Web Log of Dr. Tom O'Connell

September 02, 2010

Mexico: What to Believe?

As someone who lived in pre-drug war El Paso between 1958 to 1963, I have great difficulty adjusting to the virtual tsunami of information about drug trafficking, murder, and corruption that has been emanating from Juarez since I began following the drug war in earnest in 1995. Not only have the numbers of alleged drug-related killings increased dramatically, so has the savage and brazen manner in which they are being carried out; to say nothing of the fact that pitched battles between government forces and narcotrafficantes are being fought deep in the interior.

Even given their dramatic progression from levels reported as recently as 1995, there is general agreement that after newly elected President Felipe Calderon dutifully attempted to accommodate a Bush-Cheney call for a crack down on drug smuggling in 2006, things have become even worse: more savagery, more killings, and more disturbing evidence the Mexican government is losing control.

Even against that background, President Calderon is still claiming progress in Mexico's version of the drug war, based on the most recent arrest of another notorious drug lord. How long can such blindness persist without provoking a catastrophic failure of government South of the Border? More to the point: how might such a failure affect us?

And isn't this very reminiscent of our "successes" against the cocaine cartels and Pablo Escobar in the Eighties, to say nothing of claims made on behalf of body counts and the "light at the end of the tunnel" in an earlier war?

Doctor Tom

Posted by tjeffo at 06:01 PM | Comments (0)

August 31, 2010

Pot Prohibition: a complete history...

Tom Meyer, cartoonist, is one of the SF Chronicle's real treasures. His latest Sunday effort neatly summarizes the war on marijuana ...

Posted by tjeffo at 08:15 PM | Comments (0)

The Importance of Demographics

My decision to accept the invitation of an Oakland cannabis “club” owner to do the required medical screening of people seeking a “recommendation” to use cannabis (and thus qualify as his customers) in compliance with Proposition 215 was motivated mostly by curiosity. I already had a strong belief that US marijuana policy was terribly misguided and harbored the naive conviction it could be “reformed” on the basis of logical arguments once the dimensions of its failure were understood by enough people. But I had no specific plan for how to bring that about.

Even worse, I had no idea of how seriously that judgment understated our government's commitment to its self-induced drug problem or how daunting the idea of changing our drug policy might become.

In any event, it took a few months before I saw the required patient encounters as the opportunity for a unique study of illegal marijuana use. Even then, the task of designing such a controversial project on the fly while continuing to record data took more time than projected. Thus it wasn’t until early 2007, when I was analyzing data from the first four thousand applicants that I tumbled to the significance of their demographics, specifically their dates of birth.

The item itself was simple and straightforward, but its significance is profound and far reaching: only four percent of the first four thousand applicants seen were born before 1946. By default, the rest were all Baby Boomers or Post Boomers.

To fast forward: what that suggests to me at least, that our federal government has missed the significance of the youthful rebellion that suddenly became manifest in the mid-Sixties. Thus rather than attempting to understand and adapt to one of the the most important social developments of the Twentieth Century, America has remained committed to suppressing it with an amalgam of ad-hoc propaganda and repressive law enforcement; with tragic consequences.

The significance and complex ramifications of that hypothesis will be explored in future posts.

Doctor Tom

Posted by tjeffo at 06:56 PM | Comments (0)

August 28, 2010

How Quickly we (Pretend) to Forget

Back in January, I wrote: “Not only has the past been prologue, its cognitive errors and false assumptions have shaped the present in ways that were not- and probably could not could not have been- anticipated by our ancestors.” Even then, I didn’t realize how quickly Mexico would descend into chaos, how steep the descent would be, or how aptly it would make my point. Still unknown is the degree to which the critical implications of present reality would/will be lost on the American polity and its government.

Simply put, how long can we pretend that the chaos in Mexico is not a consequence of drug war folly? Do we really believe that our government’s rigorous preference for the ridiculous euphemism of “drug control” over the more accurate term of “drug prohibition” will hide the fact that the creation of violent criminal markets is an inevitable consequence of prohibition policies, no matter how they are named?

How quickly we seem to have forgotten it was Operation Intercept, Nixon’s unilateral imposition of drug prohibition on Mexico and the US, that initiated the folly that's blossomed into today’s carnage.

Doctor Tom

Posted by tjeffo at 04:34 PM | Comments (0)

August 15, 2010

Giant Steps Backward

Today is one of those days that’s tough on optimists.

The lead story in today’s NYT confirms my worst fears about the direction being taken by the Obama Administration: now well into its second year, it seems more deeply committed to failed policies; not just of their immediate predecessors, but also of the first Nixon Administration, which launched our disastrous war on drugs right after starting secret wars in Laos and Cambodia trying to salvage “victory” in Vietnam (or at least avoid the onus of “losing").

The reasons for their failures are as old as history: foreign invaders are resented by every population, especially if they are culturally different and their duties include killing the people they claim to be protecting. “Victory” in Afghanistan became even more elusive when killings by drone aircraft became a form of extra-judicial murder and it had to be admitted that some had been misdirected against innocent civilians.

Closer to home, the administration's support of Mexican President Calderon’s escalation of the drug war against Mexico’s cartels is more of the same; its outrageous death toll is ample evidence that it won’t succeed.

Finally; that marijuana is both the principal target of border interdiction and better palliation than the Pharmaceutical industry can offer for our distracted society's most common mood disorders is either tragic or ironic, depending on one's point of View.

Doctor Tom

Posted by tjeffo at 06:36 PM | Comments (0)

August 12, 2010

Response to the Wikileaks Release as a Litmus Test

President Obama’s immediate response to the Wikileaks release of classified reports from Afghanistan betrayed a troubling misunderstanding of events in that part of the world; even worse, a commitment to the same old beliefs that led us into the 9/11 debacle in the first place.

It’s also difficult for me to understand why the parallel between the Wikileaks event and the Pentagon Papers released by Daniel Ellsberg to the New York Times in 1971 has been missed by so many supposedly well informed observers (but not by all). While the two wars were undertaken for quite different reasons, they also share critical characteristics that would predispose them to failure.

Both were based on dishonest pretexts. Although the Gulf of Tonkin Resolution was based on an outright lie, our entry into Afghanistan might arguably have been plausible as an effort to capture Bin Laden after the crime of 9/11, but that's not how it transpired. We eased up on our efforts to capture Bin Laden in December 2001 and then waited 15 months before invading Iraq on a new pretext. By that time, Bin Laden was inaccessible, an even greater threat to peace, and the situation in both countries even worse. That the current economic debacle may have been triggered by those two wars will be debated by future historians, but the first two international Depressions to afflict the Industrial Revolution were also preceded by wars and triggered by bank failures in Europe and North America.

Beyond that, military history back to Alexander confirms that Afghanistan has successfully resisted efforts at "control" by great powers, particularly when made by armies with different cultures.

These aren't complex issues. They deserve more open discussion and coherent answers in a troubled world.

Doctor Tom

Posted by tjeffo at 05:18 PM | Comments (0)

August 10, 2010

More of the Same; but with a Twist

There are apparently no limits to the absurdities possible on the Mexican border; nor is there much evidence that either the US or Mexico is capable of learning from past mistakes in their historically futile efforts to “control” drug smuggling. Those efforts began with Nixon’s attempt to interdict marijuana in 1969 and have continued unabated. Over that interval, a panoply of drugs, ranging from Colombian marijuana, and cocaine, through Mexican marijuana and “black tar” heroin and have taken turns being the contraband of the moment, but the lack of success and increasing efforts at interdiction have remained constant.

The latest was an (obviously political) “request” handed to President Obama by by Texas Governor Rick Perry, minutes after Air Force One touched down in Austin yesterday. Citing increasing violence by Mexican drug cartels (appalling, but hardly news) Perry asked for more of the same, but in addition to more troops, he also asked the feds to use the same predator drone aircraft that have been winning us so many friends in Afghanistan and Pakistan.

Given that that the smugglers are often impoverished Mexicans who are primarily seeking to enter the US illegally to work and have been pressed into service by those running the operation, it is difficult to see how unmanned aircraft will do anything but increase the death toll and the resentment attributable to a failing policy.

Perhaps it's time to ask why marijuana had suddenly become so popular in the Sixties and why it's once again in such short supply. Just who is buying all that bammer weed; and why?

Doctor Tom

Posted by tjeffo at 04:52 PM | Comments (0)

August 07, 2010

A Species in Crisis, the need for definitions

Science & GNT

The method of thinking now known as Science has not been around for very long, especially given the more accurate perspectives it has given us for thinking of time itself. It's only been about five centuries since Galileo and Newton were born in Renaissance Europe, literally back-to-back (Newton was born in 1642, the same year Galileo died).

Not only have our concepts of time changed since GNT; so has just about everything else. Considering today's world, however briefly; it has changed more radically since GNT than in the thousands of years of prior human existence; and we may be but the latest in a chain of primates stretching back to the Miocene epoch. Nor were G & N the two smartest men ever; just two with exceptional potential who chanced to be born at a time when their talents could be maximally expressed and then fortunate enough to live to have the influences for which they are both remembered (but neither can enjoy). It’s also quite likely that two, probably more, infants with similar potential already exist; but because of the enormous competition now facing them, and how much we have learned since GNT, won't have comparable impact.

Which brings me to my first major point: the role of chance in history. It’s at least theoretically possible that if all the important variables are known in advance, anything could become predictable; however the "arrow of time" makes that unlikely. Thus there will (probably) always be uncertainty.

Or perhaps God does exist. While a supreme deity can’t be disproved, the evidence favoring one has been diminishing steadily since GNT began.

The next logical point I want to introduce is that, in an over-crowded and contentious world, arguing with religious true believers is not only a waste of valuable time and energy, it’s probably the main reason for the “crisis” referred to in the title. Muslim jihadists’ willingness to kill themselves is unlikely to be matched by their opponents, thus the logic of the Cold War still prevails and “war” is almost certainly not a "solution."

Equally importantly; problems should be defined as accurately as possible before attempting a solution. Thus the best approach may be something humanity has never done before: tried honestly to solve basic problems short of violent destruction of presumed enemies. We humans are both the problem and the solution; no one else can save us from ourselves. While I am also aware there are fundamentalists who see today’s troubling signs as confirmation that an “end of days” is almost upon us, I don’t consider arguing against them to be helpful; thus I choose not to. If I have any “faith,” at all, it’s a hope that common sense will ultimately prevail.

In the meantime, I intend to keep on writing about what I’ve been learning about human emotions from talking to pot smokers for almost ten years.

My logic is straightforward: the emotional symptoms most of them began treating with inhaled cannabis are those now most evident in the modern world; thus they offer a potential short-cut to defining (diagnosing) our global problems; a necessary first step before attempting any radical "therapy."

Doctor Tom

Posted by tjeffo at 05:23 PM | Comments (0)

August 04, 2010

Improbable, yet “Fit to Print”

Some of the material printed in the NYT lives up to its motto; a recent column by Bob Herbert was such an eloquent statement of my growing disappointment in the Obama Administration’s increasingly mindless policy in Afghanistan that I feel compelled to cite it here. However, I’m also forced to note that the fickle American public will soon forget it was the Bush-Cheney strategy to abandon Afghanistan just as Osama bin Laden was within our grasp in order to pursue their Iraq adventure. That particular folly was almost ten years, thousands of deaths, and billions of dollars ago, when the economy was stronger and a balanced budget hadn’t faded to a distant memory. Speaking of memories, ten years is clearly beyond the attention span of a culture that dotes on Lindsay Lohan’s latest peccadillo and seems ready to accept the notion that the Gulf clean-up has been a huge success.

Another report recently appearing in the Times was that the VA, under timid Obama leadership, is slowly warming up to the idea that self-medication with marijuana might even be acceptable for veterans similar to those described by Bob Herbert, so long as they live in one of the fourteen states with an existing medical marijuana law.

In support of that less-than-crisp explanation, the Times referenced the same vaguely worded letter from a VA physician to Michael Kravitz that I’d referred indirectly last Friday. What the article and Dr. Petzel's letter both leave out is the fate of potentially suicidal returnees who live in states without a medical pot law. Will they just have to make do with Ambien or one of the other legally prescribed, medications supplied by their local VA?

Doctor Tom

Posted by tjeffo at 05:39 PM | Comments (0)

August 02, 2010

A World being Overwhelmed by Reality

Ironically, Northern California’s weather has been unseasonably cool so far this summer, but such is not the case in many other parts of the world, including the Southern half of the state; to say nothing of the Eastern US, the Gulf Coast and the Deep South, where everything from triple digit heat, floods, and wild fires are being reported. Then there’s the news (and graphic videos) of other weather-related disasters: huge floods in Pakistan and wildfires in Russia. Funny; there seem to be fewer recent complaints from the far Right about global warming being a liberal “hoax.”

I just turned off the first 1/2 hour of TV news, skipping from one channel to the next as is my wont; it ranged form the improbable to the outrageous, but its theme, for me anyway, was that of a human world still so unwilling to face the magnitude of its self-made disasters that one is forced to wonder what it will take to wake it (them, us) up.

I know that I’ve been writing in this vein for years, hoping against hope that the world would get it. I’m now about ready to admit that the prognosis for meaningful recovery has never appeared more bleak; yet most of the species still seems so oblivious to that reality that I’m occasionally forced to question my own sanity.

Not to worry; whenever that happens all I have to do is to turn on CNN...

Doctor Tom

Posted by tjeffo at 04:07 PM | Comments (0)

July 30, 2010

Incremental Sanity in Action

The outcome of the process that began with the passage of California’s Proposition 215 in 1996 has yet to be decided. Barry McCaffrey, then Clinton’s drug czar, couldn’t even wait for 1996 to end before threatening the license of any California doctor for simply discussing the therapeutic use of marijuana with a patient. Fortunately, the Ninth Circuit ruled that a violation of free speech and the Clinton Administration elected not to appeal.

The presence of Proposition 19 on this year’s ballot is evidence that considerable progress has been made since then; however several related questions have remained unanswered over the past 14 years and more will be raised no matter how the vote goes in November

If Proposition 19 is defeated, federal law will remain unchanged, but the margin of victory will be of great interest to both sides, neither of which seems to have learned much in 14 years. Ironically that same interval- from 1919 to 1933- had been all that was required to bring about the demise of Prohibition.

Since 2001, the most obvious lesson of Proposition 215 seems be one that both the political supporters and opponents of cannabis have enormous difficulty acknowledging: its market is much larger than most had imagined and is still growing. Ironically (there’s that word again) the reason neither side wants to cop to the size of the pot market is that it requires a contradiction of claims each made in the past: the narcs have claimed to be “winning” the war on drugs, while stoners have claimed to be “recreational” users simply exercising free choice.

The truth, both simple and yet more complex than the medically uninformed claims of the opposing sides, is that a significant fraction, generally over 50%, of the population born since the end of World war Two has been trying inhaled cannabis as part of their adolescent rites of passage and a smaller, but still significant, minority have been using it- often for long intervals- because it's safer and more effective than competing “legal” products.

In other words, federal claims that herbal cannabis can’t be medicine are baseless and have done enormous medical and financial damage to our social structure. That such would be difficult for any bureaucracy to admit goes without saying; however a small beginning may have just been made in the form of letters from obscure VA functionaries in response to queries from a veterans' group.

This could be the first crack in the dam that’s been holding back the truth since 1968.

Doctor Tom

Posted by tjeffo at 04:48 PM | Comments (0)

July 29, 2010

A Throwback to Harry Anslinger

Joe Arpaio, Sheriff of Maricopa County (Phoenix) is a miserable human being, one of those people whose need for the limelight and bad behavior combine to become a litmus test of character. While I may neither like nor admire all "Sheriff Joe's" many detractors, I can be reasonably sure I wouldn’t have much in common with his admirers.

He and I do have a few things in common however: we were both born in 1932 and went to work for the federal government in the Fifties. I spent thirteen years- from 1958 on- as a US Army doctor until my disgust for Nixon and the war in Vietnam induced my departure, while Joe served as an enlisted MP between 1950 and 1954, before reentering federal service with Harry Ansliger's FBN in 1957 after a short stint as a civilian cop. He then survived the transformation of the FBN into the DEA before retiring in Phoenix 1992 and running successfully for Sheriff of Maricopa County, an office he has retained tenaciously ever since despite multiple law suits, court orders, and an unequivocal public record of abusing both the powers of his office and the hapless prisoners in his custody.

As luck would have it, the present anomalous situation in Arizona guarantees Joe a place in the limelight for as long as his health permits and his constituents will tolerate his irresponsible antics.

Doctor Tom

Posted by tjeffo at 04:58 PM | Comments (0)

July 28, 2010

Missing the Importance of Whistle Blowers

That there would be more immediate interest in identifying and punishing the “leaker” who supplied Wikileaks with an enormous volume of classified documents than in the significance of the documents themselves should probably not surprise us, even with the recent example of the Pentagon Papers deliberately leaked to the New York Times by Daniel Ellsberg.

What the Pentagon Papers established beyond any doubt was that the Viet Nam War had been a thoroughly dishonest federal enterprise from the beginning; one of the most important effects of Ellsberg’s disclosure was that the feckless war to “save” South Vietnam from Communism (a war already being abandoned by Nixon) lost all credibility.

Although the wars we are now fighting in South Asia had quite different justifications when launched by the Bush-Cheney Administration in 2001, they were equally dishonest from the outset and have evolved into hopeless failures for exactly the same reasons as Vietnam: a foreign army of occupation actively engaged in killing civilians faces an almost insurmountable task in trying to convince citizens of the occupied lands to accept their presence.

The 9/11 terrorist attacks were crimes; they should have been treated as such and any military operation limited to apprehending Bin Laden and his accomplices. Once he’d been allowed to evade capture at Tora Bora, all plausibility for an American presence was lost. It’s especially ironic that Tora Bora was terminated because the Americans were then so preoccupied with the upcoming invasion of Iraq.

Sadly, George Bush was not the first, nor even the only, American President to be snookered into an avoidable war, nor was Richard Nixon the only one to prolong one by escalating attacks on civilians.

