June 1994
Coordinator, California NORML
http://paranoia.lycaeum.org/marijuana/facts/mj-health-mythology.html
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Table of Myths
Myth: Marijuana is a dangerous drug
Myth: Marijuana is harmless
Myth: One joint equals one pack of (or 16, or maybe just 4) cigarettes
Myth: Prohibition reduces the harmfulness of pot smoking
Myth: No one has ever died from using marijuana
Myth: Marijuana is a major road safety hazard
Myth: Marijuana prohibition improves public safety
Myth: Drug urinalysis improves workplace safety
Myth: Random urinalysis is needed in safety-sensitive transportation jobs
Myth: A single joint has effects that linger for days and weeks
Myth: Pot is ten times more potent and dangerous now than in the 1960's
Myth: Pot kills brain cells
Myth: Marijuana causes sterility and lowers testosterone
Myth: Marijuana causes birth defects
Myth: Pot causes high blood pressure
Myth: Marijuana damages the immune system
Myth: Marijuana causes chromosome and cell damage
Myth: Marijuana leads to harder drugs
Myth: Marijuana is a dangerous drug
Any discussion of marijuana should begin with the fact that
there have been numerous official reports and studies, every
one of which has concluded that marijuana poses no great
risk to society and should not be criminalized. These
include:
the National Academy of Sciences Analysis of Marijuana
Policy (1982);
the National Commission on Marihuana and Drug Abuse (the
Shafer Report) (1973);
the Canadian Government's Commission of Inquiry (Le Dain
Report) (1970);
the British Advisory Committee on Drug Dependency (Wooton
Report) (1968);
the La Guardia Report (1944);
the Panama Canal Zone Military Investigations (1916-29);
and Britain's monumental Indian Hemp Drugs Commission (1893-
4).
It is sometimes claimed that there is ``new evidence''
showing marijuana is more harmful than was thought in the
sixties. In fact, the most recent studies have tended to
confirm marijuana's safety, refuting claims that it causes
birth defects, brain damag e, reduced testosterone, or
increased drug abuse problems.
The current consensus is well stated in the 20th annual
report of the California Research Advisory Panel (1990),
which recommended that personal use and cultivation of
marijuana be legalized: "An objective consideration of
marijuana shows that it is respo nsible for less damage to
society and the individual than are alcohol and cigarettes."
References: The National Academy of Sciences report,
Marijuana and Health (National Academy Press, 1982), remains
the most useful overview of the health effects of marijuana,
its major conclusions remaining largely unaffected by the
last 10 years of research. Lovinger and Jones, The Marihuana
Question (Dod d, Mead & Co., NY 1985), is the most
exhaustive and fair-handed summary of the evidence against
marijuana. Good, positive perspectives may be found in
Lester Grinspoon's Marihuana, the Forbidden Medicine (Yale
Press, 1993) and Marihuana Reconsidere d (Harvard U. Press
1971), which debunks many of the older anti-pot myths. See
also Leo Hollister, Health Aspects of Cannabis,
Pharmacological Reviews 38:1-20 (1986).
Myth: Marijuana is harmless
Just as most experts agree that occasional or moderate use
of marijuana is innocuous, they also agree that excessive
use can be harmful. Research shows that the two major risks
of excessive marijuana use are:
respiratory disease due to smoking and
accidental injuries due to impairment.
Marijuana and Smoking:A recent survey by the Kaiser
Permanente Center found that daily marijuana-only smokers
have a 19% higher rate of respiratory complaints than non-
smokers.(1) These findings were not unexpected, since it has
long been known that, aside from its psychoactive
ingredients, marijuana smoke contains virtually the same
toxic gases and carcinogenic tars as tobacco. Human studies
have found that pot smokers suffer similar kinds of
respiratory damage as tobacco smokers, putting them at
greater risk of bronchitis, sore throat, respiratory
inflammation and infections.(2)
Although there has not been enough epidemiological work to
settle the matter definitively, it is widely suspected that
marijuana smoking causes cancer. Studies have found
apparently pre-cancerous cell changes in pot smokers.(3)
Some cancer specialists have reported a higher-than-expected
incidence of throat, neck and tongue cancer in younger,
marijuana-only smokers.(4) A couple of cases have been
fatal. While it has not been conclusively proven that
marijuana smoking causes lung cancer, the evidence is highly
suggestive. According to Dr. Donald Tashkin of UCLA, the
leading expert on marijuana smoking:(5)"Although more
information is certainly needed, sufficient data have
already been accumulated concerning the health effects of
marijuana to warrant counseling by physicians against the
smoking of marijuana as an important hazard to health."
