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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 February 19, 2013 11:24 PM