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August 31, 2010

Pot Prohibition: a complete history...

Tom Meyer, cartoonist, is one of the SF Chronicle's real treasures. His latest Sunday effort neatly summarizes the war on marijuana ...

Posted by tjeffo at 08:15 PM | Comments (0)

The Importance of Demographics

My decision to accept the invitation of an Oakland cannabis “club” owner to do the required medical screening of people seeking a “recommendation” to use cannabis (and thus qualify as his customers) in compliance with Proposition 215 was motivated mostly by curiosity. I already had a strong belief that US marijuana policy was terribly misguided and harbored the naive conviction it could be “reformed” on the basis of logical arguments once the dimensions of its failure were understood by enough people. But I had no specific plan for how to bring that about.

Even worse, I had no idea of how seriously that judgment understated our government's commitment to its self-induced drug problem or how daunting the idea of changing our drug policy might become.

In any event, it took a few months before I saw the required patient encounters as the opportunity for a unique study of illegal marijuana use. Even then, the task of designing such a controversial project on the fly while continuing to record data took more time than projected. Thus it wasn’t until early 2007, when I was analyzing data from the first four thousand applicants that I tumbled to the significance of their demographics, specifically their dates of birth.

The item itself was simple and straightforward, but its significance is profound and far reaching: only four percent of the first four thousand applicants seen were born before 1946. By default, the rest were all Baby Boomers or Post Boomers.

To fast forward: what that suggests to me at least, that our federal government has missed the significance of the youthful rebellion that suddenly became manifest in the mid-Sixties. Thus rather than attempting to understand and adapt to one of the the most important social developments of the Twentieth Century, America has remained committed to suppressing it with an amalgam of ad-hoc propaganda and repressive law enforcement; with tragic consequences.

The significance and complex ramifications of that hypothesis will be explored in future posts.

Doctor Tom

Posted by tjeffo at 06:56 PM | Comments (0)

August 28, 2010

How Quickly we (Pretend) to Forget

Back in January, I wrote: “Not only has the past been prologue, its cognitive errors and false assumptions have shaped the present in ways that were not- and probably could not could not have been- anticipated by our ancestors.” Even then, I didn’t realize how quickly Mexico would descend into chaos, how steep the descent would be, or how aptly it would make my point. Still unknown is the degree to which the critical implications of present reality would/will be lost on the American polity and its government.

Simply put, how long can we pretend that the chaos in Mexico is not a consequence of drug war folly? Do we really believe that our government’s rigorous preference for the ridiculous euphemism of “drug control” over the more accurate term of “drug prohibition” will hide the fact that the creation of violent criminal markets is an inevitable consequence of prohibition policies, no matter how they are named?

How quickly we seem to have forgotten it was Operation Intercept, Nixon’s unilateral imposition of drug prohibition on Mexico and the US, that initiated the folly that's blossomed into today’s carnage.

Doctor Tom

Posted by tjeffo at 04:34 PM | Comments (0)

August 22, 2010

Delusional Thinking is Alive & Well in California

The magazine section in today's San Francisco Chronicle featured 2 very different op-ed pieces, but each opposed the "legalization" initiative that will be considered by voters in November. That the Chronicle would do so didn't surprise me because its editors have never exhibited clear thinking on pot issues. Even though they are at the epicenter of the "Medical Marijuana" movement, they have yet to cover it intelligently. The following will be sent to them later today, but I'll be surprised if it's published...

For nearly fourteen years after Proposition 215 passed in 1996, we have had a form of marijuana legalization: any resident over 18 able to acquire a signed “recommendation” from a licensed physician could become a “medical” user and receive a (disputed) measure of protection against arrest and prosecution under state law. Although fiercely resisted by all state law enforcement agencies and most politicians after qualifying for the '96 ballot, Proposition 215 passed handily and ultimately thrived despite the best efforts of its opponents and the manifest inability of its supporters to define “medical” use coherently.

“Pot docs” willing to sign recommendations were notably few and far between in early years, but now they compete blatantly on the internet and retail outlets ("dispensaries") selling “medical” marijuana now blanket the state despite the risk of raids by both local and federal police who often confiscate cash, product and equipment. Difficult to measure precisely, the medical gray market created by the proposition continues to grow; indeed, it was that growth, and the prospect of tax revenue replacing enforcement expenses that has helped place a “legalization” initiative (Proposition 19) on the November ballot.

As a physician who has been collecting data from an unselected stream of medical applicants for nearly nine years, I was not surprised by the very different, but equally meretricious arguments advanced by Dr. Cermak and Chief Manheimer in support of the status quo. Indeed, I have been reading similar arguments ever since discovering that both marijuana partisans and opponents share a preference for blind belief over informed skepticism.

My individual patients have not known how other applicants were answering the questions I’ve been asking as part of the standardized intake interview all undergo. Those “renewing” with me (some as often as five times) tend to understand why cannabis has been so helpful and are particularly good sources of information for that reason. I know its reliable because I’m the only one able to compare all answers. Although I have published my data statistically (to protect confidentiality) any other pot doc would be free to ask similar questions and publish their results; that’s how Science is supposed to work.

