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August 29, 2007

Three Hot Items (Legal, Medical, Political)

The long-overdue resignation of Alberto Gonzales, in conjunction with the framing of a particularly  appropriate question by Maia Szalavitz in today’s Washington Post offers yet another an opportunity to point out just how groundless  and  destructive America’s policy of making “war” on drugs has become without anyone ever seeming to notice. To begin with the role of Attorney General, that post is always filled by a lawyer; yet, as a direct result of two critical misinterpretations of the 1914 Harrison Act by the Holmes Court in 1917 and 1919, the nation's AG has become the official solely responsible for treatment of “addiction,” a condition that has never been considered a disease by Pathologists, the medical specialists most concerned with the detailed study of disease.

It should also be pointed out that although Harrison and the similarly disingenuous Marijuana Tax Act of 1937 were combined into a sweeping  omnibus prohibition law by Nixon’s Justice Department under John Mitchell in 1970, the need for a revision had been triggered by a Constitutional challenge to the MTA from the Leary Case; thus neither law has ever received any scientific validation, even by 1914 standards; let alone  those of 1969. Beyond that, anyone familiar with the roles NIDA, the DEA,  and ONDCP play as in-house drug war lobbyists must also realize that those agencies have never been neutral.

As Maia Szalavitz points out, a “disease model” of addiction isn't required to explain its usual course as an undesirable behavior. Many who have become addicted to various substances  become abstinent on their own; often without any treatment at all. Beyond that, the “disease" label may encourage defeatist thinking and even facilitate relapse in some. In addition, what I've learned from cannabis users is that pot, although not a cure-all, clearly plays a positive role in helping addicts overcome substance dependency, probably because it also treats the same symptoms that led them to experiment with multiple drugs to begin with. The use of pot as a adjunct to treating various addicitions is clearly beyond the scope of current orthodox discussions of addiction, but I predict it will eventually become a standard, especially in the case of alcohol.

My mood was then heightened even more when I clicked on this link in an e-mail and was delivered to a blog suggesting that California’s pot smokers may finally have a way to compel presidential candidates to take an unequivocal public position on their favorite issue.  I would predict that candidates with unfavorable stances on cannabis would struggle in Califronia; in any event, an early primary would be a way for them to receive that message

Could it be that internet is finally ready live up to some of the extravagant promises made on its behalf in the Nineties?

Doctor Tom   

Posted by tjeffo at 08:47 AM | Comments (0)

August 27, 2007

Urban PTSD (Medical, Political)

A feature article on the front page of today’s SF Chronicle describes how PTSD is affecting poor children exposed to violence in the city’s tougher neighborhoods; in that sense, it confirmed what I already knew must be happening in Iraq, where half the population is estimated to be under the age of 16 and where the endemic violence is even worse than in the toughest neighborhoods of the city once extolled as “Baghdad by the Bay.”

Although my interviews of adult pot smokers have confirmed that PTSD can be very effectively self-medicated with cannabis, that notion was obviously  still too politically incorrect any for mention in an otherwise tough report on the  poor job the Veteran’s Administration has been doing with PTSD among Iraq veterans that was written back in December. Although today’s SF Chronicle article deals primarily with adolescents and not soldiers, it was no surprise that it too, didn’t mention either cannabis or “marijuana.” Of some comfort is that the kids described will soon have an opportunity to help themselves by self-medicating illegally.

Of course, they may then be further traumatized by the same law enforcement agencies that haven't been able to provide them with a safe environment to grow up in.

From my interviews I can also confirm the impact of low self-esteem on school performance and the fact that PTSD and ADD can be very difficult to tell apart; in fact, my take is that the DSM is very misleading because it encourages physicians to think of entities that are really emotional syndromes as “diseases.” We simply do not understand either behavior or brain function as well as our drug policy assumes we do and the quasi-religious doctrinal requirements of that policy are currently doing far more harm than good.

