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June 29, 2009

Annals of Validation

News sources are suddenly overflowing with items endorsing what I’ve been hearing from pot smokers for well over seven years. Just as I was just about to cite the Michael Jackson tragedy in an entry about the key role played by biological fathers in their children’s mental health, I came across Debra Saunders’ column in yesterday’s SF Chronicle on last week's “drug-related” Supreme Court decision. Deciding the Jackson story will linger considerably longer in the public consciousness, I opted for the equally instructive, but somewhat more convoluted, story from Oregon.

It involves a ninth grader who, in 2001, had been clinically diagnosed with ADHD, but was not “tested” for it and later developed “depression” and “cannabis use disorder” which led his parents to send him to a private school. In 2003, they sued for “equal education” under the Americans with Disabilities Act and after several affirmations and reversals along the way, were finally heard by the Supremes, who ordered, 6-3, that they be reimbursed for the cost of tuition at their son’s (outrageously) expensive boarding school.

True to the “anti-drug” bias of American media, most accounts fail to mention, as Saunders does in her first paragraph, that the unnamed juvenile was self-medicating his ADHD with pot. The “Supreme” irony for me is that our highest court sided with physicians over cops by unwittingly endorsing, albeit indirectly, the treatment of an emotional disorder with cannabis.

That’s a practice I know to be safe and effective, but the DEA regards as a felony and NORML considers “recreational.”

Doctor Tom

Posted by tjeffo at 04:25 PM | Comments (0)

June 28, 2009

Lessons from Pot’s Past; Implications for Its Future

The major unexpected benefit flowing from my curiosity about pot culture and leading me to interview applicants seeking a “recommendation” to use cannabis medically was a study challenging a US policy based on popular misconceptions and targeting a population falsely characterized as deviant and criminal for over seventy years.

That study, now over seven years old and still in progress, did so primarily on the basis of emerging applicant demographics and by uncovering multiple shared characteristics suggesting that the pot market’s steady growth was based on marijuana's safety and efficacy in self-medicating a wide variety of physical and emotional symptoms.

With respect to the demographics, the lurid Hearst-Anslinger “reefer “madness” campaign preceding the Marijuana Tax Act of 1937 had been so famously camp that few seem prepared for one of the study’s most important implications: whatever illegal market for “reefer” existed in 1937 must have been tiny. Also, it had remained that way for another three decades before exploding in the Sixties. That it was tiny is confirmed by infrequent news about busts; however such negative evidence tends to be overlooked; particularly in a world overburdened by information and anxiety.

However that may soon change in ways that will be hard to ignore. A seldom-acknowledged characteristic of the silent majority responsible for electing Richard Nixon in 1968 has been their pot avoidance. Although small compared to the boomers they sired and nurtured throughout the late Forties and the Fifties, they have been relatively long-lived, thanks to modern medicine. What has always distinguished them has been the relative infrequency with which they try pot themselves.

A clinical observation I’ve made just often enough to have some confidence in (but have no statistics to support) is that older adults who never tried pot tend to resist using it, even after developing conditions that it should help. They will refuse to try it until late in the game; if they do so at all, it’s only after all other measures have failed and it’s been recommended by someone they trust.

People who tried pot as adolescents, on the other hand, seem to have given themselves permission to use it if they need it; even if they haven’t been recent users. In other words, adolescent pot initiation seems to carry with it lifetime permission for medical use. Thus does my demographic profile of the applicant population suggest that when the first Boomers reach Medicare age in about three years, we should see a steadily increasing demand for “medical” marijuana for the same reasons they eventually came to dominate American society: so many were born after World War II.

Doctor Tom

Posted by tjeffo at 04:15 AM | Comments (0)

June 22, 2009

Paradoxes in the News

As my recent posts on the Lynch case show, I’ve become considerably more critical of Obama for the outright dishonesty of his “Justice” Department in its handling of medical marijuana cases in California than anything he has (or hasn’t) said about fraudulent elections in Iran. In fact, my personal choice of low point among Obama’s many video moments is still his derisive snicker at the idea that taxing pot might be a fix for the budget crisis. Why? Certainly not because I thought the suggestion had merit, but because I’d hoped Obama knew better; also because his answer suggests a mindset I now recognize as one that will prove difficult to correct.

