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On November 8, voters in Massachusetts will decide on Question 4, which would legalize marijuana for residents 21 and over. Legalization opponents and proponents have waged a bitter battle filled with hyperbole. Here are the key issues.

QUESTION 4: Legalization, regulation, and taxation of marijuana. If voters say “yes,” Massachusetts will join Colorado, Alaska, Oregon, Washington, state, and the District of Columbia in legalizing marijuana for recreational use.

Issue Anti-Legalization Stance Pro-Legalization Stance My View
Youth Access Legalization will lead to increased youth access and addiction. Marijuana is easier to obtain than alcohol, and regulation will reduce access. Limited evidence from states that have legalized marijuana does not point to increased youth access or addiction, echoing medical marijuana data.
Personal Freedom Adult use of alcohol or nicotine comes with significant societal costs due to direct health consequences. Adults should be allowed to use substances as long as, for the most part, others are not harmed. Societal costs of marijuana use are unclear but likely to be less than those associated with alcohol or nicotine.
Taxes No amount of tax revenue is worth societal costs of making a harmful drug legal. An effective tax rate of 12 percent will limit black market sales. The states with legalized marijuana have effective tax rates of 25-44 percent. Colorado raised $125 million in 2015, meaning that a 12 percent tax would yield approximately $70 million less. With most marijuana sales in Massachusetts currently illegal, making marijuana legal will substantially curb black market sales.
Addiction Increased availability will lead to an increase in addiction. Marijuana is not addictive, or not nearly as addictive as alcohol or opioids. Use rates have doubled in the past ten years, but addiction rates have remained stable and are lower than the addiction rates for alcohol or opioids.
Driving Under Influence Lack of breathalyzer makes it hard to determine impairment from marijuana. Failed field sobriety tests alone may be sufficient for conviction. Marijuana field sobriety tests, even with corresponding blood test, are not as precise as alcohol impairment tests.
Racial Disparities in Marijuana Arrests No longer an issue since Massachusetts decriminalized possession of up to one ounce of marijuana in 2008. The number of arrests for marijuana went from 156 in 2007 to 4 in 2013. Racial disparities exist in marijuana possession arrests nationwide. Most evidence suggests that racial disparities are real.
Commercialization Tobacco companies will exploit vulnerable groups. The newly created Cannabis Control Commission (CCC) will regulate commercial influence. Question 4 does not offer guidance on the composition of the CCC.

Dr. Kevin P. Hill is an assistant professor of psychiatry at McLean Hospital/Harvard Medical School and author of “Marijuana: The Unbiased Truth about the World’s Most Popular Weed.”