From her perch as head of the National Institute on Drug Abuse, Nora Volkow watches anxiously as the country embarks on what she sees as a risky social experiment in legalizing marijuana.
For those who argue that marijuana is no more dangerous than tobacco and alcohol, Volkow has two main answers: We don’t entirely know, and, simultaneously, that is precisely the point.
“Look at the evidence,” Volkow said in an interview on the National Institutes of Health campus here, pointing to the harms already inflicted by tobacco and alcohol. “It’s not subtle — it’s huge. Legal drugs are the main problem that we have in our country as it relates to morbidity and mortality. By far. Many more people die of tobacco than all of the drugs together. Many more people die of alcohol than all of the illicit drugs together.
“And it’s not because they are more dangerous or addictive. Not at all — they are less dangerous. It’s because they are legal. ... The legalization process generates a much greater exposure of people and hence of negative consequences that will emerge. And that’s why I always say, ‘Can we as a country afford to have a third legal drug? Can we?’ We know the costs already on health care, we know the costs on accidents, on lost productivity. I let the numbers speak for themselves.”
Volkow, 58, speaks rapidly, even urgently, in an accent that lingers from her childhood in Mexico. The great-granddaughter of Soviet communist Leon Trotsky, Volkow grew up in the Mexico City home where Trotsky was fatally attacked. It is easy to imagine, in her passionate determination, some of her ancestor’s revolutionary fervor, melded with a scientist’s evidentiary rigor.
As Colorado and Washington state approve the sale of marijuana for recreational use and other states consider following suit, Volkow says, the notion that legalization represents a modest, cost-free move is dangerously overblown. The evidence on the supposed safety of marijuana — particularly marijuana in its modern, far-more potent form — is far from clear enough to take this leap.