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March 30, 2009

Crime and Punishment

Just by chance, as I was driving to the local suoermarket this afternoon, I happened to catch the last two minutes of Jacki Lyden’s interview of Atul Gawande, a young Harvard academic surgeon with a wide variety of interests. His subject was one I’d become increasingly aware of and developed some suspicions about, but had yet to focus on: America’s increasing reliance on imprisonment and our (obviously) abusive use of solitary confinement.

As soon as I had the chance, I googled Gawande and found that he'd just had a long article on the subject published in the current New Yorker. Fortunately, his riveting article is online and I’ve just finished reading every word.

Suffice it to say that his analysis is based on an impressive amount of personal research and dovetails with many of the conclusions about human cognition and emotions that my study of pot smokers has been leading toward. Even more remarkably, we have arrived at similar conclusions about the emotional and cognitive weaknesses now being exhibited by both the American polity and its political leadership.

The bottom line is that his opinions tend to confirm my clinical suspicions that we’re in a rapidly deteriorating situation that calls for lot more intelligent analysis, a lot less denial, and some urgent corrections.

Doctor Tom

Posted by tjeffo at 08:10 AM | Comments (0)

March 29, 2009

A Different Perspective on Mexican Cartels

Even though “Marijuana” had been demonized for its (falsely) alleged effects on youth by W. R.Hearst’s invidious “reefer madness” campaign and was finally banned in 1937, it actually failed to attract youthful interest for three decades. It wasn’t until the “baby boom” generation, born in the immediate aftermath of World War Two, began coming of age in the mid-Sixties that twenty-something young Americans (and, very quickly, their even younger siblings and cousins) discovered its appeal that a market began to develop. Thus the same plant once known by such quaint names as “muggles’ and “tea,” soon became more familiar as “pot and “weed.” But generational and demographic differences between boomers and their elders would eventually prove even more significant than mere names.

In sheer numbers, boomers were the largest generation in history, a basic fact obscured by a host of post war problems, until schools built in thriving post war suburbs became so crowded they had to hold double sessions. It was then that many began predicting boomers would continue to exert influences on society. We are still learning what they are; and that some were much less predictable than others.

The tumultuous late Sixties counterculture was one such influence while it lasted; it has also proved a demographic watershed that had a major ripple effect on the nation’s politics which, although still powerful, is much less apparent; not only to to boomers themselves, but to their children and grandchildren.

Ironically (there’s that word again), that’s because the much smaller “silent majority” that sired and bore the boomers had become so distressed by their rebellious behavior during the Viet Nam War that they elected Richard Nixon in 1968, a tragedy which, in turn, soon produced the drug war that’s now destabilizing both the US and Mexico in ways being tragically misunderstood by our most influential pundits and our newly elected President.

Listening to the speech RMN gave just a month after unilaterally shutting down the Mexican border to search for pot should put it into perspective and also explain why many still cherish the same delusional thinking.

Doctor Tom

Posted by tjeffo at 09:48 PM | Comments (0)

March 28, 2009

Ever More Confused than I’d Realized

Over the last 36 hours or so, I’ve devoted considerable (non-existent) spare time to tracking the recent eruption of interest in the drug war and our border with Mexico. The good news is that some rare attention is being paid to what has become a running sore on the body politic of both nations; the bad news is that most of the commentary is seriously uninformed, a handicap based almost entirely on ignorance about marijuana which, somewhat surprisingly, now dominates cross-border smuggling. Who would have thought a famously gentle drug like pot would ever inspire such murderous behavior? Is it reefer madness finally coming true?

I don't thinks so; it's more likely a combination of the pot market's continuing maturation and its generally unrealized superiority as an anxiolytic agent (also our sick economy, stupid).

There’s an old adage: “in the land of the blind, the one-eyed man is king.” That saying has a nice ring, but it requires am important qualifier: the one-eyed man has to be able to convince his fellow subjects that he can see. In today’s world, that qualifier is particularly apt when it comes to public “debate” over the drug war.

