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January 31, 2008

Why is such an illogical fraud still official UN policy? (Logical, Political, Historical)

The accumulated evidence is overwhelming: any intellectually honest  society should  have long since scrapped the American drug war as public policy. The same evidence is also stubbornly ignored. Beyond that, the drug war’s continued endorsement by UN treaty is a worrisome signal that unless our cognitive discipline improves, human dominance of planetary affairs might end more quickly than we would like to believe. In fact, the current behavior of most humans suggests that very few of those who accept Evolution (themselves a distinct minority) have given any thought to human extinction.

Also, if a statement that critical of the drug war had been made by a "major" Presidential candidate, the drug czar would at least have to respond; however, the recent withdrawal of Dennis Kucinich, together with Ron Paul's miserable showing in Florida,  means John Walters and his eventual replacement will be able to continue claiming drug war "success" while resisting the most minor reforms sought by the Harm Reduction lobby that controls the (puny) drug policy reform "movement."

My own interest in drug policy started in the late Sixties when I
began wondering casually why the same brilliant species that could explore the Moon would endorse such foolishly unscientific nonsense. Perhaps I was skeptical because I already knew Richard Nixon to be a dangerous liar and was immediately suspect of his 'war" on drugs. Couldn't anyone recognize its parallel with Prohibition?

But I had other things on my plate and drug policy was far from the consuming interest it would eventually become.

Fast forwarding to the present: the drug war commands more allegiance from the feds (and the world) than ever. Even as our more responsible scientists try desperately to warn the species about extreme climate change, the fact that they still refuse to even discuss the drug war tells me we humans are still in the grip of potentially lethal cognitive dissonance.

Not that the drug war is our primary danger; only that the degree of denial required to sustain it is an almost sure sign our species is still a long way from facing its biggest problem: that our ability to think rationally is critically hampered by the same built-in emotional biases we seem so adamantly committed to either ignore or disavow.

Doctor Tom

Posted by tjeffo at 06:11 PM | Comments (0)

January 28, 2008

Lies of Omission (Personal, Historical Logical)

The last entry called attention to two items published recently in lay media by an accomplished academic physician who is simultaneously Professor of Medicine at Harvard Medical School, the resident medical expert for the New Yorker Magazine, and frequent contributor to several prestigious newspapers. In addition, he’s published several books for laymen on what might be called the art of clinical practice. One of the items mentioned above had appeared last Spring in the New Yorker; the other was his review of a book by a fellow Harvard professor on what was billed as  “ Mind-Body Medicine,” and from the description, is an examination of the role played by emotions in medical outcomes.

I was critical of Doctor Groopman in both instances for essentially the same reason: what he rather carefully never mentioned. The New Yorker article focused on the very controversial condition now known as Bipolar Disorder (formerly Manic Depressive Psychosis). Under its new name, its incidence has “exploded” in parallel with the influence a new psychiatric nosology (system of classification) being developed for the Diagnostic and Statistical Manual. In addition to being diagnosed far more, BD is also being recognized and aggressively treated at younger and younger ages, as documented by the infamous case of Boston resident Rebecca Riley  and a Frontline special, The Medicated Child (produced by Boston’s WBGH).

I was critical of his book review for omitting any mention of the endocannabinoid system. Given his recently avowed interest in neurobiology, signal transduction, and neuronal growth, there’s no way he could have been unaware of the ES. Nor,for that matter, could have the authors of the academic article cited to call attention to the ES been unaware of two facts: cannabinoids are what make “marijuana” psychoactive; and despite their remarkable safety, human research involving them is strictly forbidden by the drug war.

What had struck me in the earliest histories gathered from pot smokers was how they had tried alcohol, tobacco and marijuana as adolescents and then become chronic pot users in patterns that were far more medical than “addictive.” What is so striking about how contemporary society deals with the drug war is the care with which those with something to lose avoid even implicit criticism of our destructive, futile, and blatantly unscientific drug policy.

As for medical luminaries who shy away from even implicit criticism of the drug war, whatever happened to “Primum non nocere?”

Doctor Tom

Posted by tjeffo at 04:35 PM | Comments (0)

A Change in Tone (Personal, Medical Political)

A recent change in the tone of this blog probably calls for an explanation. Although never reluctant to criticize America’s drug war, I’ve become much more direct since publication of what is hoped will be the only the first of several papers enabled by an ongoing study of California pot smokers. A major reason behind that change in tone has been the continuing insistence of reform stalwarts that “valid” medical use is limited to obviously physical indications, as opposed to those generally regarded as “mental” or “emotional.”  Such thinking panders to a bias still pervading popular belief: symptoms of emotional origin, especially when exhibited by men, are politically incorrect.

