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June 11, 2011

On Foxes Guarding Henhouses & Classifications as Guides to the Future

Alan Leshner, who earned a Phd in Physiological Psychology from Rutgers in 1969, has been one of the most visible representatives of American Science since 1994 when he was appointed Director of NIDA. In that capacity, he soon became a well known proponent of the idea that "Addiction" is a "Brain Disease," which just happens to be the mantra of the War on on Drugs; also an essential doctrine of both US and UN policy. In 2001, some five years into California's Proposition 215, Leshner left NIDA to become CEO of the Prestigious AAAS.

Although Leshner may have toned down his strident support for dug prohibition and the idea that cannabis use should be firmly suppressed, there is no reason to believe he's changed his opinion on the basic issue, which he expressed succinctly in a 1997 JAMA interview: " I am ferociously against polarizing the debate. I think that's one of the terrible problems we've made with this issue (addiction). People say that it's either a public health or a public safety issue. The truth is, it's both. And it begins with a voluntary behavior: people choose to use drugs. I don't call it morality, but I call it voluntary. And there's no question it's a medical illness and once you have it, it mandates treatment. It's a myth that millions of people get better by themselves.”

That statement reveals Leshner’s own bias; it's also an unwitting admission of his ignorance of a critical bit of medical history. He is so convinced that “Addiction” must be a “disease,” that he doesn’t bother to question how “diseases” have been defined and classified in the modern era, nor how important accurate systems of classification have become to Science. Until Rudolph Virchow began acting on his brilliant insight that microscopic changes in cellular structure were critical and near-universal reflections of physical disease, the profession lacked a basic vocabulary for rational discussion of its core subject material. In that respect, Virchow’s stroke of intuition did for Medicine what Darwin’s did for Biology as a whole: provided a remarkably useful and accurate skeleton to which could be added as-yet undiscovered "muscles" in the form of new data. To pursue the skeleton/muscle metaphor a bit further: the dynamics of those relationships are also often suggested by new findings.

There are many good examples: Mendel and Darwin never met; its even likely that neither man ever read the others' work; however, the role of Mendelian Genetics in clarifying the mechanism by which Evolution might function was prescient and did nothing to hinder the ultimate discovery of the molecular structure through which genes exert their effects. Even today, as much as we have learned by decoding the human genome; what we have learned about the complexities of genetic expression simply compounds the multiple problems still requiring solutions.

Another example of serendipity: Von Wegener's observation that South America and Africa resemble pieces of a jigsaw puzzle and the subsequent emergence of a coherent Tectonic Plate theory in less than a century is, by now familiar to most. Nevertheless; we are also reminded on a daily basis that plausible explanations of natural phenomena that cast doubt on the existence of an omnipotent deity still face tough sledding in our (not-so) modern world.

Doctor Tom

Posted by tjeffo at June 11, 2011 05:27 PM