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February 28, 2013

Signs of the Times?

The February 23 issue of Science News contains a long article by Laura Sanders on the the dearth of effective new psychotropic drugs and the generally dismal record of Big Pharma in developing new therapeutic agents for treating mental illness. The article leads off with a report of the “crushing” failure of stage three clinical trials of a new drug, LY2140023, being developed by Lilly to treat schizophrenia.

It’s apparently not a new problem, “Not a single drug designed to treat a psychiatric illness in a novel way has reached patients in more than 30 years,” observed a prominent academic psychiatrist quoted by Sanders. My own modest clinical study of cannabis use and users, now embracing nearly 7000 Californians seeking to use “weed” legally, suggests the answer: ever since Richard Nixon and John Mitchell pulled a fast one on Science by substituting rhetoric for research via the Controlled Substances Act of 1970, federal policy has been directing the Pharmaceutical industry away from “herbal" medicines and in the direction of synthetic molecules. What my study also points to are two important areas in urgent need of honest investigation.

One is the role of families in producing the chronic dysphoria that leads vulnerable teens to experiment with multiple illegal "drugs of abuse." The other is the role played by cannabis in protecting its chronic users against use of the two more dangerous legal drugs- alcohol and tobacco. What my focused questioning made clear is that the substitution effect noted by Mikuriya and others was not a conscious choice; rather it was something that happens very predictably after patients make cannabis their drug of choice and began self-medicating with with it. Those patterns were revealed by detailed questioning that directly compares their use of all three "starter" drugs which are further distinguished by the fact that all applicants had initiated cannabis by getting high, all had also tried alcohol by getting drunk at least once, and 96% had inhaled smoke from at least one cigarette.

Such focused questioning clearly shows that rather than merely substituting for the two more problematic agents, cannabis seems to reduce use use of both, probably by treating the same symptoms of stress and anxiety more safely and effectively.

At least as importantly, the study conclusively exposes Nixon’s outdated CSA as a false guide to pharmacological reality. Nevertheless the "drug war" that broke out almost overnight after the CSA was signed into law has been been endorsed by both Psychiatry and Big Pharma for four decades. If nothing else, the unseemly haste with which an obviously deceptive piece of new legislation was embraced by supposed "experts" should raise doubts about their competence. In the case of Psychiatry, the problem is one of errant classification: the DSM is simply not an objective classification despite the claims of its authors, who have been revising it almost continuously since 1952.

On another front, the drug war is taking its lumps from Hollywood as indicated by the release of a film exposing America’s anomalous prison system entitled The House I Live In. The theme of the film (which I haven't seen yet) is that the "land of the free and the home of the brave" is now imprisoned- both morally and financially- in a bogus theoretical prison of its own making which, like our runaway “Corrections” Industry, is also a creature of the drug war.

When its financial and human costs are examined objectively, an expensively failing drug war seems like an exorbitant price to pay for Richard Nixon's unhappy childhood.

Doctor Tom

Posted by tjeffo at 08:00 PM | Comments (0)

February 24, 2013

E-mail to 2 Friends (2-23-13)

Because I regard the two of you as among my most important friends and supporters in the drug policy "reform" movement, I'm taking the first opportunity I've had in a week to update you on what has happened to me over the past month- and most dramatically- in the past week.

To cut to the chase, I've now been forced out of the house I've been making mortgage payments on since June 2003. The circumstances are bizarre, to say the least, but are eminently understandable in terms of the unique research I've been engaged in since I started interviewing admitted cannabis users pursuant to their requests for the meager legal protection made available to them by California's Proposition 215.

Both of you have met J, my second wife, a person I still love deeply but have just become estranged from since leaving our home under duress last Saturday afternoon following a complex series of events I won't try to describe in detail.

Suffice it to say that her son by another marriage, a boy of seven when we met, but now a malevolent angry male of 43 (as of Feb 16) was primarily responsible. He's a person I have provided total financial support for from the time J and I began living together in February 1977.

Unfortunately, he seems warped beyond salvation by a hatred for me that, in retrospect, I should not find that surprising, based on the unexpected findings revealed by my searching interviews of chronic cannabis users as (grudgingly) permitted by Proposition 215.

