as far [Edit- I was wrong, it does] on those so you'll have to look at the prescription amphetamines category on the longitudinal issue.
    *why this category of abuse took off is unclear. I suspect the poorly regulated Internet pharmacy thing really changed the availability picture, but I really don't know.

  • Willy says:

    Since we're talking about perception (instead of reality) I would expect the cause of the rise and fall to be based in that perception and not necessarily be tied to any form of reality.
    Wasn't the 80s marked by the crack epidemic? Lots of negative press about crack may have had a spillover effect on the perception of other drugs as harmful. Crack=drugs=bad.
    And what in 1992 happened to account for a rise in drug usage and fall in perception of harm? The end of 3 terms of Republican presidents, followed by Bill Clinton. Also, there was a big economic boom. Good times, let's party.

  • Jacob Mack says:

    Marijuana is good for the nociceptors:) I agree the war on drugs of the 1980's in 1990's contributed greatly to declines and some prescription drug abuse on the incline masked the true nature of illicit drug use. The data seems to confirm this assertion.

  • becca says:

    "My readers know that I tentatively assign this to the Just-Say-No, DARE, etc drumbeat of drugs-R-bad-m'kay. I just can't think of any other things that explain such broad, US-wide effects which persisted for a decade."
    Zimelidine was first sold in 1982. SSRIs > Nancy Regan.

  • DrugMonkey says:

    at LAST, a player!
    good hypothesis becca. Now, what happened to SSRI prescriptions in the early 90s to reverse that trend?

  • becca says:

    I'm pretty sure SSRI prescriptions skyrocketed during the early 90s. But I wonder if it's possible that *effective* prescriptions (that is, when there is a psychological support network, and careful medical followup and things) started going down around that inflection point. Or possibly the efficacy of antidepressant prescription treatment went down as prescriptions went up because we have vastly more people (some of whom don't meet the strictest criteria for depression) taking the drugs for shorter periods. I'd need to know more data about SSRI prescriptions.
    I'm operating off the assumption that some large segment of people try the legal stuff to feel better, and if it doesn't work, then they start other attempts at self-medication.
    You also know my economic philosophy biases. Those are based on the notion (supported by several types of social scientific research) that people are AWFUL at analyzing costs and benefits. Therefore, I suspect that people are using post-hoc rationalizations which decreases the reported perceived harm when they use more drugs. Rather than the casuality flowing in the other direction, which assumes people are rational, and avoid drugs they perceive as harmful.

  • DuWayne says:

    *why this category of abuse took off is unclear. I suspect the poorly regulated Internet pharmacy thing really changed the availability picture, but I really don't know.
    I think it is important to recognize that the very kids who are using prescription drugs non-medically, are also the kids who are adamantly against the use of illicit drugs. The perception of the recreational use of pharmaceuticals is that it is not illegal and/or considerably safer than the use of "street" drugs.
    It is also important to recognize that access is a huge issue. It is not even a matter of internet pharmacies - at least not initially, it is a matter of going into the medicine cabinet and seeing what is there. And many kids don't even need to do that. Initiation is quite often the result of kids who are taking pharmaceuticals for medical reasons, trading their pills for someone else's.
    And it is finally important to realize that initiation for nonmedical use of pharmaceuticals is younger in general, than for any other illicit drug use. Kids are fooling around with this crap when they are generally far too young to know any better. Before their parents have even considered talking to them about drugs (for the most part), in many cases before the schools have started talking to them about it. They grow into this culture of pill popping, never having considered what most kids who use cannabis, alcohol and other illicit drugs have considered.
    There is a lot involved in why this trend has taken off the way that it has and it quite frankly scares the shit out of me as a parent.

  • pinus says:

    'I think it is important to recognize that the very kids who are using prescription drugs non-medically, are also the kids who are adamantly against the use of illicit drugs.'
    Is there data to back this up? Because, in my experience, this does not hold water....but I am aware that my own limited experience does not equate across the board.

