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December 31, 2006

Rare Insight that Deserves a Wide Audience


Today's Orange county Register, published a remarkable guest OP-Ed; one that deserves to be read more widely than any opinion piece I've seen in a long time. At a minimim, it should be required reading for every member of Congress, police chiefs at all levels, and any US or  district attorney prosecuting drug cases, as well as all the judges who hear them.

Of course, that won't happen, but hopefully, Chip Parkhursts's cogent analysis of the role of marijuana in our obscene drug war will find a wide audience because it is right on target and cuts through the usual mind-numbing rhetorical drivel to focus on key issues. To a remarkable extent, it also anticipates and describes what my own study of pot applicants suggests about the obvious relationship between cannabis, alcohol, tobacco and other drugs: those other agents are connected because tend to be tried, and eventually to be used, by the same vulnerable adolescent population; there is overwhelming evidence to that effect, but it has been overooked during the four decades that  our suprmemely dishonest war on drugs has been both distorting reality and blocking unbiased studies of drug users.

Parkhust was even prceptive enough to identify Morral's pivotal Rand study, which should have been the beginning of the end of the 'gateway hypothesis,' but which has been steadfastly ignored by our drug policy 'experts,' most of whom are held in disgraceful thrall by know-nothing federal 'science' commissars at NIDA and the FDA.

Doctor Tom

Posted by tjeffo at 09:14 PM | Comments (0)

December 28, 2006

Political Issues

Although I'm as busy as ever, an item by Eric Bailey in yesterday's LA Times was too laden with irony to forego a few comments.  It concerns a young gay man from Alabama who was so inspired by the peace of mind pot afforded him that he moved to San Francisco and eventually became a highly efficient distributor of medical marijuana under the rules that were then in effect, only to be undone by his own success.  It seems that the working class neighborhood which had at first welcomed him with open arms, turned against him after his lower prices and better service created parking and image problems. Stated as briefly as possible, NIMBY hypocrisy is as alive and well in the ultra-liberal City of by the Bay as in most other places in America.

There are several additional points to be made; one is that although still focused on chronic pain as the major excuse for pot's medical use, Eric Bailey is better informed about Proposition 215 issues than other mainstream journalists; indeed, only Fred Gardner's coverage in Counterpunch is more incisive. In particular, the fact that Bailey's story appeared on the front page of the LA Times really underscores the slapdash nature of the San Francisco Chronicle's coverage of an issue in its own backyard.

 Another point to be made is that neither those opposed to pot nor those claiming to favor its medical use seem to realize the significance of the enormous appeal pot dispensaries have exhibited in terms of the futility of current policy, nor the fact that there seem to be many more chronic users than had been anticipated in 1996.  Along with recent confirmation that cannabis is America's biggest cash crop, the popular demand for more retail outlets in California really invites comparison with the number that exist for its two legal competitors: alcohol and tobacco.

One would also have thought such considerations would have invited a more realistic assessment from a policy wonk like Professor Kleiman. Instead, he reveals that he was as clueless as everyone else in 1996 and hasn't learned very much in the past ten years.

As for Kevin Reed's plans to run a delivery service; it's not too early to predict that the DEA will wait for it to become successful before stepping in to bust him on federal charges. Local pot supporters can then either pretend not to notice or blame him for being too 'greedy.'

Doctor Tom

Posted by tjeffo at 06:37 PM | Comments (0)

December 24, 2006

Connecting Dots

An article in the  January 2007 Scientific American magazine outlines some basic phenomena concernng recently descrbed mechanisms which should eventually explain some of the clinical observations I've been recording in my interviews with cannabis applicants over the past five years. As I've been emphasizing in this blog, this has been basic one-on-one clinical research of the type that the drug war had rendered nearly impossible before Proposition 215 induced a large population of self-medicating Californians to share their experiences with me by appling for the required physician's 'recommendation' they need to use pot. The deal has been that they had to answer a series of intrusive questions about their lifetime use of several drugs, their family relationships, and their school experiences as part of the application process.

