« May 2006 | Main | July 2006 »

June 26, 2006

Inconvenient Truth 2

Inconvenient Truth 2

Just how does one begin to understand a modern world plagued by seemingly  intractable regional conflicts over the same disputed territories, even as it is wracked by violent new conflicts-at-a-distance more clearly related to factors like religious differences, distribution of wealth, and notions of history; just as cable TV warns of a series of apolitical new threats to human existence in the form of pandemics, tsunamis, super-volcanoes and collisions with space objects?

Ironically, global warming, a somewhat older ‘threat,’ originally dismissed by skeptics until its credibility was restored by recent intense weather events and some additional objective evidence, isn’t easily classified according to the first paragraph's schema; not for lack of criteria that could assign it to one of three arbitrary categories, but because it displays features of all three: to a considerable extent, it can be seen as regional, political, and all-embracing.

Which leads me, in roundabout fashion, to a point: the best way to understand our accumulated modern threats may be that all are uniquely human perceptions; some are of phenomena which have always existed, but  only recently been disclosed by scientific enhancements.  Others have clearly developed from the accelerating human population explosion (also enabled by science) of the last several centuries.  Finally,  global awareness of all is being intensified by recent advances in information technology (IT ).

Is ‘science,' then, a common denominator of our global problems? Although that's a notion to warm every creationist’s heart, it’s quickly dismissed by noting how avidly religious fundamentalists make use of scientifically-generated technology. The only ‘revelation’ is it that forces them to display an even greater degree of hypocrisy (‘cognitive dissonance’) than many other humans. Since they are also clearly not that embarrassed by their scientific ignorance, revealing it hasn’t (and probably won’t ever) change their behavior.

Is ‘denial,’ then, the elusive common denominator?

The answer seems to be that while our unwillingness to confront unpleasant (‘inconvenient’) truth is certainly common enough to be thought of as part of ‘human nature,’ it’s clearly not the only factor responsible for the current mess of insoluble problems.  An equally basic element may have more to do with our evolutionary descent from hierarchical mammalian predators and our retention of several of their behavioral characteristics.

Doctor Tom

Posted by tjeffo at 07:56 PM | Comments (0)

June 25, 2006

Inconvenient Truth

Inconvenient Truth I’ve often mentioned how an early understanding that all candidates for a pot recommendation were already chronic users led me to  screen them with a standardized interview specifically designed to explore not only whatever medical benefits they were deriving from their pot use, but also to identify and sort out whatever common factors might have induced them to become chronic users in the first place.  

It’s now been over four years since that project began and enough of the data accumulated from interviews has been entered into a modern relational database to establish that not only have virtually all of them experienced substantial benefits from their prolonged  illegal self-medication, but also to develop a tentative user ‘profile’ explaining how the current illegal commodity market  for ‘marijuana’ has grown steadily to its present dimensions over the past four decades despite unparalleled police efforts to ‘control’ it.

Beyond that; the unexpectedly complex and changing initiation patterns exhibited by the study population for a menu of other drugs, including alcohol and tobacco, also allows a tentative understanding that all repetitive use of any psychotropic agent may be rooted in a common need to self medicate. Although beyond the scope of the current data to establish with certainty,  that possibility offers a more coherent explanation of the government’s own annual surveys than ‘gateway,’ and also establishes how the gateway hypothesis was arrived at.

Which brings me to the next point: aside from chronic pot use, another behavioral phenomenon I’ve had to explain was the irrational, yet amazingly uniform, rejection by 'reformers' of  a study I thought they would have both understood and supported. Unfortunately, the best explanation of that particular phenomenon seems to be that— just like pot smoking itself—  denial of unpleasant reality is yet another form of human behavior which is both  more common and more characteristic of our species than most of us  seem either able to realize or willing to admit.

It further appears that the need to deny unpleasant (‘inconvenient’) reality may well be our species’ most pervasive and dangerous weakness; one which most accurately reflects not only why American (and global)  illegal drug markets have grown to their current dimensions, but also why so many of the political problems of our increasingly crowded and interdependent planet seem further beyond solution than ever.