Once it was understood that Proposition 215 could induce pot users to answer systematic questions about their adolescent drug experiences, there was simply no reason for rejecting such evidence with dead silence, a denial tactic the DEA was employing when the reform movement welcomed me thirteen years ago. As I’ve indicated, that movement is dominated by male pot smokers of the NORML persuasion who've been seeking to legitimize their own use as “recreational”  since 1970, a distinction which— for several reasons— the public continues to have trouble with.

There are several reasons a policy based on so many lies for so many years could become a bit murky, but the issues here aren’t that complicated, especially to anyone who knows the relevant history. Reform’s continued silence following publication of my paper only adds to my certainty they are in denial, long a favorite technic of humans whenever their cherished beliefs are challenged by “inconvenient" truth.

Although the concept wasn't articulated until 1982, we were probably closest to “nuclear winter”  in 1962; while not completely eliminated by the collapse of the Soviet Union, it seems to have been replaced as the major threat to survival by rapid climate change, from uncontrolled CO2 emissions.

My last entry claimed the drug war has denigrated the validity of human emotions, a view I’d come to only recently. What encouraged me to articulate it publicly was Jerome Groopman’s book review in today’s New York Times. I’d first mentioned Groopman, Harvard Professor of Medicne and media darling, back in April when I took issue with his less than rational analysis of Bipolar Disorder in the New Yorker. Now he’s being less than candid about issues raised by an
articulate non-medical Harvard colleague in her book on emotions and medical practice.

To cut to the chase, what exposes Groopman’s bias is his failure to even mention the endocannabinoid system, first recognized over 15 years ago, and now being investigated by Big Pharma in its search for a monomolecular agent with enough moral authority to placate the FDA. Groopmans’s neglect of endocannabinoids is made even more obvious by his references to the history and pathophysiology of stress as articulated by Cannon and Selye. In that respect, his ultimate cop out; the implication that emotions are simply not precise enough for serious (male) scientists like himself, seems especially lame.

The (unasked) question becomes: if chronic emotional stress can ultimately damage the brain, heart and kidneys enough to kill us, why not treat it with the most effective agent available? The collateral question becomes how can either the government or the nation's most responsible intitutions
justify their support of sucn a disingenuous policy as cannabis prohibition?

Doctor Tom

Posted by tjeffo at 12:42 AM | Comments (0)

January 26, 2008

Duh; It’s a War on Emotions, Stupid! (Logical, Historical, Personal)

As readers of this blog (I know there are at least a few) should have discovered by now: for over  six years, I’ve become obsessed with an ongoing study of California pot smokers, and more recently with a growing awareness that, despite its obvious merit, no one has been willing to publicly endorse, replicate, or even discuss its most obvious finding: that when questioned appropriately, a majority of the pot smokers interviewed, were easily found to have been self-medicating the same troublesome emotional symptoms now being addressed  less effectively by the “official” (FDA approved) medications cranked out by Big Pharma and endorsed by no less authorities than Congress, ONDCP, the DEA, the AMA, and the APA.

To say nothing of Academia, the liquor and tobacco lobbies, the media, prison builders, police benevolent associations. presidential candidates, the "sick and dying" wing of drug policy reform, and most of society.

Have I left anyone out? What could I have been thinking when I opened that can of worms?

Other than a growing list of expensive prescription items and a few largely ineffective herbal remedies, the only self-medication legally allowed for our emotional woes has to be with alcohol and tobacco; and then only in a “recreational” context, as defined by blood alcohol levels.
That’s another way of saying that today’s huge illegal drug market; spectacularly expanded by the drug war Nixon launched against his  political enemies in 1969, is federally protected. Never mind that it’s also an (unrecognized) consequence of the accelerating emotional stress generated in an overpopulated,  increasingly polarized, and highly competitive world still dithering over whether those threats could really be existential.

It's the original Harrison rulings come full circle; the same Supreme Court, that ruled ninety years ago  that treatment of “addiciion” is beyond the competence of mere doctors, is now in the process of slowly redefining, case by case,  just what today’s Medical Profession can safely be allowed to treat— and how.

 In the meantime, a drug war, relying on the arrest of illegal drug users (addicted self medicators) as its principal therapeutic tool, will have to continue in order to adequately protect the Public Health. It should only take a few more centuries before NIDA-approved research has it all straightened out.

In the meantime, continue to trust your federal government. If still in doubt; ask your doctor...but don't dare smoke pot, or we'll bust your ass.

Doctor Tom

Posted by tjeffo at 06:15 PM | Comments (0)

January 25, 2008

Anglo-American Cooperation (Political Propaganda)

Does ONDCP have an agent at BMJ?

