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September 30, 2007

A Good Place to Start (Political)

For anyone having trouble connecting the dots between the outcome of the Raich case in June 2005 and the current devolution of Proposition 215, a good place to start would be an article in today's Fresno Bee reporting that a gray market cannabis distribution facility whose owner has been trying to comply with the law is finally going to call it quits on Monday because he can't qualify for a business license.

Raich was an important milestone because it critically weakened Proposition 215 by launching a futile attack against the powerful federal bureaucracy that had always been obdurately opposed to any notion that cannabis might have any medical uses. Up until then, Prop 215, although stubbornly resisted, erratically enforced, and capriciously interpreted within California, had been making some progress by creating a burgeoning distribution network that had suddenly begun to arract investment from entrepreneurs who had become aware of pot's gray market popularity. Unfortunately, that popularity had been also misinterpreted by reformers: some, like Reverend Scott Imler saw it as a manifestation of greedy pot club operators taking advantage of "recreational" smokers who should have been noble enough to forego patronizing "legitimate" clubs. Others, like Bill Zimmerman, also read those users as recreational, but preferred to pretend they didn't exist.

Actually, most of the patients I've been talking to saw the law as creating an opportunity to be protected against arrest for using something they knew helped them but had been conditioned to think of as either shameful or fun. Others, more savvy, suspected they were self medicating their emotions, but were understandably loathe to admit that pulicly.

The hard reality is that those who sposored Raich were undone by their own misreading of recent SCOTUS opinions on the Interstate Commerce Clause. They thought those opinions predicted a willingness by the Court to oppose a key element of the war on drugs. How wrong they were! The Court's negative decision on Raich has greatly strengthened the hand of conservative elements within the state who want to roll back the clock.

Does that mean that the 1500 customers in Visalia, the friends they've been sharing their pot with, and all the other pot smokers in the Central Valley are going to give up pot? No; but it does make them far more likely to be illegally searched and arrested by their local police. How this will all play out, almost eleven years after the election that produced  California's pot law, is still in doubt,

Doctor Tom

Posted by tjeffo at 03:36 AM | Comments (0)

September 23, 2007

With "Friends" like this, ... (Personal)

Expanatory note: One of my frustations in blogging has been that my limited time and relative lack of web expertise have kept me from exploiting the benefits of self-publishing what is intended as a highly focused personal diary hoping to influence public opinion on a poorly understood policy issue. My first concern has been accuracy; thus I've been careful with language and think I'm now reasonably successful, except for the odd typo and grammatical boo-boo left over from a hasty revision. In the interests of time and readability, I'm going to try reducing html links to material that's readily available on the web by using italics to identify those items I'm confident should be either accepted as factual by most readers; or will become self-expanatory when googled by those wanting more details.

My last entry claimed that the unjust federal treatment of medical marijuana supporters in California has become the preferred tactic of conservative demagogues intent at defending an unjust policy; also that the leadership of the medical marijuana movement has yet to fully understand the political game they have been trying to play for over ten years. As if to confirm that judgment, a discussion has just erupted on refom's email discussion lists about what it might take to "fix" proposition 215. After the usual flurry of  incompletely thought out positions, this one has settled somewhat unexpectedly, and perhaps even productively, on the "seriously ill" issue I'd been trying to raise with little succes for over three years.

I’ll have considerably more to say about that whole subjct over the next few days (or weeks), but timeliness leads me to call attention to an upcoming report on tomorrow's Sixty Minutes telecast that should focus on what I have come to see as the most extreme and wilfully stupid of all possible interpretations of California’s initiative by anyone not employed by the federal government. Scott Imler's complaint to Morley Safer isn't even logical in terms of 215's wording, yet that hasn't kept the feds, many confused reformers, and a host of others from stubbornly endorsing an assumpion first made by General McCaffrey and often echoed by John Walters: medical training and clinical experience are simply not required to decide how "serious" any given patient's symptoms may be. That's a matter easily and accurately decided by mere observation from across the street by cops, deputy sheriffs, drug czars, cub reporters and similar braying jackasses.