Doctor Tom

Posted by tjeffo at 02:24 AM | Comments (0)

August 25, 2007

Is the Worm (Finally) Turning? (Political)

Although a latecomer to the cause of drug policy reform, I have now been reading news and opinion articles focused on the drug war  since 1995; no matter how many readers  Drug Sense Weekly  eventually reached, the four years I spent as its editor were a valuable education for me in the nuances of media attitude toward the drug war;  and probably explains why I found yesterday’s issue of The Sacramento News and Review so exciting.

Free newspapers, like the N & R  are found in most cities; as vehicles for local ads, they have less reason to cater to big corporations and many, like the Village Voice, feel free to take more consistently “liberal” stance on cultural issues, similar to those taken by liberal periodicals like The Texas Observer in trying to exert political influence a prime example of which was when the Observer’s account of gross injustice in Tulia eventually sparked enough outrage to bring about at least partial redress (although it may not have changed local attitudes).

In any event, it appears that the undisguised arrogance and  injustice with which federal and local authorities have been colluding in their persecution of medical  marijuana patients ia finally prompting  outspoken recognition in the press. Like Misha Glenny’s WP item of last week, placement may be important here as well, because Sacramento, like DC is a second home-town for California’s legislators and and higher level bureaucrats.

The straw which may have broken the camel’s back of denial, at least in terms of  medical pot in Sacramento, was last week’s one-sided prosecution of Dr. Mollie Fry. Accounts  of her trial in the conservative Sacramento Bee, when compared to those that appeared later in the News and Review should leave little doubt in the eyes of most that her treatment in federal court was both unjust and reprehensible. The larger question, with implications going far beyond pot, is how much capacity do we Americans have for recognizing and supporting such political truth?

The nation faces very similar challenges with respect to  global warming, the war on “terror,” and its support of so many of the world’s most brutal autocrats since the end of World War Two.

Doctor Tom

Posted by tjeffo at 07:06 PM | Comments (0)

August 24, 2007

A Long Rhetorical Question (Political)

In general, policies are formal statements of belief by which organizations justify rules they have passed to control the behavior of their membership. Obviously, the nature and scope of policies will vary with the size, scope, and purpose of the organization; to begin with a simple example, the owners of a restaurant may choose to have dress codes for staff,  patrons, or both and codes may also be different for lunch and dinner. Those who don’t want to conform are free to work in, or patronize, other restaurants.

 Policy problems intensify when the organization is the only game in town, as with a government. Even then, there may be enough wiggle room between the policies of village, county, and state governments, to provide an acceptable range of choice for all who want to live in a given area.

Other variables have to do with how rigorously those enforcing a policy— in large organizations, usually different from those who created it— choose to do so: does the maitre’d politely present the tieless guest with a selection to choose from, or does a bouncer shove a non-compliant customer out the side door? There may also be different standards observed in the handling of different policy violations: hookers may be allowed to solicit customers along certain streets, but barred from the lobbies of expensive hotels;  certain drugs may  be legally prescribed by licensed physicians; but mere possession of others will be cause for arrest and could result in charges  ranging from misdemeanor to felony. Finally; compliance with certain policies often varies with the targeted population.

Given such a wide range of possibilities, is it any wonder that modern America, beset by a growing population of citizens and potential citizens in a shrinking and contentious world would have trouble enforcing an irrational drug policy which is at odds with both common sense and modern pharmacology?

The short answer to that rhetorical question is a resounding no. However the long answer must be qualified by noting that, in general, the more a policy is framed in terms that don't address applicable reality, the more difficult will be its enforcement, and the less willing the organization to admit or correct the failures. America’s current major wars against terror and drugs are good examples.

