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December 15, 2009

California’s Booming Recommendation Industry

Although it's been more than thirteen years since California passed Proposition 215, there’s still a tendency to call the doctor’s statement patients require to use cannabis legally a “prescription,” rather than a “recommendation.” That the distinction was important is seen by the fate of Arizona’s Proposition 200, which has been in limbo for thirteen years, despite having received an even greater majority than Proposition 215 the same year.

Just as President Nixon’s 1972 rejection of the Shafer Commission's recommendation was the key to enabling today's booming illegal cannabis (“marijuana”) market to go forward, so was Drug Czar McCaffrey’s 1996 threat against physicians who dared to discuss its use with patients (applicants?) the key to creation of a new medical specialty of cannabis consultant, or “pot doc.” I do not claim to have been among the very first of such specialists, but I may have been one of the first to meet applicants at cannabis retail outlets, then known as “pot clubs” but now referred under the more medically respectable rubric of “dispensary.”

To return to the question of how the required physician's statement should be referred to, Arizona's experience suggests that terminology is crucial, a notion clearly anticipated in the pre-election analysis of California's initiative. Be that as it may, one of the consequences of General McCaffrey's 1996 threat was to scare most practicing physicians away from the recommendation process, thus leaving it to a relatively small number of activists, the most prominent of whom was the late Tod Mikuriya, a psychiatrist who had been championing its use since a brief stint at the NIMH in the late Sixties.

Tod was off and running as soon as the Ninth Circuit blocked McCaffrey's threat with an injunction. Therapeutic use of cannabis had been his passion for much of his professional life, thus he was already well prepared intellectually to hold clinics, evaluate applicants, and sign recommendations in multiple locations; thus provoking a blizzard of complaints from law enforcement to the Medical Board. They were accompanied by demands that the MBC conduct an investigation of Mikuriya. Although it was reluctant at first because complaints against physicians traditionally emanate from patients or their families, their delay did not signify approval of Mikuriya's practice; only that entrenched bureaucracies move slowly in dealing with unusual new problems.

Although the MBC's eventual solution was tardy, it was also grossly unfair, and obscenely hypocritical: an "investigation" that blighted what would prove to be the last few years of Doctor Mikuriya's life. However, it failed completely at its intended effect, which was clearly to frighten the other California physicians licensed by the MBC out of the recommendation business.

Quite the contrary; even as the daily press and TV were becoming glutted with articles and documentaries trumpeting the increased visibility of the medical marijuana industry and bemoaning the ease with which "patients" could obtain the required doctors' "recommendation," they neglected key questions they should have been asking: who are these doctors and what have they been learning from their encounters with people that have been punished with increasing severity by the drug war for the past four decades?

The alarming answers to those questions, if pursued logically, would lead directly to the same conclusions I have been both forced to consider and hinting at with increasing specificity for five years: our species has been pursuing a progressive course of delusional thinking from which there seems very little prospect of escape in time to avoid some catastrophic consequences.

Even as a small minority is now attempting to address the problems we face as a species, the great majority is either denying their existence or proposing partial solutions that would benefit only a limited percentage of the global population, while allowing the rest to survive as best they could.

Our underlying problems, greatly exacerbated by technology since the emergence of Empirical Science, have been overpopulation of the planet and unwise exploitation of its resources; unfortunately, our need to deny them seems to exactly parallel their severity.

Doctor Tom

Posted by tjeffo at December 15, 2009 04:03 AM