The media and marijuana legalization advocates would have Americans believe the only choices for marijuana policy are legalization or strict prohibition. Neither approach is right.
Marijuana should not be sold on the open market. Legal alcohol, tobacco, and prescription drugs kill more than 500,000 people a year. Research tells us that access and availability lead to greater use, and big tobacco showed that legal industries can play down harmful health effects of their products.
Neither is there any assurance, under legalization, that the underground market would disappear, because that market could very easily adapt to and undercut a legal, taxed product like marijuana.
But the United States should also not focus only on enforcement. Few people are in prison or jail for mere possession of marijuana, but even an arrest record can hamper chances for employment, education loans, or other public assistance. Laws that provide for a sanction but do not penalize an offender's future should be considered. Drug courts – which offer treatment with accountability – and probation programs that focus on intervention also make sense.
Finally, though existing medical marijuana programs represent little more than de facto legalization, cannabinoids – the chemical compounds present in marijuana plants – may have medical utility worth pursuing. Research should identify them and standardize their dosage and delivery form.
Just as we do not smoke opium to gain the medical effects of morphine, we should not smoke marijuana to obtain therapeutic benefits. Nonsmoked formulations (like Sativex, a mouth spray under Food and Drug Administration review) offer a safe, scientific, tested way to properly medicalize cannabinoids.
Such drugs may not mollify marijuana enthusiasts who want a "medical" excuse to smoke marijuana. But they represent a common-sense marijuana policy that the US would do well to follow.