Among the many things I've learned from systematically questioning them was that although essentially all had exhibited certain key behavioral patterns, there were a number of unexplained, yet consistent, variations in HOW those patterns had been exhibited; for example in the amounts they consumed each week, and in the daily schedules employed in that consumption. There were also obvious differences in the way cannabis affected them, as well as in some of the side effects they experienced. Among the most striking were the highly variable rates at which different racial groups had ever tried ('initiated') a standard menu of illegal psychedelics and 3 other agents: cocaine, meth and heroin.

To return to the Sci-Am article; it provides the background necessary for understanding certain related concepts which are now sweeping the suddenly-connected worlds of Genetic and Pharmaceutical research, personalized or genomic medicine to be specific.' One  surprise was discovering the rate at which such research is progressing, and my disappointment was in the (predictable) collateral discovery that no one seems to yet have thought of cannabis.

Then I quickly realized why not: it's just like other facets of cannabis research: that done by 'behavioral scientists' is aimed at validating the guilt-by-association postulates of the drug war, while that motivated by the commercial possibilities of the recently discovered endocannabinoid system has Big Pharma focused on studying the psychodynamic effects of synthetic agonists in rodents.

And if that twain have yet to meet, it's not likely those on the frontiers of 'genomic medicine' will foucus on cannabis anytime soon...

Doctor Tom

Posted by tjeffo at 08:05 PM | Comments (0)

December 21, 2006

When war is your policy of choice; how do you admit defeat?

The whole world is being treated to an object lesson in denial, a subject that’s also been on my mind recently. The Iraq Study Group, co-chaired by an old friend of the Bush family, just threw a pail of cold water on the President of the United States by informing him in no uncertain terms that we are losing the controversial war he has staked his presidency on for over four years. Beyond that, the Group’s report didn’t come up wih a suggested solution for the problem we’ve created by invading Iraq; probably because there is no best ‘way forward,’ despite their hopeful use of that term in their report’s title.

The late Barbara Tuchman, famous for her lucid analyses of the human dimension in several of history’s pivotal events, once wrote,  "A phenomenon noticeable throughout history regardless of place or period is the pursuit by governments of policies contrary to their own interests. Mankind, it seems, makes a poorer performance of government than of almost any human activity. In this sphere, wisdom, which may be defended as the exercise of judgment acting on experience, common sense and available information, is less operative and more frustrated than it should be. Why do holders of high office so often act contrary to the way reason points and enlightened self-interest suggests? Why does intelligent mental process seem so often not to function?" (from The March of Folly: From Troy to Vietnam, 1984)

After an initial dissection of the ISG report by both by the media and the pundits, the most obvious conclusion to emerge was that it didn’t change the mind of the man it was addressed to. Although noticeably less truculent in his defense of the Iraq war as both necessary and inevitably successful, he clearly hasn’t given up on it as the strategy of choice. As of today, he clearly favors sending more troops.

Which brings me, somewhat belatedly, to the point of this essay: our war on drugs, which has proven even less successful and more misguided than the war in Iraq. Its failure has been recognized by three quarters of the electorate since the late Nineties, its four decades of cumlative damage to our social infrastructure is beyond calculation, and yet it still enjoys so much unquestioning support from the entire federal government that the idea of a Drug War Study Group would be considered delusional.

This national denial should now become the central issue of the drug war; it’s clear that the grand strategy of the reform movement for over a decade: pointing out the drug war’s many shortcomings and hoping they will cause the public to demand its rejection, has also been a failure. For whatever reason, the public accepts those shortcomings and is unwilling to demand change.

That situation suggests that until we understand the reasons for that aceptance, we face the possibility that an increasingly debilitating drug war will continue indefinitely. It’s also clear that the key to its repudiation lies in demonstrating the glaring errors upon which the prohibition of cannabis has been based; in other words, the key to ending drug prohibition as policy lies in debunking its war against marijuana.