In other words,  the implications of ‘inconvenient truth’ may be far more profound than the producers of Al Gore’s movie realize.  

An amazing thing just happened in real time: as I was doing the final checks on the entry, I checked my email (it’s Sunday morning) and immediately encountered a  fascinating article in today’s NYT Magazine; one I’ve only had a chance to skim, but already know I’ll be parsing in detail for quite some time...

Doctor Tom

Posted by tjeffo at 09:26 PM | Comments (0)

June 20, 2006


There were many reasons for me to relish an opportunity to comment on Mark Kleiman's criticism of Ryan King's methamphetamine study;  so many, in fact, that deciding where  to begin, and what point of view to emphasize became problems. King's study is typical of a genre which is fast becoming pervasive: a researched meta-analysis of a specific drug-war topic published on the internet and/or as a press release. What is unusal is the laundry list of complaints it provoked from Kleiman; their length, prompt appearance, rambling nature,  and tone are ample evidence of the annoyance which inspired them.

From King's point of view, Klieman's fit of pique was probably welcome; precisely because it focuses more attention on his study. As one who has done similar advocacy, I know most such papers are written to influence public opinion; also that access to peer reviewed literature can be almost impossible for an author perceived as even mildly critical of US drug policy. The Sentencing Project has done excellent work, but most of it either has to be reported by, or referenced in, the popular press to reach the public.

In that connection, Kleiman once co-authored a paper in a peer-reviewed medical journal which played an significant role in advancing 'medical marijuana' as a political issue. I also know he  still complains about the fall-out that effort had on the delicate balancing act all prominent academic drug policy analysts must engage in.

The truth about both King's paper and Kleiman's comments is that both contain kernels of truth sorrounded by large areas of uncertainty woven together by strands of outright falsehood- and neither can be certain of what's which. That particular reality has far less to do with their diligence, scholarship and intelligence than it does with the fear, disinformation, and confusion produced by almost forty years of drug war propaganda superimposed upon over fifty years of never-acknowledged drug prohibition, the origins of which are still shrouded in considerable secrecy. Before one can lie, one must first know the truth; the great success of the drug war is that it has blocked unbiased human research so successfully that no one, especially the policy makers themselves, has ever been able to learn the truth about human drug use. Instead, the most compliant 'researchers' all dutifully parrot the prevailing myth about each illegal agent ('drug of abuse') and then support it with repetitive,  limited studies of similar populations with similar results.

My credentials for criticising both authors are based on the fact that, for the last four years, I have been engaged in a unique, ongoing study of Californians seeking to use cannabis medically. Since all had been paricipants in the illegal pot market for a variable interval and many had sampled other illegal drugs aggressively-- and I have routinely collected a lot of other data from them as part of their required evaluations-- one couild describe what I've been doing as market research of the very sort both King and Kleiman, albeit with quite different emphasis, have agreed is so difficult and uncertain. What I have learned is simply amazing. It's also very much at odds with the prevailing pot myth (large chunks of which I'd also believed), yet it's quite convincing and sheds enough light on key aspects of drug war history to show just how various  elements of the myth have developed.

A collateral reason for ambient drug war uncertainty is the fear it inspires. The evidence behind that statement is as overwhelming as it is pervasive; yet the fear itself is never openly discussed. In many respects,  the drug war may be seen as two metaphorical elephants;  the one in the national living room that no one can discuss honestly, and the other at the center of the Indian fable which the blind men struggle to describe, A major difference is that the Indian elephant  has six features over which six analysts disagree. The drug war elephant has an almost unlimited number of features over which an almost unlimited number analysts may argue-- and a host of reasons their opinions aren't honestly stated.

Doctor Tom

Posted by tjeffo at 10:44 PM | Comments (0)


Postponement I know I promised at the end of yesterday's entry (Set-up) that it was intended to set the stage for deconstruction of Professor Mark Kleiman's latest pronouncement on methamphetamine; and that's still my intention. But when I started looking at the subject in detail, I found some other things I have to get off my chest before dealing with the specific items by Kleiman and King which one would have to read to understand my comments. There's a certain ironic history here;  my first contact with Dr. Kleiman was  in 1995, when he and Sally Satel, MD  co-authored a scare piece in the LAT on the 'methamphetamine epidemic.' and I had a letter published I chiding them for their 'intellectual constipation.' The gambit worked well enough to have the Times to publish my letter; it also prompted Kleiman to (foolishly, as it turned out) join a drug policy discussion list to do battle; ironically, it was just before I left for an unusually long European vacation which- given the primitive quality of e-mail  then available- also made me miss his entire presence on the list without the opportunity to exchange even one e-mail.

