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May 10, 2007

Prelude to an Indictment (Personal)

A while back, I wrote that I wanted to organize this blog, but must confess that at the time I wasn't sure just how I'd do so.  I've now decided to start by describing my involvement with Proposition 215 applicants because it seems like a convenient way to outline what I've learned from being closely involved with them over the past five years. Two of the most important realizations from that experience have been the key role emotions play in  human behavior and the critical role point of view plays in shaping how we deal with uncertainty. My point of view has undergone a sea change since I began screening pot smokers towards the end of 2001; outlining how that happened may be the most efficient way to tell a complex story to an audience that undoubtedly represents several points of view

Over ten years ago, California voters overruled the near-unanimous objections of federal and state politicians, numerous bureaucrats, and most career policemen by passing California's medical marijuana initiative by a comfortable margin. It was, without doubt, the most important and far-reaching political victory over an apparently impregnable drug policy ever. Subsequently, several watered-down versions were passed in other states; most by initiative, some directly by the legislatures. In terms of how 'patients' might qualify as 'legal,' all state laws except California's were turned into window dressing by restrictions written into them as part of the political price (eagerly) paid by 'reformers' to either to get them on a ballot or through the legislative process. Nevertheless, advocates of drug policy reform hailed each new law as a 'victory' and were careful not to say too much about  the restrictiions. All were seen as inevitable signs that a 'failing' drug policy would soon be forced to become more rational.

Unfortunately, no one bothered to check with either the federal drug policy guardians or their legions of supporters at every level of government.  First they dug in their heels, and later they went on a delayed attack. In California, the problem was highlighted from the beginning by then-Drug-Czar McCaffrey's threat that physicians could lose their right to practice for even discussing cannabis with a patient. Although blocked by the Ninth Circuit on First Amendment grounds, McCaffrey's ploy had a chilling effect on California doctors. Thanks to a few courageous ones, Tod Mikuriya most prominently, several thousand patients received recommendations in the first few years. By late 2001, they were numerous enough to support a small network of buyers' clubs in the Bay Area and a few other venues around the state.

Although I was deeply committed to drug policy reform, I was then pot-naive because I'd never been part of 'cannabis culture.'  The key reason was that I'd finished High School twenty years before pot's arrival in the Sixties. Ironically, the corollary was another lesson I was also slow to learn: one's generational age is of crucial importance in determining one's attitude towards all 'drugs,' especially pot.

I got a chance to play catch-up with cannabis culture when I began screening patients at a busy Oakland club in November 2001. The timing also turned out to be important, because its owner, the person who recruited me, was very uniusual; something I had no way of knowing at the time. Without going into detail, I will say he was honorable in all his dealings with me;  also that he had an important impact on the evolution of medical marijuana in California by treating the opportunity to supply cannabis to patients as a business. One of the things he understood clearly was that his cutomers had to be properly qualified as patients, before he could sell to them legally ; however, he never pressured me to speed up their processing; even after I reduced the number I could see by more than half because what I was hearing from them caused me to expand the protocol used for screening them.

Two great features of blogging are that one gets to control tempo and is always free to revise what's been written on the basis of new information. In addition to 'personal,' I'm already thinking about multiple entries under two other headings: 'medical' and 'legal.'

Doctor Tom

Posted by tjeffo at May 10, 2007 04:45 PM