Doctor Tom

Posted by tjeffo at 07:16 PM | Comments (0)

July 25, 2010

Birds of a Feather (Political)

As the Shirley Sherrod story began unfolding earlier in the week, I resisted the temptation to comment. For one thing, I was too busy; for another, it just seemed too bizarre: a highly unlikely scenario in which some of the usual suspects on the far Right had become ensnared in their own clumsy trap, an attempted smear of a mid-level black female bureaucrat as "racist" without checking the most basic facts: the incident upon which the claim was based was over twenty years old and had been not only misrepresented, but also lifted out of context by someone with a history of similar dirty tricks. Nevertheless, the “story” broke on Tuesday amidst an obviously coordinated flurry of excited announcements from the Limbaugh/O'Reilly/Beck chorus.

It should have reminded others like myself who are old enough and still possessed of the requisite long term memory of Joe McCarthy’s desperate attempt to smear Army dentist Irving Peress just before the Senate hearings that brought the Wisconsin senator's noxious influence to an abrupt end in 1954.

Of course, the Guilt-by-Association similarity doesn’t end there; despite McCarthy’s public exposure as an incompetent alcoholic bully and his shockingly sudden death from liver failure at the ripe old age of 48, many still see him- not as a pathetic drunk and liar- but as a genuine American hero unfairly smeared by his political enemies.

That one of them is Cliff Kincaid, I regard as ample confirmation that my analysis is correct.

Doctor Tom

Posted by tjeffo at 06:29 PM | Comments (0)

July 24, 2010

First Exploitation, then Hope?

As the human population of Planet Earth has increased to unprecedented levels, so have its demands on the environment. Thus meeting those demands for the entire species has gradually become humanity's major source of wealth and one of its more significant existential threats. Seen in that context, the greater the human population, the more money could be made from exploiting humans through various forms of slavery and the manipulation of essential markets.

Unfortunately, there are limits. Only recently have we learned that although different populations have different ecological footprints: the resources required to meet aggregate human needs in terms of energy, fresh water, and a growing list of resources extracted from the earth (and its oceans) have their own limits. The major factor both driving and meeting human needs over the past five centuries has become the increasing efficiency of the technology enabled by Empirical Science; particularly after the Industrial Revolution began a little over two hundred years ago.

All of which heightens the critical importance of government decisions in establishing rules; not only for populations under their direct control, but also affecting smaller, weaker nations either directly or indirectly. Given the spectacular increase in human population just since the Industrial Revolution began, one does not have to be a genius to understand that humanity is in a crisis it's still unable to recognize; one for which the old ways are proving (and will probably remain) completely inadequate.

Given that our species is the only one capable of our degree of cognition, it follows that aside from some uncontrollable catastrophe such as an impact or a seismic event, the greatest threat to human welfare is human cognitive activity.

Perhaps the best we can hope for is that the forced reduction in our numbers that now appears inevitable will leave an optimum number of survivors with enough residual technology for a fresh start.

Doctor Tom

Posted by tjeffo at 04:51 PM | Comments (0)

July 22, 2010

Compensation, Decompensation, and Awareness

The first two words in the title have specific meanings which are quite different when used in Medicine as opposed to ordinary speech. Medically, they refer to a phenomenon in which mild or moderately impaired function of an organ or organ system may be made up for temporarily by compensatory change. However, there is usually a price to pay; if the impairment is mild enough, it may only become apparent with increased activity. For example, when a young, otherwise healthy, cigarette smoking golfer plays a round on a hilly course instead of his usual flat one. Even then, he may relate early shortness of breath to a cold he just got over, rather than to cigarettes.

However, as time goes by smoking will induce changes in his airways: chronic bronchitis with cough and sputum along with changes in his body habitus that may remain unnoticed by him and family members who see him every day, but would immediately be recognized by most medical chest specialists as early COPD: reduced muscle mass, overinflated lungs, a wet cough. More subtle signs may follow: ending most coughs with a soft laugh, the avoidance of exercise; or purchase of a golf cart, for example.

These changes and the speed with which they develop will also depend on his genome and the numbers of cigarettes smoked, but they will be ultimately be found to some degree in a majority of regular smokers and when compensation fails (decompensation), it may be either rapidly or slowly: as with a sudden fatal heart attack or a lingering dependency on others.

All of which explains why laws punishing use of a safe herbal remedy that regularly diminishes alcohol and cigarette use by its chronic users has been a terrible public policy and those guilty of supporting it for years are either fools or scoundrels.

But don't expect them to admit that; it wouldn't be consistent with their human nature.

Doctor Tom

Posted by tjeffo at 07:04 PM | Comments (0)

July 19, 2010

Mark Kleiman still doesn’t get it

A recent entry described how UCLA Public Policy Professor Mark Kleiman and I have been interacting negatively since 1996 over our differences on drug policy. Because I'd identified him as one of Academia's more important supporters of the drug war, I'd recently started sending him blog entries hoping to provoke a discussion. Instead, he responded with an angry demand that I stop, which I agreed to do; still not knowing if he'd bothered to read what I'd sent him.

I had an answer when his dismissive put-down of Proposition 19 appeared in the LAT. It also confirmed what I'd long suspected: Kleiman relies heavily on NIDA propaganda for both facts and assumptions about cannabis prohibition, a dangerous stance for a policy maven on a policy based almost entirely on Harry Anslinger's imagination and nearly bereft of unbiased clinical confirmation. It's a particularly vulnerable position for a policy wonk because, starting with Urban VII and Galileo, some of Science's most important revelations have started with observations that challenged false assumptions.

It's especially ironic because a paper Kleiman had written with Rick Doblin may have provided the impetus required to get "medical marijuana" on California's ballot in 1996.

I've also been one of the "recommendationists” he sneers at, but If he'd taken the trouble to read the material I sent him, he'd have learned that data supplied by the applicants I've studied challenges NIDA and DEA dogma in very fundamental ways.

Beyond uncovering several unexpected and/or under-appreciated medical benefits experienced by cannabis users, the study also revealed that some of the most critical assumptions made on behalf of the drug war are seriously off the mark and go a long way towards explaining its perennial failure to “control” pot use.

As noted only yesterday, it doesn't matter that the data may not be believed immediately; only that the false assumption is challenged. In this case, time is also on the side of pot smokers because their large numbers, still unsuspected by the establishment, will start becoming more obvious as more Baby Boomers reach Medicare age, starting next year.

Doctor Tom

Posted by tjeffo at 08:09 AM | Comments (0)

July 18, 2010

Disasters, Databases, & Stubborn Beliefs

In today's United States, most investigations of major accidents and natural disasters are eventually made public. As computer technology has evolved, such investigations have become increasingly dependent on relational databases into which pertinent items of information (data) are entered, thus automatically arranging important events along a time-line and clarifying their relationship to each other while calling attention to possible additional areas of importance. In fact, the contributions of databases to empirical Science have been a major factor in the recent acceleration of scientific progress. Unfortunately, control over just how that progress is employed has remained with the same old fallible human institutions as before.

Also unfortunately; any public policy based on creation of illegal markets is nearly impossible to study with database technology because of intrinsic human dishonesty. In essence, such laws render all data about illegal commerce immediately unreliable; whether generated by market participants or, as is now painfully obvious, by involved government entities.

So obvious has been the tendency of humans to take advantage of the opportunities for exploitation offered by any public policy of prohibition that a key modern implication: namely that there is enough difference between the rapid failure of America's experiment with alcohol "Prohibition" and the more protracted failure of its contemporary Drug "Control" Policy to justify its continued enforcement as a "war" on drugs. In other words, there's an assumption that we have nothing to learn from the past because Al Capone and his rivals were merely fighting to control alcohol, while murderous Mexican cartels are struggling for a drug monopoly.

That distinction is now so painfully unrealistic as to represent an indictment of the conceptual human thinking that still supports it. Since that includes all branches of the US federal government and most state bureaucracies; to say nothing of the nations bound by UN treaty, I don't expect much public agreement with my heretical conclusions and have long since abandoned any notion that such a huge error as the drug war can be corrected rapidly. The baggage of the past is simply too heavy.

However, I have gained some perverse pleasure from pointing out the errors of our ruinously destructive drug policy while legally gathering data from its victims. As I've learned from them, I've also derived satisfaction from helping pot users understand why they have found their use of cannabis helpful; which is why I intend to continue gathering their data and commenting on related events for as long as possible.

Doctor Tom

Posted by tjeffo at 11:30 AM | Comments (0)

July 16, 2010

Mid-July Report

The runaway gusher in the Gulf finally seems at least temporarily tamed by its new cap and the striking visual contrast between the old futility and the new calm have endured overnight. It’s still too early to know if the Obama Presidency or the economy of the Gulf Coast have been saved, but at least each has a chance at survival that certainly would have been denied to both if the ninety day mark had passed with no end in sight. Such is the reality of today’s constantly changing Brave New World as it struggles to keep up with the demands of its burdensome human population.

What we seem unable to grasp as a species is that our collective security depends on belief; not in a deity, but in the integrity of the global economy. If, at any given time, a critical fraction of humans doesn’t remain at least nominally obedient to local rules, the system may not function. If too many nations were to go rogue at once economic recovery could become impossible.

There is little doubt the human population has increased enough to stress the carrying capacity of the planet, even as Science has been revealing new existential risks a majority of humans are clearly unable to understand; let alone admit.

On a more mundane level, an historic opportunity for symbolic rejection of an inane federal policy is only a few months off in California amidst increasing evidence of great anticipation by some and continued willful ignorance by others; all very reminiscent of 1996, but with even higher stakes.

Doctor Tom

Posted by tjeffo at 04:22 PM | Comments (0)

July 04, 2010

Happy Birthday?

July Fourth, 1776 was the day the 2nd Continental Congress approved the text of Jefferson’s famous essay as its official explanation of an action they had taken on July 2nd: treason, (at least in the eyes of the British) by their rejection of the authority of King Gerge III over his American colonies. Be that as it may, the Fourth of July has been celebrated as our national birthday almost from the beginning. Among many other overlooked details, the Fourth also commemorates our first two wars as a nation: both fought against Great Britain, then the strongest military power on Earth.

The first was our Revolution; it gained freedom from the Crown and also marked the historical beginning of the end of the Divine Right of Kings as a plausible theory of government. The second, The War of 1812, matched the same two antagonists three decade later in a war neither side was prepared for. The Americans, goaded by British insults and provocations, but also seeking territory in Canada, foolishly risked their national existence, but were ultimately able to win enough key battles to claim victory. That "victory," coming on the heels of a windfall acquisition from France, also allowed the fledgling nation to pursue its hypocritical development of chattel slavery while taking its first halting steps toward ultimately replacing Britain as the World’s dominant colonial power.

Ironically and unhappily, an accidental catastrophe sustained by a British oil company just off shore from New Orleans may have exacted the vengeance an equally vengeful Andrew Jackson had denied the proud British Conquerors of Napoleon just under two centuries ago.

Doctor Tom

Posted by tjeffo at 05:17 PM | Comments (0)

July 01, 2010

Selective Analysis

This morning, I just happened to catch a jaw-dropping analysis on Fox News. Former Federal Reserve Chairman Alan Greenspan conducted an informal seminar for a bevy of respectful Wall Street analysts who were permitted to question him on the severity of our current economic woes. What was ominous was his occasional use of the term “deflation” (because it characterizes depressions); what was truly amazing was his soft shoe dance around any possibility that rampant dishonesty and theft on Wall Street, had been either assisted by complicit “regulation” or played a significant, let alone dominant, role.

What the brief exercise did for me was to update my insights into the problem I’ve been struggling with for the last few years: a coherent understanding of the various mechanisms by which we humans have created the present mess. Clearly denial has been a pivotal factor. To that must be added omission, or what is not reported by media. Greenspan’s apparently erudite analysis, was almost exclusively in economic terms. Although he touched on other factors like “culture,” he didn’t do so in any meaningful way and almost completely ignored the political dishonesty that had permitted theft of billions under cover of a “just” (but avoidable) war.

Clearly, recognized "experts” like Greenspan find it easier to get away with such highly selective analysis; especially if they take pains to limit their remarks to their acknowledged areas of expertise.

It was a masterful performance by an an old pro before a friendly audience.

Doctor Tom

Posted by tjeffo at 04:57 PM | Comments (0)

June 30, 2010

Nemesis & Apocalypse

Mark Kleiman is a professor of pubic policy at UCLA; although we’ve never met face to face, we’ve been aware of each since May, 1996 when a letter I wrote accusing him of “intellectual constipation” was published in the Los Angeles Times. It had been written in response to an Op-Ed authored by Kleiman and psychiatrist Sally Satel on the dangers of methamphetamine, a new drug "menace" then being hyped in terms eerily similar to those used to describe the crack “epidemic” a decade earlier.

I later learned from a mutual acquaintance that Kleiman, then teaching at Harvard’s Kennedy School, had been annoyed enough by my characterization to join the drug policy discussion group I’d been participating in as a neophyte, apparently intent on debate. Because communication was slower in 1996, I'd already departed on a European vacation when he began posting. By my return, he had been so rudely treated by list regulars he had resigned.

Our next brush came a year or two later when I sent him a rude e-mail after hearing a rebroadcast of his interview by a Bay Area NPR station. He responded with an expression of extreme annoyance. By then I’d also read Against Excess, his 1992 drug policy treatise and found it both confused and confusing; primarily because it tacitly endorses criminal prohibition as reasonable public policy. For me, what is inexplicable about many obviously intelligent drug prohibition advocates is their inability to recognize that the fate of the 18th Amendment should have conclusively demonstrated that human nature will defeat any attempt to outlaw commerce in a popular commodity or service. Fifteen additional years, eight of which have been spent interviewing criminal market participants, have strengthened that judgment to the point where I see continued UN efforts to sustain a global drug war in today's world as a sign our species is in deep trouble.

Parenthetically, a quick Google search also reveals that Dr. Satel seems have significantly modified a stance that was once very similar to the one Dr. Kleiman still embraces.

Moreover, current human population numbers may be so stressful and difficult to change (because of Path Dependence) that there is no practical alternative to hoping that leaders will recognize and correct them soon; a hope growing more forlorn by the day as crude oil gushes unchecked into the Gulf of Mexico.

Why, one might ask, should we concern ourselves with drug policy at such a time? One answer, applying to most humans with jobs or other projects that sustain them, is that even with an apocalypse approaching, we seem to need something to do. Besides, we’ve been here before, often without knowing it; especially since the dawn of the nuclear age. Indeed, we may have already survived several close calls; to say nothing of hazards we’d been blissfully unaware of for millennia.

For me, Mark Kleiman has come to represent the dilemma that has long puzzled our species: was our creation planned or accidental? It was set in motion so long ago and remains so inaccessible to proof that, short of a biblical Apocalypse, we are unlikely ever to know with certainty.

What makes it more poignant is that the discovery of empirical science five centuries ago might have offered something closer to real choice; had the long-established human institutions of temporal and religious power not contrived to effectively control how Science is used, a phenomenon that has forced us ever deeper into a trap from which escape may already be impossible.

Over the next several weeks, as we await various possible outcomes, I hope to outline why I think drug policy has become both a metaphor and a reason for whatever will happen.

Doctor Tom

Posted by tjeffo at 07:48 PM | Comments (0)

June 27, 2010

McChrystal vs MacArthur

Although it’s tempting to compare Obama’s firing of Stanley McChrystal with Truman’s sacking of Douglas MacArthur in Korea almost Sixty years ago, it’s considerably more accurate to compare the rookie president’s dilemma to the one we faced in a more recent conflict: our equally ill-advised adventure in Viet Nam in the late Sixties and early Seventies. It was there that we failed to learn a very important lesson, namely that a foreign army attempting to fight a prolonged guerrilla war while also maintaining the “rule of law” in a nation with a different language and culture faces an almost impossible battle. In Viet Nam, we lost a protracted war while substituting aerial bombardment for an army of draftees. In Afghanistan, we are also failing with an all-volunteer army in an otherwise similar context. Also; just as we failed to learn from the French adventure in Viet Nam, we have ignored its Russian variation in Afghanistan. Santayana was right.

I’ve now had a chance to read both the Rolling Stone article that induced President OBama to fire McChrystal and a more recent dispatch from the same author. Both lead to the same conclusion: McChrystal was a bad choice for the mission; once his disrespect for his commanding officer had been made public, Obama had no choice but to fire him. However, the two phenomena are essentially unrelated and it's also unlikely Petraeus will fare any better.

As someone who has wished Obama Well (and still does) I am increasingly distressed by his reliance on shibboleths over informed, rigorous analysis of hard facts. That’s a mistake he's also made vis a vis the drug war.

I hope to go into more detail on the reasons for those opinions in the near future.

Doctor Tom

Posted by tjeffo at 05:47 AM | Comments (0)

June 20, 2010

Fear of the Feds: Still more PC than sane

One of the reasons a public policy as incoherent and unsuccessful as the war on drugs has retained support for so long is fear. In that respect, American drug policy invites a comparison with Nazism, perhaps the most terrifying repression of modern times; also one of the most rapid in terms of gaining total control over an advanced, well-educated polity. Yet, as I learned in two recent casual conversations, just making that comparison opens one up to being called a crack-pot, anti-semitic, or worse; thus demonstrating yet again how reasonable ideas can be misinterpreted by listeners with different points of view.

My first awareness of a serious comparison between Nazism and the drug war came from two books by Richard Lawrence Miller, an American historian who is also Jewish. The first was Nazi Justiz, Miller's analysis of Nazi exploitation Germany’s vulnerable legal system to gain total control of the nation within a few years of taking power. The other was his analysis of how the US drug war bureaucracy has long been using similar techniques to enhance its power.

I recently came across an interesting example of just how pervasive fear of offending the federal drug war has become; when I searched Wikipedia for anxiolytic, a well-understood medical term coined by the makers of Valium in 1962 to advertise their product, I was delivered to an article that was exceptionally complete except for its failure to mention that cannabinoids, especially when inhaled, are powerful anxiolytics.

I consider the anxiolytic properties of "reefer" very important; precisely because they were what led to its sudden popularity with Baby Boom adolescents in the Sixties, a phenomenon drug war supporters have yet to even notice, let alone explain coherently.

The good news was that medical use of cannabis was recognized when a "medical marijuana" initiative was passed in 1996; the bad news is that almost fourteen years after the most populous state in America created an opportunity to study the very population that has been such a source of confusion, their "criminal" behavior is still considered too politically incorrect for "respectable" research.

Instead, that population's needs are being administered by"pot docs" who may soon be rendered redundant by another voter initiative.