A war on “terror” didn’t make much sense when it was announced because terror is a tactic classically employed by weak rebels against powerful adversaries. The invasion of Iraq represented a tactical error; by devoting critical military and economic assets to a battle we didn’t have to fight, we allowed the criminal organization responsible for the 9/11 attacks to regroup in Afghanistan, while enhancing its legitimacy in the eyes of many Muslims (roughly 40 % of the world’s population). The main factors limiting the impact of the cluster of policy errors committed in response to 9/11 are that Bush must leave office in early 2009 and the defeats we are sustaining in Iraq are increasingly difficult to conceal; even with the tacit cooperation of many media outlets.
A War on Terror really invites comparison with the Drug War and the Cold War (all capitalized for emphasis). In that context, Viet Nam and Iraq can be seen as unnecessary military campaigns which did great damage to innocent people while squandering American lives and economic resources. The Drug War is comparable because although it didn’t become global until the Sixties, it was a domestic fraud from its inception in 1906 and its only success has been the ability of its federal lobbyists to conceal their unbroken record of failure from the American polity.

The good news, to the extent that concept can ever be applied to American drug policy, is that its exposure as a war on marijuana allows hope that the public may yet understand that they have been tacitly supporting a costly fraud for nearly a century. A current flood of developments is sending mixed signals about those hopes, which have to be compared to the ones dashed earlier in 1972 when Nixon buried the Shafer Commission’s report, again in 1977 when NORML leaders foolishly attacked Jimmy Carter’s drug advisor, and more recently in 1992 when an unprepared Bill Clinton denied ever inhaling.

As time permits, I will try to explain those references in more detail and also finish the story of how the hippies were finally introduced to reefer.

I’ve got a lot on my plate...

Doctor Tom

Posted by tjeffo at 06:23 PM | Comments (0)

August 23, 2007

A Major Defeat and A Ray of Hope (Legal, Political)

The conviction, in Sacramento last week, of Doctor Mollie Fry and her husband, Dale Shafer,  was not only the latest legal body blow sustained by an increasingly embattled medical marijuana movement in California, it could mark the start of a whole new phase of the federal campaign to cripple distribution.

On the other hand, a last minute ray of hope flashed briefly from New England last night when Candidate Obama made it unanimous that all Democratic contenders are (finally) now on record as opposing the DEA raids in medical marijuana states. Whether that’s another case of too little, too late, or signals a meaningful shift remains to be seen, but those of us who’ve been paying attention for a while have learned not to get our hopes up; especially over Democratic signals.

Aside from their inability to add to Ed Rosenthal’s jail time despite a second conviction, the feds have a perfect record: all the California medical marijuana cases they’ve chosen to try have now been convicted by juries in Fresno (Dustin Costa), San Francisco (Rosenthal twice), and Sacramento (Dr. Fry and Dale Shaffer). Those victories can be expected to start paying off rather quickly by persuading other federal defendants to accept (typically harsh) federal plea “bargains.”

In other words, through a wily ,and perhaps illegal, campaign of using federal law to punish activity designated as legal by a valid (and never-challenged) state initiative, they may have finally managed, after years of trying, to cripple California's pot distribution network while leaving the initiative that had given rise to it intact and keeping the initiative’s supporters either mute or mouthing the same old stale “drug war is a faiure” rhetoric that has been their staple since 1997.

All in all, not a pretty picture, but with some hope remaining. However, given the intransigent federal bureaucracy and judiciary any newly elected president would have to grapple with in ‘09, it will take a major effort to free any then serving federal prison terms.

Doctor Tom

Posted by tjeffo at 03:05 AM | Comments (0)

August 22, 2007

Reason for Hope? (Political)

Briton Misha Glenny’s accurate analysis of the increasingly dire consequences of America’s drug war for both itself and the entire world contained nothing that would have been new to anyone familiar with drug policy history. What made it both interesting and potentially important were its (almost) unequivocal conclusions that prohibition is “stupid” and the American Goverment is the major remaining obstacle to a more rational global drug policy, one preferably not based on prohibition.

