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Alex Berenson's Tell Your Children is wrong regarding marijuana, psychosis and violence

Alex Berenson Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence begins early with a personal anecdote: One evening, Jacqueline Berenson, a forensic psychiatrist and Berenson's wife, recalled a case of a man "set fire to his grandmother or set fire to his apartment." At some point in the discussion, Jacqueline noted, "Of course he was tall, smoking all his life."

As a journalist, this was piqued by Berenson's curiosity. He claims he thought marijuana was relatively harmless before. But here was his wife, with all her expertise connecting marijuana with a cruel crime. When he retired, his wife told him to look at the scientific evidence. So he did it. The result is the book in which this conversation is now being retold ̵

1; a book widely circulated in CNBC, the New Yorker, Mother Jones, and the Marshall Project, and voiced by Berenson about his findings in New York Wall Street Journal and the Philadelphia Inquirer.

His central argument is best summed up in a few short lines in the book: "Marijuana causes psychosis. Psychosis causes violence. The obvious implication is that marijuana causes violence. "

I could have found this argument convincing. Over the years, I have become more and more skeptical about the legalization of drugs as I have reported on the opioid epidemic (caused by legal opioid analgesics), alcohol and tobacco. I have written that there are serious risks to marijuana, although it is believed that legalization is ultimately a better policy than a ban. I stopped using marijuana myself, in part because my husband had had several experiences when Poti's anxiety disorder flared up.

But when I read Berenson's book, I could not escape that while writing compelling reading. An experienced journalist is essentially an exercise in the selection of data and the representation of correlation as a cause. Observations and anecdotes, not rigorous scientific analysis, form the core of the book's claim that legal marijuana in America will – and indeed does – lead to a huge increase in psychosis and violence.

The book focuses largely on gruesome anecdotes of violent crime committed under the influence of marijuana, the kind of "reefer madness" the authorities and the media relied on when it first made cannabis in the 20th century had banned.

Berenson puts these anecdotes and limited data to argue that the consumption of strong marijuana, driven by the legalization of the pot in several US states, has already become a "black tide of psychosis" and "a red tide of Violence "leads. He warns that the situation is only getting worse The legal pots industry is getting bigger, with an incentive to suppress the strict rules on cannabis.

In one example, he cites a recent massive review of evidence for the merits and harms of marijuana by the National Academies of Sciences, Engineering and Medicine. In the report on the relationship between marijuana and psychosis it was claimed, "the problem explained done."

But I read the report and wrote it for Vox when it came out. The National Academies report was far from declaring this problem "settled." He was extremely cautious, warning that the combination of marijuana and marijuana addiction with psychosis can be "multidirectional and complex." Marijuana may not cause psychosis. something else can lead to both psychosis and pot use. Or the causation could be reversed: psychotic disorders can lead to marijuana use, possibly in an attempt to self-medicate.

"In certain societies," the report says, "the incidence of schizophrenia in the past has remained stable for 50 years despite the introduction of cannabis into these environments.

Berenson mentions nothing in the review of the report. He cites only the parts of the report that are beneficial to his thesis – a drawback to the massive, rigorous work of the 16-member science committee, which has scoured thousands of studies for review.

And this is representative of the book as a whole.

Berenson says he named the book Tell Your Children a witty jab among his critics because it is the original name of the notorious film Reefer Madness (19459003) (1936), which shows How people become violent after using marijuana. But the farther I got into the book, the more it seemed as if Berenson mimicked the strategy he wanted to mock. Tell Your Children is Reefer Madness 2.0.

There are concerns about marijuana and the impact of legalization. As the National Academies report shows, there is still much about cannabis that we simply do not know, including the harms and benefits. There is a risk of commercializing another product that is addictive to some and may otherwise be harmful to others, and there may be better ways to legalize or regulate potentials that minimize these risks than we do today ,

But Berenson's book, with its sensational claims and modest analysis of the evidence, does not really address these concerns. Tell Your Children claims to inform its readers about the "truth" about marijuana, but instead it is repeatedly misled.

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Berenson Exaggerates the Evidence of the Link Between Marijuana and Psychosis

Much of Berenson's book focuses on the history of schizophrenia, psychosis and the legalization movement of marijuana. But at the core of Berenson's thesis is an alleged link between marijuana, psychosis and violence and an argument that legalization and the associated higher cannabis use will lead to more violence in the US.