Fortunately, the hazards of marijuana smoking can be reduced
by various strategies:
use of higher-potency cannabis, which can be smoked in
smaller quantities,
use of waterpipes and other smoke reduction technologies,(6)
and
ingesting pot orally instead of smoking it.
Myth: One joint equals one pack of (or 16, or maybe just 4)
cigarettes
Some critics exaggerate the dangers of marijuana smoking by
fallaciously citing a study by Dr. Tashkin which found that
daily pot smokers experienced a "mild but significant"
increase in airflow resistance in the large airways greater
than that seen in persons smoking 16 cigarettes per day.(7)
What they ignore is that the same study examined other, more
important aspects of lung health, in which marijuana smokers
did much better than tobacco smokers. Dr. Tashkin himself
disavows the notion that one joint equals 16 cigarettes. A
more widely accepted estimate is that marijuana smokers
consume four times as much carcinogenic tar as cigarettes
smokers per weight smoked. (8) This does not necessarily
mean that one joint equals four cigarettes, since joints
usually weigh less. In fact, the average joint has been
estimated to contain 0.4 grams of pot, a bit less than one-
half the weight of a cigarette, making one joint equal to
two cigarettes (actually, joint sizes range from cigar-sized
spliffs smoked by Rastas, to very fine sinsemilla joints
weighing as little as 0.2 grams). It should be noted that
there is no exact equivalency between tobacco and marijuana
smoking, because they affect different parts of the
respiratory tract differently: whereas tobacco tends to
penetrate to the smaller, peripheral passageways of the
lungs, pot tends to concentrate on the larger, central
passageways.(9) One consequence of this is that pot, unlike
tobacco, does not appear to cause emphysema.
Myth: Prohibition reduces the harmfulness of pot smoking
Whatever the risks of pot smoking, the current laws make
matters worse in several respects:
Paraphernalia laws have impeded the development and
marketing of water pipes and other, more advanced technology
that could significantly reduce the harmfulness of marijuana
smoke.
Prohibition encourages the sale of pot that has been
contaminated or adulterated by insecticides, Paraquat, etc.,
or mixed with other drugs such as PCP, crack and heroin.
By raising the price of marijuana, prohibition makes it
uneconomical to consume marijuana orally, the best way to
avoid smoke exposure altogether; this is because eating
typically requires two or three times as much marijuana as
smoking.
Unlike the government, NORML is interested in reducing the
dangers of pot smoking; California NORML and MAPS (the
Multidisciplinary Association for Psychedelic Studies) are
currently researching the use of waterpipes and other
advanced smoke reduction technology.
References on Marijuana and Smoking: Donald Tashkin, Is
Frequent Marijuana Smoking Hazardous To Health?, Western
Journal of Medicine 158 #6: 635-7; June 1993; Research
Findings on Smoking of Abused Substances, ed. C. Nora Chiang
and Richard L. Hawks, NIDA Research Monograph 99 (National
Institute on Drug Abuse, Rockville, MD 1990); NAS Report,op.
cit.; California NORML, Health Tips for Marijuana Smokers.
Myth: No one has ever died from using marijuana
The Kaiser study also found that daily pot users have a 30%
higher risk of injuries, presumably from accidents. These
figures are significant, though not as high as comparable
risks for heavy drinkers or tobacco addicts.
That pot can cause accidents is scarcely surprising, since
marijuana has been shown to degrade short-term memory,
concentration, judgment, and coordination at complex tasks
including driving.(1) There have been numerous reports of
pot-related accidents --- some of them fatal, belying the
attractive myth that no one has ever died from marijuana.
One survey of 1023 emergency room trauma patients in
Baltimore found that fully 34.7% were under the influence of
marijuana, more even than alcohol (33.5%); half of these
(16.5%) used both pot and alcohol in combination.(2)
This is perhaps the most troublesome research ever reported
about marijuana; as we shall see, other accident studies
have generally found pot to be less dangerous than alcohol.
Nonetheless, it is important to be informed on all sides of
the issue.