It's the kind of simplistic evaluation of drugs and drug users NIDA has been encouraging, with considerable success, for the past 32 years. Hopefully, some of its political opponents are finally curious enough to begin questioning their own unsupported assumptions.

Doctor Tom

Posted by tjeffo at 06:29 AM | Comments (0)

September 20, 2007

Our Evolving Brains (Historical, Scientific, Religious)

The major area of disagreement between deists and atheists is usually considered to be how everything came to be: was the universe created by the unknowable power of an omnipotent God, or wasn't it? An indication of the frustration  inevitably attending most attempts to answer that question is that a bit more reflection allows it to be asked differently: assuming there is an unknowable and omnipotent creative force; is it humanoid, accessible, and judgmental of human behavior, as most deists insist?

Or is it so remote and unknowable as to be both optional and a matter of relative indifference— the atheist position.

The cognitive reality revealed by that simple change in focus is that the anwsers to complex questions depend largely on how they are framed, a consideration which, in turn, illustrates the human bias that scientific formulations nominally seek to eliminate and religious constructions inevitably embrace, or why that twain has such trouble meetimg.

Recorded history confirms that belief in an outside creative force was nearly universal in the early human societies that left written records;  we now also know from a variety of other sources that the literate human cultures once considered “ancient” were actually quite recent. From still other sources, we know that the emergence of Homo sapiens as a discrete species was also comparatively recent  on the evolutionary time scale. In additikon, our own planet, essential as it was to our evolution, is relaively small compared to others in our solar system,  itself a minor constituent of a relatively small galaxy. Finally, we know that countless other galaxies are being formed from billions of stars like our Sun.

In other words, the revolutionary way of thinking about the universe enabled by modern empirical science— which began to emerge in Europe only about six centuries ago— has revealed it as much larger  and more detailed than could possibly have been imagined by earlier humans ("ancients")  whose otherwise accurate observations had been restricted to their naked eyes. Also; the  fiercely unresolved struggle now known as the War on Terror" isn't between deists and atheists; it's between rival religious beliefs and more akin to the Crusades.

Unnderstanding the role of science in the ambient confusion is helped by considering that it depended on three key inventions over the last six hundred years. First, Gutenberg’s printing press democratized literacy and thus enabled much greater participation in scholarship. Next, Galileo’s telescope, confirmed the speculations of Copernicus and began demonstrating the vastness of space. Finally;  the microscope which, whether credited to the Jansenns or to Van Leeuwenhoek, allowed  discovery of another dimension; one filled with life but, as yet, incompletely understood.

Although our human ancestors had domesticated animals and thought of them as qualitatively different from themselves, we now know  we share a mutual dependency on DNA for replication and are part of the same evolutionary process that produced the other fauna and flora essential to our survival.

One way humans are different from other mammals is that, unlike the physical attributes which enabled other predators to dominate regional food chains in earlier times, we haven’t relied on enhanced strength, speed, teeth, or claws. Our major competitive mechanism has been the cognitive ability of our brains, which required the parallel evolution of several other characteristics: bipedalism, allowing us to be upright and freeing our upper extremities to take advantage of opposable thumbs so useful in the fabrication of tools. Also, the complex modifications of our respiratory tract so important to  language function and necessary for communicating ideas, working in groups, and educatating our progeny.

All of which, is a long prelude to a consideration of two other phenomena which are essential, but usually overflooked, characteristics of human behavior: our need to believe in abstract ideas, and our talent for bureaucracy.

We can also see that the evolutionary process that produced the brain as a organ and enabled its owners to become the dominant predators on the planet,  has occurred in two phases. The first was physical and is still going on; but so slowly  that it’s not likely that either our brain's  physical  tructure or neurochemical function  have changed much in the thousands of years since the last Ice Age.