The never-verified assumptions of Doctor Cermak and Chef Manheimer are those of the drug war as adjusted to the preferences of their professional organizations.

The brand-new specialty of "Addiction Medicine" is entirely dependent on the drug war for its existence and for a definition of the entity it treats; there's no objective standard for “addiction.” It may exist, but cannot be identified precisely enough to justify the coercive abstinence-only methods insisted upon. Also, the historical record of every criminal prohibition policy is one of abysmal failure. The most useful approach would be to look at all drug use as a characteristic human behavior that should first be understood before being subjected to one-size-fits all "treatment."

Perhaps Dr. Cermak should ask himself just why "marijuana" became so popular with adolescents in the Sixties and why its illegal market continues to grow inexorably despite the best efforts of Chief Manheimer and others.

Doctor Tom

Posted by tjeffo at 05:45 PM | Comments (0)

August 15, 2010

Giant Steps Backward

Today is one of those days that’s tough on optimists.

The lead story in today’s NYT confirms my worst fears about the direction being taken by the Obama Administration: now well into its second year, it seems more deeply committed to failed policies; not just of their immediate predecessors, but also of the first Nixon Administration, which launched our disastrous war on drugs right after starting secret wars in Laos and Cambodia trying to salvage “victory” in Vietnam (or at least avoid the onus of “losing").

The reasons for their failures are as old as history: foreign invaders are resented by every population, especially if they are culturally different and their duties include killing the people they claim to be protecting. “Victory” in Afghanistan became even more elusive when killings by drone aircraft became a form of extra-judicial murder and it had to be admitted that some had been misdirected against innocent civilians.

Closer to home, the administration's support of Mexican President Calderon’s escalation of the drug war against Mexico’s cartels is more of the same; its outrageous death toll is ample evidence that it won’t succeed.

Finally; that marijuana is both the principal target of border interdiction and better palliation than the Pharmaceutical industry can offer for our distracted society's most common mood disorders is either tragic or ironic, depending on one's point of View.

Doctor Tom

Posted by tjeffo at 06:36 PM | Comments (0)

August 12, 2010

Response to the Wikileaks Release as a Litmus Test

President Obama’s immediate response to the Wikileaks release of classified reports from Afghanistan betrayed a troubling misunderstanding of events in that part of the world; even worse, a commitment to the same old beliefs that led us into the 9/11 debacle in the first place.

It’s also difficult for me to understand why the parallel between the Wikileaks event and the Pentagon Papers released by Daniel Ellsberg to the New York Times in 1971 has been missed by so many supposedly well informed observers (but not by all). While the two wars were undertaken for quite different reasons, they also share critical characteristics that would predispose them to failure.

Both were based on dishonest pretexts. Although the Gulf of Tonkin Resolution was based on an outright lie, our entry into Afghanistan might arguably have been plausible as an effort to capture Bin Laden after the crime of 9/11, but that's not how it transpired. We eased up on our efforts to capture Bin Laden in December 2001 and then waited 15 months before invading Iraq on a new pretext. By that time, Bin Laden was inaccessible, an even greater threat to peace, and the situation in both countries even worse. That the current economic debacle may have been triggered by those two wars will be debated by future historians, but the first two international Depressions to afflict the Industrial Revolution were also preceded by wars and triggered by bank failures in Europe and North America.

Beyond that, military history back to Alexander confirms that Afghanistan has successfully resisted efforts at "control" by great powers, particularly when made by armies with different cultures.

These aren't complex issues. They deserve more open discussion and coherent answers in a troubled world.

Doctor Tom

Posted by tjeffo at 05:18 PM | Comments (0)

August 10, 2010

More of the Same; but with a Twist

There are apparently no limits to the absurdities possible on the Mexican border; nor is there much evidence that either the US or Mexico is capable of learning from past mistakes in their historically futile efforts to “control” drug smuggling. Those efforts began with Nixon’s attempt to interdict marijuana in 1969 and have continued unabated. Over that interval, a panoply of drugs, ranging from Colombian marijuana, and cocaine, through Mexican marijuana and “black tar” heroin and have taken turns being the contraband of the moment, but the lack of success and increasing efforts at interdiction have remained constant.

The latest was an (obviously political) “request” handed to President Obama by by Texas Governor Rick Perry, minutes after Air Force One touched down in Austin yesterday. Citing increasing violence by Mexican drug cartels (appalling, but hardly news) Perry asked for more of the same, but in addition to more troops, he also asked the feds to use the same predator drone aircraft that have been winning us so many friends in Afghanistan and Pakistan.

Given that that the smugglers are often impoverished Mexicans who are primarily seeking to enter the US illegally to work and have been pressed into service by those running the operation, it is difficult to see how unmanned aircraft will do anything but increase the death toll and the resentment attributable to a failing policy.

Perhaps it's time to ask why marijuana had suddenly become so popular in the Sixties and why it's once again in such short supply. Just who is buying all that bammer weed; and why?

Doctor Tom

Posted by tjeffo at 04:52 PM | Comments (0)

August 07, 2010

A Species in Crisis, the need for definitions

Science & GNT

The method of thinking now known as Science has not been around for very long, especially given the more accurate perspectives it has given us for thinking of time itself. It's only been about five centuries since Galileo and Newton were born in Renaissance Europe, literally back-to-back (Newton was born in 1642, the same year Galileo died).

