June 30, 2007
Painted into a Corner
Modern life is becoming ever more complex. Although technology has allowed us to prosper like never before, the greater understanding of nature which created that technology hasn’t allowed us to live in harmony. Quite the opposite; though many wouldn’t agree, it’s at least possible that overpopulation has combined with our emotional frailties to pose unprecedented dangers to our very survival.
Lest one think I’m referring to the festering wars that have been in the background since after World War two; I’m not. Current wars may have greater potential to become nuclear, but the danger I’m referring to may already be inescapable: it's that the denial that’s kept our species from developing strategies for addressing its urgent energy and water problems may have taken it (us) past the point of no return.
A handy metaphor for the concept I’m trying to convey is the rusting fleet of World War Two era ships that’s been “mothballed” in Suisun Bay North of San Francisco. I doubt any movie buffs old enough to have seen Caan and Duvall in Sam Peckinpaugh’s “Killer Elite” (1975), have forgotten that its stirring show-down was shot on board one of those ships with rest of the fleet in the background.
That the environmental danger those ships pose has only recently been appreciated is understandable. Sadly, so also, is the unconscionable length of time that’s elapsed. It illustrates how easily denial can paint us into corners by allowing us to agree on which phenomena we can’t bring ourselves to discuss.
Like global warming, human emotions and the war on drugs...
June 28, 2007
Still Supremely Dishonest; so, what else is new?
According to my reading of history, the legal and historical roots of our modern drug war are to be found in two misguided 5-4 decisions of the medically naive Holmes-Brandeis Court. Made between 1917 and 1919, they upheld the flagrantly deceptive Harrison Narcotic Act. The decisions effectively awarded the right to practice Medicine to equally untrained federal agents . Although their implicit dangers were warned against at the time (quoted midway through Brecher, Ch 8), the actions seem to have been excused on the basis of that era’s (generally uninformed) notions of “addiction.”
In other words, those decisions on behalf of Harrison represent the first drug exception ever carved out of the Constitution; they've also never been reviewed from that standpoint.
The historical record also shows conclusively that ever since 1920, whatever federal bureaucracy has been responsible for the nation’s drug policy has consistently given its highest priority to preventing Mediciine from studying addiction-related issues with the standards usually applied to other diagnostic and therapeutic issues.
The saddest part of the “Bong Hits” case for me is that none of the commentary I’ve read so far seems even remotely aware of the Court’s key role and dishonest service in first allowing, and later defending, the drug war. Based on the its current dominance by five devout Catholic Men (another little noted phenomenon), the drug exception now seems as judicially safe as the right of the rich to buy elections...and as endangered as a women’s right to choose.
NIDA Sponsored Research, an example of political science at work
The five year ad-hoc study this blog has been based on for the past two years now includes over four thousand individual subjects, some of whom have been seen as many as four times pursuant to a “renewal” requirement that never appeared in Proposition 215, California’s medical marijuana initiative. The story of how a non-existent requirement was ultimately grandfathered into the present chaotic implementation of an initiative now more than ten years year old is simply too confusing to relate here and will have to be told another time.
Nearly as confusing is the fact that my preliminary explanation for this blog was written in July 2005, but posted in an entry dated April 20; until one remembers the significance of the date
If anything, I’m still as convinced the seemingly radical things I wrote on July 4, 2005, are accurate, although I now hope I'd would state them a bit more clearly. A more complete evaluation of further data gathered over the ensuing two years has, if anything, increased my confidence in the accuracy of the glimpse it provides at the huge cannabis market that’s been developing steadily, but apparently beyond the notice of both NIDA and the scientists it’s been funding to maintain doctrinal purity in the drug war’s party line.
Recently, I had the good fortune of coming across an item which, when compared with my informal study, serves to illustrate the difference between real clinical research and politically correct NIDA sponsored science. For the skeptical, those with a serious interest, or those wishing to check on the accuracy of my description, the full text of the item which appeared in Pediatrics can be downloaded free, a relative rarity among peer-reviewed medical journals.
This multi-authored (8) “preliminary prospective” study from three separate institutions was designed to compare “substance-use initiation in healthy adolescents and in adolescents who have been diagnosed with attention-deficit/hyperactivity disorder.” Its stated purpose was to assess the reliability of several common behavioral characteristics as predictors of substance initiation.