Berenson draws early on the first wave of reefer madness and considered the reception of marijuana in the late 19th and early 20th centuries in Mexico and India. He argues that if Mexico and India, 9,000 kilometers apart, independently concluded that marijuana psychosis was a problem, should not we take it seriously?

He writes: "In 1901, a newspaper reported on a man who attacked strangers on a street and then" he turned around and tore his own arms apart with bites until a straitjacket could be pulled over him. he was crazy under the influence of marijuana. "

Mexicans had no cultural reason to view marijuana negatively, "he adds later," but they did. "

Berenson quotes for his information about Mexico Homeland: marijuana and the origins of the Mexican drug war of the historian Isaac Campos of the University of Cincinnati.

I know Campos personally, he taught me the history of the War on Drugs and Drug Policy when I was studying at the University of Cincinnati.I got Campos's book very early in read my burgeoning interest in drug policy, and although my memory of the early 2010s is a bit blurry, I knew that something was not right with what Berenson wrote, so I sent Campos an e-mail to support my guess

Campos warned that he only read two photocopied pages from Berenson's book in which he was quoted, but then he said that Berenson did an argument "rather misrepresented". It is not at all clear that marijuana consumption alone has caused the violent outbursts, even though it was a widespread belief in Mexico at the time.

Marijuana has been used mainly in "Mexico's peripheral areas, especially in prisons and military barracks, which are both extremely inhospitable and violent," Campos told me. At that time, it was widely believed that marijuana caused madness and violence, which could have provoked a self-fulfilling prophecy, since such behavior was considered typical during stoning. Combine all this with the fact that marijuana can really lead to paranoia and anxiety (as anyone who has used it can attest), and you get bad stories.

But marijuana is to blame, the circumstances of its use or a mixture of it and other factors? At least it's a much more complicated story than the one-sided account of Berenson.

  Pictures of marijuana plants from the 1890s.

Pictures of marijuana plants from the 1890s.
Universal Images Group on Getty Images

There is a similar story with India where asylum reports were used to claim that marijuana drives people to psychosis. Berenson acknowledges that a government report dated 1894 was issued stating that the asylum reports were grossly flawed. For example, many of them were cases related to opium or alcohol, not marijuana. However, Berenson rejects this evidence and focuses on reports, including erroneous asylum cases, that support his point of view.

He cites various studies that lend his claim scientific weight. He spends a lot of time with Sven Andréasson, a researcher from Sweden who published one of the first major studies in 1987 The Lancet which established a strong link between marijuana and schizophrenia.

"Based on his data and subsequent findings, Andréasson believes that cannabis accounts for 10 to 15 percent of schizophrenia cases," writes Berenson. "Few people suffer schizophrenia just for smoking. But many who did not get sick do so because marijuana pushes their vulnerable brain over the edge. "

Berenson continues in this direction and profiles researchers and studies from around the world, from Britain to New Zealand to show a link between marijuana and psychosis. He also cites some anecdotal examples of people who have recently had mental health problems, including Kanye West, and suggests that marijuana may have been the cause of their collapse. ("No one seemed to associate the diagnosis [West’s] with his cannabis use," Berenson complains.)

It's worth noting that you could easily do that kind of countermeasures in the opposite direction – by doing a series of studies on Google in this show look up marijuana does not to psychoses or related disorders. For example, a study from 2018 published in Nature Neuroscience suggested that schizophrenia is more likely to lead to marijuana use (possibly cope or self-medicate), not the other way around.

This type of cherry picking does not have to be done. Closer scrutiny of the evidence has provided far more clarity than a glimpse of the evidence of a journalist-whether Berenson or I-can ever offer. That's where the National Academies report comes in.

The report is very careful in its results. It should be noted that there is "substantial evidence" for a link between marijuana and psychotic disorders, and that the relationship is dose-dependent – a higher risk correlates with increased marijuana use. However, the report also notes that the explanation for the association is unclear.

Berenson prefers the idea that potency causes and worsens psychosis and psychotic disorders. However, the National Academies report says that other options are plausible: perhaps psychosis or psychotic disorders lead to marijuana use, or a third factor – such as genes or the environment – to psychosis and marijuana use. It could be a mix of all these factors.

The conclusion, if there is one, "This is a complex topic that will certainly justify further investigation." In other words, we do not yet know it.

Regardless, the National Academies also analyzed studies on how marijuana affects symptoms of psychotic disorders. This research was rather limited, although some evidence has shown that marijuana can actually improve the cognitive performance of people with psychotic disorders in the past (which may explain why people with psychotic disorders treat themselves with weeds, if they do). The report concluded, however, that the evidence in this area was limited to "moderate". Therefore, further research is needed.