What makes it an occasion for hope is that it was featured in the Washington Post. The best way to tell if has had any political impact will be to see if any of the “major” presidential contenders are moved to even mention drug policy in their stump speeches, or if serious questions about the drug war get past their political handlers. Given past performances, I’d say they probably won’t; but the hour is late and hope, as always, springs eternal.

Denny’s piece also points out that the surge in global crime really beagn when a war on drugs was initiated by Richard Nixon almost forty years ago and has only increased since. As I've often noted, the reasons why a parallel surge in America's illegal marijuana market, which had been unquestionably tiny when the Sixties began and had quickly grown to a point where pot was available in nearly every high school in America only fifteen fifteen years later, have never been explored by either side of the domestic "debate" over marijuana. The reasons for the federal reticence have not been given; nor would one expect them to be, since that discussion would only emphasize the grotesque failure of their policy.

The reason for reform's studious disinterest in whatever growth took place in the pot market during its "high school" phase is far more obscure. In any event, they may be missing an opportunity to discredit the drug war for unexpected reasons, which they,  like the feds, remain unaware of and disinclined to discuss...

Doctor Tom

Posted by tjeffo at 04:42 AM | Comments (0)

August 20, 2007

From Beats to Pranksters to Hippies... (Historical)

Twice each week, on Tuesdays and Fridays, I see patients seeking pot recommendations. If this week’s group is typical of those I’ve been seeing for the past two years, about 40% will be “renewals” who had seen me anywhere from one to four times in the past and about 60% will be seeing me for the first time. Some of the latter may also have obtained  a recommendation from another doctor sometime in the past.

If anyone had told me when I first began screening pot smokers, that Proposition 215 would be going through the weird changes I’ve lived through over the past five years, I probably wouldn’t have believed them. For one thing, I didn’t realize our drug enforcement bureaucracy is as uninformed and mean-spirited as it has shown itself to be. Nor would I have wanted to believe that the reform movement could become so stubbornly locked  into its own denial.

What reform doesn’t seem to understand is that although the public has bought their emotional arguments about “medical marijuana” to the extent that they don’t want obviously sick and dying heads hustled of to jail, it also has a misplaced sense of fairness that allows it to agree with simplistic law enforcement arguments that healthy looking ABYM in the 18-30 age range are all “cheating.”

California’s police agencies, almost unanimous in their opposition to the initiative, are no longer arguing that all  medical marijuana is a fraud, only that most of those who obtain recommendations are, thus the number of retail outlets allowed business licenses should be drastically restricted. Actually, they would prefer that none receive a license, but are careful not to say so when they appear at one City Council after another to argue for either outright bans on business licenses for dispensaries, or for moratoria on new ones. In the midst of all this, the DEA has also been carrying out its own escalating program of harassment and intimidation against property owners who rent to pot clubs; going so far as to threaten them with forfeiture.

The success of these tactics depends on three sets of circumstances:
1) The traditional reform argument that most pot use is “recreational,” therefore benign, and should be legal. Results in state after state suggest that a critical segment of the public which supports “medical marijuana” doesn’t agree that “recreational” use is so benign and is frightened by its Cheech and Chong image.

2) The public’s default position on the drug war seems to be that although it's a failure, it’s well-intentioned and we have no other choice because of the threat posed by “addiction.” This is actually a profoundly mistaken view which persists because:

3) organizations representing Medicine and its Allied Professions have been taking the easy way out by cooperating administratively with substance prohibition, a supremely foolish public policy that has never succeeded historically in any nation where it has been tried.  Nevertheless, it's also current UN drug policy.

The title refers to the history of the pot market that I keep alluding to because I think understanding the reasons behind the explosive growth in pot use which was so famously a part of the counterculture that developed right here in the Bay Area during the Sixties is key; if for no other reason than it allows a full understanding of how dishonest and unscientific (actually  pseudo-scientific) the drug war really is.

Doctor Tom

Posted by tjeffo at 02:55 AM | Comments (0)

August 16, 2007

Deja Vu all over again...

