With less than a week before recreational marijuana sales begin in Colorado, debate continues on the health impacts of the drug.
In November - one year after Colorado and Washington became the first states to legalize recreational use of marijuana - the American Medical Association adopted a resolution stating that "cannabis is a dangerous drug" that shouldn't be legalized.
"The American Medical Association took a bold step today, and they should be commended," former Congressman Patrick J. Kennedy, co-founder of Smart Approaches to Marijuana, said after the Nov. 19 vote. "By explicitly rejecting calls to neutralize their anti-legalization position, they are sending a loud and powerful message to state and local decision makers, the federal government, and the general public that to be on the side of science is to oppose efforts to expand marijuana use and addiction."
The resolution, though, will do little to reverse course in Colorado. The bigger issue, some say, is the lack of solid research on the health effects of marijuana.
"A lot of these policies would have been a lot more relevant on the vote for Amendment 64 a year ago," said Manitou Springs Mayor Marc Snyder. "The fact is, it is a part of our Colorado state constitution now, and I swear to uphold that.
"That's really the playing field that I'm dealing with right now," Snyder said.
It's a playing field that Colorado Springs City Council opted out of in July. But a handful of governments around the state have given recreational sales the go-ahead, and Manitou Springs is expected to join them after a moratorium on sales expires Jan. 31.
Manitou officials enacted the moratorium because they wanted more time to draft regulations for the sales of recreational marijuana, Snyder said.
With the strong support of recreational marijuana in the city, Snyder is facing a slew of concerns that he shares with citizens about maintaining the city's safety, values and tourism dollars.
"Nobody has a crystal ball. Everyone might have an opinion, and even a strong belief on how this will affect the community. But nobody knows for sure," Snyder said.
Dr. George Athey, a Colorado Springs-based adolescent psychiatrist specializing in youth addiction, says that legalization of pot sales is premature given the lack of solid research done on its long-term consequences.
"I disagree with recreational marijuana. I disagree with the way we have implemented medical marijuana," he said.
A position paper from the American Psychiatric Association issued in the fall warns that there is a "strong association of cannabis use with the onset of psychiatric disorders."
Athey believes that legalization will make marijuana more available to adolescents, who are at increased risk for mental illness with pot use because their brains are developing.
"It decreases motivation, impairs memory and it also impairs mental functioning. If you're in school, that's obviously a problem," he said.
Snyder has heard from residents that underground sales have made marijuana use prevalent among youth, and he's unsure that will change.
"This may be an opportunity to rid ourselves of this black-market influence," he said.
"There is a good argument to be made for marijuana that is regulated, moderated and tested," he said.
Because marijuana is a Schedule I Controlled Substance under the federal Controlled Substances Act, however, people such as Dr. Robert Melamede, CEO of Cannabis Science Inc., face obstacles from the government when it comes to studying and testing the drug.
"That's why we're doing a lot of developmental work in Europe," he said. The Colorado Springs-based company conducts cannabinoid research specifically for the development of cannabis-based medicines. The company is working on federal legislation efforts to allow products from Colorado to be used in FDA trials.
"The only pot you can get legally from the U.S. comes from Mississippi. They've been under contract by NIDA to use in experimental studies, but they will only use it for purposes of showing abuse," Melamede said. "That's their congressional mandate."
Unlike Melamede, a pot proponent who's used it for decades, Athey has never smoked pot. He explains that while the drug is not as physically addictive as alcohol, nicotine or heroin, and has no lethal dose, psychologically it can be very addictive, especially for youths.
Melamede discourages the use of cannabis among teens, and acknowledges that some research shows its negative effects on youth in particular. What those studies don't say, Melamede said, is whether there were problems to begin with.
"It's dangerous for a very small number of people, in particular those who have troubled lives," he said.
Athey acknowledges that there are holes and potential biases in current research, which he said is underfunded.
"Most drug research is paid for by the pharmaceutical companies who have a vested interest in showing their drugs have a good usage for their medical conditions. There are many conditions for which it may be useful, but it would require the federal government to fund them," Athey said. "Nobody's really studied it effectively and well enough to determine those conditions."
One area of research that needs more attention, Melamede said, is the study of endocannabinoids, or as he describes it, the "pot your body makes."
Endocannabinoids are naturally synthesized chemical compounds in the body that activate the same receptor sites as THC, the main psychoactive chemical in pot. They're in breast milk, and they regulate a variety of biological systems from conception to death, he said.
Thousands of studies on endocannabinoids support the argument that pot not only is safe, but healthy if used in the right ways, Melamede said.
Regardless, Athey said, increased research is inevitable because marijuana is being pushed for recreational and medicinal use.
"I think we all need to push the government," he said.