Two good examples are the smug editorial in today’s NYT and a recent interview of MPP’s PR specialist by liberal TV host Rachel Maddow. While I have the same problem with Obama’s backing away from his earlier position on pot Maddow gives voice to and Mirken quietly bemoans, I also know that Obama should be particularly interested in my study of pot smokers because his paternal parenting deficit is so frequently reflected in the nearly five thousand individual pot applicant histories I’ve collected to date. In that same vein, I also hear frequently about step-parent difficulties similar to those dogging the new drug czar’s adolescent stepson because they are also encountered with great frequency in those same histories.

In the aggregate, they suggest that cannabis is both the drug most frequently smuggled from Mexico into the US, and the most valuable cash crop harvested within our borders for reasons unexpectedly uncovered by a study being assiduously ignored by both the Medical Marijuana Lobby and the recently downgraded ONDCP.

Perhaps that’s what’s meant by “glacial” progress. Unfortunately, our real glaciers are melting a lot faster faster than their metaphoric drug policy homologues.

Doctor Tom

Posted by tjeffo at 09:23 PM | Comments (0)

March 27, 2009

Worse than I Thought

Last evening's CNN special report from El Paso on the impact of the drug war at the Border was a surprise, even to me. it told me that when it comes to marijuana, the gap between reality and belief is almost universal, and even greater than I'd realized.

Realistically, all I hope for at the point is that Obama will somehow get far enough past yesterday morning’s snort of derision (forget Gilliam's clueless text and just watch the video) to make an assessment of the damage Nixon's augmented drug prohibition has inflicted on the world in forty short years.

The good news is that CNN has, albeit unwittingly, opened the door just a bit; let's hope enough thinking people "get it" before this ADD nation goes charging off in another direction

Doctor Tom

Posted by tjeffo at 11:34 AM | Comments (0)

March 26, 2009

Pot and the Prez: a prediction

One thing about the Obama Presidency is that even though the content of his comments on cannabis have (so far) left much to be desired, the subject does keep coming up. Today it worked its way into his experimental Online Town Hall and although he made light of it, he admitted the subject was “popular.”

Have you ever noticed how consistently Ron Paul led GOP also-rans in political contributions? That fact and several other straws in the wind suggest to me there are many more closeted pot users than most would imagine, so I’m going to predict that the the online pot-using community will treat the next such Town Hall as an opportunity to demonstrate to the President just how popular their issue really is.

Doctor Tom

Posted by tjeffo at 11:20 PM | Comments (0)

More Lies From the DEA (Just who is in charge?)

In another disappointing development (Is there any other kind?) a pot club I’d never heard of was knocked over by a defiant DEA raid in the heart of San Francisco yesterday. Typically, although I’d heard a vague rumor of a bust as I was leaving the clinic yesterday, I’d become busy with other things and didn’t recall it until I saw the story in today's SF Chronicle (be sure to watch the video).

The lame cover story; that there were suspected violations of state law, is a blatantly dishonest spin on past statements by both Obama and Holder; it also raise serious questions about the integrity of America’s new President and just who is in charge of his embattled government.

Doctor Tom

Posted by tjeffo at 08:36 PM | Comments (1)

Futility as Usual

Attempts by governments to ban popular drugs had been failing for centuries, but that didn’t deter the UN from promulgating a treaty supported by an aging Harry Anslinger who had just became a UN Narcotics Commissioner after his forced retirement from the FBN in 1962.

That Anslinger’s 1937 ban on marijuana would become a central element of global policy years in advance of Nixon’s drug war is a tragedy that goes well beyond mere irony; Yet it’s also undeniable: being found in possession of even a tiny amount can be grounds for the arrest and detention of unlucky travelers in every international port of entry.

Yet prohibition is still an abysmal failure, as illustrated by reports from the US Mexican Border and by similar events in drug producing nations (think Burma, Afghanistan, Lebanon, and Colombia) over the past fifteen years. Indeed, the carnage in Mexico may simply represent its increasing importance as a “source country” for methamphetamine.

Finally, continued passive global acceptance of the planet’s futile drug policy is also being signaled by the lack of criticism of President Obama’s promise of continuing American support for the folly our domestic "war on drugs" has inflicted on Mexico.

Doctor Tom

Posted by tjeffo at 06:10 PM | Comments (0)

March 25, 2009

Is Invincible Human Stupidity the Drug War’s Secret of Success?