It reports on 78 carefully selected substance-naive subjects, aged 12 to 14 when the study began, who were paid for their participation and then followed for four years at four month intervals to determine what substances, if any, they had tried (initiated).
Fifty had already received a diagnosis of ADD, with or without hyperactivity and the twenty eight controls were assumed to be “healthy,” based on the absence of that diagnosis and negative evaluations when the study began.
Results confirmed an oft-noted phenomenon: alcohol tobacco and marijuana are the three nominally forbidden psychotropic agents tried most often by American adolescents; also, they are tried at relatively early ages. At the end of the four year observation period 41 (53%) had tried at least one, 29 (46%) had tried at least two, and 17(22%) had tried all three.
This was an expensive, complicated and time-consuming study, which, because it was forced to begin from within the matrix of assumptions that have long sustained the drug war, is almost meaningless. That doesn’t mean that its methods were not rigorously followed or that its results, as far as they go, were not accurately reported; only that its findings are so limited by the questions it was designed to answer as to make them a very poor return on what must have been a considerable investment of taxpayer dollars.
For example, the DSM is assumed to represent an accurate catalogue of conditions for which an increasing number of adolescents are being treated with an increasing number of the potent psychotropic agents now receiving “Black Box” FDA labels. In reality those diagnoses are mere opinions based on interpretation of symptoms that are not at all specific and would be reported quite differently by different observers.
The study’s unexpected conclusion: that the likelihood of substance initiation is more related to symptoms than to prior psychiatric diagnosis isn‘t at all helpful because it may be that neither is a good predictor of the likelihood a substance-naive teen will try a given drug by a given age.
My study, which surveyed the admitted initiation of alcohol. tobacco, marijuana, and several other drugs by a population of admitted chronic users of cannabis does confirm the association of the three “entry level” agents. It is far more longitudinal in that it has gathered a plethora of related data from a large adult population, aged 18 to 91. Grouping by year of birth essentially establishes a time-line for the development of the modern illegal marijuana market along with key generational and racial influences. It also establishes the probability of several other influences on adolescent initiation and subsequent usage which the present study does not even acknowledge, let alone address. Taken together, my findings suggest, but do not prove, that adults born since 1946 who became chronic cannabis users have exhibited patterns of drug initiation and use that suggest the presence of behavioral tendencies commonly, but not inevitably, associated with a plethora of DSM diagnoses and prior prescription of a plethora of modern psychotropic agents.
Further unbiased studies of drug using populations which have been granted amnesty from criminal prosecution for their prior dug use is certainly called for, but is quite unlikely in the present political climate. In short, a comparison of the two studies offers a peek at how NIDA control of both the design and funding of Behavioral Research has been co-opting Medicine and its allied Behavioral Sciences for nearly four decades.
How many more lives wil be ruined by a misguided and punitive policy based almost entirely on false assumptions?
June 27, 2007
Rehnquist Remembered; an exercise in revision
When I first started blogging, I was quite unfamiliar with the technique and also intrigued by its implicit potential for correcting errors at some future time. Although now reasonably satisfied that current efforts are both acceptably typo-free and reflect my thoughts with reasonable accuracy, I still cringe at some early efforts. One in particular, was so ineptly written and riddled with typos that yesterday I decided to try my first revision; however, after tackling details, I realized that a simple deletion and replacement would be intellectually dishonest, and thus decided to leave the original as is and post the revision as a current item. That decision became even easier when I saw the news of this week’s Bong Hits for Jesus ruling, one I also plan to discuss.
First the Revision:
While Jack Shafer's revelation in Slate (September 20 2005) of the late Chief Justice’s
lengthy abuse of a prescribed “sleep aid” caught me by surprise, his observation that it had not been fully addressed by his colleagues in the media did not. In fact, I predicted that Shafer's detailed parsing of Rehnquist's Placydil habit would probably provoke as little interest from his colleagues as they’d shown for similar weaknesses in other prominent conservatives: Nixon's boozing, Bennett's serial obsessions with nicotine, food, and high stakes gambling, and the prodigious appetite Limbaugh had developed for a prescription opioid.
What such media disinterest (still) demonstrates to me is the staggering amount of hypocrisy and/or self-deception required to shore up the credibility of a destructive drug policy which has done nothing but fail. Although Shafer himself clearly wouldn’t agree, I see the continued endorsement of that policy by both major political parties as a national disgrace.
