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September 28, 2009

Another Take on Legalization

Willie Brown was a poor black youngster in rural Texas before he came to live with an uncle in San Francisco in the early Fifties so he could go to college. Working his way through school, he soon earned a BA from San Francisco State and a law degree from Berkeley. Entering politics, he went on to become one of the most influential members of California's Assembly, which he led as Speaker for a record fifteen years. He was next elected as San Francisco's first black mayor just in time to guide the City to dot com prosperity while gaining national prominence for his charisma and political savvy. He's also had his share of criticism for questionable deals and controversial decisions. Now in his mid seventies, he’s a widely read columnist who is not shy about offering opinions on key issues.

He’s also just become the latest (in Sunday’s paper) to weigh in on pot legalization. While it takes courage to disagree with Willie on a political issue in California, I thinks he’s wrong for the vexing reason of juvenile use. Since the most troubled “kids” start trying pot as early as twelve; arresting them nearly 10 years short of an arbitrary limit is simply irrational, yet so long as the age of 21 is enshrined in federal law, you can count on the current bureaucracy to defend it to the death and Congress to go along.

Thus I think it will take some additional factor before Congress is finally persuaded to second guess its tragic four decade blunder.

Doctor Tom

Posted by tjeffo at 02:35 PM | Comments (0)

September 27, 2009

More on Legalization

The theme of the just-concluded 38th annual NORML Convention in San Francisco was “Yes, we cannabis,” clearly expressing the hope our embattled new chief executive will somehow find the time and political capital to support pot “legalization” between bruising battles over medical care, our economic woes, and worsening problems in Afghanistan.

On Friday evening, I was a guest at a private dinner traditionally hosted by a wealthy reform supporter; thus I had a few minutes to sound the same cautionary note as in the last blog entry: don't assume the economic strength of the medical gray market is tantamount to political support for legalization. I could tell it wasn’t that well received by all, but felt obligated to deliver it anyway.

Ironically, the same message was delivered by a local columnist in yesterday’s SF Chronicle, but for different reasons. He also considers conferee enthusiasm misplaced and unrealistic; not for lack of support from Washington, but from Fresno. While I may decry the reasons, there’s no denying he's right. As long as "recreational” pot use by adolescents is feared by the general public, they won’t support its “legalization.”

In other words, they have to understand that their offspring are at least as likely to try drugs during adolescence as they were themselves. The unlikely truth, still distorted by forty years of federal propaganda, is that of all the drugs adolescents might try, cannabis is clearly the safest; especially in comparison with the two that are legal: booze and cigarettes.

Doctor Tom

Posted by tjeffo at 01:40 PM | Comments (0)

September 25, 2009

Painted into a Corner?

Since passage of the Marijuana Tax Act in 1937, the American Federal Government has referred exclusively to the herbal remedy then known medically as cannabis and agriculturally as hemp, by the pejorative slang term, “marijuana” in all official documents. That practice has been followed so uniformly it’s now observed not only by supporters of cannabis prohibition, but also an overwhelming majority of those claiming to be neutral, and even a majority of the policy's bitter opponents.

The policy itself, still supported as ardently as ever by our federal bureaucracy, is now being implemented under the 13th presidential administration elected since the MTA became law on October 1, 1937. When its Constitutionality was threatened on Fifth Amendment grounds in 1969, the policy was immediately rewritten by the Nixon Administration in more punitive form as the Controlled Substances Act of 1970. Once signed by Nixon, the CSA also became global drug policy retroactively through an international UN treaty promulgated nine years earlier by none other than Harry Anslinger, the troll-like sponsor of the original MTA.

Since 1996, our marijuana policy, now considered a major component of American “Drug Control Policy,” has come under increasing attack from non-government organizations known collectively as the Drug Policy Reform movement. Organizations specifically supporting marijuana “reform,” have the most members and are the most visible (no surprise: more marijuana “crimes” have been treated as felonies in every year year those statistics have been kept) in campaigning for "medical marijuana” legislation, but it would be an mistake to think all successful state laws are equivalent.

Only in California has a powerful medical gray market developed, and that development has been quite erratic. More recently, it has been in concert with the brutal violence of Mexican Drug Cartels now operating along our southern border. Even so, there has been little recognition that the two phenomena are convincing evidence that an enormous illegal market of unknown dimensions has been developing steadily in parallel with our failing drug war for four decades.