I have since read Kleiman's book and, when blogs became popular, I belatedly discovered he was already an avid, prolific, and highly opinionated blogger. The sum of those discoveries  tended to confirm a number of suspicions I'd already developed about drug policy analysis and those who practice it:  we (I must include myself)) have all been victimized to a variable extent by a fundamentally stupid policy which has, nevertheless, survived for nearly a century because it's so fiercely defended;  despite its perennial (and abysmal) failure to accomplish any of its stated goals.

In fact, knowing, and being able to grasp, all that didn't prepare me for the true extent of our drug policy's perversity- and what is, most likely,  the single most important reason for its improbable success: the cognitive function which has enabled humans to dominate all other biota to the extent we have is irretrievably influenced by the emotions we all share with other animals. Human emotions can-- and do-- override logic to a considerable extent. It is those emotions which have now backed us into a corner by allowing us to overpopulate the planet to an unsustainable degree with little recognition and even less discussion of the huge dangers posed by our present numbers.

I will stop right here long enough to say that this realization came only after I'd had the chance to interview thousands of admitted pot users and then analyze their data in a customized data base. The most inescapable conclusion of that experience relating to drugs is that we humans are so impelled to deny the importance of our own emotional responses in our decision making that we have made-- and continue to defend-- a number of implausible judgements about drugs and drug use.

It's even more important to realize that the same denial mechanisms obscuring the realities of drug use can be easily seen at work in all human relations, whether they involve our neighbors or people in nations halfway around the globe. We are all possessed of identical brains with the same metabolic requirements They are subject to the same emotional stimuli and prone to respond in similar fashion to similar stresses. If for no other reason, the similarity of responses by inmates in our maximum security prisons to those of  'detainees' at Guantanamo should have us all buzzing in alarm.

Instead, we remain in denial. Key revelations, like the recent suicides of detainees seem to have been largely ignored in favor of the latest political calculus.

I am certainly aware of the 'heresy' my work with pot smokers has led me to embrace; yet the coherence of the principles revealed-- along with their  applicability to most human interactions–– is so undeniable I must describe them to others. A blog  seems made to order for doing just that...

Doctor Tom


Posted by tjeffo at 12:11 AM | Comments (0)

June 19, 2006


Set Up Although the word has never been officially  applied to drugs, US federal drug policy began evolving into prohibition ninety-two years ago when agents of the Treasury 'tax unit' created by the Harrison Act started arresting doctors complying with the new law because they were prescribing for 'addicts'. That 'unit'  eventually became the Federal Bureau of Narcotics (FBN) under Harry Anslinger  in 1930. In 1937,long after the Holmes-Brandeis Court had ruled  'addiction' to be a medical menace best dealt with by rigid federal control of all prescriptions for opiates and coca products, Anslinger used the same fear-based tax ploy to gain control over all products of the hemp plant. A critical difference was that while Harrison  allowed some medical use of opiates and cocaine under strict control, similar allowances were not made for cannabis by the MTA. Anslinger was a thuggish bureaucrat whose great skill was protecting FBN turf; his technique was simple: use arrogated authority over all things 'narcotic' to block unbiased studies of 'addiction.'

The emergence, several years after his sudden departure from FBN, of pot-smoking hippie demonstrators  experimenting with a melange of new 'psychedelics' while  urging both radical social change and an end to the Viet Nam war gave Richard Nixon one of the major items on his 1968 wish  list:  a federal police agency he could control. Although Watergate ultimately frustrated him, the DEA and NIDA--  both outgrowths of his sweeping 1970 Controlled Substances Act (CSA)–– became important to Ronald Reagan's first-term decision to intensify Nixon's drug war. Since then, the DEA has retained Anslinger's authoritative role as the major 'official' source of drug information, while NIDA has become sponsor of 85% of academic studies of 'drugs of abuse' and thus able to skew both their design and interpretation in support of our never-admitted policy of prohibition.