Mike, your analysis of the initiative's potential in the last few pages of Drug Crazy was- to use your favorite word- monumental. It was also prescient in ways neither of us could have understood when we spoke about the study in 2004 or 2005.

I knew when you used that word that you'd support my cause with R, and his funding soon produced the specialized data base C created for us. Without it as a research tool, all my applicant interviews would have been indecipherable hash. The DB has not only enabled peer-reviewed publication of a revealing study about an issue that remains inexplicably ignored; that very lack of discussion is begging critical questions which suggest that when the current denial is finally addressed, the human drug problems will can be brought closer to resolution.

Only then will we gain the required understanding of our own behavior rather than dismissing it as a set of unrelated phenomena under the rubric of "human nature."

I will end here by observing that neither Richard Nixon nor John Mitchell could possibly have imagined the misery and repression their "quick fix" for the Supreme Court's unexpected nullification of Harry Anslinger's Marijuana Tax Act would lead to.

For them, it was just a bit of clever rhetoric intended to regain the initiative from their youthful anti-war adversaries. For the rest of the world it quickly became a potentially endless war on both "drugs" and the unborn victims of careless human parenting in a world that's clearly been overpopulated by our species and can no longer afford the energy consumption it has (we have) become so accustomed to.

What is cruelly ironic is that cannabis is a drug that encourages agreement by dispelling the anxiety produced in humans by uncertainty. Had its clinical effects been addressed four decades ago, it would have mitigated our modern crisis. Instead, we rewarded the forces of repression and "control" by making cannabis categorically illegal and forbidding any honest research.


Posted by tjeffo at 12:15 AM | Comments (0)

February 19, 2013

The Drug War: Rhetoric Trumps Science

When the Supreme Court struck down Harry Anslinger’s 1937 Marijuana Tax Act in 1969, no one could have predicted the immediate impact of that decision, let alone its long term consequences or their impact on the political careers of the two men required by the Constitution to deal with the Court's unexpected ruling.

The United States takes great pride in its history as a Constitutional Democracy; in fact, we have elevated our Constitution to quasi-religious status since a bloody Civil War was fought to preserve it less than a Century after its ratification.

Indeed, it's probable that the Constitutionality of proposed new federal legislation receives more careful scrutiny from legal scholars than the myriad technical issues any new law will affect profoundly once it is passed.

Unfortunately- and this is the major focus of this essay- the medical virtues of American "drug control" legislation have never received comparable scrutiny from appropriate medical scholars. In fact, an unlikely mix of elected politicians and lobbyists have contrived to elbow physicians almost completely out of the legislative process through a combination of shame, the stigma of "addiction," and the threat of arrest.

At the same time, they also convinced a majority of the world's governments, NGOs, and educational institutions that a "war" on illicit drugs is not only rational public policy, but is also critically important, and capable of being waged successfully.

Another ridiculous premise of the drug war is that because children are so vulnerable to "addiction," it's essential to maintain a list of substances that can't be consumed by law before a certain age (usually 21). To that end, the UN now maintains an international police agency charged with identifying, interdicting, and disrupting illegal drug markets on a continuing basis.

However, medical research- unlike legal definitions- is constantly changing. Thus molecular chemists have, since the late Seventies, taken advantage of a new found ability to create drug agonists- molecules that mimic the effects of a "controlled" drug, but are not the drug itself. Some morphine agonists (fentanyl and sufenta, for example) are so much more powerful than morphine that they are only used by specially trained anesthesiologists. Nevertheless, they have found their way into illegal markets.

The problem with cannabis agonists is even greater; because it is officially on Schedule 1, cannabis agonists are technically just as illegal as "herbal marijuana;" thus they pose huge enforcement problems for the embattled DEA; one that will only grow larger over time.

Thus the planet was saddled with an unwinnable "war" by a resentful American President in 1970. Although further research has confirmed the pharmacologic benefits of cannabinoids, our federal bureaucracy steadfastly refuses to concede an inch and every president since 1974 has continued to enforce the monstrosity created by the only president forced to resign for dishonesty with rhetorical help from his good buddy: the only Attorney General to do time in a federal pen.

Thus the Controlled Substances Act represents a clear perversion of science and common sense by empty rhetoric; nevertheless, it remains the global standard. Are we a great species or what?

Doctor Tom

Posted by tjeffo at 11:24 PM | Comments (0)