Late this afternoon, a friend sent me this link to the first 150 words of a recent BMJ editorial commenting on an American-authored  article (from Walter Reed, no less) on the use of cannabis for chronic pain. The good news is that the editorial writer and, it seems, the article itself, will admit that cannabis has some “medical utility.” The bad news is that the editorial’s account of the Marijuana Tax Act distorts reality in 2008 to an even greater degree than Anslinger’s whoppers did in 1937. Since I’m loathe to purchase such nonsense, I’ve decided to restrain my curiosity until some kind soul posts the full text or I can get it from my local medical library.

A pattern of sorts emerged with a little browsing: another recent BMJ editorial took the same tack with meth using the 150 word aliquot  of free text to distort the history of, and responsibility for, today’s methamphetamine market by the 1970 CSA.  The article being endorsed was written by an academic psychiatrist in the heart of Iowa’s meth campaign.

A related item anticipating a possible UK ban on meth precursors, had also appeared recently; but there was good news: the ban appears a long way off, and the scare item had provoked some typically understated British ridicule.

Doctor Tom

Posted by tjeffo at 03:07 PM | Comments (0)

January 24, 2008

Drug Market Econometrics (Personal, Historical)

When I was an undergraduate at Cornell between 1949 and 1953, it had never occurred to me to take a course in Economics. I was a pre-med and thus already burdened with an obligatory menu that included 2 years of German, a Zoology major and as little Chemistry and Physics as possible. For the balance I’d chosen to minor in Philosophy and fill in the odd leftover time with basic Sociology, and American History including a wonderful course in the American Presidency taught by Clinton Rossiter, easily one of the two or three most  inspiring teachers I ever encountered.

It was probably that lack of formal education in Economics that kept me from pursuing the economic implications of our drug policy, despite lip service paid to “supply reduction” and “demand reduction” by both policy advocates and the popular press. For one thing, I didn’t feel qualified, for another, I already knew drug warriors  to be colossal liars who were willing to say anything.

More recently, the six year research project that grew out of my screening of  California pot applicants eventually led me to realize I’d become privy to several key facts that were probably unknown to academic economists. A reasonably detailed (but but no means exhaustive)  googling of econometrics of illegal drug markets confirmed that most academic authors are, for whatever reason, still thinking within the same federal box as everyone else, namely that the nation’s drug problem really is the public’s proclivity to use  “drugs of abuse” and not the federal government’s political decision to create, sustain, and prosecute profitable criminal enterprises. A representative specimen of such thinking can be found here.

Along the same lines, a common question often raised about pot (but almost never with respect to “harder” drugs like heroin and cocaine) is “why not just regulate and tax the stuff?” To my delight, I found that one of my earlier blog entries had included passing reference to a (rare) detailed and responsible attempt to grapple with the same subject. The discovery also moved me to actually read the authors’ lengthy analysis, for which I was grateful; because, as usual, I learned from it.

What I learned is that even an unbiased attempt to deal with the issues of pot prohibition is severely handicapped by the imposed ignorance of our doctrinaire war on drugs. For example, one of the most obvious findings to be derived from my study is that the popularity of pot has been critically driven by its unique appeal to adolescents and that long term use has almost inevitably been precreded by juvenile initiation, a phenomenon that simply wasn’t possible until large numbers of secondary school students were able to try it from about 1967 on. Another critical understanding is the relationship the study reveals between repetitive pot use, the initiation of what I now regard as the three “entry level” drugs, and the fact that (illegal) cannabis hadn't become the third member of that group until the Sixties.

The bottom line is that any meaningful econometric analysis of illegal drug markets will require at least as much transparency as now exists in markets for tobacco, alcohol, and pharmaceuticals. That we are still a long way from such transparency can be understood from the way drug policy issues are being scrupulously avoided; not only by our presidential hopefuls, but by the media pundits now interrogating them ad nauseam; mostly about trivia, as the radically advanced selection process drones on.

Doctor Tom

Posted by tjeffo at 09:39 PM | Comments (0)

January 23, 2008

What Explains Our Drug Policy Inertia? (Logical, Historical, Political

If there’s one current circumstance that should convince an overwhelming majority of Americans that their drug policy is a serious national problem, it’s the fact that the only presidential hopeful to even raise it as an issue has been Dennis Kucinich, a man respected by many for his candor and intelligence on several collateral issues, but (realistically) given no chance of being around at the end. In some ways, Kucinich personifies the liberal wing of the ineffective drug policy reform “movement,” while Texas physician Ron Paul is the darling of its more conservative wing, primarily through his tepid endorsement of “medical marijuana.”

In fact, I’ve long suspected that Paul’s surprising fund raising ability reflects anonymous donations from closeted pot smokers whose fear of exposure has long prevented them from realizing their own numerical strength.