We now have an utterly dishonest  'control' policy which three quarters of the general public see as a failure beyond fixing; yet  federal bureaucrats are free to spend billions boosting as successful. Beyond that, our powerless 'drug czar,' is merely a purveyor of propaganda fashioned from selected  data supplied by a self-interested federal police agency and augmented by 'research' sponsored by another  'scientific' agency created to study a 'disease' (drug abuse) for which objective diagnostic criteria are lacking and total abstinence  has been decreed the only acceptable goal of treatment. Among the few reliable statistics allowing a peek at what four decades of such insanity have actually accomplished: over two million prisoners in our jails and prisons, the arrest of over three quarters of a million people each year for cannabis violations, and several thriving illegal drug markets which can't be precisely measured by standard econometric techniques–– precisely because they are  illegal.

This rant is intended as background for the deconstruction of a recent Op-ed by Professor Mark Kleiman, who has made a comfortable living and achieved a considerable academic success by teaching drug policy 'analysis,' most recently at UCLA.
Doctor Tom
Posted by tjeffo at 06:21 PM | Comments (0)

June 11, 2006

Human Cognition, Emotions, and the  Rule of Law <br>

There is now abundant evidence that man isn’t the only cognitive species; several varieties of mammals— from primates to dolphins— are clearly able to communicate abstract ideas, learn new skills, and transmit at least some  knowledge thus acquired to their young. However, as we also know from our experience with human language, ‘word of mouth,’ is imperfect. Precisely because the quality of information passed from one generation to another can deteriorate so quickly,  literacy became one of the key developments required for humans to progress rapidly from planetary insignificance to the dominant species.

We can also see our own emotions clearly mirrored in animal behavior;  recent advances in our ability to observe and photograph their interactions, coupled with an increasing interest in ‘endangered’ species, has heightened our awareness of how similar their emotional responses are to our own; a perception that shouldn’t surprise anyone with some knowledge of comparative neuroanatomy.  

That brings me to another point: as knowledge of our environment and its complexity has accumulated, it’s become more specialized. We are thus increasingly dependent on various authorities to keep track of it all and help synthesize the rules and policies which determine how newly acquired knowledge affects daily life. That the process has been untidy and contentious is painfully evident: ‘sovereign governments’ interactating in a loosely knit ‘community of nations’ have produced a world which is arguably more polarized and dangerous than ever; in essence, we are reprising the Crusades of an earlier millenium––  only this time with nuclear capabilites.  As we confront the sorry melange of hypocrisy, exploitation, and violence being reported with increased speed and efficiency from all corners of the planet, it’s gradually dawning on some of us that along with an increase in the planet’s temperature, its humans are experiencing a rapid increase in ambient stress levels.

For me, at least, the obvious link with cannabis has come from four years of unique clinical interaction with a population that’s been chronically self-medicating with it, despite Draconian legal penalties. That experience has convinced me that of all the therapeutic benefits cannabis offers, its ability to quickly and safely relieve anxiety is what rapidly propelled it into third place  among all agents initiated by American adolescents in the early days oif the drug war–– and a mere decade after large numbers of ‘Baby Boomers’ first began sampling it in the mid- Sixties.

Alcohol and tobacco still retain shaky holds on first and second place. They are also seperately ‘regulated’ and not even considered by most to be ‘drugs,’ which gives them a decided competitive edge over pot; despite its obvious edge in both safety and efficacy.

Doctor Tom

Posted by tjeffo at 08:28 PM | Comments (0)

June 09, 2006

A Naive Study

A Naive Study I spent the last few weeks poring over hundreds of clinical histories obtained from pot applicants during  the Spring of 2002; right about the time I was tumbling to an insight which was to gradually  escalate into an obsession: since nearly  all applicants I was seeing were already long term pot users,  perhaps their accumulated experiences would help define the phenomenon of large scale juvenile pot use which had so clearly developed de novo during my own lifetime. In any event, such a study might also shed light on another contentious issue: how should ‘medical’ use of cannabis be defined ?