To return to Iran: for me, the very issue illustrates why conservatives tend to oversimplify complex situations; it allows them to blame others for any adverse consequences of their “faith-based” convictions while also tending to absolve them from any responsibility for similar consequences. Also, their frequent references to faith and religion reinforce the notion that they are on the side of good and that the “godless” liberals and atheists they have designated as sworn enemies should not be trusted.

It has also helped their cause that the most flamboyant pot smokers often come out of the closet early, while the those with the most to lose have tended to remain anonymous during life.

Thus does the pot our president once got high on, but had to quit to realize his political ambitions, remain more “evil” than the tobacco he still struggles with (not quite) out of sight.

On a more personal level, that our profile of pot use has elicited so disproportionately few comments is both annoying and a confirmation of the denial America's (stupid) pot policy has been thriving on.

Doctor Tom

Posted by tjeffo at 06:30 PM | Comments (0)

June 20, 2009

Iranian Digression

It’s now just over a week since Iran’s Presidential election, widely expected to show popular discontent with the incumbent, managed to do just that; but in ways that were unpredictable and potentially destabilizing. Even more significantly from my point of view, the past week’s events can be seen as a remarkably accurate metaphor for the systemic malaise plaguing our species.

From a strictly logical point of view, the fact that Iran’s President Ahmadinejad is an outspoken Holocaust denier who had received his government’s official endorsement for that view should have prepared us for the enormity of the claims surrounding that same government's report of his “re-election” a day later. While it was clear to all that the claims had to be bogus, what was left unresolved was whether they reflected ineptitude or contempt on the part of the power structure's "supreme leader".

As for the much debated political wisdom of Obama’s muted response, it’s still too early to know whether those who claim it’s just right, or his right-wing critics, who claim it’s craven, will prevail for reasons that are both similar and quite straightforward: not enough is known in the West for accurate predictions.

Similarly, does yesterday’s announcement by the “supreme leader” represent an accurate prediction of victory or wishful thinking? Can he rapidly crush the demonstrations? If he can’t, his grip on power may continue to weaken; even so, any new government that emerges will still be Islamic and predominantly Shiite, and thus hardly pro-American.

One truth most seem to (silently) agree on: thanks to Dubya’s war on terror, the US has neither the military nor the economic strength to intervene in Iran (or even North Korea, for that matter) thus we are reduced to a spectator role.

Given the present state of global affairs; that may be the safest course, but even that is uncertain.

Doctor Tom

Posted by tjeffo at 09:49 PM | Comments (0)

June 18, 2009


It seems that every time I‘m about to give up on the possibility of spontaneous drug policy enlightenment, a column like one in today's NYT appears. Even though Kristof’s thinking about the issue is almost identical to that of the late Wm. F Buckley, Jr. when he provoked so much furor in 1996, the context has been changed significantly by what has happened since, as contemporary comments (and the speed with which they have appeared) make clear.

Unfortunately, there is still the same deep division between religious type control freaks who believe a coercive prohibition policy is essential and those who are more realistic. The good news is that thirteen years later, the latter seem less inhibited and are more outspoken; but a critical question remains: can they wrest control of the world fast enough to save it from their fear-driven fellow humans who have been dominating governments throughout history?

Doctor Tom

Posted by tjeffo at 06:01 PM | Comments (0)

Darwin and Lincoln

The discovery, some time in ‘06 or ‘07, that both Charles Darwin and Abraham Lincoln had been born on the same day in 1809 was very exciting for me. My own rejection of any sort of “divine” intervention in human affairs leads me to consider it a mere coincidence; even so, coincidence in this case becomes a convenient device for learning from the lives of two men who exerted such enormous, and generally benign influence on the lives so many others— indeed, on our modern world as we now know it.

