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August 31, 2005

A Different Position on Adolescent Pot Use.

Many drug policy reformers are quick to agree with their political opponents that "kids" shouldn't smoke pot. But there's a problem with that statement; large numbers of them have been smoking it for thirty-five years. Not only are kids unlikely to stop trying marijuana, the best available evidence is that, aside from risk of arrest, the practice is far better for their mental and physical health than any alternative agents they may be drawn to.

In November 2001, when I began screening medical cannabis applicants at the largest buyers' club in the Bay Area, I had no idea I was starting a project which would soon take over my life. I now also realize that I'd bought into the same mind-set that prevents many reformers from agreeing with a concept I've been trying to explain to them since I'd tumbled to it in early 2003: pure "recreation" is an unlikely explanation for repetitive use of any agent over an extended interval; especially at the risk of felony arrest. In fact, most repetitive use of any drug has a more serious purpose than mere recreation. I'm also of the opinion that, in any sane world, self-medication with pot shouldn't require a prescription any more than one should need one to buy coffee at Starbucks, a six pack at the 7-11 or a pack of cigarettes at the local smoke shop. Beyond that, pot not only treats the same symptoms more effectively than alcohol and tobacco do; it also diminishes their use. In other words, prohibition of pot, to the extent it's effective, boosts juvenile consumption of both of the more dangerous agents.

I also think getting a "medical marijuana" initiative on California's 1996 ballot was a brilliant political move because it took advantage of the public's compassionate response to credible evidence that some very ill patients were being helped by it. What was NOT a brilliant was "reform's" knee-jerk denial of any political motive when every deputy sheriff in California began accusing us being "legalizers."

Of course "medical marijuana" was/is political.

Do right-to-lifers clamoring for a ban on "partial birth" abortion ever deny they are working to outlaw all abortion? Who said drug policy reformers had to endorse their opponents' rhetoric by agreeing pot is "bad" for adolescents; especially when data from pot users themselves shows just the opposite is true? In fact, the latest analysis shows quite clearly that ever since large numbers of troubled teens first began smoking pot in the late Sixties, the age at which they first try it has been declining steadily-- right along with the rate at which they also tried heroin.

Some "gateway."

Dr. Tom

Posted by tjeffo at 08:49 PM | Comments (0)

August 28, 2005

Drug War Hypocrisy-- and the Value of Publicity

As I've often pointed out, lack of the need to register when applying, plus
the "liberal"  wording  of California's Proposition 215 were precisely
what had induced a substantial population of chronic users to come forward--
and thus become available for my study. The corollary is that the much more
stringent  limitations agreed to by sponsors of the  medical pot
laws passed by all other states have so limited the potential applicants
as to make similar studies almost useless; at least in terms of demonstrating
any possible emotional component in their pot use (although I've had some
further thoughts on that subject and will air them in due time).

The most restrictive (and ridiculous)  law of all is  Vermont's,
recently passed by its legislature and signed by Dr. Dean; it specifies that
only patients with a confirmed diagnosis of cancer, AIDS or MS may use pot
legally.  But even that was too liberal for Vermont cops, who like most
other local police, are in agreement with the feds and will try to punish
medical users any way they can.

However, all is not lost. What Vermont's law lacks in scientific potential,
may be offset by its political value in calling attention to federal duplicity--
especially now, when current hearings in DC demonstrate the degree to
which DEA (and NIDA) will collude to frustrate research.

In a similar vein, if the execrable Raich "decision" had any value; it may
have been in encouraging journalists like New York Times columnist John Tierney
to study and comment intelligently on drug policy issues. It's clear that
entrenched bureaucracies (I include our Judicial system) will not change
drug policy unless forced to by an informed public that finally understands
how much the drug war really costs-- in both human and financial terms.

Dr. Tom

Posted by tjeffo at 01:35 AM | Comments (0)

August 26, 2005

More Drug Policy 101; the Nixon Years

Some time ago (August 19, to be exact) I promised additional commentary on certain drug policy manipulations of the first Nixon Administration which have profoundly affected American life ever since. Anslinger sponsored the Marihuana Tax Act;
but as noted earlier, the market it gave rise to didn't really get off the ground until certain other developments coalesced in the mid-Sixties to popularize pot; first with twenty-something protesters of various stripes who had, in turn, been inspired by Fifties Beats and the Civil Rights Movement to begin their own protests on behalf of Free Speech or Gay and Womens' Rights. The culmination of all those protests seems to have been the anti-Viet Nam war and youthful "hippie" movements which finally introduced pot to White adolescents on a national scale between 1966 and 1975.

