Thursday, September 22, 2011

Going Dutch: Teen Marijuana Use in the US vs. Netherlands — the Full Interview with Cal Professor Robert MacCoun

By David Downs
Thu, Sep 22, 2011 at 8:59 AM

The results of a new study published in the journal Addiction earlier this month challenged the United States' "provincial" drug policy rhetoric, especially as it relates to youth. The study compared data on cannabis use among US teens to newly available numbers on usage rates in the Netherlands and the rest of Europe. The results: The Dutch have about 700 adults-only clubs that sell 50 to 150 metric tons of cannabis per year, yet Dutch teens report lower levels of weed usage and availability than youth in the United States. The author of the study, Robert J. MacCoun, a professor at UC Berkeley's Goldman School of Public Policy and Boalt School of Law, shared with Legalization Nation some thoughts on what's going on:

(A print version edited for space is on newsstands or here.)

Legalization Nation: It seems like the major take-away from your paper is that marijuana stores can cause an increase in use, but only a modest one and it doesn't lead to harder drugs.

Cal Prof. Robert MacCoun
  • Cal Prof. Robert MacCoun
MacCoun: Yeah, it's always nice when you have a paper that has a single punchline, but the reality is that the Dutch system is pretty complicated so its a mixed story.

On one hand, it's probably true the Dutch have more cannabis use than they would have had if they hadn't adopted this coffee shop model. But at same time, the data seem to suggest that it doesn't promote escalation into harder drugs and it doesn't promote the heavier levels of cannabis use that you would see in U.S. Their actual level of cannabis use is pretty modest by European standards.

It's a trade-off, but the Dutch were probably thinking it's a fair trade-off, because they initially set out to reduce hard drug use by separating the soft drug market from the hard drug market, and the data in the paper suggests that seems to have worked.

Legalization Nation: You've been looking at this issue for twenty years. What's changed?

MacCoun: When I first started looking at it there really was so little data available it was hard tell you anything you could call definitive. There's certainly a lot more information now.

We know a lot more about other countries in Europe, so now we can compare them to their neighbors, and when we do that you might expect the Dutch would look a lot worse than their neighbors on various drug outcomes —but they don't. They're right in middle of the pack in terms of marijuana use and, as I say, they have a lower likelihood of going onto hard drug use than you would expect from looking at their numbers.

There's really been a concerted effort in the past decade to do cross-national data collection in Europe and this is partly driven by the European Union and its desire for what they call "harmonization." They want to harmonize their laws, and frankly, the neighbors of the Netherlands have been eager for the Dutch to shut down their coffee shop system. I don't think the data provide much of an indictment of the Dutch system that their neighbors might have expected.

As I mentioned in the paper, for political reasons, it does look like the Dutch are going scale back coffee shops and they're proposing to end tourist sales, which is a pretty significant change — because there may may be a million people in Amsterdam who go to shops while visiting there. It's a significant change. It's partly driven really though by the emergence of a right-wing party in what used to be a pretty liberal country.

Legalization Nation: How's the US data data you compare it to? I seem to remember RAND questioning some government marijuana stats last year.

MacCoun: I think it's really important to clarify something here. I would be willing to bet that they were talking to you about the Mexico data, because Beau Kilmer had the report last year saying the government estimate of how much marijuana comes from Mexico and what share of the market it is were just numbers that were made up.

I want to make a distinction here and I'm quite confident — I worked at RAND for several years and I was part of the team that did the Prop 19 analysis — I'm pretty sure I can speak for them in saying we would all make a big distinction between the survey data, which is by no means perfect, but has been scrutinized in various ways and seems to be pretty reliable (for example, you can look at urinalysis data and compare it to what people say in surveys and you do find that surveys do a pretty good job of accurately reflecting what people are actually using). I would distinguish that from when the government does source-country control like going into South and Central America and trying to do crop eradication. They make claims about success, they make claims about how much drugs are being transported, and those numbers sometimes seem to come out of nowhere. It's very difficult to validate those numbers and lot of those numbers are not internally consistent. They're just not very plausible.

The survey research is actually pretty good. The other sources of data are pretty dreadful, especially compared to tobacco and alcohol, where we know so much about tobacco and so much about alcohol because they're legal.

American kids: on one

These surveys really started in the 1970s and for a good ten years there was an enormous literature on the validity of these self-reports because everyone was skeptical. What we found is that there are various ways you can check it to sort of validate these reports and it turns out if someone really believes that it's anonymous they'll talk your ear off about their drug use.

I also know this from focus groups of teenagers, once they decide you're not a cop, they'll talk your ear off.

It's not perfect, but what's the alternative? The alternative is to know nothing about what's going on.

Legalization Nation: So shouldn't there be more 15-16 year-olds smoking pot, per capita, in the Netherlands than in the US?

MacCoun: That's what everyone thought, but a number of papers over the past five years have focused on this new survey data that doesn't seem to support that. There are a couple things to say about this:

The Dutch are pretty strict about not letting minors go in these coffee shops. In fact, dozens of coffee shops got shut down for letting minors in. Now, the majority of owners are really concerned about it, because they know they can get shut down.

The Dutch have reduced the street market. Since adults can go into coffee shops, there are fewer street dealers, and since there are fewer street dealers, that reduces the opportunities for teenagers to go buy from someone on the street.