Although born on separate continents into very different economic and social circumstances, the two shared a common language and both went on to become famous during their own lifetimes and to influence the lives of contemporaries and all posterity. Indeed, it is difficult to conceive of how our modern world might now look had both not lived.

It’s also significant that both became objects of hatred during their lifetimes and that both the positive and negative emotions they inspired have continued growing unabated since their deaths.

What I now see both lives as demonstrating is the power of the human brain to interpret and respond to information in ways that have a unique and lasting impact on both the intellectual and physical environment. In a sense, any who survive to maturity also have an impact that outlives us, but, in most cases, to a far more modest degree, and in ways that, except for progeny, can’t be traced. Did their great fame and notoriety bring Darwin and Lincoln (henceforth, D & L) happiness? The answer seems to be no; in fact quite the opposite. What those of us who admire them can hope is that they each gained a measure of intellectual satisfaction and peace from their accomplishments.

Why am I switching styles so abruptly? It's because Inow accept that although the unlikely research project with pot smokers I've been blogging about for over three years has provided me with clinical information known to very few others, it's also information very few seem to want, and there's not a lot I've been able to do to change that.

Given both the size of the growing blog universe and the ease with which one can now upload text, its use as a publicly maintained personal journal has never been easier. Also, the efficiency with which web content can be searched means that whatever readers I do attract can always find me. Finally; the gamut of emotional responses that seem to be inspired by any discussions of cannabis, its users, and its phenomenal modern market is so bizarre I've decided to just say what I think rather than pretend that I'm writing for people with an honest interest who are looking for an intelligent discussion.

Another way of putting it is that perhaps the least likely subject upon which one can provoke an informed, intellectually honest discussion is pot. Although I know there are many bright, well educated people with a serious interest in all aspects of its use, public pronouncements about that use are most noteworthy for the incredible silliness of policy advocates and the reticence of others with an interest to discuss salient issues honestly.

Thus I've decided to simply present what I believe to be true based on an ongoing analysis of my clinical encounters with pot smokers and let the chips fall where they may.

Doctor Tom

Posted by tjeffo at 04:21 PM | Comments (0)

June 13, 2009

Embarrassing Reminders of Drug War Crimes

Two items on smoking and health appeared in the New York Times on Friday, June 12. While either one by itself should deeply embarrass our federal war on drugs, the two, when taken together, add up to a startling revelation of how feckless and destructive our drug policy has been, and just how empty our claim to adhere to the “rule of law” really is.

The first reported the Senate vote to transfer tobacco regulation to the FDA, a move that belatedly admits cigarettes are drugs and not the “recreational” products their manufacturers have always claimed. I was immediately reminded that the first solid medical link between cigarettes and lung cancer was established when I was a first year medical student in the Fall of 1953. The resultant drop in cigarette sales was eventually countered by Big Tobacco's cynical, well financed, and ultimately successful effort to delay acknowledging obvious truth for decades while allowing it to reap more profits from its deadly products. Given the circumstances that existed in 1953, an immediate ban on cigarettes would have been impossible; also, there is ample evidence that simply banning a popular drug is ineffective. However, neither consideration can justify the pathetic failure of the government to sponsor honest research of its own, while also permitting a powerful Tobacco Lobby to spread confusion and market its deadly products to juveniles thus causing millions of additional deaths over a span of five decades. Tobacco-related deaths are not only a result of lung cancer; but are also caused by cardiovascular disease, several other malignancies, and chronic obstructive pulmonary disease (COPD).

The second Times report was on the sentencing of cannabis dispensary owner Charles Lynch to a year and a day in federal prison. That the sentence was so short was mostly due to the judge, who had clearly been requesting more help from the Obama "Justice" Department than he received. The apparent excuse from Justice for not intervening: its current interpretation of policy requires federal enforcement in cases where, in their judgment, state law has been violated!

