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November 21, 2005

Historical Background

California's "medical marijuana" initiative just celebrated its Ninth birthday; it was passed in November 1996-- nearly sixty years after cannabis ("marijuana") was first banned by the feds, and twenty-five years after then-President Nixon summarily rejected the cautious recommendations of his own "blue ribbon"  (Shafer) Commission) to decriminalize it and study its potential medical benefits. As we now know, Nixon opted instead for a disastrous war on drugs which soon began a series of dire changes in American society, the most obvious of which has been a steadily growing prison population which is disproportionately poor and dark-skinned. Parallel developments have  been real declines in state educational and health care budgets, a noticeable drop in the performance of American primary and secondary students in public schools, and- more recently- an  obesity epidemic affecting all age groups; especially children and adolescents.

  That the medical marijuana initiative was supported by 56% of  Californians over  strongly voiced opposition from sitting and former federal politicians and bureaucrats-- plus law enforcement bureaucracies at both state and federal levels-- evoked some surprise; but hardly the political soul-searching that might have attended a similar voter rejection of almost any other policy item. The entire federal bureaucracy then closed ranks in declaring  the vote a "mistake" and continued to oppose any implementation of the new law. Thus encouraged, state and local police blatantly denied their obligation to uphold California's constitution as they began harassing and prosecuting the first 'medical' users to be 'certified' by those few physicians then willing to defy federal threats and process applicants as the new law allowed.

In general, the media has continued to treat drug war topics as quirky; especially if they deal with cannabis- it has continued to emphasize word play over fact and give the default to the federal position that 'marijuana' deserves  criminal sanctions because of its presumed danger to youth.

Primarily because the Ninth Circuit upheld the First Amendment and a few communities-- mostly in the Bay Area-- provided a modicum of critical support for the new law (virtually abandoned by the Legislature and vigorously undermined by then- AG Dan Lungren), several pot clubs  survived in the Bay Area. They soon became hubs where patients from other parts of the state could be directed to compliant physicians, obtain more reliable cannabis with a greater variety of cannabis products, and network with other medical users. It was at that point (late 2002) that I began seeing a steady stream of applicants at a popular Oakland club and, soon after, at two smaller clubs; one in San Francisco and another in Marin County.

I soon gained a fairly straightforward insight: perhaps the most greatest potential benefit of the new law had been the (unanticipated) opportunity it provided for physicians to systematically examine a population of chronic pot users which had been previously "hidden" from view by threats arrest/exposure. All that was required would be a willingness to ask them the right questions, a technique that could look past their own excuses for using pot- and a way to elicit whatever other conditions most of them (seemed) to be self-medicating.

Although patient denial-- particularly by males-- that they use pot for emotional reasons is almost universal, a sympathetic approach, plus a demonstration of sincere interest-- when coupled with a "structured" interview have allowed me to elicit  a credible 'profile' of pot smokers. One of several bonuses has been a coherent explanation of the illegal market which had been launched on its present pattern of inexorable growth at about the same time Nixon launched a "war on drugs during his first administration.

That these and other issues have had little appeal to the self-appointed gurus of 'reform' has engendered a lonelier and more intense evaluation of what I've learned from applicants/patients over the past four years. Indeed, as
I've had the opportunity to see a growing number of 'renewals,' the dimension supplied by people newly educated to their own lifetime pot use has only added to my conviction that an opportunity to carry out unbiased clinical evaluations of drug users has been the (critical) missing ingredient which has allowed our feckless and uninformed drug policy to gain such undeserved power.

I look forward to sharing more insights from this ongoing study of pot use as they become available.

Dr. Tom O'Connell

Posted by tjeffo at November 21, 2005 04:21 AM