Once established within the reach of those most likely to be critically influenced by its ability to allay adolescent angst at about the time they were also experimenting with its two natural rivals, alcohol and tobacco, pot became entrenched in High Schools and its illegal market has been growing steadily ever since. Whether such use is called "recreational" or "medical" wouldn't be at all  important if it weren't illegal;  that's the rub.

If only Nixon hadn't been a hostile boozer ,he might not have rejected the Shafer Commission's report
out of hand in the Spring of 1972. Pot would likely have become legal, and we'd all be a lot better off- at least that's my belief. The story of Nixon's rejection and burial of the Shafer Commission's findings has been brilliantly researched and told in Dan Baum's 1996 "Smoke and Mirrors." It's definitely required reading for every intelligent pot user.

A companion study, "Agency of Fear", authored 19 years earlier by Edward Jay Epstein,is available to read free on the web. Although not as focused on pot as Baum, Epstein goes into more detail about Nixon's henchmen and how they responded to their Boss's frantic search for a federal police agency with which to punish enemies and project power.

It wasn't so much that Nixon had a particular interest in drugs, just that history and fate conspired to provide him with an opportunity to declare an endlessly losing "war" on them  and that several opportunistic constituencies have since learned to wage it for their own selfish reasons.

Now we are embroiled in yet another potentially endless war on an idea because another insecure (ex) boozer in the Oval Office was desperately in need of a way to prove himself. The war on terror was a no-brainer for the Bushies; too bad for them (and the victims themselves) the casualties are returning in coffins and med-evac flights; they can't be buried in a gulag like (some) victims of the drug war.

Dr. Tom

Posted by tjeffo at 08:12 AM | Comments (0)

Straws in the Wind

Two reports in today's press offer point and counterpoint in the "debate"
over medical use of pot: the first is sure to get more attention: the

New York Times [ Justice Weighs Desire v Duty - Duty Prevails ]

reported on a speech in which Justice John Paul Stevens confessed regret
at  having to rule in favor of the federal government's ability to enforce
its narcotics laws. "I have no hesitation in telling you that I agree with
the policy choice made by the millions of California voters," he said. But
given the broader stakes for the power of Congress to regulate commerce,
he added, "our duty to uphold the application of the federal statute was
pellucidly clear."

In the other item [see * below], the Sacramento Bee's Washington reporter--
probably because of the ridicule a DEA lawyer had heaped on well-known (state)
Senator John Vasconcellos-- who was testifying on behalf of a Massachusetts
researcher wanting to grow decent pot for research-- reported extensively
on an otherwise obscure DC hearing. In passing, he also described how
a second DEA lawyer assailed Rick Doblin over his own pot use *.

My distress is at the gross error in the government position Stevens voted
last June to uphold,  the 'reform' position Rick Doblin typifies in
characterizing his own pot use as "recreational," and the failure of the
media to recognize that the DEA's adamant resistance to any unbiased research
is the very antithesis of the "science" that our drug policy claims to be
based on.

The greatest irony of all is that the main reason "kids" (and adults) use
pot on a regular basis is that it treats their injured self-esteem more safely
and effectively than any of the prescribed psychotropic medications-- as
well as tobacco and alcohol.

Dr. Tom

*Vasconcellos' long-ago self-esteem panel is derided by DEA lawyer.

Posted by tjeffo at 04:01 AM | Comments (0)

August 22, 2005

Kleiman's and Satel's gyrations

More on  Kleiman's and Satel's gyrations around the pot vs meth issue:

Dr. Kleiman's brief 8/19 blog entry
cites Kate Zernike's article (the one quoting him) in taking a swipe at Joe
Califano for echoing John Walters' tough stance on medical marijuana. it's
interesting to see how prohibitionists break ranks in public. Without mentioning
Satel's NYT piece, Kleiman staked out the same position, i.e., it's a mistake
to crack down on medical marijuana at the expense of meth enforcement (even
though neither tactic "works").


The ironies are even richer; Satel's NYT Op-Ed
went so far as ridicule the "gateway hypothesis' by citing a pivotal 2002
paper by Morral et al which demonstrated mathematically that some "common
factor"  might offer a better explanation of the pejorative associations
which had made  "gateway" so attractive to NIDA and legions of researchers
for three decades ( after the first blush of enthusiasm, it had never merited
consideration as an hypothesis- let alone a "theory').