So, it would be naive to think no adults are buying in the coffee shops and are providing for younger brothers, just as that happens with alcohol in the U.S. but —

Legalization Nation: But it's not a free for all?

MacCoun: It's not a free for all.

Another thing: the coffee shops are not uniformly distributed throughout the country, but they tend to be concentrated in Amsterdam, Rotterdam and a couple of college campus towns. There actually a lot of smaller towns that don't have coffee shops.

San Francisco cannabis dispensary SPARC
  • San Francisco cannabis dispensary SPARC

Legalization Nation: What's going with this stat about how 71.5 percent of US teenagers said it's very easy to get pot, while in the Netherlands, where pot is legal, it's 41.5 percent. That seems way out of the realm of the margin of error.

MacCoun: So that' a pretty striking finding and I was just as surprised as you were by that, because I certainly expect greater perceived availability in the Netherlands. But because it's been found in more than one survey, I'm inclined to give it some credence. It's not just the Netherlands, the U.S. is an outlier with respect to all of Europe.

In the US kids have consistently told us that marijuana is easy to obtain, and the vast majority of kids at most schools will say that.

Then again, that's at least 75 percent, and it's usually more than 85 percent in a lot of schools, saying, 'It's easy to obtain marijuana in my school.' And that's been true in the US for several decades and you just don't see that in Europe. For whatever reason, we really have — in this campus market — well-established supply lines into schools.

You could try to make up a story that US kids are exaggerating for some reason, or that European kids are paranoid. I don't think it's very plausible, because there's really no risk to kids saying that they think it's easily available.

Even kids who don't use will say it's easily available. There's also no particular reward for telling them how much it's available. I don't really think it's a big motive to exaggerate, so I'm inclined to think it's just the reality of how easy it is to get marijuana in the schools.

Some people want to point to medical marijuana, but it's not a new story and marijuana has been readily available long-before we had medical marijuana in dispensaries.

Legalization Nation: And American kids are three times as likely to report using other illicit drugs. Does this validate the Dutch's market approach to the gateway theory?

MacCoun: In the U.S. we usually think that marijuana is a gateway, that it will increase the appetite for intoxicants, but the Dutch in the Seventies had a very different theory, which was the gateway is created by contact with hard drug sellers. They had this idea: if we can separate the markets and let people who want soft drugs get them without having to go to drug dealers then we can reduce the gateway and the data in my paper seem to suggest there's something to that.

Now part of it is, for reasons that no one completely understands, certain drugs have just been much more popular in the U.S. than in Europe, so crack cocaine did catch on in Europe but never to the degree it did here. Methamphetamine has caught on in Europe to some extent, but never to the degree it's caught on here. On the other hand, ecstasy is quite popular in Europe, and it's at least as quite popular here.

Nobody has a great theory about why certain drugs and populations in certain countries — even in the US. it's kind of a mystery why a drug like PCP was so popular in some parts, but never spread to other parts of the country. Or why African Americans have shown so little interest in methamphetamine. You know, I just have to throw up my hands and say "Well, it's culture." It's not much of an explanation at all. There's something going on, we don't fully understand, it's regional and cultural differences and tastes for drugs.

Legalization Nation: Does that make this paper an apples to oranges study? I think of California — let alone America — as this extremely heterogeneous place, while Amsterdam comes off as more homogeneous.

MacCoun: I think it's a fair point although it would probably be more accurate for Oslo or Stockholm than for the Netherlands, because the Dutch have a lot of immigrants from the east Indies and from other places and so it's a little more diverse. But you're right, it is a leap to generalize from the Netherlands to the US. But, as I say in the paper, it's the only game in town. If you want to understand the effects of alternatives, if we're talking about legalizing cannabis, you got to go where people have actually experimented with different policies, and so that's why it's worthwhile looking at the Dutch system. If we just refuse to look at any countries' experience other than our own, there's no opportunity to learn. This is how sausage gets made.

Legalization Nation: As an observation: it's 2011. It's crazy the hard data on effective drug policy, even basic data, is just now coming online.

MacCoun: That's right. This is one of the unintended consequences of prohibition — it becomes hard to study. If you look at tobacco and alcohol, there are vast databases about the economics of tobacco and alcohol. Then you look at marijuana: we're flying blind.

Legalization Nation: You're paper seeks to provide provisional judgments over provincial ones. What provincial notions are you talking about and how might this paper challenge them?

MacCoun: I think the US is often very provincial in refusing to look at what we can learn from other countries. There's this kind of notion of American exceptionalism —that we're different than every other country.

Now, another policy area I've been very involved in is the Don't Ask Don't Tell Issue, analyzing that during the Clinton Administration and then in the Obama administration and a similar issue came up there. People would say, "Don't tell me what's going on in the Norwegian army or the Dutch army or countries the have non-discrimination policies, I don't want to know, because they're not really a fighting force." Well, then Israel adopted a non-discrimination policy and nobody could say Israel is not a real fighting force. So little by little. Then Britain and Canada and Australia actually fought with us in Afghanistan, and they had non-discrimination policies.

And eventually, it just wasn't credible to say no other country's experience is relevant. If you look at every other country that has ended the ban on gays and lesbians, and you find that none of them had problems, you got to take it seriously. In the same way we should be cautious in looking to other countries and what we can learn from them, but we shouldn't be so provincial that we just refuse to learn.

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