Round Two: Rebutting Rebuttal
By Hunter J. White
I have been called on to respond to claims made by Mr. Degeyter. Mr. Degeyter has specifically taken issue with three points made in my rebuttal to Mr. Katz’s wild claim that “marijuana is the most dangerous drug of all time.” Mr. Degeyter’s issue seems to break down into three primary points. First, Mr. Degeyter takes issue with the claim that marijuana is not a gateway drug. Second, Mr. Degeyter claims that marijuana does not provide lifesaving medicine to people. Finally, Mr. Degeyter claims that people in fact overdose on marijuana and it is potentially fatal.
Gateway Drug Round Two
Mr. Degeyter has taken issue with one of the studies I put forward debunking the well-worn claim that marijuana is a gateway drug. What appears to be at issue here is determining correlation, and causation.
What I find particularly shocking is how the National Institute of Drug Abuse study Mr. Degeyter has quoted in his rebuttal was used. Mr. Degeyter quotes, “When discussing cross-sensitization studies NIDA states, ‘These findings are consistent with the idea of marijuana as a “gateway drug.”’”
However, Mr. Degeyter fails to finish the quote in the same line which goes on to state: “However, the majority of people who use marijuana do not go on to use other, ‘harder’ substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs” Cherry-picking is fun, but misleading when we quote scientific studies. To accuse me of misleading readers, while Mr. Degeyter misleads readers regarding the study I quoted seems disingenuous and counterproductive to making the point. Taken together, the quote supports my position that there is nothing intrinsic in marijuana use that makes a user more likely to use harder drugs.
Simply put, other factors play a much greater part in deterring later hard drug use. Race, socioeconomic status, geographic location, mental health, genetics, family support structures, and social interactions play a much greater part in determining later hard drug use. This is exactly what I stated and cited. These factors, of course, appear to get a pass from Mr. Degeyter. Of note, Mr. Degeyter only addressed one of the numerous studies I offered to support my rebuttal of Mr. Katz’s claim. Taken holistically, with numerous studies suggesting that marijuana is not unique as a gateway drug, that other substances such as alcohol have stronger correlations with harder drug use, and that other factors have larger roles in determining later hard drug use (such as those I explicitly state), I am confident that marijuana is not a gateway drug. For reference, I will include ten more studies to bolster my claim beyond the numerous ones cited in my original article that Mr. Degeyter failed to address. Perhaps Mr. Degeyter will take the time to read all of my citations, before picking just one line from one study to take issue with.
I find it challenges credulity that Mr. Degeyter seeks to parse out the difference between using the chemical compounds of marijuana, which Mr. Degeyter seems to accept as not causing later hard drug use, and the act of using substances containing those drugs, which magically does cause later hard drug use.
Marijuana and the definition of “lifesaving”
Improving quality of life means “lifesaving.” To suggest otherwise seems to underscore either a disingenuous engagement with the argument presented, or a complete naiveté of what it means to suffer or know someone who suffers with chronic debilitating conditions. If marijuana relieves chronic pain, that is saving someone’s life. It may not cure the underlying condition, but it makes life bearable and worth living. As someone who represents those in matters of Social Security, you would think Mr. Degeyter would have firsthand knowledge of what even minor relief from the agony of chronic disease would mean to those who suffer.
I would like Mr. Degeyter to tell the thousands of Texas veterans who use marijuana to stave off the insidious creeping thoughts of PTSD induced suicidal ideation that marijuana has not saved their lives. Would Mr. Degeyter care to look cancer patients in the eyes and tell them that marijuana has not saved their lives by relieving them of the agonizing pain of chemotherapy and giving them a chance to eat an keep food down without waves of nausea? I would like Mr. Degeyter also to stand before the families whose children’s’ seizures are now under control because of marijuana and tell them that their child’s life has not been saved because marijuana is only treating the symptoms. I want Mr. Degeyter to find any patient suffering from chronic illnesses who have found relief in marijuana and tell them that marijuana has not saved their lives by returning them to a state of being that they can bear.
What I find interesting are the points with which Mr. Degeyter has chosen not to engage. For instance, Mr. Degeyter claims marijuana does not save lives because it only treats symptoms, yet he has overlooked the studies in my rebuttal which show opioid overdoses and deaths have dropped in states with medical marijuana programs. Having medical marijuana as an alternative to opioids for pain management is saving lives, and the proof is in the numbers. Mr. Degeyter also seems unaware that suicide rates have dropped in states with medical marijuana programs, which studies have attributed to increases in the quality of life in those with chronic illnesses.