In the run up to last night’s historic White House Press Conference, the breaking news being breathlessly reported on the CNN broadcast I was watching (9:00 PM PDT) was the improbable violence along the Mexican Border, which had just escalated to a point that ace CNN personalities Anderson Cooper and Michael Ware were promising to report from Juarez this evening.

Minutes later, the press conference began with President Obama looking a bit more haggard than he had on 60 Minutes. After the obnoxiously self-important twits of the White House press corps began asking their usual clueless questions, Obama shone by comparison in every area but one: he answered a soft-ball question about Mexico and the drug war by promising more of the same Nixonoian stupidity that converted a dumb policy into disaster 40 years ago after the tricky one single handedly launched Operation Intercept in the mistaken belief that it would keep marijuana out of the US.

As was reported in a contemporary account published only three years later, the first battle in the modern war on drugs was a ludicrous failure, but, in what has come to be standard drug war procedure, those responsible called it a “success.”

I has been a young Army officer stationed on the Border in El Paso between 1958 to 1963; the first year was spent as a dispensary officer at Fort Bliss, and the last four as a resident in General Surgery at William Beaumont General Hospital just across the highway from Bilss.

Juarez was a somewhat sleazy, but very safe border town where we went shopping or visited restaurants and night clubs on week-ends. Any drug trade that existed was completely invisible to us. The occasional GI treated in the Beaumont Emergency Room after a Border fracas was inevitably a victim of alcohol and his own bad judgment.

Over the last fourteen years of my immersion in drug policy activism, I have become increasingly puzzled and distressed by the entire world’s endorsement of Nixon’s supremely dishonest and invincibly stupid drug war (even to the point that a significant fraction in the same movement now supports continued prohibition of “hard" drugs) but still cannot understand why so few others are unable to grasp what to me is crystal clear: the drug war has become like a debilitating virus capable of weakening the human species to a degree that threatens its very existence, yet the danger remains undetected because of a strange immunity that prevents world leaders from recognizing the truth.

I now fear more than ever for our future.

Doctor Tom

Posted by tjeffo at 11:11 AM | Comments (0)

Apparently Judge Wu has trouble with decisions...

The last entry suggested that Judge Wu may have been an inadvertent activist. Based on a quick search on Google that's the most likely possibility (and certainly the one most consistent with my jaded view of the federal bench).

No matter. The cat is out of the bag and Wu's insecurity will simpky bring more unfavoarble publicity down on the drug war.

That raises another question: how much bad publicity can the drug war stand? Based on my discouraging assessment of the IQ of the American polity, the answer is A LOT.

Doctor Tom

Posted by tjeffo at 03:06 AM | Comments (0)

March 24, 2009

Unexpected Help From a Federal Judge?

My complaints about the cavalier behavior of federal judges during highly selective prosecutions of some who became involved in California’s disputed medical marijuana program were based on cases I’d become familiar with by reading about them. Except for the two trials of Ed Rosenthal in San Francisco, most prosecutions followed the Raich decision in June, 2005 and had taken place in either Fresno or Sacramento. Several have been written up by a single author.

My own intense exposure to federal injustice has been mostly personal; it relates to the ongoing saga of Dustin Costa, who has been serving an egregious 15 year sentence in Texas since February 2007.

His trial was in Fresno; a sentence of 15 years was imposed 19 months after an unexplained (and unprecedented) transfer of jurisdiction from state to federal authorities in August 2005. There are many other cruel details; most can be found by searching the blog for "Costa.'

To return to this entry's opening thoughts, yesterday a federal judge in LA whose name was new to me interrupted the routine sentencing of an already convicted Morro Bay dispensary operator to direct a potentially game-changing question directly at Obama’s new Attorney General. The judges request, that the new AG disclose (or explain) any further changes in policy before he passes sentence on Charles Lynch, may sound uninformed, even naive.

But the possibilities are many, and at least potentially provocative; it will depend on what the judge has in mind, and to a significant degree, how the public responds. Typical of these complicated cases, Hu wasn’t necessarily questioning the original decision to prosecute Lynch, or even why he was prosecuted by the feds for a "crime" protected under stste law. On the surface, he may just be s fussbudget simply trying to find out if the new AG has any more surprises up his sleeve. On the other hand, he may be playing an activist role, either deliberately or inadvertently.