  • DuWayne says:

    I will try to get to a rather more detailed analysis of the prescription drug use - there is actually a lot of data that breaks down the types of scripts being abused in what numbers. At the very least, I will try to gather some papers and data to send you becca. I am honestly not holding my breath on getting much done for the next couple months, that doesn't directly involve school, as I am taking eighteen credits this semester...
    Part of the problem is that I not only have a lot of information on pharmaceutical abuse, I have way too much. And unfortunately it is not organized according to topic - it is interspersed with a lot of other addiction and substance use papers and data sets. I have it mostly organized by papers I wrote - papers I used. Most of the rest is just all jammed in a huge file that is not at all organized...At least I have separated addiction/substance use from gender, from evolutionary psych, general linguistics.

  • TTabetic says:

    Here is a simple explanation.

  • DuWayne says:

    Pinus - see my second comment. My email is duwayne dot brayton at gmail. I will see what I can find - but please understand that I will not get to it immediately...
    And yes, there is data to back it up. Could be a lot better, but that is the nature of research involving children and youth, about drug use. And in all honesty, comparatively speaking, the study that I have in mind could have been done worse. The biggest problem with it, was the demographics of the respondents. The survey was pretty well written.

  • DuWayne says:

    I occurs to me that I really didn't explain it very well. The age for initiation of nonmedical use of pharmaceuticals is as young as eight to nine years old. IIRC, the percentage for lifetime use for ten to twelve year olds was 3%. Age is a huge factor determining how kids are going to respond to questions about whether or not illicit drug use is ok, compared to how they feel about the use of pharmaceuticals.
    By the time these kids are in high school, they have a very different perception of the comparison of most illicit drug use, versus illicit use of pharmaceuticals. Unfortunately, by that point a lot of kids are engaging in extremely dangerous use patterns - such as mixing pills with alcohol.
    And now I am off to class...

  • Catharine says:

    It seems to me that propaganda does work. In fact, it is probably a good deal more effective than offering evidence of harm. The anti-drug adverts (this is your brain on drugs) were very effective. And, at least in the Clinton years, there were 'deals' with networks - for example ER running a show with an anti-drug message was traded for valuable network time (which would have run anti-drug ads). The anti-smoking campaign and laws have, I think, been very successful. It is now a huge stigma to be an adult smoker. (I know it's stupid, but that doesn't make it less addictive.) One only needs to consider the success of McCarthy and her anti-vaccine propaganda. As for SSRI's (and SSRA's) DTC advertising along with the McDonaldization of medicine explain that pretty well. In general, as a nation of consumers, we consume adverts uncritically *as* information. Schools produce indoctrinated consumers/workers, not critical thinkers. The question is: does the end justify the means?

  • Mu says:

    [quote]It pits the rates of past-30-day marijuana smoking against the perception of harm with regular use in the US high-school senior population[/quote]
    I'm pretty sure that's past-30-year ...

  • DrugMonkey says:

    I'm pretty sure that's past-30-year ...
    No. The three main things in the MtF survey that I talk about with regularity are the proportion of the sample that has ingested the substance in question 1) in their lifetime; 2) in the past 12 mo and 3) in the past 30 days. As you can imagine these questions address slightly different parts of the use profile in the US population.

  • Austin says:

    Possible angle for research: two music styles became extremely popular in the early nineties.
    The first is grunge, mainstreamed by groups like Nirvana (Nevermind, their first big album, was in late 1991). The whole Seattle/grunge movement was laced (at least in perception) with a heavy dose of marijuana - certainly with a "screw society, it's time to check out" attitude.
    The second I'm thinking of is rave, which of course has its own recreational drug use culture.
    Obviously I can't imply causality in either direction, but it might be significant, or at least indicative of something else. Prior to the early 90's, the most popular music genres were 80's pop, rock, new wave, and even punk - and while a lot of these might be associated with heavy drinking and tobacco, they weren't really linked, culturally, with drug use in the same way as the 90's varieties were.
    All this is just supposition from someone who lived through the 90's as a teenager (and loves pop and rave in equal amounts).