However, the much more recent process of cultural evolution is now in high gear and accelerating; it began among among the scattered human populations that had survived the last Ice Age and could have had little knowledge of each other. Now,  since the discoveries of Agriculture and Science have resulted in a functionally smaller and more densely populated planet, our individual difficulties in dealing with a new world can also be seen as increasingly important. The notion that the intellectual and emotional environment in which humans interact would remain unaffected by modern developments; or that efforts to treat symptoms generated by those developments could be arbitrarily suppressed and/or punished without severe consequences to the society committed to  such a policy are but two of the  drug war's many absurd assumptions.

That conservative demagogues are now preoccupied with inflicting those absurd beliefs on everyone is perhaps the major lesson to be gleaned from the disgraceful federal treatment of those California medical marijuana users and suppliers who have fallen into their clutches.

 It's a pity their leadership has yet to figure that out...

Doctor Tom

Posted by tjeffo at 10:31 PM | Comments (0)

September 18, 2007

Claudia Jensen MD, RIP (Personal, Political)

 This won't the first time I’ve mentioned Dr. Claudia Jensen, but this morning was the first I learned of her relatively recent diagnosis of breast cancer. Sadly, that news came in an e-mail reporting her death this past Saturday.

 Claudia and I first met at a now-defunct Oakland pot club in April 2002. We had both been recruited to screen patients by Larry K., the club’s very unusual owner who had turned it into the busiest in the Bay Area after less than a year of operation. I now realize that the volume at Larry’s club is what had allowed me to pick up on the patterns in the histories of pot smokers which suggested that many of the younger ones were almost certainly treating ADD. When I discussed it with Claudia, she didn’t disagree, but became very interested; something I would learn soon enough was very unusual for a pot doc. But Claudia was also a university-trained pediatrician who had been specializing in Adolescent Medicine; back then, she'd just taken on her HMO over an ethical issue and been made to suffer. I was yet to become aware of the courage and charisma she would later exhibit in persuading USC to offer a clinical course on the medical use of cannabis.

To this day, I don’t know who inspired the other more as far as ADD and pot are concerned; all I know is that we shared an early enthusiasm. It was therefore very disappointing when she (very quickly) became busy enough in Ventura to give up her week-end trips to Oakland. As I've since reported, she was invited by Mark Souder to testify before his sub committee in April, 2004; almost certainly with the idea of making an issue of her recommendations of pot use by a few adolescents. However, Claudia acquitted herself so well the plan backfired and Fox News downplayed her testimony, while its rival at CNBC gleefully reported it. Those with a desire to read the details of her testimony can download the pdf.

I’ve since learned from another source  that Claudia had been pressured by certain reformers not to testify because they feared she would be embarrassed by Souder over her cannabis recommendations; in particular, I know both the self-appointed medical experts who tried to dissuade her. I've since learned they are typical of reformers who've come to believe they know more about clinical Medicine than physicians who have dealt with patients one-on-one for years.

Hopefully, I'll have time to deal with such misguided beliefs in the near future..in the meantime,  I will miss Claudia and mourn the contributions she wasn't given the time to make.

Doctor Tom

Posted by tjeffo at 01:42 AM | Comments (0)

September 15, 2007

A Perspective on Evolution (Historical, Personal)

On February 12, 1809,  two exceptional men were born. Both would play pivotal roles in modern history and leave important legacies; although in quite unrelated fields. Abraham Lincoln, who was eventually elected Sixteenth American President in 1860, was born into relative poverty on what was then the frontier. Although his second term was ended by an assassin shortly after it began, his leadership during the first had provided the nascent American democracy with a second chance to succeed after its founders’ catastrophic embrace of chattel slavery in 1787.

 Charles Darwin was born on the same day as Linclon, but into a wealthy and well-connected physician’s family in Shropshire, England. His patient and responsible development of one of the most productive insights ever to occur to a human, not published until 1859, would provide the Biological Sciences with the model now being used to reverse engineer the development of life in much the same way equally crucial intuitions by several others had given rise to the modern Physical Sciences roughly two hundred years earlier. Ironically,  the concept Darwin’s name is most famously associated with can now be applied beyond biology to both the entire universe and to all human thought.