That acceptance of their lot by closeted pot smokers is also consistent with my original formulation; an overwhelming majority of Americans are overcome by inertia when it comes to our (their) drug policy. They have been as paradoxically tolerant of its global failures as they have been willing (thus far) to accept the calamitous foreign policy, environmental, and economic record of George Bush without calling for his impeachment.  Just a few years earlier, they had, also paradoxically, allowed Bill Clinton to undergo the second-ever Presidential Impeachment in our history for lying about a sexual indiscretion during a period of unusual economic prosperity.

Go figure...

Doctor Tom

Posted by tjeffo at 07:17 PM | Comments (0)

January 22, 2008

PTSD Back in the News (Historical, Legal, Personal)

Although I try to read the New York Times online fairly regularly, I did manage to miss the beginning of  Deborah Sontag’s “War Torn,” series on PTSD on January 13 (a second installment appeared yesterday).  The series, which will apparently be focused mainly on killings in which veterans from Iraq and Afghanistan have been involved since their return, is very ambitious, yet the authors admit they are probbly missing several cases because the military does not keep its own records and is not being overly cooperative; thus nearly all the incidents reported had to be gleaned from civilian press reports in the various locations where they took place.

Nevertheless, the Times investigators have managed tio find 121 cases to analyze and discuss.  One seems more heartbraking than the next and to one who is familiar with the help cannabis can provide to people with PTSD, the head-in-the-sand attitude  still being exhibited by the VA is a source of great frustration.

Doctor Tom

Posted by tjeffo at 07:00 AM | Comments (0)

January 21, 2008

The Drug War as Part of a Perfect Storm (Personal, Historical)

In the wake of the powerful 1991 Halloween Nor’easter, author Sebastian Junger's conversation with weatherman Bob Case led him to came up with the term “perfect storm” to describe how several rare circumstances had combined to produce a weather event of singular magnitude. That concept, popularized by Junger’s 1997 book, has since been extended beyond Meteorology as shorthand for similar combinations of rare events leading to generally unforeseen, and often profound, changes in the status quo.

It now appears that the rapid dismantling, forty years ago, of the century-old system for managing “mental illness” that had gradually evolved into a large, diverse, state hospital system by the Nineteen Fifties may have been one of several unique events responsible for some of the serious social problems presently disrupting schools, prisons, and urban life. In other words, we may now be in the midst a complex and slowly developing perfect storm traceable to erroneous policy decisions which, although receiving solid federal endorsement and a correspondingly large allocation of tax dollars, are really based on nothing more than blind faith; lacking even minimal confirmation from unbiased research.

In fact, similar charges of incompetence and inhumanity have been leveled against the same system of state psychiatric hospitals we began gradually abandoning  in the Sixties. The travesty is compounded further because the state hospital system has gradually been replaced by an even more expensive and brutal expansion of federal and state prisons that has quadrupled the combined prisoner/inmate population since 1970.

As for the connection between key policy weaknesses and the current mess, the problem policies have been stubbornly defended by the very bureaucracies they have nourished with billions of tax dollars, especially after American drug policy was recast as a “war” on drugs under the Controlled Substances Act in 1970. Other contributing factors have been Psychiatry’s uncritical adoption of a DSM system of classification that has literally been breeding new conditions for treatement with the steady stream of psychotropic drugs so important to the balance sheets of a Pharmaceutical Industry which itself has  evolved one of the pillars to our economy over the same four decade interval.

In addition, the number of school and pre-school children now receiving powerful psychotropic drugs for presumed “mood disorders” has grown alarmingly , as have reports of suicide and other untoward consequences of aggressive pediatric Psychiatry. Ditto, the number of young people acquiring criminal records through plea bargains for “drug crimes” (mostly marijuana offenses).

My own perspective is admittedly unusual; in addition to the six years spent profiling pot users, I'm a physician who just turned 76. I’d had a brief, but intense, month of clinical experience living among thousands of patients (inmates) at a large Eastern VA hospital during my senior year in medical school. The following year, a similarly intense month was spent as an intern admitting and observing the disposition of patients passing through San Francisco General’s Psych unit and thence into California’s network of psychiatric hospitals. That had given me an overview of the system that would start disappearing, even as I was starting a four year residency in General Surgery in Texas. I then served in Japan, where I eventually played a role in the development of a (still unknown) network of Army Hospitals set up around Tokyo to treat thousands of American casualties evacuated from Viet Nam. After returning to San Francisco during the 1967 “Summer of Love,” to begin training as a chest surgeon, I still had no way of knowing how the state hospital system I’d been introduced to 10 years earlier was halfway through its disappearing act.

What had enabled that rapid change were two developments: the near simultaneous availability of the first  psychotropic drugs able to modify dangerous behavior and the passage of Medicare, which, by unwittingly defunding existing state hospital programs, had pushed Psychiatry almost completey out of inpatient care.