Pot smokers should be aware that accidents are the number
one hazard of moderate pot use. In addition, of course, the
psychoactive effects of cannabis can have many other adverse
effects on performance, school work, and productivity.
Myth: Marijuana is a major road safety hazard
A growing body of research indicates that marijuana is on
balance less of a road hazard than alcohol. Various surveys
have found that half or more of fatal drivers have alcohol
in their blood, as opposed to 7 - 20% with THC, the major
psychoactive component of marijuana (a condition usually
indicative of having smoked within the past 2-4 hours).(3)
The same studies show that some 70 - 90% of those who are
THC-positive also have alcohol in their blood.
It therefore appears that marijuana by itself is a minor
road safety hazard, though the combination of pot and
alcohol is not. Some research has even suggested that low
doses of marijuana may sometimes improve driving
performance, though this is probably not true in most
cases.(4)
Two major new studies by the National Highway Transportation
Safety Administration have confirmed marijuana's relative
safety compared to alcohol. The first, the most
comprehensive drug accident study to date, surveyed blood
samples from 1882 drivers killed in car, truck and
motorchycle accidents in seven states during 1990-91.(5)
Alcohol was found in 51.5% of specimens, as against 17.8%
for all other drugs combined.
Marijuana, the second most common drug, appeared in just
6.7%. Two-thirds of the marijuana-using drivers also had
alcohol.
The report concluded that alcohol was by far the dominant
drug-related problem in accidents. It went on to analyze the
responsibility of drivers for the accidents they were
involved in. It found that drivers who used alcohol were
especially culpable in fatal accidents, and even more so
when they combined it with marijuana or other drugs.
However, those who used marijuana alone appeared to be if
anything less culpable than non-drug users (though the data
were insufficient to be statistically conclusive).
The report concluded, "There was no indication that
marijuana by itself was a cause of fatal accidents."
(It must be emphasized that this is not the case when
marijuana is combined with alcohol or other drugs).
The second NHTSA study, Marijuana and Actual Driving
Performance, concluded that the adverse effects of cannabis
on driving appear "relatively small" and are less than those
of drunken driving. (6)
The study, conducted in the Netherlands, examined the
performance of drivers in actual freeway and urban driving
situations at various doses of marijuana. It found that
marijuana produces a moderate, dose-related decrement in
road tracking ability, but is "not profoundly impairing" and
"in no way unusual compared to many medicinal drugs."
It found that marijuana's effects at the higher doses
preferred by smokers never exceed those of alcohol at blood
concentrations of .08%, the minimum level for legal
intoxication in stricter states such as California.
The study found that unlike alcohol, which encourages risky
driving, marijuana appears to produce greater caution,
apparently because users are more aware of their state and
able to compensate for it (similar results have been
reported by other researchers as well.(7))
It should be noted that these results may not apply to non-
driving related situations, where forgetfulness or
inattention can be more important than speed (this might
explain the discrepancy in the Baltimore hospital study,
which looked at accidents of all kinds).
The NHTSA study also warned that marijuana could also be
quite dangerous in emergency situations that put high
demands on driving skills.
Myth: Marijuana prohibition improves public safety
There is no evidence that the prohibition of marijuana
reduces the net social risk of accidents. On the contrary,
recent studies suggest that marijuana may actually be
beneficial in that it substitutes for alcohol and other,
more dangerous drugs. Research by Karyn Model found that
states with marijuana decrim had lower overall drug abuse
rates than others; another study by Frank Chaloupka found
decrim states have lower accident rates too. (8) In Alaska,
accident rates held constant or declined following the
legalization of personal use of marijuana.(9) In Holland,
authorities believe that cannabis has contributed to an
overall decline in opiate abuse. Recent government
statistics showed that the highest rates of cocaine abuse in
the West were in Nevada and Arizona, the states with the
toughest marijuana laws.