Doctor Tom

Posted by tjeffo at 05:52 PM | Comments (0)

June 19, 2010

Joe Califano: Just as stupid as ever; after all these years.

Joseph A. Califano, Jr., is a native New Yorker, Harvard educated lawyer, and career bureaucrat who entered federal service in 1961 after a stint in the Navy and soon became a behind-the-scenes power in the Johnson Administration after JFK’s assassination. He later served as Jimmy Carter’s Secretary of Health Education and Welfare between 1977 and 1979.

Unfortunately, a misguided interest in Medicine has apparently kept him enamored of the false notion that criminal prohibition can be rehabilitated into good public policy, thus he founded the Center for Addiction and Drug Abuse at Columbia University (CASA Columbia) which has since become entrenched as a drug war propaganda machine with a prestigious Ivy League address. While editing a low-budget drug policy newsletter between 1997 and 200I, I became very familiar with an unending stream of CASA “studies” that inevitably found evidence in favor of coerced “treatment” while decrying the money spent on criminal prosecution. In fact, one of the more pleasant consequences of my recent immersion in a study of cannabis users had been not having to deal with the conundrum represented by Mr. Califano and his ilk: are they evil or just stupid?

Sadly, the latest evidence has me leaning more toward evil. Yesterday afternoon, during my return from Oakland after interviews with nine typical victims of cannabis prohibition had left me more convinced than ever of the policy's stupidity, good old clueless NPR provided me with nearly ten minutes of teeth-gnashing evidence of its fecklessness: a report on the latest carnage in Mexico followed by a typical witless endorsement from Joe C.

Now I get it. Like anything human it's not all or none, but a combination of the two: thus anyone who takes Joe Califano seriously must be as evil AND stupid as he is.

Doctor Tom

Posted by tjeffo at 04:08 PM | Comments (0)

June 18, 2010

Continued Posturing

While the window for an effective plan to deal with the consequences of what CNN has just quietly upgraded from a “spill” to a “disaster” closes a bit more each day, the finger pointing continues. One is forced to wonder: if BP and other large oil companies were guilty (as they certainly were) of collective myopia in failing to anticipate the likelihood of a disastrous deep-water drilling accident, what about all the concerned government agencies and media sources who now seem completely blind to the probability that the simultaneous disruption of several important industries in the Southeastern US will trigger a wave of further business failures, foreclosures, and repossessions within months?

Given the enormity of the potential problem, isn’t it likely that refugees from the Southeast will stress other parts of the country, all struggling to balance state and municipal budgets in the third year of a financial crisis?

Also certain undeniable facts raise another question: most “advanced nations” of the world are struggling to emerge from a credit crisis brought on by their own greed and the overproduction of consumer goods, even as “developing” nations also struggle: to earn enough to afford those same goods and compelling evidence suggests that rapid changes in both climate and sea levels are directly related to their production.

Have we humans finally managed to create a problem without a solution?

Doctor Tom

Posted by tjeffo at 04:26 PM | Comments (0)

June 17, 2010

Complicit Denial

A favorite theme of psychologists and psychiatrists committed to the “addiction” model of disease is that denial is an invidious mechanism by which addicts avoid confronting their need for therapy. Such thinking dovetails very neatly with the (false) 20th Century model of coerced treatment that began with the Harrison Act in 1914 and has since gradually evolved into a “war” on drugs with essential help from the US Supreme Court, President Hoover’s Secretary of the Treasury, and President Richard Nixon.

A mainstay of drug war thinking is that the only acceptable drugs are those approved by the FDA and prescribed by physicians. Self medication with “drugs of abuse,” especially for mental symptoms, gradually became a crime requiring intervention by the criminal justice system; also a major argument for a prohibition policy (euphemistically labeled Drug Control). Another mainstay of drug war dogma is that the optimal goal of treatment is total abstinence.

My almost nine-year experience taking clinical histories from chronic cannabis (“marijuana”) users seeking to become “medical” under existing law has decisively altered my own beliefs. Rather than seeing pot prohibition as a reasonable policy as I once did (when my children were adolescents), I have become convinced that it's delusional nonsense based on a dangerous denial of obvious reality, one most humans have been brainwashed into believing.

Well beyond that, I also think our human capacity for denial is one of our species' most dangerous characteristics. Perhaps once a useful tool for keeping differences of opinion from generating conflict when our numbers were small, it has become dangerously outmoded; precisely because both our numbers and our capacity for self-generated disasters are now among our greatest hazards.

Ironically, current events, both in the Gulf of Mexico and along our Mexican border provide worrisome examples. On land, it’s the amnesia of both governments for the lessons of Al Capone and Chicago as they vow to "crack down" on cartels fighting to control lucrative smuggling corridors for “bammer” being carried across the desert by expendable human “mules.”

Out at sea, it’s the real-time drama that began over eight weeks ago when an oil rig exploded, an accident apparently neither the Petroleum Industry nor its government “regulators” ever thought possible. Nor did the public,including this observer, even know drilling has been going on for years at depths where ambient pressures limit human activity to robot devices.

Finally, the best evidence for denial is that the first concern I've heard or seen expressed since day one about the enormous risk of economic catastrophe represented by an uncontrolled gusher was last evening.

Doctor Tom

Posted by tjeffo at 07:36 PM | Comments (0)

June 15, 2010

Competitive Mismanagement

As the world awaits the outcome of what may soon come to be known as the Costner Experiment, one is forced to wonder how humanity ever found itself in such a predicament and, if the experiment succeeds, will it have learned anything from the experience?

As it turns out, the answer to the first question is now painfully obvious; but the most informed response to the second would have to be, “almost certainly not.” Dealing first with the oil disaster’s root cause, it was concisely articulated to Anderson Cooper by Costner himself in the segment I watched last night: he had approached the petroleum industry with his proposal years ago, but they had not seen any need to invest in technology for cleaning up spills. Given that they have also been drilling at greater and greater depths for years, that attitude, confirmed by their meager investment in safety and clean up, was irresponsibly reckless. The Air Transportation equivalent would have been an assertion that air travel had become so safe that airline crashes were now a thing of the past.

The real time vicarious experience of participation in these unfolding events continues; I had just listened to Congressman Ed Markey upbraid a stony faced panel of big oil execs for their behavior and then turned the set off to write this entry rather than listen to his eager colleagues wax predictably self-righteous in the TV spotlight.

It’s now time for me to drive over to Oakland to screen some new pot users seeking to become “legal’ and renew that status for others under the provisions of California’s still-disputed and much misunderstood law.

All of which simply reinforces my belief that, for all our cleverness, we humans can be maddeningly self-destructive.

Doctor Tom

Posted by tjeffo at 05:00 PM | Comments (0)

Can the crisis really be avoided?

Despite its obvious limitations, I was strongly in favor of California's marijuana legalization initiative from the time it qualified for the November ballot, and had thus been following developments closely until very recently.

However, the deepening crisis in the Gulf of Mexico had completely changed my focus; particularly after it became painfully evident that very few of those in a position of responsibility had come to terms with the enormity of the problem, or that any "solution" would have to be a remarkably lucky ad-hoc experiment. At a minimum, it would have to succeed well before the November election if a massive global financial crisis were to be avoided.

In an almost unbelievable real time coincidence, I then found myself typing this as I watched and listened to Kevin Costner explaining to Anderson Cooper on CNN how he had been developing an oil/water separation device for the past several years; also that several will soon be deployed by BP.

It's now about two hours later and this is the first chance I've had since listening to Costner to finish this entry. Why? Because other, more pressing matters intruded; and hey, we still have a few weeks to wait before seeing if Costner's invention will prevent a total melt-down of the world's financial system.

Doctor Tom

Posted by tjeffo at 02:23 AM | Comments (0)

June 13, 2010

Needed: A Scientifically Valid Theory of Human Behavior

Empirical Science can be defined as an approach to natural phenomena based on observation, hypothesis and experimentation, all ideally carried out in a collegial atmosphere of healthy skepticism and rigorous honesty. Also understood is that new observations should be scrutinized for both their accuracy and compatibility with accepted theories. In that context, it is not expected that new observations or hypotheses must be accepted by all workers in a given field; rather collegial disagreement on some issues often persists for long intervals; but without introducing error or impeding overall scientific progress

In terms of its impact on human behavior, the spectacular development of empirical Science (generally conceded to have started with Galileo) has become the single most important factor shaping human (and other) life on the planet. Indeed; violent discontent generated by ambient discrepancies in the rate of scientific “progress” and distribution of the wealth it enables may be the single most immediate threat to human existence. Although we are often reminded of other, more potent existential threats, the ones we create are important because they are at least potentially remediable and some, like accelerated climate change and looming shortages of energy and fresh water, are decidedly urgent.

In that context, it can also be persuasively argued that what our species needs most is an accurate, evidence-based theory of human behavior, one also as compatible as possible with well established scientific theory.

Whether one can be developed in time to avert all extant man-made threats is unlikely; however, it’s also unlikely that any one threat would become an extinction event. Indeed; a “natural” reduction in human numbers might even be a useful first step towards planetary stabiliization.

In future entries, I hope to present persuasive evidence that the erroneous faux-scientific theory of drug prohibition now embraced by the world's governments (for a variety of understandable reasons) has become a major obstacle to an accurate understanding of our behavior as a species.

Until that obstacle is removed, it will probably be impossible to “solve” the serious behavioral problems now being forcibly misrepresented as a matter of (seriously mistaken) policy.

Doctor Tom

Posted by tjeffo at 05:51 PM | Comments (0)

June 12, 2010

Is Denial an Ultimately Fatal Human Flaw?

My study of pot use has supplied me with a gradual understanding of the degree to which denial is a form of intellectual dishonesty, one all too characteristic of human behavior. That, in turn, brought some other human vulnerabilities into greater focus. To a degree I could not have imagined a few months ago, recent events in the Gulf of Mexico may have started the clock on a doomsday scenario consistent with my worst fears. That it also involves Mexico, the most recent subject of my “drug related” concerns, simply adds to the irony. To put it as succinctly as possible: evolving events in the Gulf since April 20, in combination with the world's swollen human population, together with our tendency to deny obvious problems and our basic insecurity may have already intensified the current economic "downturn" enough to make escape uncertain.

The reasons are relatively straightforward: the Exxon-Valdez disaster, with which the gulf “spill” is being compared, was limited from the beginning by the size of the tanker. A runaway leak from a breached well one mile below the surface is potentially unlimited; neither its rate nor its effects can even be measured, particularly until we know if it can be shut off; let alone how long that might take.

In the meantime, a rich ecosystem is being poisoned and a cascade of devastating economic consequences has been set in motion in a world already reeling from an unprecedented burden of debt; yet the concerns being voiced by world “leaders” are as pedestrian as always.

Need I say more?

Doctor Tom

Posted by tjeffo at 06:07 PM | Comments (0)

June 06, 2010

The Impact of Policy on Research

The last entry described the discovery of what I initially mistook for a whole new area of research on youthful “stress” by two neuroscientists using exotic techniques for gathering blood samples from unstressed subjects. Among other things, I would soon learn that similar physiological "stress" research has been far more common than I'd realized; although not necessarily as focused on differences between youthful and adult subjects as in my two examples.

In the first, East African baboons were being surreptitiously darted by the researcher himself, a Stanford professor who had developed it as a virtuoso technique during annual visits to Kenya over a span of decades. The other, younger and also a PhD with post-doc experience at Rockefeller, was using a more lethal technique: guillotining rat pups for the same purpose: obtaining blood samples as free from the effects of stress as possible.

As I read further about what had at first impressed me as an exotic new subject, I came across names and concepts from my college and medical school days, both now over fifty years behind me. The first was Claude Bernard, a Nineteenth Century giant considered by many to be the father of modern Physiology, and also famous for his insistence on objectivity and the concept that a millieu interieur compatible with survival had to be maintained in all species. Another was early Twentieth century American Walter B. Cannon, a Harvard professor who helped Bernard's concept along by linking psychological stimuli to physiological responses and introducing the concepts of fight or flight and homeostasis to the dialog. Cannon had also identified the adrenal gland as the source of adrenalin and a key component in a non specific pituitary-adrenal response to change ("stress") a theme that was quickly developed and expanded between 1936 and 1956 by Hans Selye as the General Adaptation Syndrome.

Based on my own certainty that cannabis became popular in the Sixties because it had been so effective at relieving adolescent stress, my immediate response was to wonder why Doctors Sapolsky and Romeo (both of whom had professed a desire to see their results extrapolated to human behavior) had gone to such lengths.

Then I got it: human subjects would have been verboten. One of the drug war's greatest successes has been to persuade laymen that research on "drugs of abuse" is illegitimate; studies of cannabis most of all. The mechanisms are federal control of most drug research funding, fear of incurring federal displeasure, and the second of three (never-validated) claims concocted to justify Schedule one in 1970: arbitrarily designated "drugs of abuse" have no "accepted" medical utility. Why? Because we say so.

Sadly, the more respected one becomes in academic research, the more important it is to remain NIDA compliant.

Doctor Tom

Posted by tjeffo at 08:01 PM | Comments (0)

May 31, 2010

How Logical Assumptions evolve into Major Mistakes

The question asked near the beginning of an article in The Scientist caught my attention: “Was it possible that stress affected young brains and older brains differently, in ways that researchers and clinicians had overlooked? ... Do adolescents and adults undergo a similar neuroendocrine response when stressed?”

The reason I’d been searching for information on Dr. Russell Romeo was the youthful researcher's growing reputation for investigating the impact of emotional stress on young animals, in his case, rat pups. Also, we had arrived at a similar key understanding, albeit by very different routes: namely that the amygdala and limbic system are critical loci for sensing, integrating, and responding to emotional stress. Finally; I had become interested in learning more about whatever neuroendocrine mechanisms he might be proposing as explanations.

What I soon learned was (typically) equivocal. I knew, of course, that because his research is further into the academic mainstream than mine, it had also to be more compliant with the official (but ludicrous) NIDA position on “addiction." Nevertheless, Romeo's focus on youth gave me some reason to believe his studies might be congruent enough with my clinical data from humans to be seen as supporting similar conclusions.

The reasons are more complicated than complex; my interest in Romeo had originally been piqued after encountering his name in a search for material on Stanford’s Robert Sapolsky, another ex-Rockefeller University fellow who had also worked and published with Bruce McEwen while in New York.

That all three investigators had become focused on stress in youthful animal models simply added to the hope their work would lend support to my most obvious, yet controversial, finding: namely, that the large scale initiation of cannabis by American adolescents in the Sixties had clearly been the key to its paradoxical (and never questioned) commercial success thirty years after being banned for obviously spurious reasons.

All that's necessary to explain that success is a realization that the safety and efficacy of inhaled cannabis in relieving the adolescent angst of baby boomers was why "marijuana" had, over time, become the most valuable crop harvested in the US and is now, also paradoxically, the most valuable and frequently intercepted illegal drug along our border with Mexico.

Another key to the increasingly complicated puzzle is yet another simple understanding: the drug war's only major success has been its placement of human populations of illegal drug users off limits as "legitimate" research subjects by continuing to insist that such use can't possibly be "medical."

Doctor Tom

Posted by tjeffo at 10:28 PM | Comments (0)

May 30, 2010

Unpleasant Memorial Day Thoughts

Watching that disastrous geyser of crude oil erupt into the Gulf of Mexico on TV news for the past few weeks has been almost as surreal as following the denial of reality that's long been standard practice for both the US and Mexico with respect to their vexing issues of illegal immigration and illegal drugs. What the three unwelcome intrusions: oil, drugs, and illegal aliens, have in common is that all are uncontrollable, almost impossible to measure precisely, and expose the penchant for dishonesty that may be the most tragic flaw in humanity's otherwise glorious cognitive ability.

If so, it would be tragic indeed, for it is that same cognitive ability that has been allowing Science to unravel secrets of the universe we inhabit at an ever-increasing rate over the past several hundred years. Unfortunately, thoughtless exploitation of new scientific technology, our innate dishonesty, and an underlying emotional vulnerability seem to have combined to produce the multiple problems we now find themselves embroiled in and from which we may have considerable difficulty escaping; primarily because there are now so many of us and we have become so adept at avoiding unpleasant reality.

I'm only too aware that I've been harping on the same unpleasant themes a lot recently; but it's difficult to imagine solutions for problems that can't be acknowledged.

Doctor Tom

Posted by tjeffo at 05:33 PM | Comments (0)

May 28, 2010

The Lessons of History

It’s not impossible for the ecologic disaster now evolving in the Gulf of Mexico to become the deep sea equivalent of the “Dust Bowl” that added so much to the woes of the Great Depression.

As someone who grew up in the East and was only four years old in 1936, I never appreciated the degree to which mismanagement of America’s grasslands had added to the miseries of an era I had lived through, but not experienced directly.

However, just reading that history now is all it takes to see that the same hubris and impatience for profit that allowed Midwestern topsoil to be blown away in the Thirties have also been responsible for whatever economic blight will follow the release of millions of gallons of crude oil into the Gulf of Mexico.

Even so, the world doesn’t seem to be paying much attention...

Doctor Tom

Posted by tjeffo at 04:22 PM | Comments (0)

May 23, 2010

Border Unreality; a sign of the times

The last entry referred to the formal state visit then in progress between Presidents Obama and Calderon. Given the gravity of the immigration, crime, and economic problems facing their two nations, the public statements of the two leaders were a travesty, as was media coverage of their meeting.

To appreciate the enormous gap between reality at the border and what was not said in Washington, one has only to compare current murder rates in the neighboring cities of El Paso and Juarez. The Texas city, which has been becoming steadily more “Mexican” in terms of its inhabitants, is still a very safe place to live, while just across the Rio Grande, Juarez is now the murder capital of the entire world.

One does not have to look far for the reason. It’s the drug war; or more precisely, America’s feckless war on “marijuana,” which has been growing more futile and incoherent every year, as illustrated by our cable TV coverage. On any given evening, one is liable to encounter a police reality show featuring bully-boy detectives with shaved heads celebrating a big bust because it took large amounts of “narcotics” “off the street,” and led to the arrest of a gaggle of low-level “bad guys.” On an adjacent channel, one is just as likely to find one of the innumerable re-runs of “Marijuana Nation” documenting the unexpected success of California’s medical gray market.