Further, Mr. Degeyter has also failed to account for the long-term damage to organ systems which come with prolonged use of many prescription drugs which are absent from medical marijuana. Medical marijuana may not cure chronic pain, but it will save a chronic pain sufferer from eventual liver and kidney failure associated with long term opioid use. The same could be said for the heightened risk of suicide associated with long term anti-depressant, anti-convulsant, and anti-psychotic medication commonly used to treat PTSD, and seizure disorders.
Mr. Degeyter may wish to claim that effectively treating symptoms is not synonymous with lifesaving medication. He is free to have that opinion. However, I am sure if Mr. Degeyter engaged with those who suffer chronic longer-term medical disorders, and those who care for those with disorders such as cancer, PTSD, MS, ALS, seizure disorders, chronic pain, and numerous other chronic conditions, he would learn that alleviating symptoms and giving back one’s quality of life is synonymous to lifesaving for them. The comments to his rebuttal from those who suffer from chronic illnesses and find relief in marijuana reflect as much.
Semantics and Overdoses
Mr. Degeyter has also taken issue with my characterization that it is impossible to overdose on marijuana. Mr. Degeyter correctly points out that the number of emergency room visits for ingestion of marijuana is not high but seems to hedge his bet that a fatal case of marijuana use may be just around the corner.
Let us begin with a simple observation from two governmental bodies that monitor overdose-related deaths—the Drug Enforcement Administration (DEA) and the Centers for Disease Control (CDC). The DEA, in its own fact sheet on marijuana, admits that there has never been a fatality from an overdose of marijuana. Let us compare that to the 64,000 deaths resulting from all legal and illegal drugs last year. The CDC’s annual reports on drug overdoses and deaths have recorded zero deaths attributable to marijuana alone in its history.
In fact, it appears that it is difficult to find reliable statistics of the number of non-fatal overdose of marijuana. While Mr. Degeyter is correct that the number of emergency room visits relating to marijuana have seen a small increase, to characterize them as overdoses appears to be a designation of his own design, rather than a statistical fact recorded by the administrative bodies responsible for tracking such events.
Mr. Degeyter may seek to distinguish what is mean by overdosing on marijuana. Let us be clear then. It is practically impossible to have a fatal overdose of marijuana. I believe the 1988 Administrative law findings challenging the controlled substance act characterization of marijuana as a Schedule I drug put it best: “A smoker would theoretically have to consume nearly 1,500 pounds of marijuana within about fifteen minutes to induce a lethal response. . . . In practical terms, marijuana cannot induce a lethal response as a result of drug-related toxicity.”
With zero deaths recorded as a direct result of marijuana use and no consensus on what is or is not an overdose of marijuana, it appears Mr. Degeyter is the one making a misleading claim about the risk of marijuana overdoses. These findings on their face destroy Mr. Katz’s claim that “marijuana is the most dangerous drug of all time,” as it has never killed anyone directly unlike the host of legal drugs currently prescribed for medical use and a host of illegal drugs.
Arguing the semantics of the risk posed by the overuse of marijuana seems pointless when the mere fact that no one has ever died of marijuana alone is enough to negate Mr. Katz’s original premise that “marijuana is the most dangerous drug of all time.”
A Word on Schizophrenia
Mr. Degeyter is correct, and I agree with him here. This is why I explicitly stated, “Simply put, if one has this predisposition, they should avoid the drug.” Like all drugs, certain members of the population simply should not consume it. I do not see any disagreement in our positions.
I admire Mr. Degeyter for seeking to clarify some of the points I raised. In fact, I agree that some of these points could have been stated in clearer and more precise language, certainly with better proofreading and editing. I suppose I took for granted a simple indulgence of hyperbole as a tool of persuasive writing in rebutting the completely non-hyperbolic claim that “Marijuana is the most dangerous drug of all time” put forward by Mr. Katz.
Even so, Mr. Degeyter appears to have engaged in some hyperbole of his own. It is not blatant falsehood to state that marijuana is saving lives. I have provided the studies to support that in terms of opioids and suicides amongst the chronically ill. Further, it is incorrect to claim that mitigating symptoms is not lifesaving, as this position betrays a total lack of understanding or empathy with what it means to suffer a chronic debilitating condition. That, Mr. Degeyter is the blatant falsehood, not my statement.
 Levine A, Huang Y, Drisaldi B, et al. Molecular mechanism for a gateway drug: epigenetic changes initiated by nicotine prime gene expression by cocaine. Sci Transl Med. 2011;3(107):107ra109. doi:10.1126/scitranslmed.3003062.
 Joy, Janet E., Stanley J. Watson Jr., and John A. Benson Jr., Division of Neuroscience and Behavioral Research, Institute of Medicine, “Marijuana and Medicine: Assessing the Science Base (Washington, DC: National Academy Press, 1999).
 IOM, “Marijuana and Medicine: Assessing the Science Base,” 1999.