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July 14, 2011

Obama’s Drift to the Right; and some notes on getting high.

Wouldn't it be ironic if Barack Obama, the first nominally black American president were also the first real Manchurian candidate in history? In the last entry, I was decidedly critical of his presidency; and that was before his offer to put cuts in Medicare on the table. Before going any further I should admit there is no precise definition of " Manchurian Candidate," a character appearing in Richard Condon's 1959 novel, and first brought to the screen in a film made in 1962, but not released for several years because of the political scruples of one of its stars. For those interested in more detail, the lengthy review by Roger Ebert is a good place to start. Briefly stated, a Manchurian candidate is a "sleeper"programmed to gain political office and then lead the country in an entirely different direction than his supporters expected. The general idea has been brought to the screen twice, once in 1962 and again in 2004 by talented directors and very different casts of talented actors.

In any event I'm using the term because I cannot conceive of any more improbable turnaround for an American President than the one Obama seems to be in the midst of. Given the intellectual dishonesty and irresponsibility of his political enemies on the other side of the aisle, his latest ploy has outraged many loyal supporters and left some stunned. In retrospect however, given the laundry list of earlier improbabilities starting with the DEA raid on pot clubs in January 2009, this latest move could be seen more as further progression in a coherent plan to betray all the principles candidate Obama once claimed to stand for.

There is another possibility; It could still turn out that Obama is simply taking a leaf from Clinton's'94 playbook in which he snookered the Republicans into shutting down the government over their “Contract with America,” much to the disadvantage of then-Speaker Gingrich, who has yet to recover and is now spinning his wheels as a minor presidential candidate.

This particular political theater is distressing to me personally because of my interest in medical cannabis and the witless war on drugs. Obama was the first candidate to ever admit his own adolescent initiation of cannabis and cocaine and also the first to admit inhaling and getting high. Beyond that, his remark, “that was the point,” in response to a reporter's question led me to hope that he might be the first politician capable of (publicly) understanding the appeal of cannabis to adolescents.

It may be progress of a sort for our third Boomer president just to admit trying illegal drugs and actually getting high. One of several bits of generally unknown cannabis culture I've picked up from my extensive profiling of applicants is that not all got high the first time they tried pot; indeed the failure rate may be over 50%. It's a phenomenon fairly well known to the cognoscenti that has been well described by Lester Grinspoon.

Why it happens is generally unknown; in essence, inhaled cannabis is the only illegal drug which gives prospective users a test to see if they qualify to use it; I can’t imagine anyone who had been unable to get high ever seeking a recommendation. Pot is also used as an “edible,” but the two routes of administration produce notoriously different effects, and as a practical matter, virtually every prospective initiate tries it by inhalation the first time.

Which bring up another bit of lore: the "body high" produced by edibles is so different than the "head high" produced by inhalation that they may as well be different drugs. Almost every user learns that sooner or later but almost none know the reason, which is that when inhaled as smoke, the active agents are delivered to he brain almost immediately and experienced almost in real time. In essence, each toke is an incremental increase in the dose, allowing the user to "titrate," its effect from memory and thus avoid overdose.

Edibles, on the other hand, belong to the gastrointestinal tract when swallowed and thus are digested, a totally different process. The digestion products then gain access to the Hepatic Portal Circulation and are processed a second time by the liver. Thus what the brain "sees" after an edible is very different than smoke; also significantly different from simple decarboxylation, which is the standard explanation. Furthermore, the details of what happens in the liver have never been studied, or- if they have- have yet to be published.

The silence of the literature on this key difference speaks volumes about the enforced ignorance of both the policy and the policy makers, who still insist that all legal cannabis for research must come from the Federal Marijuana farm in Mississippi and approved by the DEA (which always says no). It's another catch 22 in John Mitchell's maddening Controlled Substances Act.

The edible "high" is dramatically different; it lasts a minimum of three hours, sometimes longer. It is associated with a feeling or weakness in the arms and legs which is pleasant, but rules out hard work or a visit to the gym after eating a brownie. The bonus is markedly enhanced antinociception (pain relief) which is especially welcome to patients with severe pain syndromes. The such as sciatica, traumatic arthritis or various neuropathies. the relief also lasts the whole three hours. Unfortunately, unlike smoke, the potency of edibles can't be easily titrated, thus unintentional overdose is common However, most have learned to cope with that problem by either making their own or by cautious testing of each new batch from a known vendor.

That one can't find these phenomena described in the literature speaks volumes about a policy of enforced ignorance based on the imaginings of medically ignorant policeman, judges and lawyers.

What it says about clinically ignorant activists I will simply leave to the imagination. It's important because it points out the importance of clinical inquiry in determining what questions need to be asked and answered- the difference between science in search of truth or in defense of empty dogma.

Doctor Tom

Posted by tjeffo at July 14, 2011 05:34 PM