Myth: Drug urinalysis improves workplace safety
There has never been a single, controlled scientific study
showing drug urinalysis improves workplace safety. Claims
that drug testing works are based on dubious anecdotal
reports or the mere observation of a declining rate of drug
positives in the working population, which has nothing to do
with job performance. Such scientific studies as have been
conducted have found little difference between the
performance of drug-urine-positive workers and others. The
largest survey to date, covering 4,396 postal workers
nationwide, found no difference in accident records between
workers who tested positive on pre-employment drug screens
and those who did not.(10) The study did find that drug-
positive workers had a 50% higher rate of absenteeism and
dismissals; put another way, however, drug users had a 93.4%
attendance record (versus 95.8% for non-users) and fully 85%
kept their jobs for a year (versus 89.5% for non-users)! An
economic analysis of postal workers in Boston concluded that
the net savings of drug testing were marginal, and that
there could be many situations where it is not cost-
effective.(11) Another survey of health workers in Georgia
found no difference in job performance between drug-positive
and drug-negative workers.(12)
Myth: Random urinalysis is needed in safety-sensitive
transportation jobs
Government rules mandating random drug testing were
promulgated without any prior statistical evidence that
illicit drugs constituted an inordinate safety hazard. Not a
single commercial passenger airline accident has ever been
attributed to marijuana (or, for that matter, alcohol)
abuse.(1) Drug tests on rail workers found no elevated
incidence of drug use among workers involved in
accidents.(2) Random drug testing of transportation workers
was enacted as a hysterical reaction to a single 1987 train
collision, in which 16 Amtrak passengers were killed by a
Conrail train that failed to stop. The engineer and brakeman
of the Conrail train at fault were found to have recently
smoked marijuana, though it was never firmly proven that
marijuana caused the accident. The Conrail engineer had an
extensive record of speeding and drunken driving offenses
and was known by management to have drinking problems.
Critical safety equipment that would have averted the
accident was missing or disabled. A subsequent investigation
by the National Transportation Safety Board recommended that
Conrail improve both its management and equipment, but did
not recommend random testing. Nonetheless, Congress
responded by mandating random drug testing on the entire
transportation industry, from airline flight attendants to
gas pipeline workers.
Myth: A single joint has effects that linger for days and
weeks
While it is true that THC and other cannabinoids are fat-
soluble and linger in the body for prolonged periods, they
do not normally affect behavior beyond a few hours except in
chronic users. Most impairment studies have found that the
adverse effects of acute marijuana use wear off in 2-6
hours, commonly faster than alcohol.(3) The one notable
exception was a pair of flight simulator studies by Leirer,
Yesavage, and Morrow, which reported effects on flight
simulator performance up to 24 hours later.(4) The
differences, described by Leirer as "very subtle" and "very
marginal," were less than those due to pilot age.
Another flight simulator study by the same group failed to
find any effects beyond 4 hours.(5) Similar "hangover"
effects have been noted for alcohol.(6) Chronic users may
experience more prolonged effects due to a build-up of
cannabinoids in the tissues. Some heavy users have reported
feeling effects weeks or even months after stopping.
However, there is no evidence that these are detrimental to
safety.
References on Accidents and Drug Testing: Alcohol, Drugs and
Driving: Abstracts and Reviews Vol. 2 #3-4 (Brain
Information Service, UCLA 1986); Dale Gieringer, Marijuana,
Driving, and Accident Safety, Journal of Psychoactive Drugs
20 (1): 93-101 (Jan.-Mar 1988); Dr. John Morgan, Impaired
Statistics and the Unimpaired Worker, Drug Policy Letter
1(2): May/June 1989, and The "scientific" justification for
drug urine testing, The University of Kansas Law Review 36:
683-97 (1988); John Horgan, Test Negative: A look at the
evidence justifying illicit-drug tests, Scientific American,
March 1990 pp. 18-22, and Postal Mortem, Scientific
American, Feb. 1991 pp. 22-3; Dale Gieringer, Urinalysis or
Uromancy? in Strategies for Change: New Directions in Drug
Policy (Drug Policy Foundation, 1992).
Myth: Pot is ten times more potent and dangerous now than in
the 1960's
The notion that pot has increased dramatically in potency is
a DEA myth based on biased government data, as shown in a
recent NORML report by Dr. John Morgan.(7) Samples of pot
from the early '70s came from stale, low-potency Mexican
"kilobricks" left in police lockers, whose potency had
deteriorated to sub-smokable levels of less than 0.5%. These
were compared to later samples of decent-quality domestic
marijuana, making it appear that potency had skyrocketed. A
careful examination of the government's data show that
average marijuana potency increased modestly by a factor of
two or so during the seventies, and has been more or less
constant ever since.In fact, there is nothing new about
high-potency pot. During the sixties, it was available in
premium varieties such as Acapulco Gold, Panama Red, etc. ,
as well as in the form of hashish and hash oil, which were
every bit as strong as today's sinsemilla, but were ignored
in government potency statistics. While the average potency
of domestic pot did increase with the development of
sinsemilla in the seventies, the range of potencies
available has remained virtually unchanged since the last
century, when extremely potent tonics were sold over the
counter in pharmacies. In Holland, high-powered hashish and
sinsemilla are currently sold in coffee shops with no
evident problems.