Unlike Berenson's book, the report was created and analyzed by more than a dozen rigorous scientists with experience in empirical research. They considered far more studies than Berenson quoted in his book. Her conclusions, however, are much tamer than his – definitely not "committed," as he writes. That's serious.

This does not exclude Berenson's claims. It is possible that to a certain extent he is right and marijuana causes or exacerbates psychosis or psychotic disorders. But now his claims are far ahead of the evidence.

Berenson uses his argument against marijuana violence in the Reefer Madness territory

Concerning violence, Berenson's case is even slimmer, but largely sections of the book devoted to anecdotes of people who Violent crime, possibly under the influence of marijuana.

He writes, for example, about a personal trainer in Tennessee, who killed his former boss in June 2018 with a hatchet. Berenson suspects that the attack was caused by marijuana. He cited an earlier social media post in which the attacker discussed cannabis use.

That's it. Even though Berenson makes an explosive statement (one that media reports and police did not do when the case was in the news, as far as I can tell), he just gives us his suggestion that marijuana caused the attack. 19659048] That happens again and again. Berenson raises case after case of a brutal crime, arguing that the attacker has used marijuana in the past or used cannabis just before the attack. There is no evidence that marijuana caused the attack. Berenson actually admits that, saying he "can not always be sure cannabis played a role." But when he summarizes the cases, he tries to argue that there are too many of these stories to be coincidence – suggesting that marijuana causes psychotic mass violence.

"Do you want more cases? Because unfortunately there are many, "he concludes. "The black wave of psychosis and the red wave of violence gather on a green wave, slowly and steadily and surely."

  Poster advertising Reefer Madness.

Poster advertising Reefer Madness
Hulton archive about Getty Images

We've already seen that. In the late 19th and early 20th centuries, when marijuana was introduced in other parts of the US, the media and government officials published numerous reports that exaggerated the risks of cannabis. They linked violent crimes that frequently involved immigrant perpetrators with the previous use of marijuana. These reports culminated in Reefer Madness the 1936 film and the Marijuana Tax Act of 1937, which was practically the first federal prohibition of marijuana.

Berenson's case by case feels very similar to the previous panic. There is no consideration for how, for example, the circumstances in which someone plays the pot of a human could play a role, as was the case with the Mexico cases. Perhaps the reports are flawed, as was the case with asylum cases in India. Or perhaps the attackers were not driven by weeds to violence, but tried to fight mental health problems that led them to violence through marijuana. We do not know it.

In addition, in a country where there were more than 800,000 serious assaults and more than 17,000 murders and non-negligent manslaughter in 2017, and where at least 41 million people used marijuana this year and even joined together, there were dozens of cases in the course of the year Years have not convincingly proven the drug.

Berenson tries to substantiate these stories through some studies on marijuana and violence. It is true that some individual studies have found a connection, but many contradictory studies do not. For this reason, it is better to rely on extensive and rigorous verification of the evidence when evaluating data.

Such a review exists: In 2013, a study was carried out by the RAND Drug Policy Research Center on behalf of the Office for National Drug Control Policy. From this he concluded that "marijuana use triggers no violent crime and the links between marijuana use and property crime are thin." [1965] In the most provocative statement of Tell Your Children Berenson tries to argue pot is already leading to a violent confrontation. Citing the same data he referred to in his New York Times preface, he suggests that the first four states legalizing cannabis – Alaska, Colorado, Oregon and Washington – saw a huge increase in violent crimes which, in his opinion, were higher, a nationwide increase in violent crime in the same period.

Here are his data on the state of Washington:

In 2013, Washington had 160 murders and about 11,700 serious attacks, according to the Washington Association of Sheriffs & Police Chiefs provide the FBI its annual national crime report. In 2017, the state had 230 murders and 13,700 serious attacks – an increase of about 44 percent in murders and 17 percent in serious attacks. This increase far exceeded the national increase in crime. The number of murders increased by 20 percent at national level and the number of attacks by 10 percent between 2013 and 2017.

Berenson does not investigate possible causes and inequalities here. There is no serious attempt to sort out confusing variables, and only an indefinite mention of some kind of "statistical analysis." The correlation between the legalization of marijuana and the increase in violent crime is given – and is repeated throughout the book as well as repeated Berenson's speeches – as if the truth were obvious.