  • DuWayne says:

    Catherine -
    There is actually exceedingly little research into the effectiveness of the propaganda and what there is shows mixed results. For example, research that has explored D.A.R.E. has shown a range from minimal impact to an actual negative impact. The "this is your brain on drugs" campaign was not found to be terribly effective.
    The most effective PSA's (public service announcements) are those that are done in schools - specifically, when the teacher then discusses what the kids have just seen. Showing the message less often was more effective than repeated messages (theory being that kids begin to wonder about something they hear about too often).
    The literature review I read suggested that parents simply talking to their kids about substance use and abuse is by far the single most effective tool for discouraging adolescent substance use and abuse. There have been preliminary studies that would suggest parents with substance abuse problems or a history of them, should make clear to their children that they have elevated risk factors due to said abuse. Not necessarily the easiest discussion to have with a child, but I figure my boys are well worth it.
    Damn, I still need to write a decent post about talking to one's children about drugs...TOO MANY THINGS!!!!!!!!

  • Mu says:

    Ups, my brainfart, I looked at your 30 odd years of data, and didn't realize it was 30 years of 30-day data.

  • Steve Clay says:

    "I jokingly blame dope-rap". Should we really joke?. And, yes, Nirvana, Green Day, Beck... Just sayin'.

  • TTabetic says:

    And, yes, Nirvana, Green Day, Beck... Just sayin'.

    To paraphrase Bob Dylan, "you ain't them".

  • hf says:

    Just thinking out loud, but do we know what happened when those 80% left high school? If they for example decided that DARE had lied to them repeatedly, that might have an effect on their younger siblings. Also, I see the program started in 1983 and its education or propaganda starts in the 5th grade. Does that mean the decline in reported perception of harm among 12th-graders began soon after the first fully-DAREd students reached the 12th grade?

  • DrugMonkey says:

    Yes, SC, that's what I usually blame...

  • leigh says:

    my generation kinda fucked up, in my opinion. but another possibility along the lines of what becca is saying is that narcotic painkiller prescriptions really took off in the 90s too.

  • Matthew says:

    I agree with DM in the original post. Convincing people (kids included) that drugs are harmful does reduce consumption. I do wonder, though if the 90s phenomenon isn't a reaction to at least some false propaganda from the 80s. In other words, the kids have figured out that there is some risk incurred with smoking pot, but it's not as bad as mom, dad and the teachers have been telling them.

  • MOPSS says:

    As a parent of three somewhat recent high school age children, DARE doesn't work, education doesn't work, parental education doesn't work. This is out of the mouth of babes. Peer pressure, music, and other parents who feel a little pot and alcohol are normal and "as long as they do it under my roof, it's okay," have a large part in this. I KNEW what my kids were up to, the rest worked/otherwise and didn't worry about it as long as the grades were okay. My children told me a HUGE percentage of their peers used/tried. Oh, and these were middle class and above peers. And by the time they get to college, fuggedaboutit!

  • DuWayne says:

