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August 18, 2005

Drug Policy 101, An Overview

Drug prohibition, a.k.a. the "war on drugs, has developed into a policy monster, one unique among current American policies in terms of duration, intensity of the federal support it commands; also its global scope. The history of its development is similarly unique: drug prohibition began as an improbable 1914 tax measure, (the Harrison Act) which was soon converted into de facto prohibition by judicial fiat when nameless supporters began arresting physicians and eventually convinced the Holmes Brandeis Court to impose its judgment on a Medical Profession made vulnerable by the fact that it was then undergoing radical restructuring in response to outside pressure.* The issue upon which critical decision making turned as Harrison was being conceived and executed by government insiders was the nature of "addiction," a condition still hotly debated and poorly defined nearly 100 years later.

The most succinct iteration is that the"war" on drugs grew out early Twentieth Century fears of what was seen as a new and exotic phenomenon: drug addiction. While addiction to opiates was hardly new at the turn of the Twentieth Century, the historical confluence of the syringe, the hollow hypodermic needle, and more potent injectable opiates (heroin) had produced a relatively small, but highly visible population of young drug addicts concentrated among the urban poor. Early formulations which likened drugs to infectious agents producing a new "disease" seemed especially reasonable in an era when the "germ theory" was still very new; it also allowed prohibition to be seen as a form of legal quarantine. It's truly ironic that Hamilton Wright, physician/bureaucrat most responsible for Harrison, had previously gained fame for misclassifying beri-beri as an infectious disease.

What we now know-but have been excruciatingly slow to recognize- is that while addiction to injectable opiates was a new and highly visible phenomenon in early Twentieth Century cities; addiction to both alcohol and tobacco were already very prevalent among men and that a combination of technological and social developments would eventually propel tobacco use by both genders into a dominant Public Health problem by the Fifties. Indeed, while the compulsive use of alcohol and tobacco have been increasingly targeted as public health problems in the last quarter century, neither are popularly regarded as "drugs" and- as will be seen- their status as "legal" agents has given them an important market advantage over cannabis; which turns out to be their most logical competitor.

Perhaps the most consistent- and important- finding of my study of long term cannabis users is that although virtually all had initiated both alcohol and tobacco at about the same time they tried cannabis, those who eventually became chronic pot users had either quit- or greatly diminished their consumption of the two more dangerous agents. An important corollary is that although the initiation patterns noted by the first investigators ever to look at adolescent cannabis use were confirmed, the extended (longitudinal) assessment made possible by this study leads to a strikingly different interpretation: rather than a "gateway" leading carelessly hedonistic teens into becoming victims of other drugs, cannabis has functioned as an alternative- and far safer- form of self-medication for already troubled youth. The evidence also strongly suggests that- ironically, and despite its increasingly Draconian prohibition- cannabis has been protecting its oldest chronic users from the adverse effects of alcohol, tobacco and other, more dangerous, agents for twenty or thirty years.

Thus, rather than a gateway into drug problems, it has really been a gateway out of them. I have already had ample evidence that such a concept, although simple, is also very heretical. It will probably meet considerable resistance for several reasons; the most important seem to be the fear and ignorance engendered by three decades of fierce federal support of its failing policy and the others are related to the obvious dependency of the growing "Industrial Complexes" (Prison, Pharmaceutical, and Medical) the drug war has spawned.

Dr. Tom

Posted by tjeffo at August 18, 2005 04:40 AM