One could be tempted to ask "what were they smoking?' but in this case it wouldn't have been appropriate because "they" were psychiatrists once again raising concerns that schizophrenia, a much feared mental illness, might be caused by smoking too much pot-  or even just a little pot.

In late July, the respected British Medical publication Lancet published a meta-analysis purporting to show that those who'd, smoked, or were smoking, marijuana were "40% more likely" than those who hadn't to eventually be diagnosed with schizophrenia and, predictably, the world press promptly went bananas. That was upsetting to me because I've been working hard to restore a semblance of objectivity to the subject of cannabis policy and Lancet certainly wasn't cooperating.

In fact, their article and the response of the English-speaking world does not auger well for our future; if our best and brightest can be so gullible, what hope is there for ordinary people?  To begin with, the fears raised were not at all new; the pot-schizophrenia bogey man has been around the block a few times. In fact a "meta-analysis" is really a collective review which aggregates several old studies, a form of advanced medical library research. There's no new data here; only new spin.

Schizophrenia is also a disease of youth, and the most commonly diagnosed psychosis. Except that in the DSM era, we refer to it as "schizo-affective disorder." It's only when we're trying to scare the wits out of anxious parents that we revert to "schizophrenia." In any event, although it's a condition for which there's no pathognomonic (absolutely diagnostic) blood test, x-ray, or microscopic finding, it's still a diagnosis in which most experts can agree, at least more often than is the case with Bipolar Disorder or ADHD, for example.

Pot, as we all know, is commonly smoked by young people, especally over the past 40 years. Before that, it was hardly used at all; either in Britain of in North America. Thus, if there were any truth to the assertion that pot causes schizophrenia, one would expect a comparison of the incidence of new cases of schizophrenia during the pot-free Thirties, Forties or Fifties with its incidence during any of the past four toking decades to show a big recent increase.

But don't look for such a study. For one thing, it would have to call unwelcome attention to the failure of a policy that spends billions each year to keep kids from smoking pot. For another, it would almost certainly  fail to show a dramatic rise in the incidence of schizophrenia since the kids went to pot.

Another reason I think such a study would fail to show much change is that I'n now reasonably sure most repetitive pot use by young people isn't just for kicks; it's prompted by symptoms of anxiety; therefore it makes perfect sense that a population of young heads would include a few more future schizophrenics than one of young straights.

In fact, I think that's probably the phenomenon those earlier studies were looking at...

Doctor Tom

Posted by tjeffo at 05:18 AM | Comments (0)

August 14, 2007

Halberstam's Genius (Political)

The late David Halberstam revolutionized investigative reporting by employing it as a technique for historical analysis. Two of his books, The Best and the Brightest, and The Fifties, illustrate just how he did that; a collateral benefit of the technique is that although neither “marijuana” nor “drugs” appear in the index of either one, each can add to our understanding of how inhaled pot (“reefer”) would emerge as a new product in the Sixties and then take American high schools by storm while adults weren’t looking.

The technique Halberstam pioneered while researching the Best and the Brightest and later employed with great skill, not only in researching and writing The Fifties, but throughout his long career, was quite specific. It started with identifying certain trends that would critically shape the ambient culture and then telling the story of their genesis and early development. Since those trends usually began as ideas, it often meant telling the story of their human origins. In many respects, the real extent of Halberstam’s genius is best appreciated by realizing that technique was only a part of what he did; at least as important was his ability to quickly identify trends with staying power and then separate them from the more numerous false starts that flame out because they are either bad ideas to begin with, or good ideas presented too far ahead of their time.

That further understanding allows us to look at the ideas Halberstam chose to write about with new respect. For example, he began his exploration of fast foods for The Fifties with the McDonald brothers, who had pioneered fast food in one family restuarant, and were later happy to sell what they'd learned to Ray Kroc for further exploitation as franchises, a business model he then pursued with such intensity that it spawned the huge modern industry of imitators now employing armies of MBAs to figure out how best to maximize profits while selling their corporate  employers’ fat-laden snacks to an increasingly obese American polity via a constantly evolving TV industry...and so on.