    MOPSS -
    Out of the mouth of babes, is not something that I am particularly keen as taking for gospel. That rather limits the information one is working with, in particular;
    Other peer groups in the same location - your kids are not aware of everyone, even in their own school.
    Peer groups as close as other local schools - there are many factors that can cause significant differences in drug use patterns from one school to another, even in the same district.
    Peer groups in different socioeconomic demographics - makes very significant differences in use and perception of use, not always what you would think it might be either.
    Peer groups in different geographic settings - drug use patterns vary considerably between urban settings, suburbs and rural populations.
    Peer groups in different states - each state has it's own programs that piggy-back on federal programs and even the federal programs differ. Also, many other factors can be dramatically different from state to state - including availability.
    There are a great many more factors that influence not only the choices kids make, but the effect that these things you are so dismissive of have as well. While I would tend to agree that the evidence would suggest that D.A.R.E. has rather dubious efficacy, education and parental involvement can have very profound effects, depending on how they are managed. They are also very dependent on the credibility of those providing the education and parents - kids who don't trust their parents or the information being imparted by the school, are unlikely to make decisions according to what they are told by those sources.
    On the other hand, kids who have been raised by parents who engage with them, even when the topic is difficult, are more likely to listen to them about drugs. Kids with parents who have substance use disorders, who's parents are open and honest about it, are more likely to listen when their parents talk about elevated risk factors for substance use disorders. Kids who are told by their schools that "yes, some people use and never really have a problem because of it" are more likely to hear "but there are a lot of people who do end up having problems because of substance use."
    For many reasons, it is very difficult to get extremely accurate data about drug use and abuse - not the least being a lack of coherent/universal definitions (i.e. what I mean when I say "addiction" may not be what it means to you). It is even more difficult to get extremely accurate data about the efficacy of various addiction/use prevention techniques. It is harder still to get accurate data on the efficacy of substance use disorder treatment methods. What we can get pretty accurate data on, is how kids feel about the use of various substances of potential abuse and at least learn what they think was most effective/least effective in fostering those beliefs.
    Some of the things we have learned;
    When receiving the same information from schools or their peers, most teens are more likely to believe their peers (likely a perceived lack of bias). Follow-up to that - younger kids hearing it from older increases the efficacy and makes it less likely that older kids involved will use.
    Parents who are engaged with their children (not just about drugs) are capable of having a profound influence on their children's choices in regards to substance use and sexual behaviors. Being somewhat embarrassed to talk about it doesn't seem to cause problems, unless it interferes with said parent's willingness to fully engage in the discussion. Admitting ignorance also seems to be better than merely relying on and reinforcing what they are told in school (i.e. "well, I really don't know any more about that than you have learned - I am willing to learn more though"). Laying the groundwork for talking about substance use and sexuality when they are younger also makes a big difference...
    And when they are younger, kids are a lot more willing to listen to what they are told in school.
    How all of these things ultimately impact real behavior is hard to say. The older they get, the more likely it is that they will engage in substance use. By the time they are in their twenties, very few kids will have never tried alcohol and a very large percentage will have tried some illicit drug - usually cannabis. About the best we can do is work on influencing how old they are when they initiate use and patterns of use. But this is important too, because we know that the younger someone is when they initiate use, the more likely they are to develop substance abuse and addiction problems.
    Assuming that it is a lost cause and nothing we might do will make any difference is flat ignorant nonsense, that ignores the evidence.

  • Rachel says:

    Matthew, as someone who turned 12 in 1990, I don't think that's a bad hypothesis.

  • MOPSS says:

