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April 30, 2011

Pimping for Prohibition

Medicine has been overtaken by the technological advances of the Industrial Revolution to a greater extent than most other professions. Perhaps no historical event epitomizes the ignorance that clinical medicine has overcome since the beginning of the Industrial Revolution than the death of George Washington in the last month of the Eighteenth Century. The iconic “father” of his country died suddenly in his 68th year, while still vigorous; probably of epiglottitis a rare specific bacterial infection of the larynx. His demise was undoubtedly hastened by repeated phlebotomies performed by his physicians at a time when Medicine had relatively little but ignorance to offer seriously ill patients. Compare that with today’s modern “miracles,” ranging from the non-invasive imaging of diseased organs to their actual replacement, both of which have been made possible through modern science (but would be unavailable to America’s uninsured).

As medical practice has become increasingly technology dependent, it has also been increasingly divided and subdivided into specialties and sub-specialties, three of which have developed in response to US drug policy. They are “Pain Medicine,” Addiction Medicine,” and “Cannabis Medicine.” The latter is by far the newest and least well organized. So far it exists only in those states with “Medical Marijuana” laws, but the recent popularity of such legislation; to say nothing of the emergent popularity of cannabis itself in the gray markets that pot laws gave rise to, offer abundant evidence that its underground medical use had become far more common than had been either realized or admitted. In other words, passage of California’s Proposition 215 is slowly becoming the Drug War’s Achilles Heel through the legalized (albeit disputed) production and sale of a drug the feds continue to insist must remain absolutely Verboten.

Hopefully, Proposition 215, by also allowing for the first-ever systematic recording of medical histories from chronic users of a “drug of abuse,” has also made possible the ultimate exposure of American (and International) drug policy's intrinsic fatal weakness: it relies on the honesty and integrity of a species that, historically, has been committed to their very opposites.

My personal workshop for arriving at that conclusion has, ironically, been the opportunity I have had to take histories from people seeking to take advantage of Proposition 215. The information they provided me with has disclosed two salient realities: first, it confirms that "herbal" cannabis is an amazingly safe and versatile medicine. Second, many of its chronic users have been confused; primarily because it has been illegal and condemned by society's authority figures, but also because its therapeutic effects vary so much, depending on mode of ingestion, as to have confused both proponents and opponents of "legalization" to the extent that those important differences have not been recognized, let alone systematically investigated.

I will have much more to say about that issue in future entries, but first I'd like to point out that so pervasive is the human dishonesty referred to above, that all three of the medical organizations I mentioned have either sold out the patients they claim to serve (pain and addiction medicine), or are in the early stages of doing so (cannabis medicine).

Doctor Tom

Posted by tjeffo at 07:57 PM | Comments (0)

April 24, 2011

Follies Based on Invalid Theories

Theories are general concepts used by modern humans to organize various series of facts or observations into a coherent narrative. They are neither intrinsically “true” nor “false,” but probably best thought of as either valid (leading in a helpful direction) or invalid (useless at best, dangerously misleading at worst). What our recent experience with the Axis Powers in World War Two drives home is that invalid theories can mislead entire nations into destructive behaviors able to threaten the welfare of all humans. Ironically, the Cold War that followed World War Two almost immediately became an even greater threat because of the nuclear weaponry developed by (some of) the Allies to shorten the war.

Even more more dangerous, now that we've had at least a reprieve from Nuclear Winter, is the belief that the successful outcomes for “Democracy” in both wars were somehow a result of Divine intervention in favor of a loosely defined political system. In any event, that notion has been actively resisted for over a decade by another heterogeneous supranational alliance based loosely on similarly unlikely religious beliefs. In fact, one of several cautionary revelations of our recent “world” wars and the current “War on Terror” is that people deeply committed to such unfounded beliefs are easily led to commit both suicide and murder to further them.