Perhaps the most probable, but least appreciated, implication of the pot market's enormous, but unknowable size may be that the only legislative body capable of "legalizing” marijuana is the one least likely to do so: The Congress of the United States.

That's a reality few now looking far a quick change in US policy seem to have considered. In theory, anything can happen, but a quick reversal of US marijuana policy seems very unlikely in the near future.

Doctor Tom

Posted by tjeffo at 11:04 PM | Comments (0)

September 22, 2009

Omens of Change?

The September 13 entry alluded to two reasons for thinking drug war minders may feel threatened as never before by the commercial success of medical marijuana in California. One was the degree to which my study of cannabis applicants has been ignored for two years; the other, a pair of documents that surfaced recently. Before considering them, I’d like to cite a prescient passage from the last pages of Drug Crazy, Mike Gray’s cogent 1998 analysis of America's drug policy published within two years of California's unexpected approval of Proposition 215.

Correctly anticipating that the controversy could only be intensified at first, and prudently avoiding any time estimates, Gray wrote: ”The coming engagement promises to be bloody because the outcome of the whole war is at stake. Prohibition, as policy, can only ratchet in one direction. Each failure must be met with more repression. Any step backward calls into question the fundamental assumption that repression is the solution. Ultimately, every available gun will be brought to bear because marijuana is the pawl on the ratchet, the little catch that keeps the drum from unwinding. For sixty years, Harry Anslinger and his successors have put their backs to this wheel, laboring to hoist drug prohibition to the level of a national crusade. But if somebody jiggles that pawl and the drum slips, support for the current policy will plummet like a loose cage in a mineshaft because it cannot sustain a serious evaluation.”

I always considered Mike's pawl analogy particularly apt. Ironically, when I first read it, I had yet to meet him and no idea I might someday do the study he anticipated; or that he'd play key roles in both its completion and publication.

That study relied on the initiative itself to recruit its own subjects, all cooperative users; a circumstance that could not have been anticipated. Analysis of their previously unavailable data exposes the profound ignorance of the drug war bureaucracy and the degree to which American drug policy has based its dogma on false assumptions. For example, while a “gateway" effect was one of several possible interpretations of the data gathered from the first baby boomers to try cannabis, it was revealed as the direct opposite of reality by the histories of younger cohorts.

Another unexpected finding is the precise time-line followed by the modern illegal market, which, in turn, is powerful evidence that its steady growth has been related to the unique ability of inhaled cannabis ("reefer") to relieve certain distressing emotional symptoms of adolescence more safely and reliably than other agents, whether illegal or pharmaceutical.

Finally, the most important implication of the study may be that by pushing vulnerable teens toward more dangerous agents, Nixon's "drug war" has probably been a forty-year disaster. In the face of that possibility, calculated indifference by either side of the policy “debate,” is both astonishing and irresponsible. Most bizarre is the silence of the “reform” movement. Because its principals have not discussed it publicly or privately, I'm forced to conclude it's because they are still convinced their own use is “recreational.”

As for hard-line drug war supporters, two recent moves now suggest how worried they have become; one is an elaborate “Friends of the DEA” report pleading with the Obama Administration to continue raiding dispensaries. Nothing new there. The other is far more ominous; a draft proposal, soon to be considered by the Medical Board of California at its October quarterly meeting in San Diego, for sweeping revisions of its disciplinary procedures.

Even a cursory reading reveals the proposal as a breath-taking attempt to do bureaucratically what Drug Czar McCaffrey was unable do by fiat in the waning days of 1996: nothing less than premeditated murder of the new law by unfrocking the physicians needed to implement it.

How well the public will accept such a naked revision of recent history remains to be seen. Whatever happens, cannabis will almost certainly continue to be a growth industry.

Doctor Tom

Posted by tjeffo at 02:22 AM | Comments (0)

September 18, 2009

Further Evidence of Cluelessness and a Powerful Gray Market

Apropos of the last entry’s contention that the feds are being undone by the commercial strength of the gray market enabled almost 13 years ago by Proposition 215, was this item in the NYT on pot’s growing popularity on the small screen.

Just by chance, it was gleaned from today's e-mail, which also led me to another item demonstrating the lack of comprehension of their own specialty my psychiatrist colleagues betray on a daily basis, courtesy of the combined malign influences of the drug war and the DSM. Trevisan is right that the oldest boomers will start turning 65 in 2011, but he fails to appreciate that a significant fraction will be chronic users of marijuana who have been benefiting from their 'behavioral disorder" for decades, or that one of the benefits experienced by most has been a reduction in alcohol consumption to safe levels.