All of which suggests that Halberstam, who was probably researcing The Fifties during the Eighties, also had a great flair (genius?) for spotting other ideas that have exhibited staying power.

The next entry will attempt to link some of his other choices to my own personal obsession: how is it that modern America can be so smart in some respects and yet remain officially committed to such a dumb, destructive and failing drug policy?

Doctor Tom

Posted by tjeffo at 12:34 AM | Comments (0)

August 12, 2007

Questions Never Asked... (Historical)

In the last entry I proposed using a series of book reports to connect the historical dots between today’s huge pot market and the seldom-mentioned Marijuana Tax Act of 1937. One would assume that when the product a policy is intended to eliminate becomes more valuable than any other harvested crop, the discussion of such an embarrassing development should not be placed off limits.

But one would be wrong. The relevant questions are clearly not being asked by those who should be curious. Not only is the policy still fiercely defended by the drug czar as absolutely necessary; his  insistence that without it, the nation’s drug problems would be far worse does not attract the derision it should from the drug policy “experts” teaching at vaunted institutions offering advanced degrees in Public Policy.

Nor have drug policy academics ever demonstrated  enough residual interest in poor Harry Anslinger to write even one serious biography. He was the bureaucrat for whom the FBN was originally created in 1930 and then ran it until departing abruptly in 1962, He was of pivotal importance in protecting and shaping drug prohibition as policy and also the driving force behind the MTA and the author of the 1961 Single Convention Treaty. Given those circumstances, the absence of a definitive Anslinger biography can only be understood as avoiding embarrassment: his public record is just well enough known that it would be impossible to write about him without casting enormous doubt on the legitimacy of the policy itself; and certainly,  no one wants to do that.

Fortunately, a recent study of the FBN provides us with a fairly detailed look at Anslinger, albeit from an unusual perspective.

The Strength of the Wolf  by Douglas Valentine, doesn’t deliver fully  on its subtitle’s claim to be  “The Secret History of America’s War on Drugs,” however, it is a solidly researched and generally helpful effort. Ironically, it  was clearly Valentine's ignorance of drug policy history that had originally induced him to switch his focus from the CIA to the FBN. It’s also what later keeps him from being taken seriously as a policy analyst. Although upset with the CIA’s arrogance in Viet Nam, Valentine clearly agrees with the missions of our federal police agencies and doesn’t seem to question the wisdom of making certain drugs illegal.

He switched the focus of his book after discovering that anxiety over Anslinger’s departure from the FBN and its obvious need for reorganization had led a sizeable contingent of mid-level agents to leave, often through transfers to other federal agencies, after 1962. Valentine was fortunate enough to gain the trust of a retired high-ranking FBN officer who facilitated interviews with almost fifty of his colleagues. Although generally loyal to Anslinger, and the Bureau, their willingness to share personal recollections, combine with Valentine’s curiosity to produce a more detailed picture of the effect of World War Two on modern drug markets than has previously been possible.

Also,the picture of Anslinger that emerges from his underlings’ recollections is one of an insecure mediocrity who was an effective  bureaucratic infighter and whose primary concern was protecting his Bureau. The emphasis of the FBN was on “making cases” (gaining key convictions) despite its limited budget and manpower, especially during the Depression. After World War Two, when it became clear that the goals of Narcotics enforcement would usually have to play second fiddle to the goals of the CIA, it seems that everyone eventually accepted that need, even as they chafed at having to honor it.

Once one realizes that the primary motivation of our drug prohibition bureaucracy has always been self preservation through lobbying to keep drugs illegal, its behavior should become more understandable. Likewise, once one realizes that the reform movement is beset by the same emotional needs, but is forced to compete for far less money, its behavior also becomes more understandable.