One the fastest growing demographics in my registry of cannabis applicants has been the cohort born between 1982 and 1992; all of whom would have been much too young to qualify for a "recommendation" when Proposition 215 passed in 1996. Once one appreciates that long term chronic use has been based on the anxiolytic appeal of inhaled cannabis for the latest crop of adolescents to enter our junior high schools since about 1965, and that nearly all have been trying alcohol and tobacco at nearly the same average age (14.9 years) since 1971, one can readily understand the failure of a federal policy based on keeping "kids" from trying all three. It never had even a remote chance of success for exactly the same reasons parents have classically been unable to keep their adolescent "kids" from doing the same things they did.

The answer to the logical question raised by our national dilemma is two more questions: how do we get the federal government to admit a huge, costly mistake? After we do that, how do we induce some of its most powerful bureaucracies to either commit suicide or radically re-think their mission?

Doctor Tom

Posted by tjeffo at 06:03 PM | Comments (0)

May 20, 2010

Putting it All Together

I began this blog in a effort to explain what I've been learning about the human use of cannabis and other drugs by taking advantage of the opportunity California’s version of “medical marijuana” had provided licensed physicians to interview pot users. Because recognition of that opportunity had, of necessity, been a function of my own naivete, I have also gradually come to see the blog as a record of my own loss of innocence, at least with respect to modern pot culture, which only began in 1946. To have been a true insider, I'd have had to be born at least a dozen years later. Another of several lessons learned along the way is that because our unique brains are able to accumulate and analyze information (create culture) to an unparalleled degree, the circumstances of any individual human's birth have a greater impact on their ultimate development than on any other mammal. Thus a felicitous combination of circumstances is all it takes for a Darwin, or an Einstein to emerge. Newton once said: "I have stood on the shoulders of giants." Given the right circumstances, any moderately intelligent human can become a giant.

The ramifications of that concept are staggering: as our species has been gradually adapting to its discovery of Science as an efficient new tool for deciphering its environment, it has been unwittingly contriving to use scientific technology as a mechanism for converting its home planet into an overpopulated and almost unmanageable prison. The flaw responsible for this sad state of affairs may well be the parallel evolutionary development of our brain’s emotional and cognitive centers in such a way that emotions ultimately control our most important choices, whether as individuals or groups. We also have related abilities: one is secretly acting out destructive fantasies as individuals; another is forming intense emotional bonds with various groups throughout life. The former predisposes to serial murder by individuals; the latter to wars motivated by racial and religious hatred.

Ironically, the best available evidence for these conclusions is to be found in our popular media which, as a result of the digital revolution, have enhanced the ability of individual humans to expose their cognitive skills and emotional flaws as never before. A convenient current example is media coverage of the series of ceremonial meetings now taking place in Washington between Presidents Obama of the US and Calderon of Mexico.

A cursory review of only a few of the news articles written so far confirms the reporters' reluctance to explore the incredible cognitive dissonance on display in the public statements of both men. Even more discouraging are the heated comments posted in response to various news items.

Doctor Tom

Posted by tjeffo at 03:03 PM | Comments (0)

May 18, 2010

More on the Critical Distinction between "Clinical" and "Legal"

The often misunderstood term clinical implies interaction between a physician and a patient, a relationship similar to other protected professional relationships; those between investigative reporters and their sources or lawyers and their clients for example. Historically, government representatives, particularly in law enforcement, have tended to see such protections as interfering with their jobs. Although nominally required to obtain search warrants, they sometimes resort to illegal searches, which, if discovered, can have far-reaching consequences.

Two famous recent examples have been the Watergate break-in and the one that preceded it, an equally illegal search of the office of the psychiatrist who treated Daniel Ellsberg following his unauthorized 1971 release of the Pentagon Papers. The purpose of both warrantless searches was the same: to look for material that would discredit perceived political enemies of a sitting president, at that time one of the most powerful men in the world

Perhaps the most ironic aspect of the unlikely chain of events is that it began with what was unquestionably a crime and ended in the expulsion of Richard Nixon from the White House, a result neither Ellsberg nor Anthony Russo, his Rand Corporation associate could possibly have have predicted while they were laboriously xeroxing some 7600 pages of classified documents in 1971. Both men clearly understood the risks; they also believed they had a moral obligation to disclose the truths they had uncovered: how the malfeasance of four separate US administrations had involved the nation in an Asian quagmire.

Ironically, it was the decision of Nixon’s “plumbers,” many of them ex-law enforcement agents, to break into the office of Ellsberg’s psychiatrist in an effort to smear him, that ultimately led to Nixon's downfall.

Additional ironies, from my point of view, are legion. Most importantly, the modern drug war, as articulated by the First Nixon Administration, is still not only the law of the land in the United States, but also World’s drug policy. It’s also the lineal descendant of judicial decisions authorizing the police to arrest physicians they disagreed with, and were later expanded- also without scientific evidence- to permit arrest of any citizen for mere possession of forbidden drugs as defined by the spurious criteria listed in the Controlled Substances Act.

In essence,legal has trumped clinical through a series of judicial fiats issued since 1914. Until those errors are recognized and corrected, the world will continue to be burdened with a policy of proven failure, the consequences of which are increasingly difficult to recognize and have long been beyond correction for a majority of its victims.

Doctor Tom

Posted by tjeffo at 04:44 PM | Comments (0)

May 17, 2010

Medical Marijuana; arriving at a clinical definition.

As California’s contentious initiative nears its fourteenth birthday, the original concept has succeeded to the point where another such initiative, one legalizing possession and use by adults for any purpose, is on the November ballot. Once upon a time, such a development might have been considered “progress;” however in today’s bizarre world, similar divisive arguments are rarely settled for long, thus new points of contention have already been created. However, lack of agreement doesn’t mean the unique opportunity for clinical research provided by 215 was wasted. Although disputed and stymied to the extent possible by courts, police agencies, and other other non-clinical entities, it has been possible to gather and preserve previously unavailable and uniquely valuable patient data.

As one who has been accumulating such data for over eight years, I’ve always believed I had a duty to share it to the extent possible. Fortunately, near the beginning of my patient (“applicant”) experience, I realized they were a source of unique information and focused on discovering what they had to teach me. After coming to some tentative conclusions I attempted to share with presumed Reform colleagues, I was surprised at the degree to which patient evidence was discounted; either because of observer bias by non-clinicians or by clinicians with a limited view of the opportunity presented in California. By then, both my own data and its internal consistency were such that I realized the importance of preserving and sharing them, so I began this blog in the Summer of 2005.

Over the past year or so, I’ve started deliberately sharing what I’ve learned with both new patients and “renewals,” some being seen for the fifth time, thus expanding all patient encounters into opportunities to both educate them and to test the validity of certain concepts by seeking their disagreement and whatever exceptions to my general impressions their own experience might provide. It's important to interject at this point that clinicians should never think they know everything a patient has to teach them.

I now believe I’m ready to pull together a medically coherent and historically accurate clinical overview of "Medical Marijuana," the bitterly disputed legal entity created when California voters surprised the world by approving Proposition 215 in 1996.

Doctor Tom

Posted by tjeffo at 05:35 PM | Comments (0)

May 12, 2010

Forgotten; but not Gone: leftovers from the age of coal.

When the Industrial Revolution began in earnest around 1800, its first cheap fuel was coal and its first important products were textiles. Soon coal mines and mills had become sources of great wealth, but each had its own victims. In America they were the slaves who suddenly became indispensable to cotton agriculture; in England it was the poor, especially children, who came to be preferred for mining coal and working in mills.

Each population of victims provoked a humanitarian backlash; abolition movements in England and North America, and literary protests against slavery and brutal labor conditions from Harriet Beecher Stowe, Karl Marx and Charles Dickens. All eventually played roles leading to the increasingly dangerous conflicts of the late Nineteenth and Twentieth Centuries and are still factors influencing the new struggles of the Twenty-first.

One of many apparent differences was the shift in major energy sources to oil and natural gas; however, both are also products of the Carboniferous Period, simply regarded as “cleaner” and more adaptable to the expanding needs of a growing human population. Inevitably, there’s also a catch: the usual desire to exploit new technology for profit, as exemplified by yesterday’s exercise in finger pointing over a deep-water oil well polluting the Gulf of Mexico, even as the media seems impatient to get on with the latest scandal.

It reminded me of an eerie scene I’d witnessed while driving through Pennsylvania about thirty years ago: smoke pouring out of holes in the ground, left-overs from the days of coal and now, according to Wikipedia, still polluting the environment all over the world, but with little fanfare. I guess, as they say in business, their environmental damage is already "in the market."

I wonder how much more the environment can take and still nourish our species- or if the global Economy will recover from the chaos it may be about to enter.

Doctor Tom

Posted by tjeffo at 05:46 PM | Comments (0)

May 11, 2010

The More Things Change...

An item in today's NYT reminded me of an NPR interview I'd heard while driving home from Oakland in 2008. I was so impressed that I googled the epidemiologist being interviewed and ended up exchanging e-mails with her as well as blogging about how impressed I had been by her courage and forthright style.

Sadly, today's piece in the times suggests she also had an accurate crystal ball; the global financial crisis, then just a dark cloud on the horizon, seems to have made matters worse by drying up the money that was then doing some good by paying for treatment. Unfortunately, the ignorance driving spread of the disease persists.

Doctor Tom

Posted by tjeffo at 12:08 AM | Comments (0)

May 08, 2010

Empiricism & Belief; Emotions & Dishonesty: the evolitionary flaws that drive our behavior.

Although still disputed, one of the more reliable estimates of how long humans have been a separate species is about two hundred thousand years. In that connection, we now have some long-awaited evidence that humans share DNA with Neanderthals, their older relatives on the evolutionary tree foreshadowed by Darwin's prescient leap of intuition. Although one of the more useful scientific theories ever developed, the very idea of Evolution is still hotly disputed by creationists. Likewise empirical Science, which only dates back to events surrounding Galileo's questioning of Papal authority in the Seventeenth Century.

All of which allows consideration of a critical point: the same intellectual battle between empiricism (science) and dogmatism (religious faith) that began with Galileo and Urban VIII remains unresolved. In one guise or another, it lurks within most of the intractable disputes now dividing our planet. Furthermore, although top-down religious thinking has been far less productive in terms of reliable results, it remains the default for policy makers the world over

That's because authoritarian dogmatists have managed to control the trajectory of human culture, with the ultimate result that we now face a cascade of serious problems, many of which are unprecedented. The Industrial Revolution, rooted in technology, has been a cornucopia of new products for which humans quickly developed insatiable appetites, even as their largely "faith-based" national governments remained unequal to the tasks of regulating commerce equitably or settling international disputes amicably. Indeed; arms production for "defense" is now an important branch of global commerce.

Meanwhile, technology was also facilitating an enormous increase in the human population which may already be beyond the planet's capacity to sustain. However as the current Climate Change debate demonstrates, global response to such crises is variable, signaling that we can expect even more debate before a mitigation strategy is adopted. Finally, Climate Change may be merely one of several crises in our intermediate future.

Many readers may already be put off by this sobering assessment; yet, my interpretation of both human nature and current events has been shaped by the unique opportunity I've had to study the human use cannabis as it's been evolving over the past 40 years.

The first thing I learned was that cannabinoids are safe and very effective against several common emotional disorders. The second is that nearly all of pot's considerable medical benefits have been obscured by drug war propaganda. Finally, that the failure of the US (and world's) drug policy is now so obvious that the prolonged refusal of those who enforce it to accept even minor criticism brings both their intellectual honesty and the legitimacy of their policy into serious question. In fact, the progressive cognitive dissonance of the drug war makes it a superb metaphor for a disaster that can be neither admitted, nor "controlled."

The current oil leak into the Gulf of Mexico and the erratic eruptions of an Icelandic volcano, are examples. Once one becomes cognizant of the extreme reluctance of governments and corporations to admit past mistakes, the basically irrational nature of typical partisanship becomes more apparent.

Given the modern panoply of (predominantly) human disasters, it would behoove us to recognize how dangerous the split between scientific and religious thinking has become; also the degree to which the religious variety has become society's default. Just imagine how unlikely it would be for a declared atheist to be nominated for the Presidency by either major party.

Doctor Tom

Posted by tjeffo at 05:55 PM | Comments (0)

May 05, 2010

Behind the Headlines, and a Useful Concept

In 1952, I was a senior in college and Dinah Shore was belting out TV commercials for Chevrolet. Harry Truman was in the White House and the idea of a huge oil slick bearing down on New Orleans would have seemed utterly improbable. Nevertheless, there was still a lot to worry about: an unexpected "police action" in Korea had raised the first-ever threat of nuclear war after Russia’s 1949 nuclear test obviated comforting predictions by western scientists that it would take them at least fifteen years. The “loss” of China to Communism, also in 1949, plus revelations that Russia's nuclear program had been assisted by espionage only added to McCarthyism and the national paranoia it engendered.

What the Chevy commercial did foreshadow was a reality that couldn’t have been anticipated in 1952: that burgeoning technology, cheap energy, and explosive population growth could lead so quickly to today’s related dilemmas of rapid climate change and looming shortages of oil and fresh water.

The process by which such interconnected problems might have evolved is increasingly referred to as Path Dependence, a relatively new term which, although still unfamiliar to most laymen, is the subject of turf battles within academia, particularly the disciplines of Economics, Sociology and History.

When broadly interpreted, the concept becomes very useful for the component-by-component analysis of any directional change. In that context, the greater our planet’s human population, the more likely it is to become trapped in its (our) past and the more difficult change becomes.

To that outline must be added a simple caveat: policy mistakes are made by humans; because our emotions render such admissions difficult, particularly by the agencies responsible for them, correction becomes difficult and is inevitably delayed.

Thus does the uphill struggle to "reform" a failing, destructive drug policy based on nearly a century of fear and false assumptions become readily understandable.

Doctor Tom

Posted by tjeffo at 03:23 PM | Comments (0)

May 02, 2010

Parsing Mexico, 3

The last entry ended on the suggestion that trade in “marijuana,” an illegal drug almost unknown to most Americans when JFK was elected has, since then, become important enough to threaten economic and political stability in both Mexico and the United States. Further, that the two governments' mutual reluctance to acknowledge such obvious problems suggests they may be even more serious than is being reported.

The evidence for those startling claims is relatively straightforward: marijuana use, essentially unchronicled before the 1937 Marijuana Tax Act, remained rare throughout the Forties and Fifties. That the few celebrity "busts” that did occur received so much publicity (Gene Krupa in 1943 and Robert Mitchum in 1948) only emphasizes their rarity. The relative insignificance of whatever market there was for marijuana between 1937 and the early Seventies is further confirmed by the explosion in arrests that began in conjunction with passage of the Controlled Substances Act in 1970 and has been sustained into the present as successive waves of adolescents have continued trying "pot," between ages 12 and 18, a phenomenon amply confirmed by Monitoring the Future surveys since 1975.

What Accounts for the Timing of Pot's Popularity?

The first literary interest in marijuana was by "beat" authors . As the first whites to use it and write about it approvingly, they were clearly an important influence on the emergent “counterculture” that developed when Baby Boomers born right after World War Two began coming of age in the Sixties. Drug experimentation and use soon became one of their hallmarks. Because they were so new and unfamiliar to boomers' parents, the drugs their children were trying: marijuana, LSD, and other “psychedelics,” were all the more frightening, a circumstance that clearly played a key role in Richard Nixon's 1968 political comeback, which in turn, enabled his dubious legacy: Watergate, diplomatic recognition of China, extension of the Viet Nam war to Laos and Cambodia, and the “War on Drugs."

Just as the 1914 Harrison Act was bereft of science that could justify its assumptions about “addiction,” there have never been pharmacolgic studies that would support the assumptions by which the Controlled Substances Act's Schedule 1, gives medically untrained lawyers (US Attorneys General) the power to prohibit drugs they literally can't understand for what amount to moral or religious reasons.

Anyone with the necessary medical knowledge should be able to recognize there now exists an enormous amount of medical literature refuting the CSA's Schedule 1 assertion that cannabis and other listed agents lack “redeeming” medical benefits. That assertion was absurd in 1970 and is now ridiculously out-of date. A critical question then becomes: why is such an absurd, obsolete assumption still the basis of a UN treaty that subjects any international traveler to arrest for mere "possession?"

Whether we are at more risk from an uncontrolled oil rig in the Gulf of Mexico or equally uncontrollable political instability on dry land may be a moot point.

Doctor Tom

Posted by tjeffo at 05:59 PM | Comments (0)

May 01, 2010

Parsing Mexico, 2

Although I’d spent five years in El Paso, one in an Army dispensary at Fort Bliss and the next four across the highway as a surgical resident at William Beaumont Hospital, I hadn’t been back there since August, 1963. Thus I’d found it difficult to reconcile descriptions of violence and mass murder now emanating from El Paso with the peaceful memories I still have of that interval in my life. One source that's helped has been Charles Bowden, an author I’ve yet to read in detail, but, thanks to Google, one who has already filled in several blanks in my understanding of how crime and corruption have changed that part of the border. it's important to note that Bowden probably has more than a nodding acquaintance with drugs, but he's clearly not a reform activist.

I didn’t visit Mexico again until 1975 when we spent a week in Mazatlan on vacation from a burgeoning civilian practice. There followed, at intervals, similar weeks in Cabo San Lucas and Puerto Vallarta: the last in the mid-Nineties. By that time we’d settled on Puerto Vallarta as a favorite destination, partly because it was so easily reached on a Alaska Airlines. Perhaps providentially, a growing interest in drug policy had radically changed our travel destinations from 1995 on.

Another thing I recall from our visits to Mexico is how surprised I was to learn of the relative value of its petroleum reserves, a hot topic of conversation in the Eighties. What Bowden’s essays also brought home is that same industry’s relative decline because of aging infrastructure and depleted reserves, not to mention the growing global demand. In other words, Mexican and US petroleum are in the same quandary. Quite apart from global warming, there's a looming oil crisis. The only questions are when, and how violently it will become manifest. Ditto water, for that matter.

All of which helps focus on the factors mentioned in yesterday’s entry. Although "foreign," Mexico and the Gulf are near neighbors, yet we seem to have trouble thinking about their current problems; perhaps because there are no easy solutions. However those problems are approaching crisis levels, thanks to prolonged neglect (denial).

I haven’t even mentioned “marijuana,” a contrived name for a product long associated with Mexico, but one that didn’t begin to become an important economic engine in both nations until it’s anxiolytic properties were discovered by American "kids" over forty years ago.

