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January 07, 2009

An Untold American Success Story; Part 9

As indicated on December 20 2008, this series was prompted by a challenge: that I summarize the most important revelations of the seven year study of pot smokers this blog has (sometimes tediously) reported on since 2005. As I’ve been hinting throughout, the exercise, together with the research required and the stimulus of a deadline, have combined to focus me as never before. After I began writing Part 9 yesterday, I realized that I was finally in possession of enough data to not only sketch a broad outline of what I’d learned, but also to issue a public challenge those who support the drug war, whether wittingly or unwittingly, will find difficult to ignore.

Thus I plan to deviate a bit from the format of the first 8 parts and jump ahead to a history of Proposition 215’s evolution since 1996 and how it has influenced the accidental study begun in late 2001. There are several reasons for thinking the time is right for such a move, but rather than present them, I’ll just go ahead and trust astute readers to understand

Proposition 215: A Personal History

That California voters passed Proposition 215 by a comfortable margin in 1996 clearly surprised both sides of what had become a slowly progressive and long-standing argument over the wisdom of a federal marijuana policy that had quickly assumed a key role in America’s “drug war” dating from its inception as the Controlled Substances Act of 1970. Unrealized by all but a few policy wonks, the CSA itself had been Richard Nixon’s radical expansion of an already stupid and irrational policy with legislative origins in the deceptive Harrison Act of 1914.

What is now also clear is that in 1996, neither side of the “medical marijuana” argument had the foggiest idea of how to proceed after the election: the federal government and its allies had been confident of victory and remained adamantly opposed to any concession of “medical utility” to cannabis, while their political opponents had relied almost completely on its well-documented properties as an anti-nauseant in cancer and AIDS, and thus lacked both a coherent pharmacological theory and clinical data for any additional benefits.

At first, implementation of the new law was hampered by the unfocused opposition of its opponents and the absence of any patients with recommendations. However, thanks to a few activist physicians and an injunction from the Ninth Circuit, a grower-retailer network gradually developed and began supplying reliable cannabis products to the twenty thousand or so patients, mostly in the Bay Area, who sought and acquired the needed “recommendations” during the last four years of the Clinton Administration.

My entry into that budding network was as an experienced clinician, but a relative pot novice two months after 9/11, soon after Bush Administration drug warriors, who had been as sluggish as their national security counterparts in sizing up their opposition, were suddenly distracted by the destruction of the World Trade Center. One of my vivid recollections of 9/11 is that I turned on the kitchen TV expecting to watch John Walters’ confirmation hearings, only to see the North Tower burning .

Although I had no way of knowing it at the time, the ensuing postponement of Walters’ appointment would provide me with additional time to grasp the significance of applicant histories and begin developing a coherent hypothesis for integrating pot’s multiple complex medical benefits into a (long neglected) clinical perspective.

I can now see that three other historical accidents were of critical assistance in that respect: the first was that rigorous law enforcement had rendered any unbiased clinical evaluation of pot’s steadily growing (and slowly aging) user population nearly impossible during the Eighties and Nineties. The second was the simultaneous development of the DSM into an improbable, but dominant system of psychiatric nosology (nomenclature) that prompted the third: Big Pharma’s eagerness to develop a profitable, but relatively ineffective (and dangerous) panoply of federally blessed palliatives for anxiety, insomnia, and mood disorders at a time when the traditional (legal) self-medication mainstays, alcohol and tobacco, were both falling out of favor.

Finally, my increasingly solitary efforts to understand the emerging picture of chronic marijuana use were assisted by the relative lack of interest displayed by other “pot docs;” the veterans because most were themselves pot smokers in denial of their own symptoms, and the younger late arrivals who seem most motivated by easy money from the flood of chronic users who began seeking medical recommendation in late 2003 and early 2004.

That demand, in turn, prompted the opening of a spate of lucrative new “dispensaries” around the state in locations where none had existed. They finally caught the attention of local police and their federal allies, thus provoking a backlash, the early phase of which was signaled by the “Oaksterdam” furor in the Spring of 2004 that was reported with (typical) incoherence by the local press.

The next installment of this saga will be the last for a while. In addition to describing the current stand-off between police and the medical marijuana industry, it will document the absurdity of America's drug war and point out the relevance of that absurdity to contemporary domestic and global messes

Doctor Tom

Posted by tjeffo at January 7, 2009 06:10 PM