Nor have its well-documented failures ever provoked honest interest from the lofty institutions allegedly devoted to policy analysis. Although its deceptive nature was implicit in its 1914 debut as an improbable tax law, the 1914 Harrison Act was endorsed by a medically ignorant Supreme Court and thus thoughtlessly converted into criminal prohibition in the process. It should certainly have been re-examined following Repeal of The Eighteenth Amendment in 1933; yet it continued to be accepted without question until another Supreme Court decision in 1969 threatened its even more artless 1937 clone, the Marijuana Tax Act.
The first Nixon Administration then used that threat to the constitutional basis of the MTA to assert an entirely new and far more sweeping prohibition mandate when it pushed through the Controlled Substances Act of 1970. Just as with Harrison, the spurious rationale for the CSA continued to be fear of “addiction,” a condition which has, nonetheless, remained bereft of unbiased clinical study since 1914.
However, the CSA went much further than Harrison: it provided the Attorney General, an authority unlikely to ever have medical, or even scientific training, sole authority for assigning suspected addictive agents to Schedule One, which is tantamount to making them absolutely illegal for anyone but sworn law enforcement officers to handle or possess. Although an administrative law process was created for internal review of scheduling decisions, the prompt rejection of Judge Francis young’s 1988 decision, together with DEA’s protracted delays of renewed efforts to reschedule marijuana, serve as convincing evidence that, absent public or Congressional outrage, the rescheduling of any agent the DEA doesn’t want rescheduled will be impossible.
The ease with which the makers of Marinol were able get their product rescheduled from schedule two in 2000, apparently just to facilitate its sales, simply stands as further evidence of how dishonestly any law can be administered by a hostile bureaucracy.
The truth no one seems willing to admit is that our drug policy has become a federal lobbying effort on behalf of thriving criminal markets which, in addition to enormous profits, also generate a host of collateral benefits that a wide variety of society’s most important institutions have become very used to over the years; one might even say they are addicted.
As we know only too well, whether one thinks of addiction as a disease or a behavior, the first step in overcoming it is getting past the denial that it even exists...
June 25, 2007
Darwin’s Intuition (Logical/Historical)
What were the factors, which in 1831, allowed a curious young man to recognize a logic of sorts behind the obvious complexity of the multiple exotic life forms he’d been privileged to observe during a short visit to a remote cluster of islands?
That list is both long and arbitrary. It starts with the fact that Charles Darwin had been lucky enough to be born into a well-to-do English family with an interest in scholarship. Also that he had a fair-minded father who allowed him to accept the position of naturalist on the Beagle despite his own misgivings. At least part of those misgivings had been provoked by Darwin’s extended education, which included dropping out of Medical School in 1827, and investigating a number of other scientific disciplines before seeking the position of naturalist on the Beagle. We do know, however, that once Darwin finally settled on his career choice, he pursued it with singular dedication and intellectual honesty for the rest of his life.
Another factor that shouldn’t be taken for granted is luck; mere survival of a five year ocean voyage during the first third of the Nineteenth Century was not something to be taken for granted; witness the misfortune of Wallace, Darwin’s slightly younger (and far less famous) contemporary who lost his entire first collection of specimens on the return voyage from South America and was lucky to survive at all.
Finally, there’s the role played by the Galapagos Islands themselves: from our modern vantage point, with its better understanding of the complex geological dynamics responsible for such unusual Island formations as Iceland, Hawaii, New Zealand and Madagascar, we can understand that the Galapagos probably offered Darwin the best opportunity of all for the critical insight he brought home with him and then nurtured carefully for 28 years until it was finally published as a coherent hypothesis in November 1859.
However, despite its anticipation of several biological disciplnes that were literally undreamed of in Darwin’s time, and its almost seamless subsequent integration with our knowledge of what we now call the cosmos, there is still intense oposition to Darwin’s theory from those with a “creationist” view of reality. Even as the October 2009 bicentennial of Darwin’s birth approaches, well educated people with advanced degrees can still find ample support for sneering denunciations of his work which, if one bothers to read them at all, inevitably betray an ignorance of both Science and Logic.