Doctor Tom

Posted by tjeffo at 06:22 PM | Comments (0)

September 13, 2009

Background of a Peer-Reviewed Study 2

The last entry described how I'd become involved in a continuing study of medical marijuana nearly eight years ago. I should emphasize that before I began interviewing applicants as required by California’s then five-year-old-law, I had little idea of what that review process would involve, let alone what it might reveal. I’ve since come to understand that going to High School in the Forties made me different from my "pot doc" colleagues. Although their defiance of the drug czar in the initiative's first year had been crucial to the eventual development of today's state-wide retail distribution network, their acceptance of chronic musculo-skeletal pain as the most common basis for "valid" use of cannabis had obscured pot's historically important anxiolytic function in assuaging the adolescent angst of baby boomers. That difference is perhaps best explained by our different focus: as boomers themselves, my younger colleagues were seeking reasons to justify their contemporaries' current pot use; as a cultural outsider, I was unwittingly trying to understand why the largest adolescent generation in American history had found a relatively unknown illegal drug so attractive.

The small gray market that developed slowly in the wake of Proposition 215 became a nucleus of clubs in the Bay Area and a few other locations; from late 2003 on, it entered a growth spurt that attracted attention from local governments, law enforcement, and the media. The Raich decision in June 2005 was soon followed by an increase in both federal raids and local prosecutions. Although intense police lobbying produced a temporary reduction in the number of "dispensaries," a second surge in the medical gray market produced the hundreds of retail outlets now operating in populated parts of the state and generating articles in influential publications that, for the first time, raise doubts about the long term future of America's huge drug war bureaucracy.

In other words, despite the drug war’s best efforts, the commercial success of California's admittedly flawed medical model is forcing many local police agencies to accept the law, albeit grudgingly; and a gray market that barely survived the first few years of Proposition 215 is now robust and continuing to grow, albeit erratically.

I'm often asked by applicants if I think pot will become legal soon. Because I know how deeply entrenched the drug war bureaucracy has become over the past four decades, and how reluctant all politicians will be to admit such a huge national mistake, I don't think the death of our drug policy will be quick or easy; let alone, pretty. However, two circumstances now encourage me to think it may be sooner than I would have guessed, even a few years ago. One is the almost total silence with which my paper has been received in the two years since publication.

The other is a set of documents I just became privy to. they reflect the extreme desperation of the drug war bureaucracy after thirteen years of quasi-legal "Medical Marijuana" in California.

The next entry will look at both as omens of an uncertain future.

Doctor Tom

Posted by tjeffo at 03:49 AM | Comments (0)

September 06, 2009

Background of a Peer-Reviewed Study

After I began screening pot smokers at an Oakland “buyers’ club” in November 2001, it took several months for me to understand that Proposition 215 had created a unique opportunity for studying pot use. By then, it was April, 2002, and I was briefly embarrassed that it had taken me so long to “get it.” May and June were spent deciding which areas of personal history to focus on and what questions to ask about them. It was a busy time because I’d also started seeing patients at 2 other Bay Area locations on alternate Thursdays. Once I started organizing the data in early 2003, I quickly understood that a database would be needed and population demographics might be important.

Also in 2003, I began informally discussing my findings with reformers in two e-mail discussion forums I’d participated in for years, and subtle, but unmistakable signs told me that a significant fraction were upset by what they were reading. But it wasn’t until May '04, when I reported on 620 consecutive patients to a reform audience in Virginia that I discovered that at least a few reformers were dismissing my applicants as mere “recreational” users and their body language confirmed that the mild hostility I’d sensed from the e-mail discussion groups had been real, but- significantly- at no point was my data ever challenged, and all attempts to seek out specific objections to its accuracy failed .

Two new developments dominated the news in California after my return from Virginia: the Oakland City Council had gone ahead with its plans to restrict business licenses for pot clubs, and police agencies around the state had begun urging their local governments to restrict or deny them completely. Soon the Oakland club where I’d been working had lost its license and consequently had to renege on its offer of space in their San Francisco branch. I was suddenly without a practice location and office help, but Dustin Costa, a former patient, who was out on bail after being arrested for growing, and was starting to organize the Merced Patient Group as part of his defense, invited me to interview its applicants. That was helping to sustain my practice in June, 2005, when the Raich verdict suddenly changed California’s political climate once again.