I've learned not to put too much trust in the integrity of federal judges, but must admit that Wu's novel behavior is encouraging. If nothing else, it calls attention to a particularly egregious injustice, one almost made to order for the classic medical marijuana pitch.

Perhaps a good technique for those living in LA; indeed, anywhere in California, would be to pump up the very well done Drew Carey Video and hope the judge will see it.

As for me, I'll be watching developments in the hope that someone in the Obama Justice Department will notice how far the drug war has led America from the ideals it still claims to believe in, but trashes every day in its courts and prisons.

It would be nice to feel proud of my country for a change.

Doctor Tom

Posted by tjeffo at 10:46 PM | Comments (0)

March 15, 2009

Annals of (illegal) Medical Research

One of many adverse effects of America’s war on drugs has been an effective ban on medical research on cannabinoids, key constituents of "marijuana”, the nation’s most popular “drug of abuse.” Following its first prohibition in 1937, cannabis was banned a second time, and with increased vigor, by Nixon’s pernicious CSA in 1970 and has subsequently been targeted by a series of additional penalties that can strip unlucky users of jobs, professional reputations, property and custody of their children.

In extreme cases, sloppy execution of search warrants being served at the wrong address has even allowed police to kill unlucky occupants with impunity.

But the greatest cost may turn out to be delay in recognition of pot’s medical benefits, a possibility mentioned by Doctor Woodward of the AMA in 1937 and specifically raised by Richard Nixon’s own blue ribbon committee in 1972. As I’ve been reporting since shortly after Proposition 215 provided me with access to a large population of pot smokers, the major benefit they’ve been experiencing, usually without being able to express it in medical terms, is predictable short term relief of anxiety. In other words, pot is an effective anxiolytic, which, because it is inhaled, is under user control.

Encouraging support for that concept came from an unexpected source only yesterday. Although I’ve long known of Fred Gardner’s extensive knowledge of both Medicine and cannabis, his just-published report on the anxiolytic properties of cannabidiol caught me by surprise, as did information that significant (and long overdue) interest in both quality control and research is being manifested by participants in the emerging gray market close to where I’m now seeing patients in Oakland.

It appears that the glacial pace of progress in our understanding of cannabinoids, first enabled by Proposition 215 over twelve years ago, may just have been stepped up a notch.

Doctor Tom

Posted by tjeffo at 09:25 PM | Comments (1)

March 14, 2009

A Growth Market?

Is the pot market bucking the present economic trend? Or is it just that the current market debacle is encouraging more people to take advantage of pot's anxiolytic effects? Will those successful at growing for personal use be tempted to sell their surplus weed to their friends? Or to strangers?

Anyone living in the Bay Area is surrounded by evidence that "all of the above" is probably the best answer. My brand new copy of Atlantic, one of the few print magazines I still subscribe to, described an enterprise I had just become aware of: Oaksterdam University, a new addition to the the neighborhood where I started as a "pot doc" at the infamous (and long-shuttered "Third Floor" on Telegraph.

Sadly, the owner who recruited me to screen his potential customers back in November 2001, has just accepted a five year federal plea deal. Why he returned from Costa Rica is something I plan to ask him when I write. Just as I was reading about his plight, a one hour CNBC special on California's burgeoning new industry air began to air on the tube.

The thriving market is progress of a sort; not as neat or orderly as I would have preferred, but progress nevertheless. Hopefully pot will be legal before our seacoasts are under water.

Doctor Tom

Posted by tjeffo at 07:44 AM | Comments (0)

March 13, 2009

Good News, Bad News

Amid reports of the this year's first four winning sessions on Wall Street, its prudent to remember that it took over two years for the Great Depression to bottom out in January 1932.

Another item becoming more intrusive on this Friday afternoon is related to my favorite subject: the degree to which all organizations tend to cut the drug war enormous slack. This time it’s growing violence on our border with Mexico which is becoming harder than ever to ignore. If the LATimes link above doesn’t work for you, this one should.