The point being, of course, that neither Science nor Logic will ever convince those with a firm conviction arrived at through anti-scientific religious thinking. Such is the nature of (blind) “faith.”
That we all seem to be capable, at some level, of similar faith based conclusions does not inspire confidence in the future of our species; nor does the fact that there may have never been a greater dearth of competent world leadership at a more critical time in its human history.
June 24, 2007
Delusional Thinking in the Land of ED (Personal/Political)
I began screening pot smokers seeking medical recommendations in late 2001 after being recruited by a man who'd been running a "buyers' club" in Oakland for less than a year; I've already explained that although I'd been an activist in the drug policy reform movement for about six years, I was still a relative stranger to what might be called "pot culture." Little did I realize how that naivete would become both a blessing and a curse.
The blessing was that it allowed me to recognize certain key features in the applicant population that other pot docs had been taking for granted; the curse was that my enthusiastic early reports were seen by many in the movement as evidence I was either greedy or gullible and, in either case, couldn't be trusted. The blessing was that I was then left strictly alone to develop a study which, had it been endorsed by others, might easily have been knocked off track.
This way, it's all mine.
Those same considerations have also allowed me to realize that I couldn't have changed that outcome for the simple reason that I had first to learn two things that couldn't have been known in advance: 1) all applicants were already chronic users; 2) one's birth year is a critical element in determining whether one will ever become a pot smoker at all. That's because trying pot early; either during adolescence or by one's early Twenties, seems an almost essential requirement for later chronic use, and large scale youthful initiation of pot didn't begin until the baby boomers born right after World War Two began coming of age in the late Sixties. Additionally; each subsequent cohort of pot smokers born after the first has had distinctly different experiences with alcohol, tobacco, and other drugs. In other words, there has been an important, but relatively unnoticed, evolution within the aging (and now huge) illegal pot market that has grown steadily since the first Nixon Administration suddenly expanded drug prohibition from a quietly failing federal policy into a drug war.
The confusion referred to in the title refers to our beliefs about what is meant by "recreational" and "medical" drug use, as well as our acceptance of the notion that designating certain immigrants and drug imports as "illegal" will "control" them. Just as delusional may be our beliefs that we have time to deal with global warming in a context where NASCAR is still a growth sport, that (eventual) cuts in petroleum consumption will be enough to prevent inundation of our coastal cities, and all "nano" phenomena are potentially helpful.
June 23, 2007
More of California’s Confusion (Political)
Yesterday’s entry offered a partial explanation for two wildly disparate numbers: public support for medical use of cannabis, now estimated at between 60 and 70 % in many states, and last year’s miserable failure of a bipartisan effort to garner even tepid Congressional approval of the same concept (38.6%).
That public support is still growing has recently been evidenced by introduction of new bills in states lacking an initiative mechanism. That it’s still narrowly focused on the “seriously ill” is evident from the Connecticut governor's veto of a successful bill.
At the risk of adding a bit more complexity to an issue that already seems a bit too confusing for many of the Californians actively participating in Proposition 215’s evolution (but seemingly unaware that an evolution is taking place), I’m adding a reference to a commendably accurate report on the recent increase in pot docs, dispensaries, and patients by Ethan Stewart in the Santa Barbara Independent.
Medical marijuana is only one of several topics Stewart has researched, but he’s done such a good job in the May 3 piece, I hope he’ll revisit it often.
June 22, 2007
A Different Take on Federal Woes (Political)
Now that it's Summer, it must be time for another another test of medical marijuana's Congressional popularity, a.k.a. the Hinchey- Rohrabacher amendment, a biparisan resolution calling for the de-emphasis of medical marijuana prosecutions in those states which have passed medical marijuana laws. It's an exercise in futility that's been going on for a few years; by my count, which may not be entirely accurate, this will be the sixth time the measure will come to a vote. Again, I may be a bit off on my numbers, but last year's defeat was a high water mark of sorts because H-R atrracted 163 out of 422 possible votes (38.6%), in losing by its smallest margin ever.