The implications are that because bureaucracies inevitably compete, those with missiions based on politically correct lies have an unfair advantage over those based on more attainable goals...

Doctor Tom


Posted by tjeffo at 08:40 PM | Comments (0)

August 10, 2007

A Simple Question (Historical, Political)

Although the admonition to “keep it simple, stupid,” is a relatively new one, the underlying idea certainly isn’t. In the spirit of seeking enlightment by the shortest possible route, and also because 2007 marks the Seventieth anniversary of the Marijuana Tax Act and the Fortieth anniversary of the Summer of Love, I plan to spend a few entries exploring the connection between those two phenomena.

One way to do that is will be to make use several easily accessible books, some, not written directly about pot, which authoritatively document important historical milestones needed to understand a simple, yet confusing, story: how today's pot market could become so big while so many pretend not to have noticed.

Towards the end of 2006, the news that pot (marijuana) is now America’s most valuable cash crop caused a brief ripple of excitement before being promptly forgotten. As it flashed across the attention span of those who read English, it didn’t seem to surprise anyone enough to provoke what, to me, had become the most obvious question: how had a commodity outlawed by Act of Congress in 1937, allegedly because of its danger to adolescents, become such a huge economic force in a mere seven decades? Another question, made even more obvious by the silence of those with most obvious stake in the issue:  why their denial?

Doctor Tom

Posted by tjeffo at 04:39 PM | Comments (0)

August 08, 2007

A Predictable Development (Historical, Political)

An item in today’s Salon exposes a phenomenon that would have been eminently predictable to anyone able to connect the  required dots: there is now a thriving market providing locally produced heroin to American military personnel in Afghanistan.  

One way to encompass several of those dots at once would be by reading a book by Alfred McCoy in any of its updated editions. Originally focused only on Viet Nam and researched as his PhD thesis at Yale, it became the first Politics of Heroin, originally published in 1974, but only after the intervention of a then-young NYT editor who just happened to be a fellow Yalie.

Apparently stung by his critics, McCoy, who had gone on to an academic career at Wisconsin, devoted an entire sabbatical to updating his research into CIA connections with drug trafficking in both Central America and Afghanistan. That was the 1992 version I read and, to my naive dismay in 1996, could not provoke the NYT, Washington Post, or LA Times into recalling as they were coordinating a scurrilous attack that drove Gary Webb from his job at the San Jose Mercury News and, ultimately, to (a questionable) suicide.

So much for a “free press;” it's almost enough to make one a conspiracy theorist. Come to think of it, the Salon article didn't mention any of those readily available historical links...

Doctor Tom

Posted by tjeffo at 08:09 PM | Comments (0)

August 06, 2007

To Err is Human (Political, Clinical)

Yesterday’s NYT Magazine contains a remarkable item written by an elected politician who now admits he was wrong in favoring the US invasion of Iraq right up until it began. Had it been written by an American politician, it would have been even more remarkable, but Michael Ignatieff is Canadian; yet his mea culpa is especially relevant because most  of it is devoted to a cogent analysis of the consequences of being wrong in general and how the complex process of error correction, which must inevitably follow consequential errors, is made even more complex by the unwillingness/inability of the key actors (often politicians) who made them to admit they were wrong.

In other words, President Bush, the person most responsible for the ill-advised American effort that destabilized a key nation in an important part of the world, still exerts major influence over its eventual outcome. Clearly, since he still refuses (at least publicly) to even consider the possibility that his decision was an error, there’s little hope it will be “corrected” before the next Presidential Election in November 2008.

Another key point Ignatieff makes is the importance of time; the simplistic idea that even minor errors can be corrected in such a way as to return to the status quo that existed before they were made may be appealing, but it’s obviously wrong. While what has happened in Iraq since March 1, 2003 may have actually benefitted some participants and been a disaster for others, it has also impacted every Iraqi and every American and will have consequences that will affect human history for as long as it is studied.