    DUWAYNE
    I realize that I probably came across as the disgruntled parent that I am. I was a boomer hippie who had my children later than my peers and did not realize that my generation had not passed on some important lessons. After raising three teens that were close in age, I am disillusioned. This because I was an involved parent who watched my son become a marijuana addict. The experimentation started in high school, and we immediately took steps to attempt to control the problem as much as possible. Once he went off to college and was free from supervision, he smoked daily with his peers. There probably is a biological reason why he started and why he continues to smoke. He is on his own now.
    You provided quite a bit of good information, and made some excellent points. Nevertheless, it is important to listen to “the mouth of babes.” My daughter is now a successful junior at a private college working towards a B.S. in Biology. She has discussed drugs with her peers in college from urban, rural, and suburban settings and they all agree that their high schools had major drug problems. She did NOT try cannabis in high school but had friends that were users. She had a strong enough character to resist both cannabis and alcohol in high school. So did her sister.
    You discussed peer groups in other schools, districts, etc. These kids got involved with other schools due to sports. They knew what was going on. The DARE officer out rightly told us that the school with the worst drug problem was the top Catholic high school of the area. The water polo coach, biology teacher, and Spanish teacher at my kids’ high school were cannabis smokers and the students knew it. The water polo coach succeeded in getting drug testing eliminated the year he coached. His best players were cannabis smokers and he did not want to lose them. The biology teacher lived in my neighborhood. He admitted that he smoked to a few of his students. The Spanish teacher smoked medical marijuana so she felt comfortable in admitting it to her students. Did I agree with this philosophy, NO! I doubt the principal knew this was going on in his school. I live in the Pacific Northwest, so maybe acceptance of drug use is regional.
    My daughter explained how social status was extremely important. She didn’t have it, but stated that her character was strong enough to avoid drugs/alcohol in high school. My other daughter also avoided it, but maybe it was because she didn’t want to pay the price of family drama. My son did not have social status, nor the esteem needed to avoid it. I asked about the kids whom I thought had social status and she pointed out that the pressure to maintain status encouraged use. The geeks with good grades wanted to fit in, so they did it. She felt peer education would work, but it wasn’t offered at the high school. She also agrees with you that drug education needs to be offered at much younger ages, middle school was too late. I still think that it is worthless to educate the kids until you can educate the parents. However, good luck getting them out of their drunken stupor at college pong games on Parents’ Weekend. Yes, the state college newspaper did have a student editorial requesting that the parents to remember that they were adults and to not get so drunk that “you embarrass your kid as they hold your hair out of your face as you barf in the alley.”
    You are right that parental education could work. The high school tried it, but only four parents showed up. You mentioned parents need to educate their kids, I did. If propensity to addiction is genetic, then my kids were at risk and I told them about risk and pointed out the kind of damage it did (a few relatives made fine examples). We talked about protecting the still-developing mind. Some of the other parents were laissez faire about cannabis or alcohol. They figured that they did it and survived and their kids would be fine repeating their behaviors.
    It is not a lost cause, but it is an uphill battle. Many parents’ main concern is that their kids have a good time, are happy, and get good grades to get into college to get that sheepskin. Some people honestly can drink, smoke, and still survive. For me, the battle is for kids like my son, and maybe his high school peer who is in prison now because in his senior year of high school he took his car out for a final spin while high and killed a woman because his parents were going to sell his car due to his use.

  • DuWayne says:

    MOPSS -
    I am sorry about your son - I can very strongly relate to what he is going through, because I went through it - along with about every other substance I could get my hands on. The unfortunate truth of the matter, is that nothing will change until he decides he wants it to. Unfortunately, the younger one is, the less they want to stop.
    I sincerely hope that your son decides to wise up about his use. It would be nice to have something heartening to tell you at this point, but I dropped out of high school eighteen years ago and am a year into college (ironically, studying neuropsych to go into addiction) at 33. I have spent much of that time with other people smoking pot and using other drugs, it took finally getting psychological help that I have needed for years to stop smoking pot virtually every day.
    And full disclosure, I have smoked pot five times in the last year - since I went on medication. I do not really look at that as a problem however, given where I am coming from and how quickly I got to where I am.
    And yes, PacNW definitely has a regional thing going in regards to accepting drug use - but it is a rather odd relationship (I am back in MI temporarily, until I transfer schools back out to Portland). Though the openess to students by teachers is something that I voraciously oppose and believe me, when I am back in the area, that is something I intend to do my small part to deal with.
    Parental education is a huge issue and I really wish I knew the answer. Coming from the place I do, it is hard sometimes for me to remember that parents are often times pretty seriously fucked - that was not my experience, nor was it what I saw in parents around me. And this did include the parents of many of the friends I made as an adult, who were of a clique back in the day, using way to many drugs together (for example, I have several female friends who grew up together, who are named after herbs). Some of them took some time settling down after they had kids, but once they did, they actually grew up.
    Honestly, a significant portion of the problem of addiction is social. As a society, we are bent on moralizing addiction to such a degree, many people who have substance use problems refuse to admit to themselves they have a problem. "Addicts are fucking weak and pathetic - that cannot possibly be anything like what and who I am." This moralizing has implications on so many levels that it makes it extremely difficult to figure out how to fix it.
    And the thing that pisses me off the most, is that the behavior of addiction is something that virtually everyone on the planet engages in - we just don't usually call it addiction, because many habits and obsessive behaviors are completely benign - sometimes even positive.
    Seriously though, I am very sorry about your son. Clicking on my name will take you to my blog, which has a sidebar full of great resources and my email address if you would like more (keeping in mind that I am taking eighteen credits this semester, so I am not always prompt about reply). I would also heartily recommend you check out Dr. Lance Dode's The Heart of Addiction. I have read a lot of books about addiction and outside books for clinical practitioners, that is the very best.