Not only have our concepts of time changed since GNT; so has just about everything else. Considering today's world, however briefly; it has changed more radically since GNT than in the thousands of years of prior human existence; and we may be but the latest in a chain of primates stretching back to the Miocene epoch. Nor were G & N the two smartest men ever; just two with exceptional potential who chanced to be born at a time when their talents could be maximally expressed and then fortunate enough to live to have the influences for which they are both remembered (but neither can enjoy). It’s also quite likely that two, probably more, infants with similar potential already exist; but because of the enormous competition now facing them, and how much we have learned since GNT, won't have comparable impact.

Which brings me to my first major point: the role of chance in history. It’s at least theoretically possible that if all the important variables are known in advance, anything could become predictable; however the "arrow of time" makes that unlikely. Thus there will (probably) always be uncertainty.

Or perhaps God does exist. While a supreme deity can’t be disproved, the evidence favoring one has been diminishing steadily since GNT began.

The next logical point I want to introduce is that, in an over-crowded and contentious world, arguing with religious true believers is not only a waste of valuable time and energy, it’s probably the main reason for the “crisis” referred to in the title. Muslim jihadists’ willingness to kill themselves is unlikely to be matched by their opponents, thus the logic of the Cold War still prevails and “war” is almost certainly not a "solution."

Equally importantly; problems should be defined as accurately as possible before attempting a solution. Thus the best approach may be something humanity has never done before: tried honestly to solve basic problems short of violent destruction of presumed enemies. We humans are both the problem and the solution; no one else can save us from ourselves. While I am also aware there are fundamentalists who see today’s troubling signs as confirmation that an “end of days” is almost upon us, I don’t consider arguing against them to be helpful; thus I choose not to. If I have any “faith,” at all, it’s a hope that common sense will ultimately prevail.

In the meantime, I intend to keep on writing about what I’ve been learning about human emotions from talking to pot smokers for almost ten years.

My logic is straightforward: the emotional symptoms most of them began treating with inhaled cannabis are those now most evident in the modern world; thus they offer a potential short-cut to defining (diagnosing) our global problems; a necessary first step before attempting any radical "therapy."

Doctor Tom

Posted by tjeffo at 05:23 PM | Comments (0)

August 04, 2010

Improbable, yet “Fit to Print”

Some of the material printed in the NYT lives up to its motto; a recent column by Bob Herbert was such an eloquent statement of my growing disappointment in the Obama Administration’s increasingly mindless policy in Afghanistan that I feel compelled to cite it here. However, I’m also forced to note that the fickle American public will soon forget it was the Bush-Cheney strategy to abandon Afghanistan just as Osama bin Laden was within our grasp in order to pursue their Iraq adventure. That particular folly was almost ten years, thousands of deaths, and billions of dollars ago, when the economy was stronger and a balanced budget hadn’t faded to a distant memory. Speaking of memories, ten years is clearly beyond the attention span of a culture that dotes on Lindsay Lohan’s latest peccadillo and seems ready to accept the notion that the Gulf clean-up has been a huge success.

Another report recently appearing in the Times was that the VA, under timid Obama leadership, is slowly warming up to the idea that self-medication with marijuana might even be acceptable for veterans similar to those described by Bob Herbert, so long as they live in one of the fourteen states with an existing medical marijuana law.

In support of that less-than-crisp explanation, the Times referenced the same vaguely worded letter from a VA physician to Michael Kravitz that I’d referred indirectly last Friday. What the article and Dr. Petzel's letter both leave out is the fate of potentially suicidal returnees who live in states without a medical pot law. Will they just have to make do with Ambien or one of the other legally prescribed, medications supplied by their local VA?

Doctor Tom

Posted by tjeffo at 05:39 PM | Comments (0)

August 02, 2010

A World being Overwhelmed by Reality

Ironically, Northern California’s weather has been unseasonably cool so far this summer, but such is not the case in many other parts of the world, including the Southern half of the state; to say nothing of the Eastern US, the Gulf Coast and the Deep South, where everything from triple digit heat, floods, and wild fires are being reported. Then there’s the news (and graphic videos) of other weather-related disasters: huge floods in Pakistan and wildfires in Russia. Funny; there seem to be fewer recent complaints from the far Right about global warming being a liberal “hoax.”

I just turned off the first 1/2 hour of TV news, skipping from one channel to the next as is my wont; it ranged form the improbable to the outrageous, but its theme, for me anyway, was that of a human world still so unwilling to face the magnitude of its self-made disasters that one is forced to wonder what it will take to wake it (them, us) up.

I know that I’ve been writing in this vein for years, hoping against hope that the world would get it. I’m now about ready to admit that the prognosis for meaningful recovery has never appeared more bleak; yet most of the species still seems so oblivious to that reality that I’m occasionally forced to question my own sanity.

Not to worry; whenever that happens all I have to do is to turn on CNN...

Doctor Tom

Posted by tjeffo at 04:07 PM | Comments (0)