In that setting, it should not surprise us that we humans, who have also contrived to quadruple our numbers in a little more than one hundred years, may be experiencing- individually and collectively- more species-induced psychological stress than at any time in our short separate existence; also that we are impelled in that direction by intensely competitive mammalian instincts left over from our biological heritage and first pointed out by Darwin, in a disputed theory that, despite its great utility, is probably either denied by, or unknown to, the majority of living humans.

To place these seemingly random observations into perspective, the best scientific evidence is that humans only came into separate existence as a species about two hundred thousand years ago in a universe now considered by Science to be around thirteen and a half billion years old on a comparatively insignificant planet that has only been around for about 4.5 billion years and upon which complex multi-cellular life forms didn’t appear until about five hundred and seventy million years ago.

In other words, the best available evidence, most of which was only uncovered after we developed spoken and written language (essential forerunners of scientific thought) is that our intrinsic insecurity and consequent desire to “control” our environment may be responsible for our current folly.

Thus our amazing cognitive abilities, under the influence of our (even more) powerful emotions, may have seduced us into the headlong pursuit of “control” that now threatens us in so many ways that our powerful need to deny painful reality makes us loathe to even consider.

As has become increasingly apparent through my experience with thousands of the Americans seeking to avoid irrational punishment for their use of a safe and useful (but illegal) “drug of abuse” is that our drug policy is simply one more example of a dangerous human folly based on an invalid theory.

It gets worse: “Addiction” theory is even less coherent than the myths of Bushido, Aryan Supremacy, and Fascist doctrine (best articulated by Mussolini that gave rise to World War Two. or the vague Dialectic of History that sustained International Communism throughout the Cold War.

Can we see through the folly of "Addiction Theory" in time to save ourselves?

Doctor Tom

Posted by tjeffo at 05:37 PM | Comments (0)

April 21, 2011

Who's in Charge at Justice?

No sooner did I chide the Prez for his mixed signals on “Medical marijuana” than there’s news of federal prosecutors in Washington State coming up a mean-spirited requirement that threatens their state-level counterparts with prosecution if they attempt to implement a recent change in Washington’s state’s medical marijuana law.

Such bare-faced defiance of a Justice Department policy clearly announced by both AG Holder and President Obama in 2009 raises obvious questions about who is running Justice, is it Holder and Obama? Or have the lunatics taken charge of the asylum? The whole point of the medical marijuana initiatives that began appearing on state ballots in 1996 was to express (profound) voter dissatisfaction with a high-handed, medically ignorant federal law, the 1970 CSA, passed entirely without updated medical or clinical evidence and citing “principles” in “Schedule One” which had no more medical, legal, or moral authority than the 1935 Nuremberg laws, by which the Nazis formally converted Germany’s Jews into non-citizens without any rights whatsoever.

The crippling flaw in federal law claiming to "control” “marijuana” is that it was completely fanciful. Originally based on the absurd lies of Harry Anslinger. In contrast, the various state laws challenging federal dogma are conservatively written. In any case, the “debate” has been largely uninformed by reports gleaned from what may well be the most reliable sources available: people willing to risk arrest in order to use cannabis over extended intervals because it provided better relief from serious symptoms than legal pharmaceuticals. The idea that such self-medicating chronic users are all "criminals" looking for a good time is as absurd as it is untrue, mean-spirited, and contrary to established fact. That US government employees of our Department of “Justice” would stoop so low is a disgrace to this nation and what it claims to stand for.

Time to fish or cut bait; if Obama can’t control his federal yahoos, he’s lost my vote in 2012.

Doctor Tom

Posted by tjeffo at 11:59 PM | Comments (0)

April 20, 2011

Politics: How did we get stuck here?

Despite the surprising momentum of the "Medical Marijuana" market that has been fitfully unveiled since 1996, cannabis prohibition will almost certainly remain an untouchable federal policy throughout the balance of the Obama Administration and- as now seems likely- he is re-elected; throughout his second term as well. Should his re-election bid fail, it's virtually certain that whatever Republican Administration comes to power would soon try to restrain the momentum of 'Medical' use.