Thoughtful readers may wonder why the idea that pot has important medical benefits, one for which popular support has been growing for years and now stands at 60-70%, should be lagging so miserably with politicos who have to face re-election every two years and for whom, at least the appearance of fairness and compassion may trail only campaign contributions in importance. The answer is really quite simple: anonymity. Popular support for medical marijuana is inevitably tested in public opinion polls, whereas important votes in Congress are recorded; meaning that one must be able to deal with a "soft on drugs" charge from one's next political opponent . Obviously, the relevant political calculus assumes that the public's antipathy for "druggies"and attendant fear that their own kids will become "addicts," still trumps sympathy for those who are obviously sick and/or dying. The recent veto of Connecticut's highly restrictive medical pot bill by its female governor, herself a breast cancer survivor, is as good an example of that calculus as one could ask.
In its own way, the persistent and well-intentioned efforts of H-R's sponsors to goad their fellow Congressman into being more accepting of medical use may have helped create another political trap similar to the one reform fell into when it pushed Raich on the Supreme Court in the mistaken belief that the distaste certain Justice's had expressed for the New Deal in a Texas gun case would combine with logic and fairness to trump the hostility the court Court had expressed toward "the scourge of drugs" in another (unfair) ruling in another now-forgotten case.
Details of the trap, a shrewd ploy by a red-neck Oklahoma senator named Tom Coburn (who also happens to be a pro-life gynecologist) are explained in a an Iowa NORML post.
The real explanation for the dichotomy may be something that's very difficut to prove but is suggested by the wide swings in numbers of both pot applicants and pot docs in California: the growing national sympathy for medical marijuana reflects facts documented by MTF surveys: a large fraction of American adolecents began trying pot in the mid Sixties and have continued to try it ever since. An unknown fraction of them became chronic users for periods of years; whether one classifies them as "recreational" or "medical," two undeniable facts remain. One is that the market they represent is continuing to grow; the other is that, while the social legal, and employment pressures that keep them "in the closet" about their pot use have also been growing, they are still free to express anonymous support for pot at the ballot box and in surveys.
Isn't it time to educate the older ones about why they may have found the benefits of pot attractive enough to continue using for a years as adults; whether or not those old enough have continued using it into their forties and fifties?
June 21, 2007
Another Failure of Incremental Truth (political)
As should now be clear to anyone with a bent for logical analysis and a modicum of accurate information, the drug war has been an expensive and destructive policy failure which, neveretheless, remains backed to the hilt by all three branches of our federal government nearly forty years after it was inflicted on us by the first Nixon Administration.
Are those thousands of federal bureaucrats now lobbying on behalf of the drug war as part of their job all dishonest? That’s manifestly impossible to say with complete assurance for the obvious reason that human motivation simply can’t be determined with certainty; witness the trouble and expense our legal system goes through on a daily basis and how (completely) unsatisfactory the result (or just what aspects of “possession with intent to sell,” “plea bargain,” “correctional institution,” or “Guantanamo” do you not understand?).
The latest demonstration of an obvious point: that nearly every aspect of the medical marijuana “debate” is now hopelessly mired in politics and religion, is provided by the fate of Connecticut’s medical marijuana bill, which after being carefully shepherded through the legislature, was vetoed by the state’s conservative Republican governor for silly, but predictable reasons.
Also bear in mind that the bill itself was a typically restrictive effort of the type required to earn a stamp of approval from the medical experts at MPP.
June 20, 2007
A Pleasant Surprise
A little over 6 months ago I posted a reference to Keith Olbermann's MSNBC interview of Doctor Claudia Jensen, a Southern California pediatrician who had also been educated by patients who'd been using cannabis to treat their ADD at about the same time I had; in fact we'd discussed ADD a lot after making the same discovery more or less independently while she was working briefly at the same (now defunct) cannabis club in Oakland that gave me my start. It was thus a pleasant surprise to discover a film clip of Claudia's interview on You Tube, which had apparently been posted about nine months ago.
Although the interview was occasioned by the failed attempt of Rep. Mark Souder of Indiana to embarrass Claudia by hauling her before his Congressional Sub-Commmittee it has been turned into a significant victory for medical use, truly a gift tthat keeps on giving...and certainly worth a look.
June 19, 2007
Guerrilla Warfare, Bureaucratic Style
Guerrilla warfare is usually thought of as involving rebel attacks on an established government; in the case of medical marijuana, it's just the opposite. The "law,"otherwise known as California's Proposition 215, has been reviewed twice by the Supreme Court, which, however reluctantly, left it intact. Nevertheless, government forces at all levels, in both their official capacities and through their private professional organizations, have continued to oppose it even as public pressure, in the form of new medical marijuana legislation in New York and Connecticuit, has been increasing.