Presumably, the sin was sale to an underage minor in this case, a particularly odious canard because cannabis facilitated successful treatment of a rare and aggressive bone cancer that typically attacks adolescents. If such contrived logic is the Obama Administration's ultimate defense of the DEA, it's a position that is medically, morally, and logically indefensible; far more typical of the usual Democratic Party pandering to conservatives many have come to loathe and not the “change” we wanted to believe in.

But, far beyond that, the juxtaposition of the two reports emphasizes the profound intellectual dishonesty of a drug policy that consistently allows our government to cut excessive slack to a variety of well-heeled corporate killers, while demanding the arrest and harsh punishment of millions of young people self-medicating with a safer alternative to alcohol and tobacco.

The moral failure of the drug war has been total: first they declined a 1972 recommendation to study pot honestly, then they spent billions justifying the arrest of millions of pot users, thus pushing others into self-medicating with its two deadly, but legal, alternatives.

Complicit “research” purchased by NIDA from willing behavioral scientists in an obvious effort to support federal policy errors will not stand rigorous scrutiny indefinitely. Similarly, the failure of both Big Pharma and Academia to acknowledge the potential therapeutic benefits of cannabinoid agonists after discovery of the endocannabinoid system in the early Nineties will be increasingly difficult to explain to our descendants in decades to come.

Doctor Tom

Posted by tjeffo at 08:25 AM | Comments (0)

June 11, 2009

Back to the Future

Although “recorded” human history implies written language and we tend to think of the first humans to devise writing systems some six thousand years ago as “ancients,” modern science has revealed that Homo sapiens, a species that's been around for only a few hundred thousand years, and is thus new as species go, are probably descendants of Miocene Apes that didn't make their appearance until about nine million years ago. Beyond that, the techniques of Science are such that much of what we now consider “progress” had to wait until certain widely believed assumptions about the physical world could be subjected to critical scrutiny, a process that has been shaping the modern world at an increasing rate since the beginning of what we now call the Industrial Revolution.

In other words, most of what we now (think) we know about the Universe (Cosmos, Metaverse) has been learned since George Washington was born in 1732, not quite three hundred years ago. To belabor that example a bit further: just as we now realize he was just another fallible human, Washington's limitations didn’t prevent him from leading an improbably successful rebellion against the dominant imperial power of his time. Further, like every other major historical figure, his impact on history depended mostly on chance, in the sense that it could not have been accurately predicted in advance. Beyond that, the consequences of his leadership have become inextricably intertwined with countless other events. Yet; somewhat paradoxically, to the extent we do understand the cosmos, the evidence that it behaves in discernible repetitive patterns (“natural laws”) has been growing, as has the influence of our own species in shaping events on our home planet.

The origins of what is now loosely defined as the Scientific Method go back to the work of Galileo and Newton in devising experiments by which the then-heretical postulates of Kepler and Copernicus could be tested. In essence, the beliefs of Science and (monotheistic) Religions have been in conflict ever since then, and can be seen as foreshadowing much of the strife that has plagued the world since before the turn of the Twentieth Century (and well before).

Our modern paradox is that ever since humans became the only species able to employ cognition to make choices and fabricate complex tools, we have been exerting a significant impact upon our planet's other life forms. Through Science, that impact has been magnified to a point where we may now be altering the weather patterns those life forms depend on for sustenance.

At the same time, the continued domination of human cognition by religious thinking, together with our appetite the artifacts made possible only through science, are competing in ways that are forcing human behavior into directions that do not auger well for either short or long term species survival.

One may well ask why a "pot doc" who only recently became preoccupied with the human use of cannabis would be writing about such abstruse concepts. An answer is hinted at in two recent periodicals; first the July-August issue of Atlantic (not yet online) that arrived only yesterday. What caught my eye was Jamais Cascio’s response a question Nick Carr raised in the same magazine just a year ago: Is Google making us “stoopid.” Cascio's answer seems to be far from it; but Google- and the web in general- are definitely having an impact on how we choose to exert our cognitive influence.