I set out to develop an unbiased interview format as a research tool. The intrinsic logic of the situation made the proposed study seem such a no-brainer I was almost embarrassed it had taken me so long to come up with it. Little did I anticipate the mixture of disinterest and antipathy the study— and the data— would inspire. It’s now been four years; and even though a lot of data has been accumulated and some of it coherently presented to many people with an alleged professional interest in Medicine, Drug Policy— or both— ‘stubborn disinterest’ is the kindest way to characterize its reception. Significantly; except for a very few individuals, there’s been an almost universal tacit refusal to enter into detailed discussions.

What has changed significantlty–– and just recently–– is that enough of the mountain of accumulated data  has been processed in a brilliant  relational data base to repudiate federal cannabis (“marijuana”) policy as the fraud many have long suspected it was; but could never ‘prove.’  What is also surprising is that such an obvious fraud could have been so durable. In fact, the implcations of its durability for the cognitive processes by which  we dominate our planet may extend far beyond drug policy.

In a more restricted and practical vein, the detailed portrait of modern American pot use provided by the data base— whether it is immediately understood and accepted or not— should ultimately sound the death knell of the drug war that teen  pot use frightened RMN into declaring just over  37 years ago.

Since the details revealed by data base analysis which most apply to its eventual publication in ‘peer-reviewed’ medical literature are  technical  and statistical, I won’t disclose them here. However, I  believe  the extraordinarily destructive nature of our drug policy makes it reasonable to at least list the study’s major implications.

1) The US has been burdened by a deceptive policy of drug prohibition since 1914.

2) It was then, and contrinues to be, based almost entirely on fear of ‘addiction,’ an entity which although uncritically designated as a 'disease' by some and the focus of a putative medical specialty, still eludes coherent definition and cannot be diagnosed with precision.

3) Although outright cannabis prohibition was added to our oppressive 'control' of coca products and olpiates in 1937 for spurious reasons and with shockingly little discussion, it was retained under the omnibus controlled Substances Act (CSA) during the first Nixon Administration in 1970.  The law had been rewritten only because SCOTUS, in a trypically clueless drug policy ruling, had threatened  the legislative basis of  prohibition for reasons which were peripheral to its (probable) unconstitutional flaws.

5) The most important questions about the new phenomenon of widespread juvenile pot use, which should have quickly occurred to anyone professionally concerned with drug policy during the Seventies–– have never even been asked–– let alone answered:

Why did an agent ignored by the public for thirty years suddenly become so popular with youth— not only in America, but around the world?

Why has an inadequate and unpersuasive ‘gateway theory’ remained  both the major focus of cannabis 'research' by the Behavioral Sciences and the major reason touted by policy advocates for its continuing harsh prohibition?

Clearly, the sustained incremental growth of an illegal commodity market for cannabis is just one of many elephants in the drug policy living room; yet one is forced to wonder why such an obvious question was never asked. That’s especially true once one realizes that the mid-Sixties were when the first ‘Baby Boomers’ were sumultaneously coming of age and discovering pot.

That nearly all who became chronic users had first tried both alcohol and tobacco was interpreted by the first researchers ever to study adolescent pot use as evidence that it was a ‘gateway’ to ‘harder’ drugs. Other possible explanations, which might have been investigated then or later, have been largely ignored while ‘gateway’  has remained the major focus of Behavioral Science studies funded by NIDA  since its creation in 1975.

The original ‘sequence’ of initiations is no longer true and pot’s relationship to the other two agents is best explained by the realization that pot soon became the third entry-level drug tried by by anxious teens, along with alcohol amd tobacco. Although alcohol and tobacco are still not perceived or regulated as ‘drugs,’ and both are more dangerous to individuals and society, they remain legal and loosely regulated while mere possession of cannabis is rigorously punished. When it's realized that another finding was that nearly all chronic pot users reduce their use of both agents after settling on pot as their drug of choice, the perverse stupidity of the drug war comes into even sharper focus.

That’s all I have time for today; more later.

Posted by tjeffo at 12:20 AM | Comments (0)