The final component required for a delayed perfect storm seems to have been the war on drugs which, by criminalizing effective and newly available self-medication with cannabis, has created a youthful drug culture that has itself evolved into a global complex of illegal markets with generally noxious consequences that tend to be either denied of minimized by the same government agencies supported by perennial policy failures.

Ironically, the California governor under whom state hospital closures began was Ronald Reagan. His successor, under whom the exodus continued, was Jerry Brown, now the state AG. Also ionically, there is no evidence that either man ever tumbled to the  significance of the profound changes in Psychiatric care that occurred during their combined sixteen years in office.

The same could be said of ONDCP, the cabinet-level entity that has evolved to oversee the war on drugs since passage of the CSA in 1970. That same massive inertia produced by deep beaureaucratic commitment to flawed policies is not uniquely American; it’s mirrored everywhere in the modern world.

We don’t yet know how all this will end, but as most working doctors know, illnesses complicated by patient denial are difficult to treat successfully. To make matters worse the denial in this instance seems to be by both patients and physicians (the public and government).
Doctor Tom

Posted by tjeffo at 05:20 PM | Comments (0)

January 18, 2008

Presidential Politics and Pot (Personal)

It woulld probably come as a surprise to most Americans, but there is a (more or less) organized political movement opposed to the drug war. That knowledge of the “movement’s” very existence would surprise most voters  is also a fitting measure of its futility. That’s especially so because more than just a cursory look at how reform organizations spend most of their time, effort, and money  reveals that it’s almost all about being noticed: they are trying desperately to get their fellow citizens to discover how ”bad”  the drug war is for both the nation and the world,  a game they have been trying to play with little success since 1970, when NORML became the then-new “drug war’s” first full-time political opposition.

Unfortunately, most reformers have yet to understand that although their federal opponents had also jumped off on the wrong foot intellectually, they had done so fifty years before a drug war was ever declared, and after first securing the “full faith and credit” of the US Federal  Government for a stealth policy of drug prohibition. That essential detail was taken care of when the 1914 Harrison Act was upheld by two obscure 5-4 Supreme Court decisions.

To return to the present: among the many ways to understand how completely the drug policy refrom movement has been failing, perhaps the best is to look at  their three favorite Presidential Candidates after first realizing that  they are favorites only because of (mostly) cautious statements made  on behalf of medical marijuana.  Those three candidates, in likely order of their own name recognition, are Ron Paul, Dennis Kucinich and Mike Gravel.

Enough said, also enough for now; more later.

Doctor Tom


Posted by tjeffo at 04:35 PM | Comments (0)

January 17, 2008

What Ever Happened to Ecstasy? (Clinical, Historical, Speculative)

At the turn of this century, the media were all abuzz with sensational reports about Ecstasy (E, MDMA, Love Drug). Touted as the latest drug threat to youth, MDMA was a synthetic with psychedelic properties that had first been synthesized as a possible weight loss pill by Merck on the eve of World War One. Although patented, it was promptly forgotten because of the war and never produced commercially. Discovered in the Seventies by legendary American chemist Alexander Shulgin, it was soon being investigated by a small coterie of psychologists as an adjunct to group therapy.

 Relatively easy to synthesize, MDMA is an entheogen, but not a hallucinogen; it apparently produces its pleasant effects by inducing a surge of serotonin.  Soon, it had spawned a small recreational market,  that— when brought to the attention  of the DEA— (predictably) resulted in a ban.  Equally predictably, sales received a quick boost from the publicity and soon there was a thriving international black market resonating with the youthful Rave Culture, one in which several other “club drugs” were often consumed simultaneously.

Was this another counterculture in the making?

Apparently not; In short order, we’d had 9/11, a war on “Terror,” and a ratcheting up of global tension. There was also a scandal discrediting the most sensational studies claiming that Ecstasy produces permanent neurologic damage. The market definitely retreated and the “anti-drug forces were quick to claim credit without explaining why scolding would work in the case of E, but not against pot. A further short step backwards on the way the policy doesn’t address psychedelic issues at all allows us to see just how much the policy abuses science.   Drug War “truth” has Increasingly, been whatever irrational nonsense the policy has needed to defend itself against critics.

That defense has had other costs: we are now wedded to an improbable system of classification for mental illness; one that produces record numbers of named disorders for treatment by the steady stream of new, and  comparatively ineffective, psychotropic medications that are now Big Pharma’s biggest source of profit.

Lest we forget; it has also taken only 40 years for the drug war to quadruple the number of prisoners in our jails and prisons; almost exactly the  same interval that’s elapsed since new “anxiolytic” drugs released in the Sixties led to the abrupt closure of the huge state hospital system that had grown up for treating “mental illness” from a completely different perspective. Was that wise? Haven’t we simply replaced a relatively ineffective, but reasonably humane system with a brutal one that is both more expensive and less effective?