Just how that happened and the socio-economic significance of pot's illegal market will be topics for another day.

Doctor Tom

Posted by tjeffo at 08:10 PM | Comments (0)

April 30, 2010

Parsing Mexico; initial thoughts

Within the past several days, Arizona’s passage of a state immigration law that merely reinforces several provisions of existing federal law has captured center stage at a time when two other contentious issues: an oil rig disaster just off New Orleans and a political shift that will affect coming Florida elections aren’t fading. The two elements that all three controversies have in common are Mexico, our immediate southern neighbor, and the illegal cross border drug trade that’s been growing since Nixon’s election over forty years ago but has never been honestly addressed and is now being avoided more carefully than ever.

Another key element left out of all discussions is that the four biggest sources of revenue for Mexico’s struggling economy have become illegal drugs, illegal immigration, petroleum, and tourism. That the first two are being increasingly curtailed by the US and the last two are declining is both a major conundrum and a reason that the two nations struggle to find common ground.

As must be clear to all thoughtful parties by now, the current situation is threatening political stability in Mexico and anarchy there must surely affect political stability here.

More later, as time permits.

Doctor Tom

Posted by tjeffo at 04:21 PM | Comments (0)

April 25, 2010

Annals of Duplicity

The first item in the current Issue of the New England Journal of Medicine is a completely one-sided Perspective on 'Medical Marijuana” written by two legal scholars with unspecified connections to the University of Maryland Law School.

At first glance such prominent consideration of a controversial topic in what many consider the nation's premier medical journal might seem to auger well for "reform;" especially in light of the opportunity Californians will have a little over six months from now to vote for full “legalization.”

Sadly, my now-extensive clinical experience with admitted users of the forbidden herb leads to a very different conclusion: the piece is subtle confirmation of two related facts: first, those with a vested interest in protecting the drug war from honest scrutiny are finally beginning to realize that the steadily expanding illegal “marijuana” market they have been so blind to for forty years is finally big enough to threaten their policy. Nevertheless, because they still have the law on their side and enough support from the usual sycophants to believe their “war” is still salvageable, many supporters are not ready to quit. In fact, total collapse of the world's drug policy may have become so unthinkable as to render its failure literally “too big to admit.”

The NEJM Perspective does represent some good news, but only by implication, and it's accompanied by a daunting implied challenge. Although the authors (and publishers) have unwittingly facilitated exposure of several intrinsic drug war errors and various ways its supporters have been distorting evidence in its defense, the ultimate political challenge is to force Congress to admit defeat by repealing the CSA. Thus the major value of poorly coordinated state laws is that they permit the illegal market that has developed under the auspices of federal policy to be studied.

However well intended they may have been, recent recommendations by both the American College of Physicians and the AMA are of little value because they embrace the same restrictions on "research" as those insisted upon by the (medically ignorant) authors of federal drug policy.

Future entires will deal with the many inconsistencies brought to light by the NEJM; whether the various parties "get it" or not remains an open question, but the overwhelming evidence is that someone is lying.

Doctor Tom

Posted by tjeffo at 09:22 PM | Comments (0)

April 20, 2010

Blindsided by a Volcano

As this is written, it's still too early to tell whether the eruption of an Icelandic volcano with an unpronounceable name is merely a warning of our extreme vulnerability to forces beyond human control or if it actually marks the beginning of the end of the world as we know it. It's still early in my day on the West coast, but none of the “mainstream” news sources on the internet are considering the worst-case scenario that's been implicit in the eruption of Eyjafjallajokull since it began a few days ago: we may all soon be trapped on a contentious, overcrowded planet where the most universal rule of all, the power of wealth, no longer applies and we are the only species critically dependent on an economy for survival.

The supreme irony is that we were recently treated to an imaginative TV series based on the premise that somehow, all humans could disappear at once. I found it mildly interesting, but because it offered no realistic explanation of how that might happen and I've been preoccupied with other matters, I lost interest fairly quickly.

Now we have a chilling example; a phenomenon with the potential to produce, within a fairly short time, a meltdown of the global economy and the greatest challenge to human existence our species has ever faced.

Just think about it; how quickly and smoothly could we adapt to a world without money? We may soon find out.

Doctor Tom

Posted by tjeffo at 03:52 PM | Comments (0)

April 19, 2010

Global Interdependence (and the need to admit error)

The eruption of a volcano in Iceland and its unprecedented impact on both air travel and the global economy call attention to a point I've recently become aware of and blogged about only yesterday. Science can be a two-edged sword. Not only is it showering us with previously undreamed of wealth, it has allowed our numbers to grow almost exponentially and thus created risks we are often unprepared for. The hazards posed to jet engines by volcanic ash, weren't even discovered until incidents in the Eighties called them to the attention of aviation safety experts. Others involved the near-miraculous survival of commercial aircraft despite ruined engines, which immediately raises questions about how many earlier crashes might have been caused when the similar rare phenomena weren't recognized.

The most famous such event occurred in Southeast Asia where volcanic eruptions are more common and airspace less densely traveled. The present one reverses both characteristics and emphasizes how little is known about key details of the hazard, to say nothing about the ripple effect of mass cancellations; not only on air travel, but on commerce in general. That those effects could suddenly threaten the survival of solvent businesses in a global economy suddenly made fragile by an unexpected increase in debt should also be sobering.

For me, it also emphasizes how vulnerable we have all been made by our species' tendency to exploit new technologies for the wealth they produce without fully considering what additional risks might be involved. Rather than ban all air travel, it clearly makes more sense to examine past mistakes and try to learn from them.

It's especially difficult to correct mistakes we still can't admit: the drug war, for example.

Doctor Tom

Posted by tjeffo at 04:01 PM | Comments (0)

April 18, 2010

A Shift in Emphasis

Yesterday I attended the Hemp Expo at San Francisco's venerable Cow Palace. More properly it was in Daly City, the next town south on the Peninsula separating “The City,” as most Bay Area residents still call it, from San Jose, upstart home of the computer industry and more populous than The City for many years. Change isn't always recognized when it occurs.

That could be a metaphor for things learned at the Expo, some confirmed impressions I've been gathering from an intense association with pot users since 2001; but others are more recent. The most important is a big step beyond even my most recent insights, which had been the enormous size of the illegal “marijuana” market and its gradual expansion to critical mass under the noses of the DEA and NIDA, both before and after their creation in the mid Seventies. Also why they've been so blind to the reasons behind that market growth and why it signals their ultimate down-grading and/or absorption by other agencies in the relatively near future.

Almost no one believes the drug war works as originally intended; someone merely suggesting it (John Walters is an example) risks being considered ridiculously out of touch. Indeed, few of the policy's most ardent defenders make such claims any more. Their arguments in favor of retaining it are increasingly defensive and lean heavily on necessity. For example “we know from the scourge of illegal drugs and the damage caused by alcohol and tobacco what terrible things would happen following legalization.” That such irrational claims still resonate with enough with the voting public to sustain a failing policy is, by itself, an indication of our national problem. It also tends to validate what has become my main thesis: humans weren't an existential threat to their own welfare until the discovery of empirical Science in Europe about five hundred years ago. The rapid success of Science, progressively compounded by the new technologies it produces, has allowed exploitation of “nature” in ways that were unpredictable just a few years before their appearance. A good example is how the Twentieth Century acceleration of both communication and transportation technology has helped reshape the global economy. The century also saw a four-fold increase in the Earth's human population despite two historically lethal “world” wars and the 1918 Influenza Pandemic.
Even more ominously, the same scientific “progress” may have uncovered an evolutionary design flaw lurking within our otherwise marvelous brains. The window on history allowing that startling deduction has been the war on drugs. More specifically, it's been the failure of the federal government's “marijuana” policy as elucidated by a study of the policy's victims made possible after California passed Proposition 215 in 1996, thus marking the nation's first successful voter rebellion against a questionable policy. To a degree I still have difficulty believing, responses to the initiative by both proponents and opponents, have helped reveal the serious brain flaw alluded to above and previously described by neurologist Paul MacLean. I feel some sense of urgency in describing it as coherently as possible because I've also become aware of how much denial is abroad in the world. Also that our biggest problem is not the war on drugs, which is simply a convenient example of the problem.
There are multiple other more urgent and serious problems facing us. In the short term, the most dangerous may be the planet's dangerously swollen human population, driven by their unruly emotions into making making terrible decisions like 9/11, even as others cling angrily to an unsustainable status quo.

Doctor Tom

Posted by tjeffo at 08:05 PM | Comments (0)

April 14, 2010

Debunking Anslinger

The evidence Harry Anslinger presented on behalf of his Marijuana Tax Act in 1937 was such gross exaggeration of a few sensational cases and he himself so obviously lacking in appropriate training and experience, that current “marijuana” policy can only be seen as a daring fraud sustained well beyond any reasonable belief in its validity or a shocking example of government duplicity. There’s simply no middle ground; the policy’s fraudulent nature can no longer be hidden and “marijuana” possession is still punished by arrest at virtually every US or international port of entry.

On a personal level, I still remember Anslinger as a pompously self-important bureaucrat from a government training film screened as part of Public Health during my third-year in medical school (1956), thus I favor the first explanation. Seated behind a huge desk, unfailingly referred to in the voice-over as “the honorable” Harry Anslinger, he menacingly warned of the dangers to physicians and nurses resulting from their access to "narcotics" and promised swift punishment to any caught abusing those privileges.

Despite that improbable air of omnipotence, Anslinger could not possibly have anticipated the sweeping array of arguments and augmentations that would be support in support of his lie once he left office and "kids" began to discover the appeal of "reefer" in the mid Sixties. Starting with Nixon's "war" on drugs and extending through each successive presidency and all drug czars the policy's budget and needless human damage have been keeping pace with its hyperbole.

In reality, the policy Anslinger is remembered for is a sad commentary on human nature, a judgment now well supported by history. The drug war’s evils are easily matched or exceeded by those of the Inquisition, American Chattel Slavery, the Holocaust, suicide bombings (whether Kamikaze or Jihadi) and a host of other follies subscribed to by numerous members of our species.

When I first appreciated what pot smokers could tell me, I became naively optimistic that simply repeating their histories to the "movement" would begin to turn US drug policy around. Little did I realize how quickly the same sectarian divisions that afflict all human organizations would surface. I now realize that “truth” has as many variants as colors have hues; thus every pot smoker (not to mention those who have never been high) has their own definition of “medical” vs “recreational” use.

What it adds up to is simply another variant of “truth:” In addition to Al Gore’s “inconvenient” variety, I’m thus forced to be patient with its “incremental" variant. The good news is that we can be reasonably sure that the thread-bare nature of federal dogma is now so obvious that pot prohibition shouldn’t be the law of the land for very much longer.

I hope to have more to say about this a few days from now when I'll be discussing how badly the drug war has muddled the complex pharmacology of the marijuana “high,” and what their ignorance reveals about their policy.

Doctor Tom

Posted by tjeffo at 05:25 PM | Comments (0)

April 11, 2010

The Marijuana “High:” therapy or a criminal act?

Our long-term study of Californians hoping to have their use of marijuana recognized as "medical" under the terms of a disputed state initiative may be as significant for what it reveals about bureaucracies as for the light it sheds on pot use. Whatever demand existed in 1937, the actual market for inhaled cannabis (“reefer”) must have been very small, based on the percentage of applicants who were born before the Baby Boom began in 1946 (3.92%). Probably of equal significance, their average age at initiation was significantly higher: over 30 for those born before 1935 and over twenty-five for those born between 1936 and 1945. In fact, the two most important bits of information from our study may be demographic evidence suggesting why the drug war has failed to discourage teen aged “marijuana” initiation, as well as troubling evidence of the lengths government bureaucracies will go to avoid owning up to big mistakes.

One example of the latter: the importance of the Baby Boom to current American history is well recognized but that era is clearly being seen very differently by drug policy enforcers and individual boomers who might have sampled “drugs of abuse” as adolescents. To enforcers the era was an evil to be denounced, rather than an important historical event to be studied or understood. Also, it doesn’t require extraordinary powers of deduction to realize that the Boomers themselves were not only younger than the “reefer” smokers who preceded them, they were a lot more numerous and could well have shared generational experiences that shaped their drug use and other behaviors very differently (exactly what happened). In the same vein, the study also demonstrates how far government bureaucracies will go to resist suggestions their policy may be failing, let alone that they should search for ways to correct it.

Ironically, a Rand study published in November 2002 had reached conclusions very similar to ours but has never been linked to it by others. Nor did it provoke the discussion it should have when first published. Finally, in a brief reassessment published in 2003, the authors actually strengthened their criticism of the "Gateway" hypothesis but explicitly disavowed any support for marijuana “legalization*”

Later this week, I hope to spell out how a clinical dissection of the marijuana “high” as a poorly understood therapeutic and cultural phenomenon that has been vilified for forty years can begin to resolve current contradictions and hopefully, facilitate a more rational discussion.

Doctor Tom

* "Conclusions Marijuana gateway effects may exist. Our results demonstrate, however, that the phenomena used to motivate belief in such an effect are consistent with an alternative simple, plausible common-factor model. No gateway effect is required to explain them. The common-factor model has implications for evaluating marijuana control policies that differ significantly from those supported by the gateway model...However, the study does not argue that marijuana should be legalized or decriminalized."

Go Figure...

Posted by tjeffo at 08:01 PM | Comments (0)

April 06, 2010

Convincing Evidence of Federal Ignorance

The science of Pharmacology was relatively undeveloped when the Marijuana Tax Act was introduced by Harry Anslinger in 1937, thus the phenomenon of getting “high” on “reefer” was relatively unknown and easily demonized. Not only was repetitive (chronic) use of cannabis by inhalation relatively unknown, the public he was misinforming about its dangers had no basis for disbelief and the federal policy he was enforcing had arrogated its authority on the basis of overblown fears of "addiction."

Not much has changed since 1937. As MTF and SAMSHA’s repetitive studies of adolescent drug initiation have confirmed, about half of of all American teens have been trying to get high by inhaling “marijuana” since 1975, thus also confirming that despite rigorous enforcement and ever-increasing felony arrests, trying marijuana remains an adolescent rite of passage on a par with trying alcohol and cigarettes. My data also confirm that not everyone who tries marijuana is able to get high the first time (some required three or four attempts). Yet everyone seeking a recommendation eventually succeeded and now expects to get high each time because, although never defined in clinical terms before, the "high" is clearly an essential element in the self-medication process.

As is evident from the current drug czar's most recent statements, federal opposition to any use whatsoever may be softening. Moreover, most of the millions of living Americans who have succeeded in getting high on "weed" since 1965 know from their own experience that it's not a phenomenon that could possibly be understood by the (approximately half) of other citizens whose drug initiations had included alcohol intoxication and the "head rush" of a cigarette, but excluded the marijuana high.

That long history of federal opposition to pot use, along with the opportunity provided by Proposition 215 to interview thousands of chronic users has provided me with enough evidence to be confident that dedicated defenders of the drug war are either woefully ignorant of cannabis basics or extremely dishonest.

One of the more convincing demonstrations of that ignorance is the complex history of Marinol, developed at considerable federal expense, only after oncologists began suggesting that severely nauseated chemotherapy patients try marijuana. That revelation is further strengthened by my low-tech clinical research among self-medicating pot users revealing some well-known differences between the effects of edible and inhaled cannabinoids that have never been elucidated or seriously investigated by either the Pharmaceutical Industry or academic pharmacologists.

Given the great potential benefits of legal cannabis, the past forty years of enforced ignorance in support of unscientific nonsense was a high price to pay; one further compounded by millions of destructive felony arrests over the same interval.

Doctor Tom

Posted by tjeffo at 04:22 PM | Comments (0)

April 03, 2010

Getting it (All) Wrong

The single most important fact revealed by the lonely study of cannabis applicants I’ve been engaged in for over eight years is a no brainer: today’s enormous demand for “marijuana” began rather abruptly when the Baby Boomers who started appearing suddenly after World War Two began coming of age in the Sixties.

The factual basis for that statement is just as obvious: the basic demographics every “pot doc” dealing with California’s slowly emerging applicant population should have been collecting; their dates of birth and the age at which they first tried to get “high” by inhaling cannabis. For two such basic items to have not been gathered (or deliberately ignored) by the hundreds (thousands?) of “pot docs” now writing recommendations for a growing applicant population is painfully apparent to me from their silence. Nor have the self-appointed medically untrained gurus presuming to speak for various reform organizations deigned to comment. Their silence on questions I've raised about marijuana’s sudden popularity in the Sixties has been almost as deafening as that of their arch rivals in the federal government.

In fact,it was that stubborn silence on the part of both parties that led me to understand that denial is one of our species’ most characteristic flaws. Like so many other easily overlooked entities: dishonest advertising, rampant obesity, the increasing incidence of autism and a host of others; once one becomes aware of them, they are nearly impossible to ignore.

To return to the Baby Boom, I just happened to catch Tom Brokaw’s special last evening and was even more disappointed than expected; but hardly surprised. Obviously basking in the success of his praise for the “Greatest Generation” and convinced that he has just become a generational expert, Brokaw comes across as knowingly judgmental while completely missing several important points. Even the Daily News TV critic caught his deficiencies.

Hopefully, I’ll have time to return to the Baby Boom in coming months as California prepares to vote on the most important national issue in the coming November election.

Doctor Tom

Posted by tjeffo at 03:01 PM | Comments (0)

April 01, 2010

California’s Legalization Initiative in Historical Context

As the last quarter of the Eighteenth Century began in 1776, an improbably successful rebellion was launched on a flourish of rhetoric promising government based on equal treatment of all citizens. The ensuing Revolutionary War not only led to a new nation that soon attracted freedom-seeking immigrants from all over the world, it also marked the beginning of the end of absolute political power based on heredity at a time when the flowering of scientific technology was about to produce a cornucopia of agricultural production and consumer goods that eventually became known as the Industrial Revolution.

Unfortunately, the Constitution adopted just eleven years following America’s Declaration of Independence betrayed its lofty ideals by secretly protecting the institution of chattel slavery, a decision that would critically shape the new nation’s early development and eventually lead to a corrosive Civil War. Slavery was ended, but American federal power was enhanced to a degree that soon encouraged imperialist expansion based on military power. In essence, the nation that represented the planet’s first potentially viable attempt at Democracy has instead played a pivotal role in enabling its present volatile state of overpopulation, unsustainable consumption of resources, and violent political instability.