As we come nearer in time to their joint bicentennial, perhaps their conincidental births will inspire coincidental assessments of how their lives have affected human history in its relatively short span since then; or perhaps not. Lincoln is now revered for the improbable feat of preserving federal hegemony over a deeply divided nation engaged in what was then the first "modern" war,  a bloody and protracted struggle that has continued to divide it both racially and politically; even as it continued to grow in size and global importance as the country that turned the tide against Germany and its allies in the First World War, "saved" the world from Axis domination in the Second, and then vanquished the Soviet Union in the Cold War that followed.

A sober assessment of that same nation's current activities is nothing less than shocking: on the domestic front, it remains deeply committed to a punitive drug policy that selectively punishes its poorest and most vulnerable citizens in improbable ways that are endorsed and carried out by all three branches of the same federal government Lincoln preserved and in obvious violation of the pious claims made by its founding manifesto.

That drug policy is also being steadfastly ignored by the gaggle of candidates from both political parties now competing expensively for one of the two nominations that will produce the next American President; even as the current holder of that office is stubbornly defending a destructive war that, although now opposed by a large majority, will still be in progress when he leaves office and probably well beyond. An ironic counterpoint is that the same incumbent is a member of the "party of Lincoln," which, since the end of World War Two, has neatly swapped roles with the party that had controlled the deeply prejudiced Solid South from Reconstruction onward. Ironically, the first phase of Reconsruction was undone by a deal which "elected" another Republican who also received a popular minority (in 1876).

To return to Darwin and his legacy: although scientifically validated as a theoretical construct comparable in importance only to Gravity and the Periodic Table, the Theory of Evolution is widely opposed politically, and in many instances, prevented from being studied by a majority of the planet's human subscribers to one of several organized religions. An interesting consequence of that opposition is that there has been far more international progress in exploring space than in any unbiased scientific understanding of human behavior.  We have racked up a series of stunning successes attributable to international cooperation in what was once a "Space Race," while failing abysmally to curb the fratricidal impulses now so manifest in the "War on Terror," which is more properly thought of as a modern reprise of the Crusades.

As a token of how promptly and wilfully any controversial idea is now vilified by political opponents, I feel constrained to add that my preference for that term is based solely on logic and does not connote any approval of Osama bin Laden.

One conclusion that could well be drawn from whatever comparison between Darwin and Lincoln may ensue over the next 18 months is that although Science may have allowed our numbers to explode to unanticipated levels while increasing both human knowledge and the relative wealth of a comparative few, those increases have generally come at the cost of the short, miserable lives a rich minority is inflicting, albeit often thoughtlessly, on the poor majority.

An additional realization, becoming clearer almost by the month, is that Global Warming, still politically opposed by the same forces that oppose Evolution, poses an enormous threat to the tattered economic model that still permits our burgeoning human population to function on a day-to-day basis.

Doctor Tom

Posted by tjeffo at 06:55 PM | Comments (0)

September 11, 2007

Letter from the Gulag

I’ve been struggling (as usual) to keep up and also make good on my commitment to trace the origins of today’s pot market.Just when I wasn’t sure what to do next, Dustin came through with a letter he’s had typed (or maybe typed himself) with the clear intention that I would OCR it and post it to the blog. That text, with edits only for spelling and punctuation, follows. I've added a few comments of my own.

Then, time permitting, I hope have a few comments-- perhaps even the first installment of an explanation of how today’s huge pot market came into being.


Hi Doc,

Interesting tidbits enclosed, each pertaining in its own unique way to the Medical Marijuana Movement:

One has to do with a prison reform group's planned march on Washington. This is an obvious opportunity to reach out and begin to build a coalition, but the Medical Marijuana Movement is not (yet) involved. Why is that?

Editor:  I don't know Dustin's basis for thinking reform isn't interested, but I do know that the people at November.org sometimes feel they are treated like like second class citizens by other reformers.