But as the old saying goes, correlation is not causation. Aaron Carroll, pediatrician and researcher at the Indiana University School of Medicine, made this claim on Twitter and found that there is a link between the sale of organic food and autism, but no one seriously believes that two connections are connected to each other. 19659063] When it comes to marijuana and violence, you can also draw correlations in the opposite direction. Mark Kleiman, an expert in drug policy at New York University, told New York magazine: "Cannabis use and especially heavy cannabis use has been on the rise since 1992. During this time, national homicide rates have fallen by more than 50%.

As with the link between marijuana and psychosis, the disorder of correlation and causation is the reason why more stringent scientific assessments are needed. We have this: Benjamin Hansen, an economist at the University of Oregon, has compiled an analysis that measures how high the murder rates in Colorado and Washington would be if they had not legalized marijuana.

His conclusion: "While it is true that the murder rates in CO and WA increased more than in the entire nation, the murder rates in Colorado and Washington were indeed below the data they had predicted the trends in the murders of 2000 to 2012 ", which is almost complete before they legalize marijuana. He added, "At best, this does not suggest that the legalization of marijuana can increase violence and potentially even minor negative effects."

On the other hand, the lack of evidence showed that legalization had a major impact A Big Impact Violent crime should not be very surprising – based on Berenson's early entry into the book, in which he gives some figures for the expected effects of marijuana on psychosis and violence.

Based on the work of a Dutch epidemiologist, Berenson estimates that "one in 250 people can develop psychosis through cannabis use" in high-consumption countries. He writes, "The United States is a big country. In the last decade, about 40 million Americans were born. An increase in psychosis by 0.4 percent would mean that an additional 160,000 of these children will suffer a severe mental illness by 2040. Many thousands of them will eventually commit murder and other violent crimes.

In the context of Berenson's book, this should really be alarming – "Thousands" of more violent crimes sound scary. But considering that there are currently 330 million people in the US and 1.2 million violent crimes in just one year, these "thousands" seem less worrying over several decades. It is a fraction of a fraction of one percent of all violent crime in America.

This is the worst scenario – one in which Berenson's erroneous claims are held to be at face value – and this is far from the end of the world. Berenson purposely undermines his own allegations of mass violence.

Berenson is right that marijuana is not risk-free.

Berenson is right in one respect: It's true that marijuana is not harmless.

The review of the evidence by the National Academies speaks in favor. It found evidence that marijuana is associated with respiratory problems (when smoked), car accidents, stunting academic and other social achievements, and lower birth weight (when smoked during pregnancy).

There is also a risk of addiction. As Annie Lowrey reported for the Atlantic, federal surveys suggest that one in ten people who consume marijuana become addicted. These are not claims of doctors or cops. These are users who report in national polls themselves that they have difficulty in stopping using marijuana, even if it results in neglecting their responsibilities and having other negative impacts on their lives.

Aside from the harm to individuals, overuse and dependency are likely to be bad society as well. Jon Caulkins, an expert in drug policy at Carnegie Mellon University, said to me, "At some level, we know that it's not likely that you spend more than half of your waking hours that have made you drunk for years, a Pulitzer Prize or discover the cure for cancer.

Based on federal and state data, it is still unclear whether legalization of marijuana leads to more cases of addiction or other marijuana-related harm. But considering the true risks, at least it pays to keep an eye on the matter.

There is also much that we do not know about marijuana, including the question of whether the much stronger cannabis strains that people use today will create new problems have not been seen before. This is especially highlighted in the National Academies report : We have data related to the drug, though we are dramatically changing a lot of politics.

On the other hand, Berenson makes some good points to the exaggerated benefits of medical marijuana. Although advocates have claimed that marijuana treats everything from Parkinson's disease to inflammatory bowel disease, epilepsy, and PTSD, the evidence is very limited. The National Academies analysis found "conclusive or substantive evidence" that cannabis can help with chronic pain, nausea and vomiting caused by chemotherapy, and patients with symptoms of multiple sclerosis spasticity. However, the use of marijuana for other diseases is not limited to any scientific evidence

This is not nothing, but it is clear that proponents of marijuana are far ahead of scientific evidence with their claims. To this end, they make many of the same mistakes that Berenson commits in his book.

  A man smokes marijuana in a medical marijuana cooperative in San Francisco in 2004.

A man smokes marijuana in a medical marijuana cooperative in San Francisco in 2004.
Justin Sullivan / Getty Images [19659080] There are also legitimate concerns about how the US legalizes cannabis.