Also, are the homeless alcoholics now sleeping it off in our parks and doorways simply older and less violent “patients” than the ones we are filling our prisons with? How long can we tolerate such an expensive and destructive policy before discussing it openly?

When was the last time a Presidential Candidate said anything at all about the drug war?

Doctor Tom

Posted by tjeffo at 08:01 PM | Comments (0)

January 14, 2008

Connections (Personal, Historical)

I was launched on today’s entry when I had occasion to google bariatric surgery and quickly became surprised at the degree to which our current obesity “epidemic” has transformed a once marginal surgical subspecialty into a sought after money maker.

Morbid obesity and its opposite, the emaciation secondary to prolonged starvation, aren’t simply two extremes; they’re also a good introduction to my (recurrent) theme: the importance of our emotions in determining our behavior. In many respects, and also whether encountered in humans or animals, obesity and emaciation both involve behavioral factors because their development inevitably requires more time and outside support than ”nature” usually allows. 

To cut to the chase, there are now a variety of surgical procedures offered to the morbidly obese, arbitrarily defined as having a body mass index (weight/height ratio) greater than 40:1. As with most other choices, the more effective procedures, in terms of predicted weight loss, are also more expensive in terms of both expense and surgical risk.

That we are currently engaged in worrying about obesity, global warming, protecting our borders, and addiction shouldn’t keep us from recalling that wealth and power go hand in hand and have a way of sniffing each other out, which is why “conservatives,” who typically endorse the most traditional ways of thinking, also tend to be the most lavishly rewarded by respected organizations.

The obesity connection also highlights the money connection. Now that it's becoming almost normal statistically, there’s a lot of money to be made by treating fat people. If that  sounds analogous to drug addiction,” it's meant to.

Last week, I described how our intellectually threadbare drug policy has been corrupting Psychiatry, especially in its management of children. This week I’m raising another aspect of the same phenomenon: our fundamentally dishonest policy of drug prohibition requires considerable behind-the-scenes intellectual support from respected people and, by implication, the institutions they represent, in order to survive as protected public policy. This list, although a bit outdated, can serve as a basis future discussions.

Doctor Tom

Posted by tjeffo at 10:22 PM | Comments (0)

January 13, 2008

A Peculiar Disinterest (Personal, Speculative)

One way Proposition 215 might have been thought of right after it passed in 1996 was as an opportunity for the Initiative process to function. Initiatives had originally been intended as ways for the electorate to either scrap or amend policies that had become controversial; in other words, an enhancement of the democratic process. 215 had been passed because cannabis prohibition, always contentious, had become more so as evidence of pot's medical benefits continued to mount in the Nineties. One seldom considered point is that although it had been used chronically by untold millions of Americans in the thirty years after the 1970 Controlled Substances Act passed, and millions more had tried it for the first time in the ten years since 215 passed, none of that use had ever been studied systematically. Even after the existence of a compliant user population with multiple shared characteristics had been pointed out  in 2004, little interest in them had been manifest.

Apparently they were not seen as either fitting the preconceived notions of reform or fulfilling the vaguely dire predictions of the DEA.

What had been assumed instead, by nearly everyone expressing an opinion, was that any young person with a pot recommendation who looked healthy to a deputy sheriff from across the street must be a cheating "recreational" user who was somehow hurting the generally older and sicker “legitimate” users.

In other words, although both the feds and the advocates of medical use now seem in agreement about who the irresponsible recreational users are, neither side wants to talk much about them. Perhaps the feds finally realize that the ernormous demand uncovered by having a functioning gray market for a few years means that teen pot initiation is here to stay and their policy is ultimately doomed.   

 My data also suggests that pot’s sudden popularity among teens in the Sixties had been due to the rapidly accessible and relatively easily controlled anxiolytic properties cannabinoids exhibit when inhaled, a premise that would be quite easy to test in a sane world.

That cannabis might also play a role in the initiations and subsequent use of alcohol, tobacco and selected other drugs by its regular users had long been suspected; that fact alone makes the manifest disinterest of reform in confirmatory evidence to that effect something requiring an explanation. Finally, the tacit acceptance by the  global scientific community, of  four decades of shabby “science” backing America’s drug war should not be ignored either. I'm not seeking people to blame, only raising questions  about our own behavior as a species.

If ever there was an American sacred cow based entirely on unscientific nonsense, it’s been our war on drugs. Unfortunately, in the real world, such policies have not been either all that rare, or uniquely American; Third Reich, anyone? But how about chattel slavery here in the US; or ethnic cleansing in Bosnia?