For Dustin, the cost of Raich was enormous; in August he was summarily re-arrested on a federal warrant by a posse of California police officers brandishing guns and then taken to the Fresno County jail, where he was held without bond for 15 months. In November, 2006, he was convicted by a federal jury that was kept from hearing any relevant testimony; next, in February, 2007, he was sentenced to fifteen years and packed off to to serve his time in a prison in the Texas Panhandle.

My personal experiences with his ordeal, plus the crudely dishonest federal efforts to subvert Proposition 215, have convinced me that American drug policy is even more cruel, unjust, and stupid than I had imagined or (like most people) want to believe. Thus the reasons why such a travesty is still the world’s drug policy by UN Treaty should be a far more urgent item of interest to our species then is now the case.

In a nutshell, that’s also why I now see denial as the greatest threat to humanity's well being.

Doctor Tom

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

September 04, 2009

Cannabis and Insomnia

Michael Jackson’s funeral reminded me that on December 30, 1996 drug czar Barry McCaffrey went on national TV to deliver the federal government’s rejection of California’s medical marijuana initiative. Among other things, he ridiculed the idea that insomnia could possibly be an indication for pot use.

The initiative survived his threats against California physicians, but only because the Ninth Circuit of the Supreme Court saw it as a First Amendment violation and issued an injunction. Thus did Proposition 215 narrowly survive and ultimately allow me to gather data explaining why millions of American adolescents have continued trying pot year after year and why so many have continued using it as adults despite the risk of felony arrest and other harsh penalties added during forty years of unrelenting drug war.

As for insomnia being trivial, Michael Jackson, perhaps the most famous (and poignant) insomniac on record, was interred yesterday. His initials are not only shorthand for “marijuana;” they should remind us he might still be alive if it were legal; instead he was given a fatal sequence of legal benzodiazipines to help hm sleep. If his unfortunate physician is ever charged, it won't be because of the the drugs he prescribed, but because of the way they were administered.

Only occasionally in the weeks of uninformed discussion since Jackson's untimely death, was his well-known childhood abuse at the hands of his biological father linked to the obvious symptoms of anxiety he manifested throughout his adult life. While there may be no better illustration of the tragic consequences of dysfunctional parenting during childhood; Jackson is by no means, the only shy celebrity remembered for a troubled childhood, problem drug use, and a premature drug-related death.

I don't know if Michael Jackson ever tried pot, but I'm fairly certain he was subject to too much scrutiny to self-medicate with it. By the time his early success and that string of electrifying music videos made him a huge international icon, he was already trapped by childhood demons and limited to dangerous, but legal drugs for his intractable insomnia.

Have you been paying attention, General McCaffrey?

Doctor Tom

Posted by tjeffo at 03:47 PM | Comments (0)

September 02, 2009

3 More Book Recommendations

A little over a month ago, I listed six books I’d found helpful after becoming seriously opposed to the drug war. All were primarily concerned with policy; three had been written in the early Seventies and three in the mid Nineties. Today I’d like to add three more; all with a focus on the drug culture that began in the Sixties and were written by authors who freely admit their own drug use. That's why I found them so valuable; for one thing, they educated me on several aspects of the counterculture I'd been only vaguely aware of, for another, they will educate readers with open minds by demonstrating the differences between their authors' generally liberal points of view and those of well known drug policy hawks like William Bennett, who still regards "addiction" as evil, but can't understood that he has publicly embraced at least three (ditto Rush Limbaugh, with two to his credit).

Another reason for listing these books together is that they appeared at intervals after Nixon’e drug war; thus they also illustrate generational differences similar to those exhibited by the applicants I’ve been interviewing (which adds to my suspicion that the adult humans psyche is far more intensely influenced by childhood experiences than ls commonly realized).

The three books, in order of original publication:

Reefer Madness, by Larry “Ratso” Sloman.

Focused on the late Seventies and early Eighties and well researched, it contains a lot of info on Harry Anslinger and the Marijuana Tax Act. One example is a more nuanced reading of Dr. Woodward's prescient objections to it than I have ever seen; there's also a useful 1998 Afterward by Michael Simmons.

Acid Dreams Extremely well sourced review of the Sixties; more focused on psychedelic drugs than on marijuana per se, but a useful reminder that the two categories should always be considered within the same general context.

The Cannabis Companion by Steve Wishnia.

The most recent, and (by far) best illustrated of the three; also the one with the weakest historical point of view. The author is a formal editor of High Times.

Doctor Tom

Posted by tjeffo at 08:23 PM | Comments (0)