A good example can be found in another article published this past week-end in CounterPunch. Eric Ruder’s account of how the Army is  dealing with the entity known as PTSD is entirely consistent with the behavior displayed by our federal government after both the Viet Nam and Gulf Wars. That PTSD exists is now recognized by most medical authorities; however, both its genesis and optimal treatment are still uncertain, and most physicians could be expected to remain silent on whether it can be safely and effectively treated by cannabis (marijuana).

That's a bit of clinical reality I’ve had confirmed repeatedly by patients seeking my recommendation  to use it in accordance with a Califormia law that is now more than ten years old, but still opposed by the same President Bush who started the fiasco in Iraq and still insists we are “winning.” It's also implicitly denied by the medically untrained "reformers" described by Fred Gardner; also in this week's CounterPunch, who insist they are winning despite the increasing success of the DEA in colluding with local cops to crush a late-blooming pot distribution network in the Southland that neither the feds nor reform either anticipated or understood.

Doctor Tom

Posted by tjeffo at 05:44 PM | Comments (0)

August 04, 2007

Predictable Developments ("Neuroscience")

One of many ways anyone with a brain should be able to recognize that America’s war on drugs (a global policy actively promulgated by the UN) is a colossal failure was highlighted by a front page article in today’s Washington Post. Roig-Franzia’s account of the alarming increase in criminal violence accompanying the prosperity that NAFTA brought to the region is a story as old as the hills; it has also been repeated so often since the days of Al Capone it’s a wonder he and other writers are able to muster the phony outrage required to report it as expected by his editors, let alone that a “prestigious” news source like the Post would find room for it on a front page cluttered with accounts of more recent follies like the Iraq War and the catastrophic failure of an annually inspected,  heavily traveled bridge in heart of an important American city.

What those stories all get back to is the same fatal flaw in human cognition: our manifest inability to be entirely rational in those cognitive areas that impinge on our strongly held existential beliefs. That same flaw seems to have finally given our species a degree of (uncontrollable) influence over our planetary environment that will assure us of survival short of whatever our full potential might have been.

In the final analysis, that may not matter; it may well be as Will Durant once suggested, that life is just “a planetary eczema that soon may be cured.”

Doctor Tom

Posted by tjeffo at 07:35 PM | Comments (0)

August 01, 2007

More Supreme Ignorance

Although I thought I was inured to the amount of spin routinely applied to news in this country, I was dumbfounded by the optimism expressed in the initial reports that our newly appointed Chief Justice had suffered a repeat seizure while vacationing in Maine. Let’s just say that I had never seen the word “benign” thrown around quite so liberally and inappropriately in any description of a potentially serious medical problem at such an early a stage.
Finally, today’s NYT item raised some of the common-sense cautions that any competent physician should have been able to come up with upon hearing that an otherwise healthy fifty-two year old male had sustained his second grand mal seizure in 14 years. Certainly the issue of prophylactic treatment with anticonvulants is important for two reasons: first, the real danger inherent in repeat episodes and second, a fact  the Times article makes reasonably clear: there is no completely benign and effective  prophylactic anticonvulsant regimen which is also well tolerated by even a majority of candidates.

One thing sure to not be reported in any newspaper is that marijuana seems to be an effective and well tolerated anticonvulsant. I was relatively unfamilar with that fact until I began taking histories from pot smokers and encountered several with convincing histories similar to one posted on the web: they were patients in whom standard regimens were either failng to prevent seizures or had produced intolerable side effects, who have been seizure free on pot for extended intervals. Of course, they had discovered that as a result of their chronic illegal use which they had previously considered "recreational."

As for the Chief Justice, who recently authored a sweeping Bong Hits decision that surprised very few, but pleased even fewer, he would presumeably reject such "anecdotal" evidence out of hand and agree with NIDA that any such reports are unworthy of “serious” research (whatever that is).

Doctor Tom

Posted by tjeffo at 09:42 PM | Comments (0)