Doctor Tom

Posted by tjeffo at 06:59 PM | Comments (0)

January 10, 2008

Connecting Dots (Personal, Historical)

Among the first crimes committed by most American adults were their trials of two legal drugs, alcohol and tobacco, at an an illegally early age. That fact alone should provide supporters of our futile drug war with an understanding of why their policy is, at best, a waste time. However, the doctrinaire (religious) claim that our drug laws are absolutely necessity is the nearly universal response of elected federal politicians, especially Republicans. That rejection of the drug war’s failure, when coupled with its acceptance as a necessity are solid evidence that support for it as policy is illogical.  Also frightening.

So great is the current “reality gap” between drug war doctrine and what can be easily learned from a few Google searches, that continued suppression of the medical pot market, denial of its significance, and their massive fear-based propaganda campaigns are about the only tactics drug warriors have left.  Interestingly the same reality gap now poses a growing  danger to the reputations of policy supporters; especially those with academic pretensions: no matter how passive, any support at all could easily become a source of future embarrassment few academics would survive.

One way to understand that in greater depth is a consideration of how the term “anxiolytic,” came into use over ten years after “Miltown” (meprobamate), had been introduced as a “tranquilizer” in 1952. There are varying opinions about what led to the new term, but one thing is  clear: from the Sixties onward, “legitimate” anxiolytic agents have become a (necessary) revenue bonanza  for both physicians and the Pharmaceutical Industry, even as US drug policy has fallen for the blandishments of a runaway DSM system of psychiatric nomenclature while preserving as sacrosanct its core assumptions that “addiction” as a disease to be avoided all costs.

Timid recognition that inhaled cannabis is a potent anxiolytic and the (logical) deduction that it was that property that jump-started today's massive illegal  market at the High School level is both an undeniable finding of my study and the best rational explanation of  MTF data gathered by the federal government since 1975.

We may finally be at a point where reality is about to catch up with myth...

Doctor Tom

Posted by tjeffo at 09:50 PM | Comments (0)

January 09, 2008

Good News, Bad News (Personal, Political, Historical)

The first item under “good news” is that the Harm Reduction Journal has finally “published” the peer reviewed article they accepted in November. it’s a lot more readable in final format than the provisional Pdf because the tables and graphs are much easier to interpret. The significance of that article for me was that it established the reality of the specific population of chronic pot users I’m continuing to follow and will be able to update from time to time. It also gives me a lot more leeway for using the blog to analyze related news, a poignant current example of which is the Frontline report on the Medicated Child  that was broadcast for the first time yesterday and is available for viewing online.

The bad news is that since 2003, I’ve been writing about the same general issues covered (very well) by Frontline, and  have been  pleading with both my fellow Pot Docs and the “reform” community for their understanding and support. Both have, so far, been largely withheld for reasons I have gradually come to understand, but am becoming increasingly impatient with.

I’ll have a lot more to say about these and other troublesome  issues in  the near future, but— as usual— I'm very pushed for time and will have to quit here...

Doctor Tom

Posted by tjeffo at 05:57 PM | Comments (0)

January 07, 2008

Dishonest Harassment on Behalf of the Drug War (Personal, Logical Historical)

The unvarnished truth about our war on drugs is that in the nearly four decades since it was (unofficially) imposed  as a major new policy initiative on the basis of an insecure president’s uninformed medical judgment, it has been gradually corrupting most American institutions at all levels, and in a variety of ways.  Because supporting evidence for that statement can’t be gathered “scientifically,” it is mistakenly considered “anecdotal,” and thus usually excluded from newspapers by the editors who also decide how cub reporters will write up  minutiae relating to the day-to-day implementation of California’s highly evolved eleven-year-old medical marijuana initiative. The net result is that the drug war is still coasting on the same basic “reefer madness” assumptions invoked on behalf of the MTA seven decades ago.

Talk about the “dead hand” of the past!

For the past six years, I’ve had other sources on information on police activity: patients who have been stopped by the CHP or their local cops on a shabby pretext, then had their cars illegally searched and their marijuana confiscated before all charges were later dropped (or sometimes not dropped) by the local DA. That California’s state and local bureaucracies have remained very hostile to medical use is a no brainer that’s almost never discussed openly, as the following case demonstrates: a 43 year old man I saw for “renewal” last Friday had been stopped by a local policeman early in December because the trailer hitch on his vehicle allegedly obscured its rear license plate. As soon as he rolled down the window, the policeman announced that he could smell marijuana and ordered him out of the car. After three separate field sobriety tests, he was arrested for DUI marijuana and taken to jail where blood was drawn and he was held until his family could bail him out. He'd brought with him a five page DMV medical form identifying him as someone obligated to attend a vaguely described procedure, after which a “hearing officer” may recommend restricting his license for “ drug addiction.” This was the DMV's first beaureaucratic response to  input from an anonymous peace officer without medical training and well in advance of the still-pending criminal procedure!