Next, is an AP report that appeared in a West Texas Newspaper of a Narc who turned against the War on Drugs and now makes a living peddling CDs on how not to get busted for drugs. What is most interesting about this particular story are the comments by NORML executive director Alan St. Pierre. He said the Cops  "take great professional umbrage at this," and went on to basically, say the cops are our friends and we shouldn't upset them. Could've fooled me! If the cops are our friends, why don't they give us a pass like they do when they stop illegal immigronts, instead of that cheesy Bullshit we hear now about how they enforce Federal law?  One wonders what St. Pierre has been smoking, and this is no isolated incident. In the April,2007 issue of LA Magazine, St. Pierre come out swinging again, this time saying that most of the supporters of Prop 215 were Anarchists.

Editor: The activities of Barry Cooper, the ex-cop he's referring to, have been extensively debated on drug policy discussion lists. It's an issue that comes up all the time: "harm reduction" measures can do considerable good. They can also generate profits for  entrepreneurs with a helpful message. I haven't visited Cooper's web site, but I'm sure it's easy to find.

C'mon Alan, that really isn't rain I feel on my leg, is it? Perhaps Benedict Arnold would be a more appropriate name for Alan St. Pierre. Third, I included a copy of three letters to the editor that appeared in the 8/30/07 edition of the Wall Street Journal, all pro legalization and damning to the War on Drugs. What I found interesting about them was that they appeared in the Wall Street Journal, a notoriously Machiavellian bastion of neocon ideology. It's a good thing, a signal of sorts that the War on Drugs is losing favor on the right. When you consider that, along with the recent tete a tete between Ethan Nadelmann and former Newt Gingrich Chief of staff, and notorious fascist prick, Grover Norquist, supposedly seeking ways to end the War on Drugs; and Dale Gierenger's born again gushing about the Legalization buzz in California,  I almost get warm fuzzies. Is there a sea change afoot?

If there is a change in the wind, it is only because of the hard work and courage of the California Medical Marijuana Movement, and the increasing militancy of our more courageous activists. BRAVO!! And shame on  Poobahs like St. Pierre. I don't know what NORML expects to achieve by schmoozing with the cops, whose shiny new pigmobiles and swat team funding depend on Federal grants. making them Uncle Sam’s bitch. Maybe they actually believe the hype that these badge-heavy jerks would have us believe ... disgusting!

Sorry about the typos. All we have to use here are crappy typewriters, and just being able to use them is a privilege. My cataracts have progressed to the point that I'm nearly blind now. It doesn't help when it's time to proof-read.

The good news is the Feds may fix my eyes soon...

More Later...

Dustin's Address is:

Dustin Costa 62406-097       
Federal Correctional Institution
Big Spring TX 79720   

Genesis of the Modern Illegal Pot Market
Now that I've been educated by pot smokers I try to educate new patients, not only about how they compare to the others I've seen, but also about what I think it all means. One of the concepts that seems most difficult for many to grasp is that the huge national pot market we have now has only been developing since the mid Sixties, and that its growth has literally been  a function of the widespread pot initiation in high schools and junior high schools since then. As each year's newcomers try pot, an unknown percentage of initiates either became steady consumers right away or took it up after an interval in which they may have tried other drugs. Their subsequent long term use of cannabis is clearly what has been adding repeat customers (and value) to the still-growing illegal market for just under four decades.

This is a fact the feds, for obvious reasons, have chosen to ignore, and professional drug policy activists, for reason of their own, have  chosen not to address. While I understand the sensitivity of  reformers to the "kids" issue, I also see the unaddressed ABYM issue as a big problem in California; also, beyond all rhetorical arguments, I believe the purpose of research is to learn the truth. The truth is that, starting in the mid Sixties, inhaled cannabis joined alcohol and tobacco as the third entry level drug tried by over half of all American teens.   In addition, a number of  other revelations- that after young people become chronic pot users, they inevitably drink less and try to quit smoking cigarettes-- are powerful arguments against present policy which, when "successful," steers adolescents away from pot and pushes them towards alcohol, tobacco, and other drugs.