Berenson specifically states that he is writing about legalization now. At the end of his book, he fantasizes about the collapse of the marijuana movement, as was the case in the 1970s, when marijuana decriminalization became increasingly secure across the country. He writes that "in the late 1970s, when enough people experienced marijuana's effects at close range, the tide was almost instantaneous."

However, he also fears that it may be too late – that legalization is already creating a huge industry a huge financial incentive to exaggerate the benefits of marijuana, downplay the risks and fight regulations. Er behauptet, dass "die vollständige Legalisierung Milliarden von Dollar für Neuinvestitionen in Cannabis-Geschäfte einbringen und Beschränkungen noch schwieriger machen wird."

Dies wäre in Amerika kein neues Ergebnis. In der Tabak-, Alkohol- und Opioidindustrie haben Geldinteressen alles getan, um die Risiken ihrer Produkte herunterzuspielen, selbst wenn Zehntausende (bei Opioiden und Alkohol) oder Hunderttausende (bei Tabak) Amerikaner sterben jedes Jahr.

Aber das vollständige Verbot hat seine eigenen Kosten. Hunderttausende Menschen werden jedes Jahr in den USA wegen Marihuana verhaftet – was möglicherweise zu einer Vorstrafe oder Gefängnisstrafe führt. Schwarze Amerikaner werden viel häufiger verhaftet, obwohl sie zu ähnlichen Raten Unkraut wie weiße Amerikaner verwenden. Der Schwarzmarkt für Marihuana finanziert auch wirksam gewalttätige Drogenkartelle und Menschenhandelsorganisationen auf der ganzen Welt, so dass sie ihre Gewalt ausführen können.

Deshalb fordert Berenson die Entkriminalisierung, wenn die Strafen für den Besitz reduziert werden, der Verkauf jedoch völlig illegal ist Kompromiss. “Er schreibt:„ Menschen sollten nicht wegen Marihuana-Besitzes festgenommen oder ins Gefängnis geschickt werden. Wenn sie dumm genug sind, um in der Öffentlichkeit zu rauchen, sollte die Polizei ihre Gelenke nehmen und ihnen ein Ticket geben. Wenn sie stumm genug sind, erwischt zu werden, während sie auf Bewährung sitzen, sollten sie ins Gefängnis zurückgeschickt werden. Wenn sie jedoch in der Privatsphäre ihres eigenen Zuhauses Gebrauch machen wollen, dann sei es so. “

Es gibt andere Möglichkeiten. Ein 2015er Bericht von RAND listete ein Dutzend Alternativen zum Standardverbot auf. Zu den Möglichkeiten gehören die Legalisierung des Besitzes, nicht aber der Verkauf (wie Washington, DC und Vermont), die Zuständigkeit für den Verkauf von Staatsagenturen (wie es einige kanadische Provinzen tun, und wie einige Staaten erfolgreich mit Alkohol), nur zulassen Non-Profit-Organisationen, um Pot zu verkaufen, oder die Teilnahme einer Handvoll von streng kontrollierten, gewinnorientierten Unternehmen.

 Ein Diagramm mit verschiedenen Optionen zur Legalisierung von Marihuana.

RAND Corporation

Wenn wir kommerzielle Legalisierung betreiben, können die Regierungen dies auch tun nehmen Sie einen härteren Ansatz als einige Staaten. Sie könnten höhere Steuern erheben. Sie könnten Warnschilder benötigen. Sie könnten das Marketing einschränken. Sie könnten bestimmte Produkte verbieten, z. B. Lebensmittel, die Kinder ansprechen könnten und eher (nicht tödliche) Überdosierungen verursachen. Sie könnten die Dosisstärke einschränken. Sie könnten Systeme schaffen, die es den Verbrauchern erschweren, zu viel zu konsumieren.

All dies bedeutet, dass es echte Risiken für Marihuana gibt, berechtigte Bedenken hinsichtlich der derzeitigen Form der Legalisierung, die Amerika akzeptiert, und Alternativen zu dem, was das Land tut macht dabei neben der falschen binären Wahl zwischen Verbot und kommerzieller Legalisierung.

Es gibt jedoch Möglichkeiten, über all diese Probleme zu schreiben, während gleichzeitig die Nuancen und Details erfasst werden, die sie benötigen. Dafür empfehle ich Marihuana Legalization: Was jeder wissen muss von Caulkins, Kleiman und Beau Kilmer, die alle Wissenschaftler und Wissenschaftler der Drogenpolitik sind. Ich empfehle Berensons Buch nicht.

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