Concerned about what this might represent, I contacted two attorneys and learned from one that it may well be a new tactic  intended to further harass medical users. More suspicion that it may be a straw in the wind: it's taking place just a week before I'm being forced to go to a nearby county to appear at the trial of a patient I saw only once in early 2004.

Although I really don’t have time for such harassment, the good news is that I’ll have the chance to scope it out in person and report back on it next week...

Doctor Tom

Posted by tjeffo at 05:16 PM | Comments (0)

January 06, 2008

Hear No Evil... (Personal, Historical. Logical)

The most obvious conclusions to be drawn from my six year clinical study of California pot smokers is that our federal drug policy has almost certainly been spectacularly wrong; not only about the effects of marijuana, but also about the significance of its continuing large scale initiation by juveniles, a  phenomenon that could never be properly addressed by annual federal student surveys, despite the millions spent on them since 1975.

The main reasons for hedging the devastating conclusion above with “almost certainly” is that my study is, so far, the work of only one investigator. Also, of necessity, it has to rely on data provided by self-selected “volunteers.” Nevertheless, the very uniqueness of the opportunity to study them, when considered in light of reform’s non- response, should immediately raise 2 other serious questions: how is human cognition affected by our emotions, and isn’t that the critical issue that’s still being almost  universally ignored by so many of the policy "experts" one would expect to be more curious??

 That our national drug policy was both  dishonest and doctrinaire should have been obvious, almost since its inception during the First World War; yet its bipartisan support only intensified after it was abruptly converted into a ”drug war” by Presidential fiat in 1969. Even as its societal distortions were becoming grotesque and its failures  have become increasingly well known to the public over the next three decades, the policy itself  has retained enough political support to seem as invulnerable as ever.

Just why a failing policy wsould continue to be supported so avidly is still uncertain; it may simply be that human fear of death is now finding expression as religious faith. Certainly, our human intolerance of such beliefs, especially when they differ from ours, is a well known cause of most wars

In any event, American drug policy from its very inception in 1914, has served as a workshop for fascism.  Trying to “reform” it without correcting its mistaken assumptions  is akin to excusing the pseudo science behind the Holocaust or continuing to ignore (and thus deny) the  unacknowledged racism that justified American Slavery and Segregation. The intensity of NIDA's organizational bias is so unabashed  that any "research" it would sponsor should be immediately suspect

To err may be human, but admitting one could have been wrong is downright un-American.

Doctor Tom

Posted by tjeffo at 11:36 PM | Comments (0)

January 01, 2008

What’s at Stake in the Drug War? (Personal Logical, Historical)

To the extent we are able watch the mind-numbing and increasingly grotesque spectacle of the current Presidential Campaign, two simple conclusions would seem indisputable: first, that money is of critical importance and second, the candidates are so preoccupied with spinning what passes for political truth that trusting any one of them is a bit like buying a lottery ticket. About the only real choice will be when the electorate gets to select either a Republican or a Democrat next November; and judging from recent examples, both parties have become so co-opted by corporate interests that the resultant differences, while very real, will not come close to reflecting the most critical choices America, and the world, should be making in the years ahead. In that context, Global Warming is simply the most obvious issue we should be thinking about as a species.

Not that we Americans are that different from other humans; if one compares the Peace of Versailles with the aftermath of World War Two, one could argue that American dominance of the latter may have produced an arguably “better” outcome, but an equally credible  conclusion could also be that any such comparisons are invalidated by the accelerated growth in both human population and scientific technology that occurred between 1919 and 1945; all of which illustrates the imponderable nature of historical comparisons.

Another inescapable conclusion is that we are a species in perpetual conflict over basic issues relating to the choices enabled by our greatly enhanced cognitive abilities. As I’ve been emphasizing here, the collective decisions about the “nature” and derivation of those abilities that have always been made by governments are of critical importance. All of which I now realize (but had previously been unable to articulate) was why I’ve long considered global acceptance of a  dogmatic and irrational American drug policy to be a major cause for concern.

Beyond that, I have more recently come to understand that widespread resistance to logical criticism of that policy is perhaps even more worrisome;  however a realistic assessment of current political beliefs also tells me that dramatic changes in either our drug policy or its current level of acceptance are unlikely and that simply uncovering more objective evidence of their irrationality would be the best use of my remaining time.

Simply stated, America’s highly evolved drug war may be a prime example of human susceptibility to the blandishments of “control.”  As such, it can serve as either a model of what we should be avoiding or as an accelerant of our ultimate extinction. The choice (or its convincing illusion) will be ours.

It’s very frustrating to realize I won’t be around to see how it all plays out, but at the same time, very exciting to have had the privilege (or illusion) of discovery.

Doctor Tom

Posted by tjeffo at 07:12 PM | Comments (0)