True, other narcotics exist on the market today -- and like marijuana, they are also addictive. Whether they are more or less addictive than marijuana remains uncertain, but advocates say the chronically ill should be able to choose what works best for them while opponents say only tested, carefully titrated drugs should be used as palliatives. Weighing the rights of the sick with marijuana's long and short-term side effects is a delicate balance. When marijuana is smoked, users often suffer similar short as well as long-term problems to those of regular smokers, including a smoker's cough and breathing problems. In fact, "marijuana smoke contains 50% to 70% more carcinogenic hydrocarbons than does tobacco smoke" (Legalization of marijuana, 2010, Legalization of marijuana). The active agent in marijuana, THC, has been linked to short-term memory loss: 4th graders who tested equally on tests of memory and were retested in 12th grade has notably poorer performance, relative to their peers, if they admitted to being heavy marijuana smokers, although once again proponents of the drug argue that correlation does not imply causality: marijuana smokers may simply be part of a demographic group less focused upon grades than non-smokers (Medical marijuana fact sheet, 2009, White House).

Advocates of legalization for medical use have a likely 'alternative' agenda, critics contend, namely full legalization, which would be a disaster for society. "Smoking marijuana leads to changes in the brain similar to those caused by cocaine, heroin, and alcohol. All of these drugs disrupt the flow of chemical neurotransmitters, and all have specific receptor sites in the brain that have been linked to feelings of pleasure and, over time, addiction. Cannabinoid receptors are affected by THC, the active ingredient in marijuana, and many of these sites are found in the parts of the brain that influence pleasure, memory, thought, concentration, sensory and time perception, and coordinated movement" (Medical marijuana fact sheet, 2009, White House).

But even if one concedes the point that marijuana use on a recreational level has largely negative effects for the user, and its medical benefits are dubious, some economists argue that the U.S. is losing a potential source of revenue: just like 'sin taxes' on alcohol and cigarettes yield high levels of revenue. "Marijuana legalization -- replacing prohibition with a system of taxation and regulation -- would save $7.7 billion per year in state and federal expenditures on prohibition enforcement and produce tax revenues of at least $2.4 billion annually if marijuana were taxed like most consumer goods. if, however, marijuana were taxed similarly to alcohol or tobacco, it might generate as much as $6.2 billion annually" (Moffat 2010). Marijuana use may be problematic, but the loss of revenue it generates for the state regarding law enforcement, and the financial benefits regarding future taxation mean that a new policy is required.

If marijuana use was legalized in such a wholesale fashion, however, the logistical aspects of regulating legal use seem nightmarish. "Does legalization of marijuana mean its sale to any willing buyer should be legal? What about the sale of legal marijuana...

There is a simple reason that it is rare to hear a description of the mechanics of marijuana legalization: all of the ways marijuana can be made legal are either ridiculous, or frightening, or both. In addition, the U.S. has international treaty obligations not to legalize marijuana, or any other illegal drug, for non-medical use" (DuPont 2007). Granted, the legal aspects of drug enforcement and policing are frustrating in terms of their bureaucracy and often arbitrary nature. But policing taxation and distribution of marijuana in a legal fashion on a wide scale would seem even more difficult within the U.S.
However, the Dutch have taken a very different attitude than the Americans and most of their European counterparts: "Dutch drug policy is unique in the whole world. It is directed by an idea that every human being may decide about the matters of its own health…Another idea which guides Dutch laws in their drug policy is a conviction that hiding social negative phenomena does not make them disappear - on the contrary makes them worse, because when concealed, they become far more difficult to influence and control" (Amsterdam drugs, 2005, Amsterdam Info). Marijuana is considered a 'soft drug' in the Netherlands, and is thus legal. Ensuring that drugs are legal also enables better quality control, and reduces toxicity and overdoses for users. This ensures that the drug is not sold to minors, and is used in a relatively controlled fashion. Large scale cultivation is forbidden, although skeptics question whether the widespread use of cannabis could really be supported by 'home' growers, and contend that the Dutch are still part of the worldwide drug trade (Amsterdam drugs, 2005, Amsterdam Info).

Growing sympathy for individuals with terminal illness in the U.S. suggest that some states may legalize marijuana, perhaps in a non-inhalant form to reduce the risks of smoking. But on a wide-scale basis, for recreational use, there are logistical questions if a nation as large and diverse as the U.S. (in contrast to the small, law-abiding nation of the Dutch) would benefit from expanded legalization. However, if marijuana continues to be illegal, that means a continued drain financially in enforcing a widely disregarded, mocked, and perhaps unenforceable law. A shift overall in drug policy to treatment, or reducing demand, rather than punishment or supply-side tactics seems more beneficial, although drug treatment and medical treatment of users is also expensive. Regardless of what policy is implemented, marijuana enforcement is costly -- even for those citizens who do not use the drug.