Within that context, America’s war on drugs is also UN policy. Although not a prime cause of our species' current malaise, it can easily be seen as both metaphorical and contributory. In a narrower context, the coming ballot initiative to legalize cannabis in America’s most populous and progressive state can also be seen as an important indicator. Simply stated, a global policy of arresting and incarcerating people for self medicating with “marijuana” betokens a degree of hypocrisy, ignorance, and denial incompatible with long term solution of our species' most pressing problems.

Doctor Tom

Posted by tjeffo at 04:54 PM | Comments (0)

March 29, 2010

A Line in the Sand

On March 4, three weeks to the day before an announcement that California’s marijuana legalization initiative had qualified for the November ballot, Gil Kerlikowske, former Seattle Police chief and the Obama administrations low-profile drug czar, spoke to the California Police Chiefs in San Jose where he spelled out firm federal opposition to any further liberalization of medical use and to any effort at legalization. It was traditional reefer madness; not as over the top as John Walters’ flagrant nonsense, but bad enough in its own right to reflect negatively on the Obama Administration’s reputation for honesty.

Within the following week, several angry reform responses took issue with both Kerlikowske’s facts and logic, which were simply an updated rehash of familiar slanted arguments cherry picked from recent NIDA sponsored literature. Unfortunately, they also omitted any mention of my data showing that properly taken applicant histories reveal that the vast majority were born after the Baby Boom started and that today’s huge “recreational” market didn’t begin until the mid-Sixties, a critical finding steadfastly ignored by both reform and ONDCP .

Thus the indications are that the pre-November “debate” will be an unenlightening rehash of 1996 arguments; however, given California’s robust pot market and the sagging economy, it’s quite likely the initiative will pass anyway. If so, it will present its opponents in both state and federal government with a new set of problems (and perhaps threaten dispensary profits).

In any event, it will be interesting.

Doctor Tom

Posted by tjeffo at 03:07 PM | Comments (0)

March 27, 2010

How California’s Legalization Initiative Changes the Equation

Even though it’s been known for quite some time that a marijuana legalization initiative might qualify for the November ballot in California, it wasn’t until Thursday’s announcement that I could focus my thoughts enough to decide on a response. Now that the initiative is reality, it’s interesting that not only did I come up with a response, I can also explain why it’s positive, start making plans to implement it, and list reasons why they may or may not succeed.

What the reality of the initiative did was reveal the prompt negative responses of all three California gubernatorial candidates. That, in turn, confirmed for me there's still a huge gulf between those with a vested interest in the drug war as policy and those dedicated to “reforming” it. Thus do the early responses of the three most likely candidates confirm that senior politicians in both major parties remain clueless about both the appeal of marijuana for large numbers of Americans and the size of its illegal market.

It will be my privilege to explain the significance of those relatively simple concepts over the coming months in a setting that will be increasingly difficult for all interested parties to ignore.

As Bill Clinton (or James Carville) famously reminded us in 1992., simple ideas are more likely to be understood. If we can't get it in the next eight months, there's always another election and pot is unlikely to go away.

Doctor Tom

Posted by tjeffo at 07:36 PM | Comments (0)

March 26, 2010

The Other Shoe Drops

The announcement, in yesterday’s San Francisco Chronicle, that an initiative calling for the “legalization” of marijuana had qualified for the November ballot must have confirmed the worst fears kindled in drug war supporters almost fourteen years ago by the unexpected passage of Proposition 215.

What struck me most about the Chronicle story was the degree to which it misinterpreted important related events over that same interval, many of which had transpired right here in the Bay Area. However, my own experience had prepared me for the confusion by revealing that none of the interested parties were seeing reality through the same prism and the most authoritarian voices were often the most confused. In that respect I had been well prepared for the reactions reported locally the Chronicle and nationally in the New York Times, both of which reflected an ambient confusion, although with somewhat different emphasis.

My own crowded schedule precludes more than passing mention of what is really a landmark event, one unlikely to turn out exactly as predicted by the experts. As for November: if the initiative passes, some large helpings of crow will be in order soon afterward and some rapid adjustments will have to be made, both in Sacramento and in Washington.

Another development seems inevitable: whatever happens this time around, eventual nationwide legalization of Marijuana will happen; the only remaining questions are how messy the process will be and how much avoidable injury will de done by the self-appointed experts on both sides.

Our species has always had great trouble doing the right thing; especially when it comes to our most important decisions. Our experience with "marijuana" is simply one more example.

Doctor Tom

Posted by tjeffo at 03:39 PM | Comments (0)

March 23, 2010

Cognitive Dissonance and the Debate over Medical Care

George Santayana, an American scholar born to Spanish parents, but abandoned by his father at 5 and raised in the US for the first half of his life, is best known for observing that, “Those who do not remember the past are condemned to repeat it,” which probably explains why last Sunday’s Congressional debate over the federal government’s role in health care was so reminiscent of an earlier division that afflicted our fledgling American experiment in Democracy and ultimately plunged us into Civil War. So bitter was the antebellum debate over slavery, and so violent were the feelings it generated among elected representatives that in 1856, a Congressman from South Carolina savagely attacked a Senator from Massachusetts in the Senate chamber with a cane brutally enough to disable the older man for three years. Amazingly, although expelled from Congress, Brooks was never charged with a crime and was defiantly re-elected by his home state. Ironically, he soon died of “croup” before he could finish his term.

Although their names have undergone the political equivalent of magnetic pole reversal, modern Democrats and Republicans exhibit the same powerful emotions as those displayed by supporters of Sumner and Brooks. Today’s Red State, Tea Bag, Republicans, clearly no longer the "Party of Lincoln," now have a different agenda. They are fiercely supportive of the right to life but insist medical care is far too expensive to be extended to the surviving fetuses they hope will be saved from abortion by a Supreme Court chosen for that purpose. By the same token. the Catholic justices on the Court can apparently be counted on to support the expanded police powers that have produced the world’s largest prison system. How else could we punish criminals who dare to self-medicate with illegal drugs like "marijuana?"

Doctor Tom

Posted by tjeffo at 04:23 PM | Comments (0)

March 13, 2010

The (slow) March of Time

Fred Gardner is a journalist and author from Alameda who has long been helpful in educating me on the politics of cannabis and its medical uses. I recently had occasion to re-read a Gardner column from six years ago in which he generously published findings I was preparing to present to a national meeting of reformers on the East Coast. I was struck by two things: how well my then-new findings have been confirmed by the thousands of additional interviews I’ve done since it was written, and the degree to which they are still ignored by those with agendas on both sides of the “legalization” issue.

Some things never change, or more properly, like tectonic plates inching past one another, they change so slowly that when the earthquake finally happens, it’s a bg surprise.

Fred’s other item, the one on asparagus, has even greater relevance today because we know air transportation plays a greater role in CO2 release than expected, thus it’s likely the shift in asparagus production motivated by the US desire to reduce cocaine availability has come at additional unexpected costs: not only are American farmers and consumers being hurt; so also is the global environment.

Meanwhile, the drug war continues supporting the price of cocaine and Hillary just returned from a trip to Latin America in which she admitted the failure of US drug policy but urged further intensification of the same old failing tactics.

Doctor Tom

Posted by tjeffo at 07:39 PM | Comments (0)

March 07, 2010

Senior Citizens: the Key to “Legalization”

Despite the refusal of conventional media and spineless politicians (is there any other kind?) to face reality, I’ve been predicting that a sea change in public opinion on cannabis prohibition should begin rather abruptly in 2011 and become increasingly evident with each passing year. That forecast was based primarily on the demographics of the population of pot applicants I’ve been studying for over eight years; 96% of whom were born during or after 1946, which just happens to have been the first year of the Baby Boom. With at least half of all “kids” (adolescents) surveyed since 1975 admitting that they’d tried “weed” by the age 18; also given the consumer loyalty documented among my applicants, it’s very clear that when the first wave of Baby Boomers becomes eligible for Medicare, many of them will be seeking to renew the recommendations they already have. The critical difference is that they won't be easily written off as misguided "druggies;" rather they will become the senior citizens politicians ignore at their peril

An additional (anecdotal) finding I haven’t tried to quantify statistically, but have found remarkably consistent, is that seniors of my own generation (the deluded "moral majority" that elected Nixon in 1968) who never tried pot themselves are extremely resistant to ever using it, even after incurring physical conditions it’s known to palliate. On the other hand, people who tried it during their teens are far more open to its medical use, whether they'd used it in the interim or not. In other words, getting high as an adolescent seems to confer lifetime permission for later medical use, should the need arise.

Quite by accident, I stumbled across a non-medical journal with a vested interest in the health of seniors and discovered that it had done an impressive survey in 2005 that tended to confirm the implications of my data even then. It’s thus even more clear to me that as pot-savvy seniors gradually replace their fathers and grandfathers in the electorate, the politicians they choose will have to reflect their views; that’s particularly true if the crazies now running the American asylum get their fondest wish and defeat Obama’s (not-so-great) health care initiative.

Entirely in keeping with the disconnect that seems to afflict those in authority, the forces of prohibition have looked at the same data and come up with an entirely different interpretation.

We shouldn't have long to wait for an answer; I predict that by 2016 (perhaps even before), there will be a viable cannabis legalization bill before Congress.

Doctor Tom

Posted by tjeffo at 06:21 PM | Comments (0)

March 03, 2010

“Marijuana” and dashed hopes

Just why Harry Anslinger selected a relatively obscure Mexican slang term for demonizing inhaled cannabis in 1937 remains just as uncertain as solid evidence of why he did so remains scarce; nevertheless, subsequent developments make it clear that whatever market for “reefer” might have existed in 1937 must have been small and remained that way until the mid-Sixties; when it began growing to its present size, best described as enormous, but unmeasurable.

In any event, ignorance and carelessness are painfully obvious in the Marijuana Tax Act’s legislative history; not to mention the incoherence and adverse social impact of the Controlled Substances Act by which the Nixon Administration expanded the MTA in 1970. That such “thinking” remains at the heart of official policy in both the US and the UN is solid evidence that current world leadership is sadly lacking; even as our species struggles with unprecedented levels of pollution, overpopulation, climate change, and depletion of critical resources.

Most revealing of all may be the reluctance of those in authority to even acknowledge the obvious, a trait known as denial. Cartoonist Walt Kelly may have said it best when he observed through his character Pogo that “we have met the enemy and he is us.”

How these gloomy observations relate to my ongoing study of marijuana use is becoming clearer to me by the day; even as any hope they will provoke a degree of recognition in people with the power to influence policy fades. President Obama's victory inspired many to believe the "change" he claimed to represent would favor their particular issues; none more than myself. Indeed, he is a poster boy for my typical pot smoker: an academically gifted bi-racial outcast raised by a single mother whose only known contact with his biological father had been a two hour meeting at an airport. He'd also acknowledged he'd once been high on weed, and tried other illegal drugs. Finally, he's known to have an intractable cigarette habit. What better American President could I have hoped for?

Alas, that hope is running out; he seems far too nice a guy to do all the things I want him to do between now and 2012: find some advisers with balls, fire the entire DEA, and take on opposition yahoos directly for their obvious stupidity instead of acting like a bipartisan wuss.

Doctor Tom

Posted by tjeffo at 04:43 PM | Comments (0)

February 19, 2010

Good News, Bad News

I was pleasantly surprised by a headline above the fold of this morning’s print edition of the SF Chronicle (how long can it survive? I’m always forced to wonder) reporting that “Clinical trials show medical benefits of pot.” That news wasn’t news to me, but the long-delayed recognition of pot’s efficacy in MS was gratifying, particularly because I have painful memories of sitting through two Larry King specials devoted to new developments in MS during which neither the words “marijuana” nor “cannabis” were even mentioned. I found the denial infuriating because I knew how rigorously the producers would have had to either screen or censor their not-quite celebrity guests to maintain such drug war purity.

So much for the good news; the bad news was that most of the money made available way back in 1999 has been spent and a program that is finally producing results is in danger of being starved financially.

Of course, it would never occur to the “bona fide” researchers in Academia or the wannabe scientific experts from ASA and NORML that a lot of non-criminals have been breaking America’s stupid drug laws for decades to treat not only multiple sclerosis, but a lot of other conditions as well. As a matter of fact, the people who have been applying for medical legitimacy under the provisions of California's Proposition 215 for over thirteen years are a valuable resource that's been shamefully neglected by self-appointed experts in both Academia and “reform” for far too long.

What might have opened their eyes a bit sooner could have been a few more pot docs willing to take decent medical histories and publish their results.

Doctor Tom

Posted by tjeffo at 03:28 AM | Comments (0)

February 15, 2010

Edibles and the “Body High”

That there are considerable differences between smoked and orally ingested cannabis is emphasized by use of the term “body high” to describe the effects of “edibles.” That federal policy makers still don’t understand either those differences or their physiologic bases is made clear from their failure to discuss them and from their subsidization of Marinol.

Whatever its basis, the general silence on those issues adds up to an indictment of both American drug policy and the intellectual honesty of our species as well as a suggestion that our tendency to deny unpleasant reality may be a serious human weakness.

To start with basic anatomy and physiology: taking "drugs" into the body (ingestion) is possible through a variety of mechanisms. When they can be volatilized by heating and then inhaled as vapor (“smoked”) the lung becomes an organ of ingestion. Since pulmonary venous blood drains directly into the heart, there's no faster way for cannabinoids to reach the brain. That’s also true of the nicotine in cigarettes and cocaine when it was processed into “crack” after ether extraction proved so unsafe.

Unlike drugs ingested by smoking, those we swallow must be digested in the gut and absorbed into the hepatic portal circulation thus delaying their arrival at the brain and exposing them to modification by the liver before they get there. It's slowest of all when the stomach is full and also explains why the effects of edible pot can’t be readily titrated.

There are other differences, all added by the liver, which not only receives the lion's share of pot’s pharmacologically active ingredients after an edible is consumed, but also adds three of its own, presumably by the same process of molecular deconstruction that characterizes its major function in other animals.

1) Pot’s duration of action is extended to three hours or longer after oral ingestion.

2) A degree of muscle relaxation that seems significantly greater than after smoking is noted by nearly all. Intense enough to interfere with most physical activity, it's the most common reason cited for avoiding edibles.

3) The nocioceptive (pain relieving) properties of smoked pot are intensified; an observation made most commonly by those with neuropathic pain (pain of nerve origin).

That these differences have not been addressed by either Big Pharma or Academia becomes readily understandable within the current setting of criminalization in which all “legal” cannabis intended for research must first be approved by the DEA and can then only be obtained from the federal marijuana farm in Mississippi.

Doctor Tom

Posted by tjeffo at 06:47 PM | Comments (0)

February 14, 2010

The Marijuana High: what policy wonks still don’t know

Because the population I’ve been studying since late 2001 consists entirely of Californians seeking a doctor’s approval to use pot under the terms of Proposition 215, all have experienced the marijuana “high;” itself a unique phenomenon erroneously considered by those who never experienced it as the equivalent of alcohol intoxication

As every experienced pot smoker knows, nothing could be further from the truth; although getting high and getting drunk are the expected effects of both drugs, they are very different. Both are also very common events. With the single exception of seeking a “head rush from a cigarette, getting high on “weed” and drunk on “booze,” at well under the legal age- have been rites of passage for over half of all Americans since the University of Michigan (and later the federal government) began doing their surveys of youth in the Seventies. The cannabis applicants I’ve been studying do report trying all three at about the same average ages and well before trying any other illegal agents.

Their drug initiation patterns and other data also confirm that federal drug policy officials, their critics in "reform," and most academic drug policy experts have not developed an accurate picture of human marijuana use; initially because of imposed ignorance before 1997; more recently it seems to be denial. For over 13 years Proposition 215 has been allowing something the DEA and NIDA had successfully blocked from their beginnings in 1973 and 1975 respectively: unfettered medical access to a large population of illegal drug users. That the drug was marijuana, has been especially valuable because of the (unsuspected) role it has been playing in moderating the use of more problematic agents, literally since before Nixon’s election in 1968.

Perhaps the best way to illustrate still-prevalent ignorance is to discuss the marijuana high in terms of its clinical pharmacology, rather than in the obligatory rhetoric insisted upon ever since Nixon foreclosed unbiased clinical research by rejecting the Shafer Commission's plea in 1972.

The Inhaled High

Getting high begins when the first toke is almost immediately followed by a subjective feeling described by 80% of those surveyed as “relaxation.” The immediacy with which it is experienced confirms that whatever was in the smoke had an immediate effect on the brain, which is interesting, because at least half of all applicants report they failed to get high the first time they tried and many had to try several times before they were successful. Once successful however, a high is readily produced whenever one lights up.

More tokes are taken in relatively close succession until inevitably, one fails to enhance the high. This is important because it signals a refractory period during which additional tokes will simply be a waste of money. In essence the refractory period is also a signal the user is as high as it’s possible to get on that particular strain at that tme. Since both users and strains can vary considerably, it should not be surprising that one user may get high sooner than another, or that intensity may vary. The dominant pharmacologic effect is anxiolytic; onset is rapid because the drug is smoked; dosage can be precisely titrated for the same reason. Finally, the high is evanescent; it’s over in about an hour. Another very important consideration is that the good feeling that came with the high can linger for another hour or more, depending on circumstances.

For some users, the termination of the high is an opportunity to light up again; but only if certain conditions exist: they must not be under hostile observation, they must be able to afford it, and they must be comfortable while high in the presence of “straights.” Since the normal response is the famous “paranoid’ reaction (an unpleasant feeling that straights know one is high and disapprove) how to overcome it to the point of being comfortable has to be learned. Thus some users are able to get high repeatedly throughout the day; however the refractory period guarantees that the effect is not cumulative, as it usually is with alcohol. Other than mild ataxia (a cerebellar effect) and a tendency to become hyperfocused on interesting phenomena, cognition is not impaired and is often enhanced.

As most pot users have discovered, the high produced by edibles is strikingly different than the one produced by inhalation. There are good reasons for that difference, but they haven’t been elucidated pharmacologically because “marijuana” is illegal. However 215 has allowed the differences to be recognized clinically and described in some detail. I’ll deal with the “body high” produced by edibles in another entry.