Doctor Tom

Posted by tjeffo at 09:26 PM | Comments (0)

March 12, 2009

Rules of Criticism

My discovery that West Coast Leaf has a web presence should simplify airing my disagreements with public positions taken by Reform organizations, many of which are unknown to the general public, (including a majority of my patients). On the other hand, airing disagreements might easily raise ethical issues best addressed now:

1) Patient Information and Confidentiality: I've always believed that because I'm a physician, I'm obligated to treat any medical information learned from or about a personal acquaintance as confidential, whether they've consulted me professionally or not. On the other hand, I'm free to discuss information that has already appeared in a public record. Recent examples are my speculations about Michael Phelps' ADD and George Bush' drinking problem.

2) Criticize the Message; not the Messenger. Mostly I try to follow this rule; exceptions are people who have taken public positions I consider either outrageously dishonest, punitive, or both. Good examples are Rush Limbaugh and Bill Bennett. Any number of politicians, including some Democrats, might also be mentioned.

Doctor Tom

Posted by tjeffo at 05:14 PM | Comments (0)

March 09, 2009

A Welcome New Web Presence

Recent entires to this blog have expressed an increasing distress at the continuing reluctance of most contemporary human organizations to acknowledge the perennial failure of America's "war" on drugs, plus the seemingly invincible ignorance that still characterizes most written opinion, both popular and scientific, on the subject of human drug use. Finally, there's been an undeniable sense of loss left over from my ostracism, partially voluntary, from the "reform" organizations I once identified with and which had provided me with access to the historical details needed to create context for an accurate understanding of any complicated subject.

To cut to the chase, I've just discovered, perhaps belatedly, that all four issues of a free newspaper devoted to medical marijuana that had appeared about a year ago and been made available for distribution to patients, is now on the web. West Coast Leaf is but a mouse click away, also that the site contains all 3 previously published hard copy issues in HTML format.

Since I now have a better understanding of what divides us and have accumulated enough patient data to point out essential differences between my clinician's view of pot use and those of other interested parties opposed to federal doctrine, I can see new, positive opportunities for discussing differences of opinion in a non-confrontational way.

To have that happen right after the election of the first American President with the potential to slay the drug war dragon is almost overwhelming. I look forward to the challenge.

Doctor Tom

Posted by tjeffo at 06:48 AM | Comments (0)

March 04, 2009

So Much to Write About; So little Time

The lamentation in the title might serve for any number of think pieces as our overcrowded, fearful world teeters on the brink of economic and mental depression. With respect to the former, historians have generally recognized two major economic depressions since the Industrial Revolution began around the beginning of the Nineteenth Century. The first, known as the "Long Depression," and variously described as having started in 1873 or 1893, is beyond the direct recall of all living humans.

The second, and more recent, is now popularly referred to as the Great Depression. It began with a stock market crash in October, 1929, persisted throughout the Thirties and is considered to have lasted in the United States until the end of World War Two in 1945. Thus its entire duration is also beyond the direct memory of most living humans.

Although there are many uncertainties over dates and nomenclature, there is general agreement that the two depressions mentioned above had certain features in common: they took place in Europe and North America and were definitely interdependent as evidenced by bank failures on both continents; they also generated considerable social ferment and were bracketed by modern wars of progressively increasing scope and lethality. Finally; despite the economic hardships and deaths produced by (or related to) those events, an unprecedented and sustained increase in both global population and wealth has been experienced over the last two centuries.


Although it sank to its nadir in the month I was born (January 1932), I was too young for personal memories of the Depression's worst early years. Much of what I now know about them is from the dimly remembered recollections of several older cousins on my father's side of the family who, at various times and for protracted intervals, were squeezed into my grandfather's small three bedroom house for the simple reason that not only did he own it, he was the only adult with a steady job.

My own first fragmentary memories of the larger outside world included the collection and flipping of "war cards" depicting battle scenes from the 1937 Sino-Japanese War (they came wrapped with square penny bubble gum wafers). My first sustained memory of the outside world literally began on September 1, 1939, which was not only the day Germany invaded Poland, but also the Friday of that year's Labor Day Weekend, thus our first awareness of World War Two was a news broadcast over the car radio as my mother was driving to Long Beach on the South shore for the annual chore of closing up our modest beach house for the Winter. I continued to follow the war closely through the Fall of France in June 1940. My interest was then directly engaged that same Summer when my mother's sister and her three children fled just ahead of the bombing of London, arriving by ship and staying; first at the beach house, then moving with us into into our suddenly overcrowded five room apartment in Queens for the start of school in the Fall.