Beyond that, an overview of the entire population I've seen has me very comfortable with the idea that insecurity and anxiety are the symptoms most people are addressing with repetitive use of any psychoactive drug except prerhaps caffeine. From that perspective, cannabis is by far the safest alternative for most. The bottom line is that I have yet to meet patients I thought would be well served by my refusal of to provide them with a recommendation to use pot.

Those with an interest in the genesis of the Modern American Pot Market are invited to do some preliminary reading on the 1937 Tax Act: first read the minutes of a January 17 meeting of a gaggle of federal conspirators who were already committed to a "transfer tax," but groping for the right words. Then read the finished MTA itself (by April 2, 1937) and the on-point overview by David Solomon.

Within the next few days, I hope to link the historical phenomena which led to a the drug fueled counterculture of the Sixties and suggest why we haven't seen its worst excesses repeated since the mid Seventies.

Doctor Tom

Posted by tjeffo at 08:33 AM | Comments (0)

September 08, 2007

Humanity at an Impasse (Political)

Although the specific terms would have sounded unfamiliar to Charles Darwin and fellow "naturalists" when Origin of Species was  published in 1859, it’s now quite clear that Homo sapiens is exerting a destructive influence on Earth's planetary ecology. My reason for choosing those terms is to call attention to current evidence from multiple sources that our species evolved comparatively recently in Africa, and then waves of our ancestors began a series of migrations over 100,000 years ago. By the end of the last Ice Age, or 10,000 years ago,  the surviving descendants of those migrations were engaged in establishing the enduring human settlements later found on all of Earth’s large land masses, save Antarctica. Scientific progress over the last five centuries has allowed virtually all such residual cultural isolates to be discovered while also establishing that they share the same genome.

Thus we humans are both the most recently evolved primates and certainly the most successful in terms of total numbers and ultimate global distribution. We are also just beginning to discover that we are the first species capable of exerting enough impact on Earth's ecology to accelerate the extinction of multiple species; ironically including our own.

The characteristic most responsible for that environmental dominance has been our cognitive ability; once thought unique, but now recognized as present, albeit to a much lesser degree, in multiple other species. Contrary to the once popular belief that animals are mere “brutes,” incapable of the logical and emotional responses which characterize human behavior, we now know that many species exhibit feelings appropriate to their circumstances and several have demonstrated enough cognitive capacity to devise purposeful new behaviors and pass them on to the next generation. Thus the differences between human and animal cognition appear more quantitative than qualitative.

If we focus on the impact of the cultural changes attributable to human brain function over just the last several centuries, we see that  modern science and technology led to a quadrupling of the human population during the Twentieth Century alone. At the same time, it also expanded the complex global economy required for the maintenance and continuing expansion of that population, even while fighting two "world" and multiple other wars during the same interval. Ironically, it is the continuing increase in human numbers that is primarily responsible for the creation of new wealth, while disputes over how wealth should be divided have always been major sources of the human conflicts that lead to war.

The lesson now being taught by climate change, but clearly discernible in several more limited ecologic niches, is that the prompt, almost routine, economic exploitation of new technology  may create unanticipated problems requiring considerable time to become obvious. To the extent they have also become important to a particular economy, their correction may become so costly and contentious as to be nearly impossible.

Thus our human conundrum is becoming clearer, almost by the day: as our numbers increase, so does both our tendency to compete with each other and the malign environmental impact we exert; thus urgently needed solutions are rendered progressively more difficult. A glaring example: dealing effectively with global climate change, which now seems only the most urgent of several threats to human survival, would be greatly facilitated by stabilization of the human population at far below today's levels; yet the highly polarized belief systems subscribed to by the contentious sovereign nations making up the UN preclude any discussion, let alone implementation, of such a solution.

On the other hand, simply marking time and carrying on business as usual while those nominally in charge of the planet continue to dither doesn’t seem like an acceptable option either. In the final analysis, we humans may well have been screwed by our own cognitive prowess.

How all this is logically related to cannabis and Proposition 215 will be discussed at some length in the near future.

Doctor Tom

Posted by tjeffo at 06:52 PM | Comments (0)