US NY: OPED: A Whiff of 'Reefer Madness' In U.S. Drug Policy

My article in O'Shaugnhessy's had identified Morral's common factor as the
unrecognized, but invaluable role pot has played as a safer alternative to 
alcohol and tobacco for troubled youth since the late Sixties.

My article:
Cannabis Use in Adolescence: Self-Medication for Anxiety

Dr. Tom

Posted by tjeffo at 06:30 AM | Comments (0)

August 20, 2005

American drug policy in the News:

In the News:
The highly political nature of American drug policy- together with the control of funding for both Academia and Medicine which the feds have been exerting for years- has produced a particular type of drug policy punditry. Two "experts" routinely receiving a lot of Op-Ed space in our nation's most influential newspapers are Mark Kleiman and Sally Satel.

I have a particular reason to remember them because the first letter to an editor I ever had published in a comparable newspaper was written to criticize a 1995 (or '96) Op-Ed on the dangers of meth they'd written for the LA Times. Kleiman was so upset at my derision of their "intellectual constipation" that he briefly joined a drug policy e-mail discussion forum- with mutually unsatisfactory results.

He is a professor of Public Policy at UCLA and Satel is a psychiatrist who runs a Methadone clinic in Washington, DC. Of some interest to me is that they have both have been moved to side publicly (and apparently independently) with many of the police agencies now protesting the Bush Administration's recent emphasis on cannabis at the (apparent) expense the war on meth. What I would find amusing- if their ignorance weren't so supportive of our stupid national drug policy- is that they are still so obviously confused about illegal markets and unwilling to accept that those markets were created and are sustained by the same futile policy they continue to endorse.

Beyond that; both are apparently still "true believers" who actually think police suppression of criminal markets reduces their size- despite mountains of historical evidence to the contrary.

Op-Ed written by Satel

News item quoting Kleiman

Dr. Tom

Posted by tjeffo at 06:36 AM | Comments (0)

August 19, 2005

More Drug Policy 101:

More Drug Policy 101:

The Harrison Narcotic Act of 1914 became the grand-daddy of today's drug war after the Holmes-Brandeis Court ruled- in a series of 5-4 decisions- that its clumsy 'tax' ploy gave federal government agents criminal control over any physician's ability to prescribe certain drugs. In 1937, Harry Anslinger, sponsored the Marijuana Tax Act (MTA) to similarly restrain prescription of cannabis. The major difference was that no 'medical' exception for pot was ever provided and it was later banned outright by Congress in 1970 (just as heroin had been banned in 1922). Cannabis evaporated from the US Pharmacopeia in 1942 so doctors trained after that date no longer learned of it's medicinal uses and effects.

Although he wrote about 'narcotics' with great confidence, Anslinger was a bureaucratic thug with two years of college. He clearly knew little about cannabis; thus it's almost diabolically ironic that his campaign against it was based on the ludicrous claim that it induced homicidal mania in some adolescents. He certainly could not have known that pot would be almost completely ignored by youth for nearly thirty years until unforeseen circumstances conspired to introduce it to large numbers of them on a national scale in the late Sixties; nor that another SCOTUS decision would strike down his MTA just in time to provide the administration of newly-elected Richard Nixon (1968) with carte blanche to write an omnibus drug law. Nor finally; that the resultant CSA (1970) would greatly expand both federal and state police powers and thus set the stage for the runaway policy monster our drug war was has since become- powered largely by pot arrests.

In the next entry, I'll explain how several of Nixon's "plumbers" of Watergate fame were also key players in a frantic first term search for the federal police powers he desired to both tighten his grip on government and punish his political enemies.* That quest took most of their time and would eventually result in creation of the DEA- even as they and their boss were being shown the door because of a foolish break-in which had merely been a side-show for its main participants.

There may be some symmetry between Watergate and a more current subject; I refer to the arrogance displayed in a recent Central Valley case,* which dramatically illustrates both the zeal with which the feds have been colluding with state and local law enforcement to hamstring California's 'medical marijuana' initiative and how they may have finally been led to overreach. The case of Dustin Costa should attract considerable media attention over the next few weeks.

What Costa's case may also represent is a first-ever opportunity for all medical users - not just those with certain "valid" conditions- to participate on their own behalf.

Dr. Tom

* http://www.mercedsun-star.com/local/story/11099236p-11855355c.html

Posted by tjeffo at 04:20 AM | Comments (0)

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 04:40 AM | Comments (0)