It began in 1996, before Proposition 215 could go into effect, with Drug Czar McCaffrey's disgraceful December 30 press conference. Although approved by a comfortable majority of California voters, implementation within the state has been opposed from the very beginning, and in nearly every way possible, by the same individuals and organizations that campaigned unsuccessfully against it. Federal olpposition has, if anything, only intensified under McCaffrey's less charismatic successor.
It also hasn't helped that press coverage of medical marijuana news within the state has, with rare exceptions, been myopically local and unimaginative. Whether a result of editorial policy or because such coverage is routinely assigned to the least experienced reporters is a matter of conjecture, but the fact remains that most of the repetitive news items generated by the latest local ban on "dispensaries," or the "moratoria" enacted by local governments (usually as delaying actions before later enacting a ban) read like they were written by the same person.
A brave exception has been Pat McCartney, former editor of the Auburn Journal turned investigative reporter. Pat's journalistic interest was piqued early by the 1999 arrest and mistreatment of Steve Kubby in his local jail. Convinced early on that feds and locals had been colluding to frustrate implementation of Proposition 215, McCartney has unearhed compelling evidence to that effect. As a result of trying to interest others in the story, he has been encountering the same denial I've experienced, and for similar reasons: no one with something to lose wants to take on the feds.
June 04, 2007
It’s literally impossible to overstate Tod Mikuriya’s importance to the disorderly and largely ineffective movement working to legitimize the medical use of cannabis in California (and thus the nation). The largely unwitting ‘movement’ is deeply indebted to him for both the key any other illness phrase, which was all that allowed California's Proposition 215 to became the only such measure of any clinical relevance; it was also Tod’s dogged certification of the thousands of pot smokers in Northern California who applied for recognition as ‘patients’ and the (disputed) right to possess cannabis during initiative’s first five years.
The reason is simple: all Proposition 215 could allow was, at best, a disputed gray market; one that would have been quickly harassed out of existence by a statewide unconvened conspiracy of local police, sheriffs, and district attorneys. Instead, a small distribution network of ‘buyers clubs’ was enabled by the work of Tod and the few other ‘pot docs’ willing to write the ‘recommendations’ required by any clubs' potential customers. Tod was not only the pot docs' leader and inspiration, he was the only one willing to travel around the state holding clinics and writing the thousands of recommendations that would fan the hostility of law enforcement and finally coerce the Medical Board into disgracefully abusing their authority to punish him.
If the importance of one’s life is measured by the number and publishers of obituary notices provoked by one’s death, Tod was quite successful; if as is usually the case, reality differs, I would suggest that Fred Gardner's columns in Counterpunch are the best way to grasp what Tod did: his description of the ordeal Tod endured at the hands of the state’s faceless medical bureaucracy is a good start; then read Fred's obituary, ‘Doctor of Last Resort.’
June 02, 2007
Parsing the Rosenthal Verdict (political/logical)
There are several ways to understand that marijuana prohibition is an ongoing fraud; one is by comparing the absurdity of the government’s most recent effort to harass a reform icon with the quiet efficiency with which it has been able to blight the lives of other medical pot growers who didn’t enjoy similarly favored status and were thus tried without as much public scrutiny.
The details of the second Rosenthal trial are even more farcical than the first, but still amount to a federal victory which, although ugly, represents a ‘W’ in their eyes because it produced a conviction. Ditto the sentence imposed by a federal judge in Fresno on a man of similar age charged with growing a similar number of plants in the even more unjust context of the double jeopardy enabled by Raich.
Ed Rosenthal’s second conviction by a Bay Area federal jury not only dashes hopes raised by the first trial; it also summarizes reform’s continuing failure to learn from the ten year opportunity provided by Proposition 215. The biggest reason for that failure has been its leaders’ stubborn adherence to a cherished ten-year-old belief that an informed public would, like Wm. F. Buckley Jr., reject drug prohibition once they became aware of its failures. However, a 2001 Pew Research poll disclosed that the public was already aware of those failures and inclined to accept them. This week’s continuing meek acceptance of the glaring discrepancy between the Costa and Rosenthal verdicts is just further confirmation of the most reasonable interpretation of that six-year-old report.