  • LindaCO says:

    Late to the party, but I got a flier tucked in my front door the other day for one of the several new medical marijuana dispensaries that are popping up around town here in Colorado. The flier went on about what one could do to get a physician referral, and was such a thinly veiled attempt to get people buy the stuff (hey! college student discounts!), it made me wonder what kind of effect this is going to have on future rates of use.
    As one acquaintence pointed out, the regular pharmaceutical companies aren't allowed to advertise this way (not sure if that actually is the case), why should these folks?

  • Maia Szalavitz says:

    The idea that "just say no" and all the heavy-handed DARE propaganda and mandatory minimums of the 1980's worked is belied by the trend lines in actual use: drug use starts dropping dramatically years *before* the Reagans started going nuts about drugs, drug use peaks in 1979-81 and then falls. It falls especially steeply after college basketball star Len Bias died from cocaine use in 1986.
    *Honest* information-- not government propaganda-- is what works to the extent that anything does (though people falsely believed he died from crack, the event was not a PR campaign and was the real death of an admired, healthy young person). What also works is real personal experience of harms-- this is why we have the phenomenon of "generational forgetting." The younger sisters and brothers of crack smokers (in the 90s) didn't need any PSA's to tell them not to use, the drug itself put them off. What rose were other drugs because we always need a "demon' drug and it has to be worse than the prior one in order to effectively be advertised by the media.
    That's why crack is worse than heroin and meth is worse than crack and Oxycontin is worse than meth-- and whenever these stories run, the hardcore users head to the dealers to ask for the latest "worst" drug.
    Pretending that marijuana is as harmful as other drugs is one reason that drug propaganda continuously doesn't work-- you can get kids to believe its harmful but when they see that it isn't especially, they're not going to believe you about cocaine, meth, etc. Which is not good.
    Most effective antidrug campaigns have been those against smoking: but they have the overwhelming evidence of real, lasting harm to use, they don't have to fake it.

  • DrugMonkey says:

    drug use starts dropping dramatically years *before* the Reagans started going nuts about drugs
    Yes, and the trendlines are pretty continuous such that it is hard to identify one single program or campaign. Just Say No and Nancy Reagan are but convenient taglines for the anti drug messaging. Don't think you've shown that anti-drug messaging is not effective here. I will also point out that the Len Bias event was the only one I've found yet where a single event seems to be associated with a dramatic behavior shift. This had nothing to do with "honest" information and everything to do with the *reach* of that information, IMO.
    What rose were other drugs because we always need a "demon' drug and it has to be worse than the prior one in order to effectively be advertised by the media.
    you are not making any sense with this passage. Yes, crack was one of the few drugs which did not rebound through the 90s but heroin did. "narcotics other than heroin" which is mostly the diverted prescription meds went way up. (looking at chapter 5 of vol II of MtF for anyone who wants to follow along)
    Pretending that marijuana is as harmful as other drugs is one reason that drug propaganda continuously doesn't work
    So explain the trend during the 80s. What happened? What changed in the early 90s? The antidrug message was sustained through the 80s. As we got into the 90s we had the emergence of dope rap and medical marijuana as possible PR messages which would explain a change in behavior.
    NORML and friends, btw, were there throughout the 80s although I think that it is possible that the emergence of the Internet allowed those advocates to reach more people. That I might buy.
    Most effective antidrug campaigns have been those against smoking: but they have the overwhelming evidence of real, lasting harm to use
    the PR message has been essentially uncontested too. Big Tobacco gave up telling us ciggies are good for us and hunkered down into "personal freedom" and "you can't prove they cause harm"..when was that? mid 70s maybe? Significantly different situation with all the cannabis advocates of various stripes.

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