To frame the issue in terms of cannabis, its popularity as an illegal drug has clearly increased in parallel with the incidence of the ADD behavior Carr so eloquently describes and Cascio refers to repeatedly. From my clinical perspective, the absurd federal insistence that pot must remain forever illegal was first tested by California’s Proposition 215 in 1996 and is still staunchly defended by most police agencies and the Obama Administration. In the second timely item, the San Francisco Chronicle reported that "legalization" may well be tested more directly in 2010.

Thus, we may still be on track to accomplish the general intent of Proposition 215; although by a route its 1996 backers could not have predicted. In another entry, I’ll explain why whatever initiative voters get to vote on will probably also be “stoopid.”

Doctor Tom

Posted by tjeffo at 10:54 PM | Comments (0)

June 10, 2009

More of the Same

One of the more glaring examples of denial in our modern world is the degree to which the failure of America's war on drugs has been either ignored or systematically misinterpreted; not only by our own government, but by those of the UN nations bound by treaty to enforce it. With the exception of the Netherlands and Portugal, drug war heresy has been rare, and even where it has emerged, often been timid and reversed by American arm-twisting. Witness: Australia, Great Britain, and Canada.

Given the mountain of available evidence, any pretense that the drug war has been even occasionally successful, or represents rational public policy, simply cannot stand serious scrutiny; yet the official pretense continues. Although the latest example of failure is again Mexico, one need not stop there; Colombia has been ravaged by violence since the cocaine trade began to expand in the Seventies while people in other “producer” nations, notably Burma and Afghanistan, are each paying a high price for their involuntary participation in illegal drug markets. In every instance, the violence and political instability can be related to one factor: huge revenues generated by thriving criminal markets.

Although I recently had hopes that the “change” being touted by the Obama Administration might include a measure of sanity with respect to marijuana prohibition (the crown jewel of police agencies surviving on their drug war failures), I am now convinced that hope was forlorn. However, I’m still curious as to how we will respond to the latest challenge from Mexico, a long-suffering nation where a repressive government is trying to please its obtuse Northern neighbor by enforcing a policy no one wants to admit is so unbelievably stupid.

Sooner or later, someone will have to wake up to reality; one hopes there will still be time to save us from our multiple other follies.

Doctor Tom

Posted by tjeffo at 05:30 PM | Comments (0)

June 04, 2009

Going Back in Time

One of several themes I’ve been harping on with little visible effect is that the modern mass market for marijuana didn’t start developing until young adults and their adolescent brothers, sisters, and cousins began trying it in the Sixties. Once it caught on with youthful baby boomers, it became an overnight sensation, but only with them.

Characteristically, the pot market that began growing in the Sixties has remained a youth market; nearly all its new customers tried it while in High School or Junior High, and with at least half (perhaps more) of all new students admitting to trying pot since Monitoring the Future surveys began in 1975, it hasn’t taken long for the modern market to dominate all illegal drug markets.

The percentage of youthful initiates who continue to use pot on a regular basis can’t be measured directly, but the increasing appetite for "medical" marijuana here in California, despite the vigorous opposition of both federal and state narcs, can no longer be hidden by the inept reporting of the state's newspapers nor the dissembling of police agencies. The reasons are obvious: once a substantial number of retail “medical” outlets opened, growers were able to sell to the same buyers through either a black or a gray market. It combines the convenience of multi-level marketing with price support by the police (compare today's with those given in the Time article).

Now that Google is making our past more accessible, it’s literally possible to go back in Time (Magazine) and read a revealing account of how marijuana was perceived and used around the time of the Marijuana Tax Act. One of the more famous pot busts of that era was drummer Gene Krupa in San Francisco in 1943. An unexpected bonus from Time’s account was then-contemporary lore, amply confirming there was appreciation that pot was a healthier and more peaceful alternative to alcohol; also that law enforcement was just as unfair as it is now. The major difference between then and today is a big one however; our modern failure is much more costly and destructive.

Doctor Tom

Posted by tjeffo at 05:42 AM | Comments (0)