Just how we've reached this impasse is worthy of some discussion; particularly given the hopeful euphoria that followed Obama's 2008 victory. A major reason is that right out of the box, his support for medical use proved much less vigorous than hoped; better described as timid and uncertain. Also, as he settled into his main job of running the country, his obvious desire to create an amicable climate in Washington also worked against him. The GOP has become an extremist Right Wing party and will likely remain that way. Its members tend to see any desire by political enemies to compromise as a weakness to be exploited. Those with a particular interest in drug policy also seem emotionally committed to the idea that a prohibition policy can be made to "work" by the imposition of enough coercive force.

Notwithstanding the 2012 election results, the drug war seems assured of enough Congressional support to survive as a protected policy for the indefinite future. Neither does it lack support from a Supreme Court that's been stacked with a Roman Catholic majority by fundamentalist Republicans intent on overturning Roe V Wade.

Then there's key human characteristic we may have underestimated; one well illustrated by both the survival of faith in prohibition as public policy and the dynamics of the modern pot market that also suggests illegal cannabis is likely to remain a protected policy for the predictable future. It's the pervasive role played by our intrinsic dishonesty in virtually all our interactions ranging from marital unions to international treaties: we cheat to the extent possible.

The major reason the Scientific Method emerged as our dominant tool for studying the environment was its insistence on transparency and intellectual honesty. The best way to understand relative lack of success of "civilization" over the last five centuries may be that the humans who retained control of nations somehow avoided extending the standards to Science other endeavors while, at the same time, devoting the lion's share of scientific knowledge to the age-old power struggles that have always divided us.

Doctor Tom

Posted by tjeffo at 05:56 PM | Comments (0)

April 17, 2011

Annals of Enforced Ignorance: 2

The last entry started out as a relatively pedestrian exercise comparing the failure of alcohol prohibition with that of the drug war in order to stress how little we had learned from the former in our pursuit of success for the latter. However, since it was posted, I’ve had some additional insights by combining background research for that item with evidence supplied by the patients I’ve been studying for the past 10 years. Taken together, they suggest that our species may be so far down the road of social and environmental folly that we’ll have trouble saving ourselves from the cascade of major catastrophes now lurking in our intermediate future (the mounting accumulation of unusually severe weather events is an ominous case in point.) Although the underlying causes are still far from certain, an important one appears to be a flaw long present within our brain’s evolutionary trajectory that became more dangerous once human cognitive abilities and numbers reached modern levels.

To begin with the background research: an insight from David Kyvig’s masterful Repealing National Prohibition led me to realize that because the 18th Amendment had been generated by exactly the same flawed human notions as the dug war, the latter was more an upgrade of bad old ideas than a brand new folly. The important understanding is that a significant fraction of all humans has always entertained similar beliefs; namely a preference for “control” by enacting repressive rules and laws to punish new ideas (“heresy”). Beyond that; it’s been so common for so long that the leadership of human institutions is typically top-heavy with “control freaks” who see different ideas as the greatest threat they have to deal with (think Hitler, Rush Limbaugh, and the drug war to see where I’m going). Once repression becomes institutionalized within a society, it becomes both part of accepted belief systems and dangerous to oppose (or even criticize). Right now America’s drug war, which has been policy for four decades, has sponsored entrenched medical, legal, and “correctional” industries dependent on treating (or punishing) “druggies.”

Demonstrating the critical importance of individual actors in the creation of destructive absurdities, the prime movers behind our cannabis (“marijuana”) dogma were Harry Anslinger and Richard Nixon. Anslinger created and nourished the reefer madness myth; Nixon, by rejecting his own committee’s recommendation in March 1972, slammed the door on any possibility of softening the war on cannabis (“marijuana”). Sadly, Anslinger and Nixon had lots of help from the Behavioral Sciences and the Law, both of which literally tripped over themselves to do bogus "studies" in support of the absurd claims of the the CSA's baseless Schedule one.