Doctor Tom

Posted by tjeffo at 02:36 AM | Comments (0)

December 14, 2006

Welcome Support...

Over the past few months, I’ve been pointing out that America’s war on drugs has been a forty year failure which bears a striking resemblance to the equally forlorn, but much more recent, war in Iraq; one which will enter its fourth year on March first.

Drug war casualties remained largely uncounted  for years while slowly crowding our prisons and populating our inner cties with the homless. American military casualties in Iraq have been assiduously counted ever since an insurgency began shortly after the quick initial military victory. Although an attempt was made to ignore them at first, the growing numbers of civilians casualties generated by the insurgency have since became much more visible to an increasingly disapproving global audience.

Nevertheless, domestic support for our Iraq policy remained surprisingly strong until some ill-defined threshold was crossed quite recently, but I hadn't noticed any formal comparisons between Iraq and the drug war until this past week;  which is why I was so gratified to read Neal Peirce’s articulate and hard hitting December 11 column.

Admittedly,  one column hardly represents a trend; but given the rapid unraveling of our  Iraq war, its days as a credible policy would seem to be  numbered and although we may be considerably further from a repudiation of our more deeply entrenched drug policy, its resemblance to the Iraq fiasco could greatly simplify that task. It would also help if the reform community were to catch up with some of our more articulate and well informed drug policy critics in the media: John Tierney, Arianna Huffington, and Neal Pierce, for example.

Doctor Tom

Posted by tjeffo at 04:44 AM | Comments (0)

December 12, 2006

More Government Medical Practice

As previously noted, the critical foundation of our modern drug war goes back to a pair of 5-4 SCOTUS decisions in 1917 and 1919 which interpreted the 1914 Harrison Act, ostensibly a tax measure, as empowering federal Treasury agents to second guess medical prescriptions for drugs derived from the opium poppy and the coca bush. In 1937, the even more devious Marijuana Tax Act placed an absolute ban on all products of the hemp plant. The CSA of 1970, which is the basis for today’s war on drugs, simply asserted a different basis for what had originally been the very devious usurpation of our original Constitution’s assignment of regulatory power over Medicine to the various states.

It is from that background that one should interpret the latest Congressional tinkering with Medicare, a measure claiming to reward physicians who practice ‘quality’ medicine (as defined by the government) by paying them more than those who do not. The most distressing aspect of the long-winded NYT report on the legislation is that while some of those who opposed the measure cited the obvious danger implicit in medically untrained politicians setting standards for medical practice, there was no recognition that the process had started with our drug laws. It’s also fairly clear that had any of the quoted authorities  recognized the association, they wouldn’t have had the courage to say so.

In the meantime, the most obvious and odious legacy of that long forgotten Harrison Act, the aggressive criminal prosecution of both prescribing physicians and patients in severe pain at both state and federal levels, is still with us.

Doctor Tom

Posted by tjeffo at 04:30 PM | Comments (0)

December 10, 2006

More on Denial

 In several recent posts, I've alluded to the phenomenon of denial as a key factor in sustaining an irrational drug policy in the face of convincing evidence that it's unscientific, unjust, and unworkable. That such denial is also a universal human characteristic seems particularly obvious from the difficulty everyone is having in confronting the failure of our effort in Iraq. Another painful example is our Supreme Court's approach to global warming: the same justices who regarded an unsubstantiated drug problem as requuiring unprecedented intrusion into the privacy of school children don't seem able to develop enough concern to believe that a broad scientific concensus relating CO2 levels to rapidly changing global temperatures might actually justify new environmental legislation.

Doctor Tom

Posted by tjeffo at 08:58 PM | Comments (0)

December 06, 2006

More on PTSD...

Followng a week of leaks, the actual report of the Iraq study group turned out to be simply bipartisan confirmation of the obvious: invading Iraq was a huge mistake, it's proving very costly, and we have yet to develop good plan for getting out. To me, the real surprise has been how steadfastly the Bush Administration has been able to deny reality and still get away with it.

