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June 28, 2007

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.

My analysis:
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.

My criticism:
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?

Doctor Tom

Posted by tjeffo at June 28, 2007 05:07 AM