So efficient has drug war propaganda become that neither the feds nor the pot users they were trying to repress had any idea of how huge the illegal pot market was becoming, let alone its dynamics or the important health benefits it's been providing to its growing population of users. 503 of the 6400 applicants in my registry since have aged into eligibility for a recommendation and taken the trouble to apply since Proposition 215 was passed in November 1996.There are undoubtedly hundreds of others waiting to become eligible or saving the money.

In that connection, once the “initiation” of marijuana by trying to get "high" had become an adolescent rite of passage (probably by 1972) any possibility the CSA could block growth of its market was over. Sadly, The DEA and NIDA, which had yet to be formed, still nourish their belief in the efficacy of punishment, adding further to the trauma produced by a foolish policy.

That seems like quite enough unpleasant realty for one day.

Doctor Tom

Posted by tjeffo at 08:32 PM | Comments (0)

April 15, 2011

Annals of Enforced Ignorance: 1

A question asked frequently by activists opposed to the drug war is why both the federal government and the general public have ignored the most obvious lesson to be learned from our 14 year adventure with alcohol prohibition: that using the criminal justice system to punish commerce in a desired commodity simply creates a lucrative criminal market, corrupts law enforcement, and breeds violent crime. Beyond that the two policy failures are rarely compared because drug prohibition (euphemistically referred to as a policy of "control") is still being actively pursued; thus from a political point of view, analyzing its failures would be tantamount to performing an autopsy on a living patient. In other words, both national populations and their governments seem loathe to acknowledge failures in progress. The most convincing recent example of that phenomenon was the mutual reluctance of Germany and Japan to accept defeat in 1945; its most dire consequence was prolongation of the agony of both nations. First it was necessary that Berlin be occupied by the Russians, following which Hitler's suicide in the bunker finally allowed the Germans to accept an outcome that had become inevitable following their defeat at Stalingrad in the East and the British/American successes after D-Day in the West.

The next requirement was to force Japan, always an unlikely ally of the Nazis, to also surrender. That was accomplished by use of an unprecedented weapon to destroy two Japanese cities, a decision that, while perhaps best under the circumstances extant in 1945, has critically affected the course of subsequent history and the outcome of which still remains unknown.

To return to what was intended as the theme of this essay: the idea that both governments and the nations they rule are loathe to acknowledge obviously losing wars while still in progress: there have been several recent US examples: although Korea remains a standoff, our most costly defeat in a "shooting" war to date was in Viet Nam. However the longest- and perhaps the most costly- has been our largely metaphorical "war on drugs;" which amazingly, also enjoys UN approval and has been waged all over the world since the Sixties; even by our political enemies.

A major reason for that global acceptance is that the drug war is politically correct; thus its very necessity is rarely questioned by the media and its most obvious failures: the carnage on America's southern border and the growing political instability in Mexico, for example may be reported by the media, but are rarely analyzed in depth in either nation.

Parenthetically, all UN treaty signatories have also bought into drug war failure; they are also predictably unwilling to give up an excuse for spying on their own people.

Here in the US, there is also great denial implicit in the way our historical failures are remembered: Nearly a century later, “Prohibition” might conjure up a variety of quaint mental images for three hundred million living Americans, but most would be hard put to recall there was a unique Repeal Amendment in 1933, let alone that it had been necessary to cancel a similarly unique Amendment passed in 1919 on the promise it would be the permanent solution of all society's alcohol problems.

Apart from the difficulties listed above, today's drug war is so complex and shrouded in ignorance as to seriously hamper attempts at intelligent comparison with alcohol prohibition. For one thing, the 18th Amendment only targeted booze. For another, it only prohibited commerce in booze; consumption was never made a crime. In that context, the very idea of a positive drug test would have been outrageous in the free wheeling Twenties; probably even more so in the impoverished Thirties when Hollywood movies often portrayed enviably rich patrons of night clubs as hard-drinking, cigarette-smoking, and "glamorous." Compare those images to modern portrayals of grimy crack houses, meth-cooking trailer trash, or vacuous Cheech and Chong “stoners.”