In that connection, an NPR report on PTSD among recent Iraq returnees  that I happened to hear while driving home on Monday evening might also be described as shocking, but not especially surprising. I have personally encountered the same blame the victim attitude among die-hard retired military who still think we should have ‘won’ the Viet Nam war and look upon ex-comrades who have been tormented by PTSD for decades as shirkers and ‘sad sacks of s__t.’

Thus knowing that the public is still in denial about the legitimacy of using cannabis for any symptoms of anxiety becomes even more understandable. As Walt Kelly once famously said: ‘we have met the enemy and he is us.’

Doctor Tom

Posted by tjeffo at 10:23 PM | Comments (0)

December 03, 2006

More on PTSD...

In several recent blog entries I've promised to discuss the anxiety-related syndromes which my clinical conversations with applicants have shown unequivocally to be treated safely and effectively by their chronic use of  cannabis. Specifically mentioned were various named anxiety disorders as well as PTSD, ADD, and chronic insomnia.

Over the past few weeks, several items in the popular press have been so well timed that I couldn't resist using them to illustrate various key points. The good news is that they've simplified the making of those points; the bad news is that their order has been completely random. Since the blog's search function works quite  well, I've had to content myself with the belief that the diligent readers I'm hoping to reach will use it  to make whatever connections they find necessary.

One such item is a wire service story on drug use by soldiers in Iraq, which reinforces several ideas I've been emphasizing: the first is that most drugs, including alcohol and tobacco, are tried for the first time ('initiated') during adolescence. The second is that they tend to be tried, as Denise Kandel and others first pointed out in the Seventies, in sequence; with alcohol and tobacco first. However, rather than a 'gateway', as was mistakenly assumed back then, pot, in its inhaled form, was really a new drug with unique appeal to adolescents. The proof is that within ten years of its introduction to baby boomers in the mid Sixties, it was being tried at exactly the same  average age as alcohol and tobacco, and well before all other illegal drugs.

 Another point is that among its early chronic users were GIs from Viet Nam who discovered it was safe and effective treatment for their PTSD  long before that entity had been named and adopted as a 'diagnosis' by the committees of psychiatrists and psychologists who took over the DSM project in the ('just say no') Eighties.

If one recalls that it was also then that the military began going to some lengths to weed out pot users before enlistment and has been testing recruits aggressively ever since, I would expect our modern GIs are predisposed to use alcohol and tobacco as stress relievers. Speculation is somewhat complicated by not knowing what percentage of them might have tried pot before enlisting (because I know THEY would be more likely to turn to it for stress than those who hadn't).

Like most human behavior, this account is becoming complicated. Perhaps the best way to simplify it is to end by recalling that the main lesson learned from all my converstaions with current users is that the illegal pot market has been thriving since the Nixon era because pot has proven so effective at releiving adolescent angst, which in our modern world, seems to be increasing on an almost daily basis.

All of which leads me to believe that although immediate political prospects for pot legalization remain murky, it's quite clear that the illegal market for it will remain robust, whether it's sold in buyers' clubs, dispensaries, or back out on the street, just as it was before Proposition 215 passed ten years ago.

Doctor Tom

Posted by tjeffo at 07:25 PM | Comments (0)

December 02, 2006

More on Add

In a previous entry, I had occasion to mention the testimony of Dr. Claudia Jensen before the Souder Committee in which she described how she’d learned that young adults with ADD were smoking cannabis to relieve the symptoms for which they had once been treated with Ritalin. Little did I know that she had also been interviewed by Keith Olbermann on MSNBC and had delivered an equally lucid explanation of her findings on TV. Sadly, such an intelligent appreciation of the opportunities offered  by 215 to find out who has been using pot with benefit remains rare. I also haven’t forgotten that I promised to discuss the apparent mechanisms by which inhaled cannabis treats anxiety; all I need is a little spare time...

Doctor Tom

Posted by tjeffo at 04:54 AM | Comments (0)