Contrary to popular myth, greater potency is not necessarily
more dangerous, due to the fact that users tend to adjust
(or "self-titrate") their dose according to potency. Thus,
good quality sinsemilla is actually healthier for the lungs
because it reduces the amount of smoke one needs to inhale
to get high.
Myth: Pot kills brain cells
Government experts now admit that pot doesn't kill brain
cells.(8) This myth came from a handful of animal
experiments in which structural changes (not actual cell
death, as is often alleged) were observed in brain cells of
animals exposed to high doses of pot. Many critics still
cite the notorious monkey studies of Dr. Robert G. Heath,
which purported to find brain damage in three monkeys that
had been heavily dosed with cannabis.(9) This work was never
replicated and has since been discredited by a pair of
better controlled, much larger monkey studies, one by Dr.
William Slikker of the National Center for Toxicological
Research(10) and the other by Charles Rebert and Gordon
Pryor of SRI International.(11) Neither found any evidence
of physical alteration in the brains of monkeys exposed to
daily doses of pot for up to a year. Human studies of heavy
users in Jamaica and Costa Rica found no evidence of
abnormalities in brain physiology.(12) Even though there is
no evidence that pot causes permanent brain damage, users
should be aware that persistent deficits in short-term
memory have been noted in chronic, heavy marijuana smokers
after 6 to 12 weeks of abstinence.(13) It is worth noting
that other drugs, including alcohol, are known to cause
brain damage.
Myth: Marijuana causes sterility and lowers testosterone
Government experts also concede that pot has no permanent
effect on the male or female reproductive systems.(14) A few
studies have suggested that heavy marijuana use may have a
reversible, suppressive effect on male testicular
function.(15) A recent study by Dr. Robert Block has refuted
earlier research suggesting that pot lowers testosterone or
other sex hormones in men or women.(16) In contrast, heavy
alcohol drinking is known to lower testosterone levels and
cause impotence. A couple of lab studies indicated that very
heavy marijuana smoking might lower sperm counts. However,
surveys of chronic smokers have turned up no indication of
infertility or other abnormalities.
Less is known about the effects of cannabis on human
females. Some animal studies suggest that pot might
temporarily lower fertility or increase the risk of fetal
loss, but this evidence is of dubious relevance to
humans.(1) One human study suggested that pot may mildly
disrupt ovulation. It is possible that adolescents are
peculiarly vulnerable to hormonal disruptions from pot.
However, not a single case of impaired fertility has ever
been observed in humans of either sex.
Myth: Marijuana causes birth defects
While experts generally recommend against any drug use
during pregnancy, marijuana has little evidence implicating
it in fetal harm, unlike alcohol, cocaine or tobacco.
Epidemiological studies have found no evident link between
prenatal use of marijuana and birth defects in humans.(2) A
recent study by Dr. Susan Astley at the University of
Washington refuted an earlier work suggesting that cannabis
might cause fetal alcohol syndrome.(3) Although some
research has found that prenatal cannabis use is associated
with slightly reduced average birth weight and length,(4)
these studies have been open to methodological criticism.
More recently, a well-controlled study found that cannabis
use had a positive impact on birthweight during the third
trimester of pregnancy with no adverse behavioral
consequences.(5) The same study found a slight reduction in
birth length with pot use in the first two months of
pregnancy. Another study of Jamaican women who had smoked
pot throughout pregnancy found that their babies registered
higher on developmental scores at the age of 30 days, while
experiencing no significant effects on birthweight or
length.(6) While cannabis use is not recommended in
pregnancy, it may be of medical value to some women in
treating morning sickness or easing childbirth.