The drug war targets a wide variety of chemical agents that have little in common other than their designation by the Attorney General as (illegal) “drugs of abuse.” At the same time, we are asked to accept pharmaceutical "uppers" prescribed by pediatricians and psychiatrists as “therapy” for hyperactive third graders and “go pills” dispensed by Air Force flight surgeons to bomber crews as essential to our various war efforts (probably less now that Predator drones attacking Afghanistan are controlled from an Air Force Base near Las Vegas).

In other words, context plays a critical role in how the same behaviors are defined- and how those engaged in them are dealt with.

History also matters. The Prohibition and Drug War eras are thought of very differently by the various generations that grew up under their influence. Prohibition is rarely remembered for giving birth to the modern Mafia. It helped school them in the value of modern business methods while also financing their acquisition of the tools a disciplined ethnic gang would need to compete successfully with both rivals and local police: telephones, trucks automobiles and machine guns. When prohibition ended abruptly in 1933, the criminal organizations it supported were able to segue easily into illegal drugs, labor racketeering, gambling, prostitution, and loan sharking. Their most brilliant organizers, often vicious murderers in real life, became folk heroes while still alive, and later served as models for the fictional heroes of the Godfather series.

But perhaps the biggest reason society has not learned from Prohibition's failure has been how consumers of prohibited contraband were portrayed under the two policies. “Two fisted drinkers” who can “handle their liquor” are still macho heroes on college campuses, but pathetic “druggies” and “junkies” are scorned for their “addictions” In contemporary culture, our drug policy gets a big assist from both Medicine and the Law because both agree that ”addiction:” is a treatable “disease” of celebrities and sports heroes able to afford rehab, but a "crime" requiring prison time when encountered in the poor denizens of rural trailer parks and urban ghettos.

Both medical and criminal "addiction" are now readily diagnosed by mere possession, either "internally" (in urine) or in one's baggage; all that's required is a small quantity of a designated “drug of abuse. As is obvious from current media reports, the disposition of such cases varies greatly, depending on the wealth and social status of the offender/patient.

More on this later.

Doctor Tom

Posted by tjeffo at 05:22 PM | Comments (0)

April 11, 2011

A Species in Trouble; the Quest for "Control"

As noted in recent entries, the pace of human cultural evolution was accelerated when we added writing (literacy) to our cognitive skill-set a few thousand years after the last Ice Age. Of comparable importance was ascendancy of the Scientific Method, the organized beginnings of which can be dated from the lifetimes of Galileo and Newton, which, by a remarkable coincidence, are linked chronologically. Galileo died the year Newton was born, in 1642.

The importance of their combined contributions to knowledge can't be overstated: for the first time, human conceptual abilities were enhanced by a set of rules that, when applied with a modicum of transparency and intellectual honesty, could reliably lead to insights (theories) that could, in turn, serve as both guides to further investigation and bases for organized disciplines with shared vocabularies and methods of measurement. In other words, advances in the basic sciences eventually became commercially valuable in ways that made individual lives easier and more productive, thus rapidly leading to a cascade of effects that stimulated growth of both wealth and the human population. To the extent those disciplines were mutually understood and shared their results, progress was even more rapid, as can be seen by comparing the growth of technology from 1800 on.

Unfortunately, political control of how science is funded and applied has remained in the hands of competitive sovereign governments with quite different cultures and ideologies. The same is true of the multinational corporations that compete almost as intensely as nations in a world, that is being made smaller, more competitive, and more crowded by the same sciences governments are attempting to “control.”

All of which may explain how humanity has arrived at its present impasse; perhaps more accurately described as a plethora of impasses confronting the species all over planet: ideological, climatic, religious, political, and financial.

If we look to the Behavioral Sciences for guidance, we are disappointed because the human competitive impulse still seems to be clearly in control despite the lateness of the hour.

Doctor Tom

Posted by tjeffo at 06:26 PM | Comments (0)

April 06, 2011

More on Cognition, Empiricism and Human Behavior

We humans, collectively humanity (Homo sapiens), are clearly not the only cognitive species, but our cognitive abilities so far exceed those of other surviving Hominidae as to make us unique. Those same abilities have allowed us to develop language and writing, which in combination with our other skills, have enabled us to study both ourselves and our cosmic environment with an increasing degree of precision and accuracy, especially since the advent of empirical science in the Sixteenth Century.

