Main | About Dr. Tom's Web Log »

April 04, 2005

Why this Blog? (an update authored on July 5, 2005)

Note: What follows is a rewrite of the original April 2005 entry; it's intended to enhance the longitudinal quality implicit in any blog as a (uniquely) accessible public journal.

It will focus primarily on the conundrum that developed after California passed its unique "medical marijuana" law (Prop 215) in 1996. Although in effect for over eight years, recent developments- including the execrable US Supreme Court, Raich "decision" and yet another overwhelming vote against a Congressional attempt to rein in the DEA, (the Hinchey Rohrabacher Amendment) demonstrate that the strategy of drug war opponents, using sympathy for medical use as a political tool) is still grossly unsuccessful at the federal level. In the past, that was arguably because supporters of the drug war had enjoyed such great success in preventing meaningful scrutiny of their policy; but an alarming new development: rejection by the organized "drug reform" movement of credible evidence that federal policy has been both egregiously dishonest and indefensibly destructive is now helping the feds to avoid the kind of scrutiny needed to indict the drug war in the only court that really matters: public opinion.

In that connection, it's important to realize that in 1969, newly elected President Nixon's "drug war" was a radical expansion of what had been a long-standing, but relatively unimportant (in terms of the size of the existing illegal markets). policy. Nixon's war on drugs, as implemented by the Controlled Substances Act of 1970, represented a huge legislative expansion of what had really been a carefully protected policy failure. The CSA quickly allowed drug policy supporters at the federal level to control drug-related research while simultaneously conducting an effective propaganda campaign on behalf of their version of the truth: Although ostensibly one of Public Health aimed at protecting careless teens from addiction, diagnostic and therapeutic decisions had already been taken away from physicians by Supreme Court decisions upholding the Harrison Act of 1914, thus leaving future control of the poorly defined entity of "addiction" to police, prosecutors, and judges for the indefinite future.

Both that future and the false sense of control promised by federal policy were greatly increased by Nixon's dug war, as implemented by the CSA in 1970.

What (finally) allows some very contrary opinions in the ever-contentious drug policy arena is information gathered from thousands of California pot smokers in compliance with state law. The new law relied on licensed physicians to evaluate those requesting a patient designation; the government literally created cannabis evaluation as a new specialty by immediately threatening any doctor attempting to do so. Subsequent developments seriously reduced the ability of applicants to find and access such physicians and also reduced the willingness of either group to publicly acknowledge such encounters; let alone whatever personal information had been either sought or disclosed.

To cut to the chase; by late 2001, conditions in the Bay Area had devolved in such a way a that it was obvious to most of the applicants trying to convince me they were "legitimate" pot users that claiming some form of chronic pain relief would be their best tactic. They simply hadn't known (as I hadn't) how receptive I'd be to data suggesting that the same emotional symptoms that had made anxiolytics, mood stabilizers, and anti-depressants Big Pharma's most lucrative products had also inspired the modern pot market .

In other words, inhaled pot had long been treating those symptoms more safely and effectively than Prozac, Paxil, Ritalin, or Adderall when those agents first became avaible. Analysis of patient responses-still incomplete- has now progressed to a point where it allows some very pejorative conclusions about pot prohibition itself and raises serious questions about whether any substance prohibition should even be considered responsible public policy.

I won't begin by presenting detailed results for the simple reason that the study itself is still in progress and data entry is still lagging; in specific discussions, I'll try to cite the most recent data processed. Because I hope to always be updating, I hope eventually to be able to respond to specific questions .

The article, in the Winter/Spring 2005 O'Shaughnessy's,was written in December, 2004 and is still accurate. What is considerably more recent is the understanding of my need to understand the rejection with which "reformers" greeted it. While not exactly positive, that experience was has proved to be as important as the data itself because of the understanding it provides as to how drug policy has evolved into a public policy monster.

I will continue to comment frankly on why I believe current observations should impact drug policy politics, and will not be shy in identifying both opposing opinions and those who are venturing them. However, I will try to deal only with the opinions themselves- and then only in settings where authorship is unmistakable.

Readers who disagree are, of course, free to e-mail me. If enough interest develops, a public forum might result.

Doctor Tom

Posted by tjeffo at April 4, 2005 04:39 AM