Myth: Pot causes high blood pressure
According to the NAS, the effects of marijuana on blood
pressure are complex, depending on dose, administration, and
posture.(7) Marijuana often produces a temporary, moderate
increase in blood pressure immediately after ingestion;
however, heavy chronic doses may slightly depress blood
pressure instead. One common reaction is to cause decreased
blood pressure while standing and increased blood pressure
while lying down, causing people to faint if they stand up
too quickly. There is no evidence that pot use causes
persisting hypertension or heart disease; some users even
claim that it helps them control hypertension by reducing
stress.
One thing THC does do is to increase pulse rates for about
an hour. This is not generally harmful, since exercise does
the same thing, but it may cause problems to people with
pre-existing heart disease. Chronic users may develop a
tolerance to this and other cardiovascular reactions.
Myth: Marijuana damages the immune system
A variety of studies indicate that THC and other
cannabinoids may exercise mild, reversible immuno-
suppressive effects by inhibiting the activity of immune
system cells know as lymphocytes (T- and B-cells) and
macrophages. It is dubious whether these effects are of
import to human health, since they are based mainly on
theoretical laboratory and animal studies. According to a
review by Dr. Leo Hollister:(8) "The evidence [on immune
suppression] has been contradictory and is more supportive
of some degree of immunosuppression only when one considers
in vitro studies. These have been seriously flawed by the
very high concentrations of drug used to produce
immunosuppression. The closer that experimental studies have
been to actual clinical situations, the less compelling has
been the evidence."
The immune suppression issue was first raised in research by
the notorious cannabophobe Dr. Gabriel Nahas, but a flurry
of research by the Reagan administration failed to find
anything alarming. The recent discovery of a cannabinoid
receptor inside rat spleens, where immune cells reside,
raises the likelihood that cannabinoids do exert some sort
of influence on the immune system.(9) It has even been
suggested that these effects might be beneficial for
patients with auto-immune diseases such as multiple
sclerosis. Nevertheless, not a single case of marijuana-
induced immune deficiency has ever been clinically or
epidemiologically detected in humans.
One exception is the lungs, where chronic pots smokers have
been shown to suffer damage to the immune cells known as
alveolar macrophages and other defense mechanisms.(10) It is
unclear how much of this damage is due to THC, as opposed to
all of the other toxins that occur in smoke, many of which
can be filtered out by waterpipes and other devices(11).
There is no reason to think marijuana is dangerous to AIDS
patients. On the contrary, many AIDS patients report that
marijuana helps avert the deadly "wasting syndrome" by
stimulating appetite and reducing nausea. Cannabinoids do
not actually damage the T-cells, which are depleted in HIV
patients: one study even found that marijuana exposure
increased T-cell counts in subjects (not AIDS patients)
whose T-cell counts had been low.(12) Epidemiological
studies have found no relation between use of marijuana or
other drugs and development of AIDS.(13)
Myth: Marijuana causes chromosome and cell damage
According to the NAS,(14) "Studies suggesting that marijuana
probably does not break chromosomes are fairly conclusive."
Cannabinoids in themselves are neither mutagenic nor
carcinogenic, though the tars produced by marijuana
combustion are. Some laboratory studies have suggested that
high dosages of THC might interfere with cell replication
and produce abnormal numbers of chromosomes; however, there
is no evidence of such damage in realistic situations.
Myth: Marijuana leads to harder drugs
There is no scientific evidence for the theory that
marijuana is a "gateway" drug. The cannabis-using cultures
in Asia, the Middle East, Africa and Latin America show no
propensity for other drugs. The gateway theory took hold in
the sixties, when marijuana became the leading new
recreational drug. It was refuted by events in the eighties,
when cocaine abuse exploded at the same time marijuana use
declined. As we have seen, there is evidence that cannabis
may substitute for alcohol and other "hard" drugs. A recent
survey by Dr. Patricia Morgan of the University of
California at Berekeley found that a significant number of
pot smokers and dealers switched to methamphetamine "ice"
when Hawaii's marijuana eradication program created a
shortage of pot.(15) Dr. Morgan noted a similar phenomenon
in California, where cocaine use soared in the wake of the
CAMP helicopter eradication campaign.The one way in which
marijuana does lead to other drugs is through its
illegality: persons who deal in marijuana are likely to deal
in other illicit drugs as well.
National Organization for the Reform of Marijuana Laws
1001 Connecticut Avenue NW, # 1010 Washington, D.C. 20036
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