Unfortunately, the process by which we developed those cognitive skills has been neither smooth nor gradual; rather it has been irregular and contentious. That the skills themselves were originally enabled through an extremely slow and irregular process (Biological Evolution), was intuited only recently by Charles Darwin on the basis of observations made during a brief visit to the Galapagos Islands at the age of 26. In retrospect, the history of Science, roughly since the Fifteenth Century on, confirms the key role played by empiricism in the parallel development of its basic disciplines: Physics, Chemistry, and Biology, in enabling the formulation of our most productive scientific theories to date; Deep Time, Evolution, and Continental Drift, to mention but a few.

Appreciation of that relationship led to Uniformitarianism, a concept first suggested by Scottish geologists James Hutton and Charles Lyell and later named by English polymath William Whewell. Its validity now seems accepted, at least implicitly, by most working scientists. Nevertheless, as mentioned earlier, the evolution of Science as an approach to knowledge has been far from smooth, primarily because of the prior existence of long-standing non-empirical religious beliefs based on the deduction that a supreme deity must have created the universe. Such assumptions were well entrenched when Science literally burst upon the scene, thus it’s not surprising that our species remains embroiled in conflicts already in progress when Galileo was born. What is especially ironic is that the technological discoveries (and the information they have allowed us to compile) that most confirm the validity of empiricism are being used by its religious enemies to kill and maim their fellow humans in the name of their (assumed) creator.

The reasons are obvious. the strength of our species comes from our ability to cooperate by sharing both knowledge and physical ability to achieve common goals; behaviors clearly exhibited by other mammalian species, not to mention social insects (although in the latter, such cooperation seems more related to pheromones than to thought). To pursue that idea a bit further, it’s also clear that social insects don’t have to agree on a common goal before sacrificing their lives to achieve it, whereas humans, will not, under most circumstances, commit suicide for an idea.

However, the deliberate use of Kamikazes in the latter stages of WW2 and the currently frequent use of suicide as a weapon by members of the Moslem faith demonstrate that under the right emotional circumstances, such extreme “weaponization” becomes both reasonable and possible for humans, perhaps even for scientists.

Doctor Tom

Posted by tjeffo at 05:56 PM | Comments (0)

April 04, 2011

The Drug War’s Only Victory

American drug policy is an important metaphor for "Democracy" because it represents a significant failure on the part of all three branches of our federal government; yet its witless concepts regarding "addiction" are embraced by every UN signatory nation as manifested by the fact that travelers found in possession of even small amounts of cannabis ("marijuana") are subject to arrest and criminal prosecution in virtually every international port of entry.

American drug policy has evolved on the basis three cardinal pieces of federal legislation: the Harrison Narcotic Act (1914), the Marijuana Tax Act, (1937), and the Controlled Substances Act (1970). Each was initially upheld by the Supreme Court. Although both Harrison and the MTA were eventually struck down by unanimous decisions, there was no significant effect on enforcement practices. Indeed, the repudiation of the MTA in 1969 was unrelated to its most egregious flaws and, ironically, provided the impetus for the policy's Draconian consolidation into a more difficult target for legal attack.

As a practical matter, the Court's bias and scientific ignorance have both been critical to the policy's acceptance because they firmly established the dominance of legal definitions over scientific standards in matters relating to "drugs."

As domestic US policy, our legally dominated approach to drugs has also been an inhumane failure, yet it still seems to retain public approval (itself a questionable assumption because the closest to a national referendum on drug policy have been several state votes on "medical marijuana"). In any event, the continuing dominance of a cruel, obviously failing global drug war should raise serious questions about our species' ability to cope with the enormous cultural stresses engendered by the Scientific Revolution a mere five centuries ago.

Doctor Tom

Posted by tjeffo at 09:41 PM | Comments (0)