Doctor Tom

Posted by tjeffo at 06:03 PM | Comments (0)

February 13, 2010

The High Cost of Imposed Ignorance

In March, 1972, when President Richard Nixon summarily rejected the reasonable, but timid recommendation of the Shafer Commission to decriminalize marijuana add investigate its potential medical benefits, the federal government still lacked the agencies he would later create to carry out his “war on drugs.” Thus passed the last slim chance to restrain the wave of arrests already under way as the nation’s police forces struggled to suppress the criminal market that had been created thirty-five years earlier by Harry Anslinger’s baseless Marijuana Tax Act.

Instead, that illegal market has continued growing steadily to its present enormous, but difficult-to-measure size, protected by the same ignorance and denial that has characterized “marijuana” law enforcement since 1937. Added to the current cost of the violence on our border with Mexico must be the lives destroyed by criminal prosecution of people for the “crime” of self-medicating with a safe, effective medicine; to say nothing of the mortality and morbidity incurred by those driven use its legal, but deadly alternatives: alcohol and tobacco. In retrospect, such costs are attributable to both Nixon’s rejection of the Shafer Commission’s plea and the compliant American media that allowed him to get away with it. Ironically, it would be the same media that would later drive Nixon from office for the relatively trivial Watergate affair, and is still in denial about both the size of the marijuana market and the enormous human cost of their own denial.

Indeed, the efforts of our species to implement a drug policy the UN adopted well before Nixon’s first term amply qualify as “insanity,” as defined by no less authority than Albert Einstein. In retrospect, what has been missed by those insisting on the necessity of marijuana suppression since the CSA became law has been any recognition of the sudden increase in the popularity of inhaled cannabis in the mid-Sixties, let alone questions about why "marijuana" became so popular when it did and is now the most sought-after illegal commodity on the planet.

Even more disturbing than the present grotesque failure of government, the media, or Academia to raise such questions is the world-wide denial that sustains our ignorance. When I first began blogging about what I've learned from the opportunity Proposition 215 offered for studying the behavior of pot smokers, I didn't realize the degree to which it would confirm the eminently sensible suspicions of Paul Maclean, which suggest there is an evolutionary basis for our paradoxical behavior as a species.

If he's right, our prognosis for a rational recovery is grave indeed, because it would have to be a first; our best hope may be that the non-violence of Ghandi, as encouraged by Einstein, might continue to find root as it did with MLK.

Doctor Tom

Posted by tjeffo at 12:52 PM | Comments (0)

February 11, 2010

More Background

In the last entry I referred to a temporal connection between Adolph Hitler’s consolidation of power in Germany and the passage of Harry Anslinger’s Marijuana Tax Act in 1937. Such connections were what talented science historian James Burke converted into books, a series of Scientific American columns and TV series on both sides of he Atlantic. With appropriate apologies to him, the following will mention similar links between Hitler’s and Anslinger’s two permanent legacies: World War Two and the War on Drugs.

Neither war was the exclusive contribution of either culprit to world history. What they did share, other than being born just three years apart, was a rise from obscurity through combinations of luck, chutzpah, and intellectual dishonesty, plus the ability to seize unexpected opportunities to make a mark on history. Unfortunately for us, both succeeded.

Born in 1889, Hitler had an unhappy adversarial relationship with an elderly, strict father who died suddenly when he was ten. Orphaned four years later by his mother’s death from breast cancer, he was then a bohemian art student; also homeless for a while. Lucky to even survive daring service in World War One, his rhetorical gifts propelled him into a position of leadership in the Nazi party. Ten years after a hare-brained putsch in 1923, that he was also lucky to survive, he suddenly found himself positioned to assert complete control over a nation that shared his resentments and would follow his assertive leadership while also tolerating his virulent antisemitism.

Born on this side of the Atlantic just three years after Hitler, Harry Anslinger, had also learned fluent German (from Swiss-German immigrant parents). Towards the end of World War One, his language ability landed him a job with the Armistice Commission in Europe; he would not leave federal service until retiring on his seventieth birthday and then served as the First UN Commissioner of "Narcotics," a position from which he promoted America's drug policy into its global clone.

His big career break came in 1930 when his wife’s uncle, Andrew Mellon, then Secretary of the Treasury, elevated him from a mid level job in the Treasury's Prohibition unit (doomed to elimination following Reform) to serve as the first Director of the newly formed Federal Bureau of Narcotics, a position from which he quickly arrogated the same degree of control of American drug policy as Hitler had the seized over the German nation.

From 1937 on, the comparison becomes less immediate, primarily because Hitler’s 1939 gamble of World War Two entailed far greater personal risk than Anslinger’s Marijuana Tax Act. Thus the delayed metaphorical war Anslinger enabled required help from yet another insecure wannabe warrior named Richard Milhous Nixon. The biographers of both men make clear that they each shared Hitler’s instinct for racial prejudice, if not its virulence.

The Asnlinger-Nixon drug war is still being fought. Despite medical marijuana’s implicit threat to its existence, it shows no sign of ending soon. Often overlooked is that it's waged by the whole world through national police forces against “enemies” who are simply trying to self-medicate. Because illegal drugs are, by and large, safer and more effective than their legal alternatives, the damage being inflicted is both enormous and almost impossible to quantify.

Finally, what seems to render global drug policy most impervious to rational criticism is humanity’s amazing tolerance for its obvious stupidity and failures through the phenomenon of denial. A cognitive species unable to face reality would seem to have limited prospects of solving its most pressing problems.

The smoking gun that could ultimately challenge that denial is the enormous success of illegal marijuana over the forty years that the world has been attempting to suppress its use. I plan to outline that success, and the reasons behind it, in the next entry.

Doctor Tom

Posted by tjeffo at 07:05 PM | Comments (0)

February 10, 2010

Essential Background

The Nazism that led Germany to almost destroy itself as a nation in twelve short years and the American drug war I compared it to in the last entry were both institutionalized repressions carried out by central governments. The speed at which they took place is the major difference between them; Hitler’s rapid acquisition of power between 1933 and 1935 allowed him to marshal the German people behind his impossible dream (lebensraum) of world conquest quickly enough to enable the invasion of Poland on September 1, 1939.

Constitutional restraints keep any American President from consolidating power nearly that quickly; however the CSA, Nixon’s radical enhancement of the power of America’s poorly conceived drug policy, has commanded unquestioning support from all three branches of our federal government since 1970, despite its well recognized role in the expansion of our prison population during that same interval.

The drug war’s particular impossible dream was soon defined as a “drug free” society. In both Germany and the US, the pursuit of officially designated national dreams led to the identification and punishment of internal enemies as scape-goats that would justify the use of extraordinary powers, allegedly to protect ordinary citizens from contamination. The American counterparts of Germany’s, Jews have been “druggies,” a concept clearly recognized by Richard Lawrence Miller in Drug Warriors and their Prey (1996) and emphasized in Nazi Justiz, his companion study of Hitler’s astute consolidation of power through Germany's vulnerable courts.

Bogus science also played a key role in both repressions; Nazi theory relied on the discredited ideas of Eugenics. In America, fear of addiction was a seed planted by the Harrison Act of 1914, nurtured by Harry Anslnger in 1937, and brought to unholy fruition by Nixon’s CSA in 1970. Ironically, the concept of “addiction” has remained stubbornly elusive, even as a behavior, and never been defined by Pathology as disease, despite the claims of drug war bureaucrats.

Not only is American drug policy burdened by its questionable biological assumptions, it clings stubbornly to the erroneous economic beliefs of prohibition that should have been decisively repudiated by Repeal in 1933. In brief, Prohibition (the Eighteenth Amendment) relied on respect for the law to prevent the criminal arbitrage that doomed it as policy. Within the relatively rapid span of 14 years, the Eighteenth Amendment had taken its place on the scrap heap of history, a process undoubtedly accelerated by the Great Depression. Unfortunately, survival of its belief that prohibition is reasonable public policy had already been guaranteed in 1930 when the FBN was created and placed under the control of a medically ignorant bureaucrat firmly committed to the idea that addiction is a police problem

Given Anslinger’s family connections, bureaucratic skills, and and intellectual dishonesty, things could only have become worse from there. Worse they became, in remarkably close parallel with Hitler’s success, when the MTA became law in 1937.

Doctor Tom

Posted by tjeffo at 05:00 PM | Comments (0)

February 08, 2010

Getting it Wrong

Both the American drug war and Nazism under Hitler between 1933 and 1945 are extreme examples of anomalous human thinking. What they also have in common is that they demonstrate what can happen when circumstances combine to empower an entire government, or in the case of the drug war, a large branch of government, with a dangerous degree of autonomy and the freedom to pursue mistaken ideas. In essence, i just compared America's war on drugs, to Nazism, a universally despised system widely recognized as the ultimate of evil. That notion, at first glance, might seem shocking to some.

Actually, the combination of essential elements exhibited by both phenomena isn't all that rare. Once one is able to consider them as straightforward examples of human behavior, similar situations can be see toabound. A convenient one, also American, is the system of chattel slavery that ultimately evolved in the Antebellum South. Over less than 3 centuries, slavery had become an inhumane system that gave ignorant overseers and slave traders almost complete authority over a group of humans defined solely by the color of their skin. Slaves were not recognized by federal or state law as human; almost no legal penalties were imposed on an owner who allowed his slaves to be punished excessively; even murdered.

Another characteristic often shared by such repressive systems is tolerance by the rest of society, a process often facilitated by circumstances that keep victims out of sight within institutions such as prisons or mental hospitals where ordinary rules do not apply and budget constraints and overcrowding can encourage a degree of callousness in the staff. Again, the most convenient example I can think of is the systematized barbarity of the modern American Prison system.

As it happens, I think I’ve also discovered the “smoking gun” needed to convince a majority of rational people that the drug war is as big a mistake as I’m claiming. What gives me some hope is that there are numerous examples in human history of critical insights that, almost by themselves, made sense out of what had actually been a random hodgepodge of mistaken ideas. Darwin’s intuition of a rational order driving what we now call Evolution (he didn’t call it that immediately) remains the best example I can think of. A smaller one, but one leading to dramatic reversal in a destructive practice was Silent Spring by Rachel Carson.

I’m painfully aware of how much I’m asking of readers who haven’t been conditioned, as I have, by years of realizing just how insane our drug policy had become without being able to articulate that conviction convincingly. The missing element was a concrete example that could pull enough grotesque drug war elements together into a convincing package. I now think I have such an example which, like so many other such phenomena, has been hiding in plain sight all along. All that was required was a proper focus.

That's enough for one day; the unveiling will come later.

Doctor Tom

Posted by tjeffo at 03:46 PM | Comments (0)

February 02, 2010

Annals of Supreme Hypocrisy

The first 'self-evident' truth asserted in America's revolutionary manifesto is that “all men are created equal;” yet when our founders, Jefferson among them, drafted a Constitution eleven years later in Philadelphia, that notion was cynically betrayed by their decision to embrace chattel slavery so seamlessly that neither word appeared in the document itself; nor was the institution of slavery addressed by the Bill of Rights appended before ratification. Instead, the onus of being a black slave was expanded judicially in 1857 when the Chief Justice of the Supreme Court explained that because they had been permanently excluded from citizenship by the Constitution, slaves could not sue for rights they didn't possess.

That reasoning so enraged abolitionist John Brown that his attack on a federal arsenal became the proximate cause of a bloody Civil War, one of the results of which was emancipation of all slaves. However, even that benefit was soon reduced by another terrible Supreme Court decision, namely that "separate" is the equivalent of "equal;" a notion that would allow a policy of Segregation supported by domestic terrorism to endure in the postwar South for almost sixty years before a Court presided over by an unlikely "maverick" finally agreed to uphold both the Thirteenth and Fourteenth Amendments.

In that context, I don't think it either unreasonable or impolite for a nominally black President to publicly rebuke the Court’s current 5-4 Catholic male majority for putting his Office on auction to American Corporations. He's certainly read enough history to know it's not that long since other Americans were bidding on his father's ancestors or hanging them from trees; both activities cleared at the federal level by this Court’s predecessors.

For any who think I also hold the Court responsible for their uninformed meddling in the practice of Medicine and subsequent foolish endorsement of the war on drugs, the answer is a resounding YES!

I see Justice Alito's response as remarkably uncool and revealing; I also doubt that any of his trial judge colleagues would allow it in their court rooms.

Doctor Tom

Posted by tjeffo at 07:50 AM | Comments (0)

January 31, 2010

Apocalypse Soon?

An article written by two experts on climate and atmospheric science in the January print edition of Scientific American revisited the idea of Nuclear Winter by warning that even a “limited” exchange between two recent nuclear powers like India and Pakistan has the potential of reducing the global food supply enough to threaten a sixth of the world’s humans with starvation. I was suitably impressed after reading it, primarily because I’d already given considerable thought to the same issue; however, I was completely unprepared for (and disappointed by) the vacuous comments following the article in the on-line edition. If they are representative of the current readership of Scientific American, our species may in even more trouble than I'd feared.

Doctor Tom

Posted by tjeffo at 07:45 PM | Comments (0)

January 28, 2010

History and the Brain

We humans are not only the most recently evolved mammals, we are also the most dependent on our brains for survival; not that there aren’t several other critical attributes; upright posture, for example. Recent fossil discoveries have provided evidence that considerable primate evolution must have preceded the eventual migration– first of Neanderthals, and later of our own ancestors- out of Africa.

In many respects, the realization that we had evolved began with Charles Lyell, and other geologists, whose writings were well known to Darwin and without which, his critical observations could not have taken root. Indeed, so important has been the impact of Science on human behavior that, In many respects, the whole span of human history predating the Industrial Revolution can be seen as but a prelude to the present day, one in which record numbers of humans are locked in a struggle for mastery of the planet with weapons inventories that are deadlier than ever; made more so because a substantial fraction of one camp is so willing to commit suicide to deliver them.

Not only has the past been prologue, its cognitive errors and false assumptions have shaped the present in ways that were not- and probably could not could not have been- anticipated by our ancestors. Only recently have we acquired satisfactory descriptive terms for the responsible cognitive phenomena. Because they might not be understood as intended, I'll use capitals and italics: Cognitive Dissonance is a mental quirk allowing the simultaneous embrace of mutually contradictory ideas. Denial is our all-too-common refusal to recognize when a dangerous degree of Cognitive Dissonance has developed. Finally, Path Dependence postulates that to the degree any system undergoes directional change, substantial alteration becomes increasingly difficult. Thus the more profound a logical mistake and the longer it was believed within an organization (or body politic), the less likely its amicable correction.

The final realization needed for an understanding of the modern human dilemma is that our brains had been set up long ago for it by the separate evolution of the emotional and cognitive centers residing within each of us. However, It wasn’t until Science gave us the ability to reproduce to a dangerous degree while still continuing to compete in the same old ways that the situation became truly desperate.

For those still cherishing the myth of an all powerful creator, whatever happens becomes His Will, and thus nothing to get too excited about.

Doctor Tom

Posted by tjeffo at 06:01 PM | Comments (0)

January 24, 2010

Collective Lunacy; as reflected by two recent judicial exercises

I must admit that even though I was perceptive enough to warn about a new curia after the Roberts Court first tipped its hand in the Bong Hits for Jesus case, I was also blindsided by the audacity of the “free speech” monstrosity just concocted by what is emerging as the fascist gang of five on our highest court. While all three branches of the government devised so hopefully by our sainted founders in 1787 have been hopelessly corrupted over two-plus centuries of national existence, the dubious honor of being the most grotesquely inappropriate should probably go to the Supreme Court, precisely because it usually receives the least attention; a circumstance that only highlights its clinkers and failures. Think Dred Scott and Plessey, followed by its failure to deal with the consequences of either for nearly a century after the Civil War. Hardly a vindication of Jefferson’s famous 1776 rhetoric, which can now be seen as just as hypocritical as his personal failings.

Typical of global media inattention to the foibles and anomalies of our species is the current lack of American interest in what is undoubtedly our Supreme Court’s most glaring current anomaly: its recent radical alteration in composition. Not only have those changes been both radical and swift, the idea that they wouldn't necessarily impact its decisions would be laughable were its implications not so tragic.

As if to prove every cloud has a silver lining, the recent unanimous Kelly decision by the California Supremes struck down the numerical plant limits slipped into SB 420 by the police lobby at the last minute; however true to its craven refusal to take on drug war lunacy, the Court left considerable wiggle room for local prosecutors to argue over “reasonable” limits.

What's more liable to prove an effective restraint on wasteful state prosecutions is a lack of tax revenues attending the "financial crisis" we are still reluctant to call a Depression.

Prozac anyone? Or would you prefer pot?

Doctor Tom

Posted by tjeffo at 07:43 PM | Comments (0)

January 23, 2010

Delayed Corrections of Past Errors; how humans became a smart species with a grim future

One of human cognition's most neglected areas is our tendency to overlook a relatively simple concept: most progress in human knowledge can be seen as new information (partially) correcting widely believed errors of the past, some of which had achieved great credibility. The best known example may be when Galileo’s observations through a primitive telescope corrected the then-accepted notion of a geocentric universe. For me, the most important part of that story is the one most often omitted: that the orthodoxy that induced Urban VIII to punish Galileo for heresy still dominates human affairs; even as the existence of our species is threatened by its stubborn preference for myth over the more plausible explanations of empirical science.

There are many reasons why; one is that our highly evolved brains can't keep pace with our rapidly evolving culture. In Darwinian terms, our need to compete still trumps our ability to cooperate for our own good; thus “success” becomes vanquishing contrary ideas, even when it means preferring the siren songs of a Hitler, a Pope, or an Ayatollah over hard-headed (but uncertain) scientific reality, a process greatly enhanced by scientific ignorance. Is there any better explanation for the gutting of that most sacrosanct of all Constitutional Amendments by a gaggle of Catholic jurists added to the court by Republican presidents intent on reversing Roe v Wade?

Another reason is our well-demonstrated preference for denial; a tendency facilitated by our relatively brief life-span compared to the almost impossible-to-grasp concepts of infinity with which modern cosmologists must wrestle. In that context, it’s easy to understand why our concepts of the "future" are so truncated.

As I’ve often been moved to explain in the past, these existential warnings were not on my radar in 2001; they are a natural consequence of having to understand how the American federal bureaucracy could have been led so far astray from a more readily understandable explanation of the juvenile pot use that caught our national attention in the Sixties. That realization eventually led to others: competition, greed, and denial play critical roles in most human interactions. In fact, without them, today’s huge, technology-dependent global economy could not have evolved into an engine capable of sustaining, however imperfectly, a human population of between six and seven billion.