One of the few print magazines I still subscribe to is Atlantic. This month’s lead article was written by Richard Florida, an academic whose father was about the same age as my older cousins and also grew up during the depression in the New York Metropolitan area under very similar circumstances. Drawing heavily on his father’s depression era experience to set the tone, Florida leaves little doubt that he sees today’s financial problems as very similar to the Thirties (although he doesn't quite forecast a depression). The lion's share of his long article then focuses on metropolitan areas, a subject he has been writing about extensively, with an emphasis on how they may be impacted by a severe economic downturn. It didn’t take me long to learn that although Florida has many fans, he has not not been without critics, most of whom seem both conservative and disdainful.

My own criticism of Florida isn't because of his focus on metropolitan areas as centers of creativity, which I generally agree with, but because he, like almost every academic author writing seriously about current events pretends there is no such thing as a war on drugs in the United States, let alone that it's not a serious impediment in dealing with our financial crisis. So widespread and pervasive is this pretense that the drug war isn't a problem (or perhaps, more accurately that that it's an affordable insanity) that I now see the human capacity for denial as a major cognitive flaw in our species; a form of dishonesty that could bring about chaos even faster than the looming energy problems we are also reluctant to deal with.

Doctor Tom

Posted by tjeffo at 04:36 PM | Comments (0)

March 03, 2009

Economy More Deeply Troubled than Thought; Bush Off the Wagon? Comments Enabled

It's becoming harder than ever for economic pundits to avoid the D word as news of the breathtaking drop in both American and overseas markets hits home.

At the same time, as someone who has become obsessed with the damage done by America's unwise policy of drug prohibition, I also see our economic woes differently than most and fear that the most promising American President elected in my lifetime may become ensnared in the mess left behind by the worst. I'll have a lot more to say about these contentious issues in the near future; which brings me up to the main point of this entry.

As a senior citizen who had arrived relatively late at both information technology and Drug Policy Reform and then took up blogging even later, I now find myself in a strange bind: the newly acquired computing skills that had enabled me to jump into two new arenas in late 1995 are becoming almost as dated as the first computers I’d bought back then. Buying new computers as needed to keep up with advances in processor power while continuing to practice as a “pot doc” has been relatively easier than keeping abreast of recent networking techniques; especially since becoming a bit of a maverick has forced me to do most of it myself.

The real reason for this entry is that I just learned how to enable comments, a process that took longer and was more complicated than I’d expected, but is now a click away.

Doctor Tom

Posted by tjeffo at 05:07 AM | Comments (0)

March 01, 2009

The News overtakes Reaiity

I’d obviously had no idea that as I was posting the last entry, Rush Limbaugh was in the midst of a jaw-dropping escalation of his already unprecedented attack on a sitting President. Isn’t His Fatness jumping the gun a bit? After all, the 2012 election is still nearly four years off and he’s already had his hat into the ring for over a month.

On a more serious note, the visceral quality of Limbaugh's hatred is on display for anyone with the wit to recognize it; perhaps the most sobering realization is that he will retain a substantial following of true believers who, although considerably less articulate, are just as consumed by rage. If this sorry event proves anything, it's that human emotions do play major roles in both our cognition and our behavior, which is clearly one of the major implications of our opportunistic study of pot smokers and, I suspect, the primary reason so many people have been pretending not to see/understand it.

Limbaugh's outburst calls up another well-known incident, one for which he, like Cindy McCain before him, could easily have been prosecuted, had they not been so well-connected.

While we're on the subject of American "Justice," here's a convenient collection of articles on the treatment of Americans who had every reason to believe they were being protected by an initiative that had been allowed to stand following repeated reviews by both state and federal "Supreme" Courts. Nevertheless, they have since been prosecuted by federal authorities and many are now serving obscenely disparate sentences.

Pardons for most, if not all, would send a powerful message.

Doctor Tom

Posted by tjeffo at 08:42 AM | Comments (0)