A key interjection at this point is that the failure of Communism demonstrated the importance of consumer rewards in balancing the drudgery and repression intrinsic to planned economies; however Capitalism has its own problems. One is that population growth has been a continuing requirement for “success.” In other words, is prosperity even possible in a shrinking economy? We have yet to find out.

At the same time, the most troubling problem facing the world's economy may be its dependence, since the Industrial Revolution began, on population growth and competition, both of which were also greatly facilitated by scientific technology. Unfortunately, the most recent scientific discoveries now suggest that exploitation of the Earth’s resources may have been overdone to a point that forces us to conserve and recycle more efficiently even as we must also consider replacing major energy sources; all without any assurance that they could be accomplished soon enough or, as importantly, that political stability could be maintained during whatever interval proves necessary.

Given current levels of global strife, the track record of international decision making, and currently favored methods for conflict resolution, the smart money would have to bet against "success."

Doctor Tom

Posted by tjeffo at 06:13 PM | Comments (0)

January 20, 2010

Suspicions Confirmed

Today’s NYT carries two stories that, to an uncanny degree, confirm two growing suspicions about our species: the first is that we are more easily misled than we realize; the second is that there are far too many of us for our own good.

The first such item concerned Medical Marijuana; in its brief first paragraph, its author added two and two and proudly came up with five: “there is no good scientific evidence that legalizing marijuana’s use provides any benefits over current therapies.” In the course of the article, there's even more; two short paragraphs later he states, “Marijuana is the only major drug for which the federal government controls the only legal research supply and for which the government requires a special scientific review.” (Duh!)

The rest of the article compounds that fuzzy logic by zeroing in on the argument currently favored by marijuana opponents: that because it must be smoked, it simply can’t be "medicine."

Actually, “smoking” is a form of drug delivery that is both very complex and efficient; there's already abundant evidence that smoking herbal cannabis (“marijuana”) over prolonged intervals is safer than previously supposed; perhaps even safer than not smoking at all.

Harris further contradicts himself by describing Marinol a federally sponsored “edible” that results in significantly different effects than either smoking or ingestion of the still-illegal oral preparations sold in "dispensaries."

Finally; with respect to Mr. Harris’s misleading article, the failure of both federal experts and their counterparts in Academia to even notice such obvious discrepancies is powerful evidence that our clever species is so driven by greed and fear that it is easily intimidated by brazen fascists.

That’s my seque into the second Times article, documenting the not-so-surprising victory of a Massachusetts version of Joe the Plumber over the lackluster candidate for what was assumed to be a safe seat. There are so many familiar historical parallels, ranging from Hitler in 1933 to Dubya in 2000, that recounting even the best-known would be boring.

Color me discouraged; more on the key differences between eating and smoking pot as tme permits...

Doctor Tom

Posted by tjeffo at 07:05 PM | Comments (0)

January 17, 2010

Questions Raised by Two Books Worth Reading

In April 2008, I reviewed Douglas Valentine’s Strength of the Wolf, a well researched study of Harry Anslinger’s FBN, as revealed through a host of interviews with veterans of that agency, many of whom had transferred to the CIA between Anslinger’s Kennedy-endorsed elevation to the UN as its first High Commissioner of Narcotics in i962, and his unrepentant departure from public life in 1970.

Once piqued, Valentine’s interest in the FBN generated a second book, the Strength of the Pack, in which he takes a closer and more contemporary look at the evolution of American drug policy since 1968, the same year Richard Nixon alertly convinced America’s clueless “moral majority” to choose him over the luckless Hubert Humphrey. It was an election close enough to rival the only two occasions when naked power politics and the archaic Electoral College system combined to thrust the Presidential candidate with the fewest popular votes into the White House.

The immediate price of Rutherford B. Hayes 1886 "victory" was abrupt termination of Reconstruction and eventual imposition of segregation (through Jim Crow). The most obvious costs to date of the Bush versus Gore fiasco in 2000 have been two ruinous wars, a badly fractured global economy, and eight years of inactivity on climate change.

Although Valentine seems to harbor some belief that an "honest" drug war could “keep drugs off the street,” he is under no illusions that either the CIA or the DEA, as the FBN's successor agency, has ever fought it honestly. Far from it; he understands the two have had a common interest in using America's drug policy as smokescreen for their bureaucratic power plays; also that both have found it essential to employ narco traffickers as informants, a practice that inevitably leads to granting "drug criminals" a degree of immunity. What he also makes clear is that the Cold War gave the CIA an upper hand over other federal agencies following World War Two, an advantage it has not yet been forced to surrender.

Less clear to me is whether he understands the essential dishonesty of a national drug policy that has been systematically betraying everything America claims to stand for since 1914.

Another worthwhile book, somewhat older in terms of its publication date, but displaying a deeper understanding of the essential fecklessness of America's drug policy, is Drug Warriors and their Prey, by Richard Lawrence Miller. Like Valentine and other non-academic historians who have been more forthright in criticism of popular ideas than their brethren in Academia, Miller has had to achieve a degree of commercial success in order to march to his own drummer.

Also like Valentine, Miller seems have discovered drug policy through interest in a related phenomenon: in his case, it was Hitler's lightning takeover of German political power in the Thirties by taking advantage of that nation's underdeveloped legal system. Of considerable interest to me is that an endorsement of Miller's logic, similar to that offered by gun lobbyists, has yet to be offered on behalf of either Blacks or drug users, both of whom seem to be playing designated roles as scapegoats in modern society.

Segue to the rapidly deteriorating situation in Haiti which is growing worse by the hour and was also eminently predictable a week ago: from the ineptitude of those claiming to be "in charge," and the desperation of humans trapped in a pestilential hell-hole in which the dangers of starvation and disease are increasing by the day.

Will the watching world tumble to what's at stake here? Or will it (as usual) just avert its eyes and focus on more trivial issues?

Doctor Tom

Posted by tjeffo at 06:58 PM | Comments (0)

January 14, 2010

Haitian Agony: a Reproach and a Warning

It’s difficult to understand how anyone could remain unaffected by the grisly details of the human tragedy now being recorded on the world’s television screens. Haiti is the western half of the island where Columbus landed in 1492 and promptly claimed for Spain as Hispaniola. It was also the first place in the Americas where African slaves were brought to replace the original inhabitants after a near-depopulation suffered under Spanish rule.

Over the next three centuries, Spanish, French, and British colonial interests vied with Caribbean pirates for control of the western half of the island (Saint-Dominique) then ruled by France. Shortly after the revolutionary government of France granted a disputed degree of freedom to “mulattos” (some of whom had fought against the British during the American Revolution), the first, and only successful, slave rebellion in the new world began in 1791 and ended with creation of the Republic of Haiti in 1804

That successful rebellion had far-reaching consequences; one of which was French loss of interest in the New World and the Louisiana Purchase which, in turn, led to Lewis and Clark’s expedition. Together, they lent great impetus to westward expansion of the United States towards its “Manifest Destiny,” the capstone of which was our war with Mexico over Texas.

At the same time, the Haitian revolution served as both a grim warning to those dedicated to preserving American chattel slavery and a major reason for their refusal to consider any moderation in its practice. Although Lincoln insisted in his first Inaugural that the Civil War was only to preserve the Union, it became more apparent in his second that he saw slavery was the real issue. Ironically, a disgruntled Southern loyalist, upon hearing that speech, was moved to take action soon afterward.

That history is the main reason I regard our long-continued neglect of Haiti a disgrace and its current misery a dire warning of what might happen if we continue to ignore the emotional basis of human behavior and fail to realize that denial and repression aren’t sustainable as answers to the grave problems humanity now faces.

Doctor Tom

Posted by tjeffo at 06:47 PM | Comments (0)

January 13, 2010

Another “Victory” over Mexican Drug Cartels?

Hours ago, the Mexican government announced its fourth “victory” over the dreaded drug cartels in recent weeks: the arrest, in the Baja California city of La Paz, of Teodoro García Simental, an upper echelon cartel leader with a particularly grisly reputation for beheading cartel enemies; even dissolving some of them in acid.

Given that the real reason for the violence is the enormous popularity of marijuana north of the border, I’m still left with one question: how long will it take for Americans to wake up to the fact that whether it’s cocaine from Colombia or marijuana from Mexico, the driving force behind drug violence in both countries is the stubborn insistence of Yanqui policy makers that a policy of prohibition can be made to work?

Doctor Tom

Posted by tjeffo at 03:26 AM | Comments (0)

January 12, 2010

Good News, Bad News, and an Interesting Future Confrontation

The good news is that New Jersey appears about to become the fourteenth state with a medical marijuana law; the bad news is that its sponsors have promised it will be restrictive enough to avoid the “excesses” of California’s Proposition 215, all of which begs a few questions: do they really think they would have succeeded if 215 had been rejected by California voters? Haven’t 12 other states around the nation been passing similar laws at the rate of about one a year since 1996? What is it about “momentum” that they don’t understand? How does one put toothpaste back in the tube?

Just how Jersey’s restrictive law will evolve under a hostile governor will be interesting. The match-up will be between the market for a safe, effective anxiolytic drug with a well-established, albeit illegal, infrastructure; one that grows by appealing to troubled adolescents in an age of anxiety. It will be opposed by clueless bureaucrats, still relying on the powers of arrest and prosecution in an era of diminishing tax revenues.

My money is on the safe therapeutic agent.

Doctor Tom

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

January 11, 2010

Worse than I Expected

Yesterday I mentioned the National Geographic Channel's Border Wars documentary and expressed some hope for a realistic look at two of our modern follies: trying to seal our Mexican border against poor people and drugs. Judging from the "preliminary" episode, which will apparently air again tonight, right before the "first" episode (!) the series will be another uncomprehending, and incomprehensible, exercise in patriotic puffery.

Rather than trying to supply some context by explaining how the "wars" began and have evolved, the script thrusts us right into battle as we ride along with intrepid Border Patrol Agents in high tech vehicles and Blackhawk helicopters playing cat and mouse games with desperate smugglers and coyotes attempting to deliver drugs and pathetically poor aliens across the Arizona border.

There's no doubting the sincerity of the agents' emotions or that the dangers they face are real; however, we get no perspective from their decperately poor quarry. The truth is that all are being filmed for our entertainment; mere pawns in the money and power games now dominating human existence. The series looks like it will end up as just another tawdry example of "Reality TV."

There is no mention of the fact that back in the Fifties, we had tried to address the illegal immigrant problem with a Bracero (guest worker) program, or that, by the time the program was discontinued in 1964, American teens had yet to discover the anxiolytic appeal of "marijuana," thus there was hardly any demand for "pot" North of the Border.

Forty-five years later, the current plight of our species becomes a bit more understandable; but only to those who remember the past.

Doctor Tom

Posted by tjeffo at 04:20 PM | Comments (0)

January 10, 2010

Drug War Lies Exposed by Applicant Initiation Patterns:1

Schedule One was created by the Controlled Substances Act of 1970 to designate certain drugs considered so far beyond the pale that mere possession of a detectable amount without special government permission became grounds for arrest. That the criteria for listing those agents are ridiculously unscientific can be inferred simply from reading them; that they would not be applied fairly can be inferred from the fact that the CSA gives ultimate authority over the list to a Cabinet officer who must be a lawyer: the US Attorney General.

It also goes without saying that the CSA was written at the behest of the only US President (also a lawyer) forced to resign because of his own dishonesty even before the bureaucratic enforcement mechanism for what amounted to an entirely new policy had been created. Indeed, one of Nixon's last Executive Orders created the DEA, which can be considered the successor of Harry Anslinger's infamous FBN.

Not that I have a problem with lawyers per se, my problem is with them practicing Medicine, a profession in which they were not trained, but tend automatically to assume their lack of depth and clinical experience can be made up for by a quick top-down study. Nor do I have a problem with relatively honest plaintiff's attorneys; my own experience has convinced me that diligent physicians who communicate with their patients have much less to fear from tort (malpractice) attorneys than from federal bureaucrats possessing both the power of arrest and the ability to hide their errors and misdeeds.

In fact, if one traces modern US drug policy back to its origins in the 1914 Harrison Act, one learns that the only prime mover of that unfortunate legislation who was a physician was Hamilton Wright, a little-known wannabe-bureaucrat in the (TR) Roosevelt Administration who helped set it in motion and whose 1917 obituary can be read here. An interesting footnote to Wright's truncated career, noted in the obituary: his one claim to fame as a researcher had been to mistakenly identify a vitamin deficiency as an infection.

Once in place, validated by the Holmes-Brandeis Court and rooted in fear of the (still-undefined) phenomenon of "addiction," the false central theses of Harrison have remained under the control of judges, legislators, and police bureaucrats who have consistently used their greater political clout to cow Medicine into complicit silence in much the same way temporal and religious authorities have used similar power to control. access to the benefits of Science from the time of Galileo and Newton onward.

By the way, the false central idea of US drug policy is not that certain drugs ("of abuse") are dangerous and potentially harmful; it's that those harms are best defined by medically ignorant functionaries and mitigated ("controlled") by prohibition laws that inevitably create lucrative criminal markets.

By a fortunate coincidence, my early questioning of cannabis applicants asked about their initiations of several "drugs of abuse." The aggregated answers, which do show that chronic pot users tried more than their share is offset by data showing that as pot smoking became an established practice, its practitioners have been progressively less likely to try heroin or use more dangerous drugs repetitively. In other words, the devil is in the details; as usual. A graphic lesson in the futility of prohibition as policy will air tonight on the National Geographic Channel; I'm curious to see how far it will go in actually verbalizing the folly of prohibition, but I'm not expecting miracles.

Doctor Tom

Posted by tjeffo at 06:44 PM | Comments (0)

January 07, 2010

How Two Losing Wars Might End

Two discrete drug wars are being waged along our border with Mexico; one, the futile American “war” on drugs, is relatively bloodless, but it’s the underlying cause of the other, which is setting new records for bloodshed: the one involving rival Mexican cartels and hapless Mexican government forces over control of the increasingly lucrative smuggling corridors through which low grade Mexican weed is delivered to our still-growing domestic market. Improbable as it might have seemed at the height of the crack epidemic in the Eighties, weed now leads all other illegal drugs in return on investment. If there’s a better measure of drug war futility, I have yet to hear of it.

Another failing American war, the one on terror, almost completely displaced both Mexico and pot from the front pages over the Holidays, but at least one detailed analysis cited drug war futility and its links to both Mexican violence and America’s hunger for marijuana. Somewhat ironically, it appeared in the conservative Wall Street Journal, and although it didn’t cite the medical benefits of pot, now being reduced by its illegality, it did give an accurate description of how profits from illegal markets encourage violence and lure disposable low-level players into violent distribution networks (just like Prohibition in Capone's Chicago).

Lest anyone think “legalization” of any illegal drug will happen overnight, the only legislative body on Earth with the power to do that is the Congress of the United States; on the other hand, 2011 will mark the first year of pot-smoking baby boomers' Medicare eligibility. If there are as many of them as I suspect, Congress should finally start getting the message. It also makes it likely that "marijuana" will be the first "drug of abuse" to be legalized; not because it is "soft," but because it is an effective palliative medication for so many of its users.

Who knows? Another benefit of legal pot might even be a reduced Medicare budget as pot smoking geezers gain access to cheaper and more effective medicines than the ones offered by the Big Pharma cartel.

Doctor Tom

Posted by tjeffo at 06:04 PM | Comments (0)

January 03, 2010

A Change in Drection

The global drug war’s failure is a phenomenon that can be explained either in starkly simple terms or in the complex detail favored by historians. The simple explanation is that lessons that should have been learned from the failure of America’s Prohibition Amendment between 1920 and 1933 have yet to be applied to the world’s massively failing drug war.

Why that is so still eludes me. That it’s a form of denial has long been clear, but what is most troubling is that once one is alerted to how commonly the same mechanism has been, and is being used to avoid dealing with other unpleasant global realities, the danger posed to our species simply can’t be avoided. But it is. I have now concluded my best option is to resume the narrative of pot prohibition’s failure, but in greater detail and longer installments appropriate to its historical complexity. What follows here is the brief overview.

In 1920, America unwittingly launched two apparently separate prohibition policies, each of which was bound to end in failure, but ironically, the lessons of the first still haven’t been applied to the second; indeed, official rhetoric holds that drug prohibition remains an essential national and global policy. The reasons for that denial, and some way around it, would seem to be of great importance to the entire species, for they clearly relate to the function of our defining organ, the brain.

The next entry, which may be some time coming, will try to deal with some of the complexities that have been hiding the truth about cannabis and its (unsuccessful) prohibition from both the public at large and those who should be most interested.

Doctor Tom

Posted by tjeffo at 06:24 PM | Comments (0)

December 25, 2009

The Silent Crescendo of Denial

Two of the more important lessons I’ve learned through taking histories from cannabis applicants have little directly to do with pot pharmacology; rather, they relate to overall human behavior. The first is that fathers are far more important to the self-esteem of their children than is commonly realized; the second is that humans are so averse to admitting mistakes they will carry denial to ridiculous lengths to avoid any admission that they might have been wrong.

To start with what are, for me at least, the most recent and obvious examples of pernicious denial on a global scale: last week, both the US and Mexican governments trumpeted the death of drug lord Arturo Beltran Leyva in a gun battle with the Mexican military as an important "victory” in the drug war. However, I saw it as just the opposite: an indication that America’s drug policy has been an even bigger failure than our disastrous attempt to "prohibit" alcohol between 1920 and 1933; it shouldn't be that difficult to understand that there’s essentially no difference between Leyva’s killing in 2009 and the Saint Valentine’s Day massacre of the Bugs Moran gang in 1929; yet there were no op-eds or editorials making that point immediately after the "victory" was announced.

Even more astonishing, from my point of view: after the family of the Mexican Marine who was both the official "hero" and the only “good guy” killed in the shoot-out was brutally murdered in an obvious act of revenge, I could find no editorial mention of drug war futility. It’s a subject that seems to have become such a global sacred cow that it’s now safely above criticism.

How does one fix a problem one can't acknowledge? Can this species be saved from itself?

Doctor Tom

Posted by tjeffo at 12:40 AM | Comments (0)

December 20, 2009

Message from Copenhagen: Let them eat cake.

The failure of one hundred ninety-odd sovereign nations meeting in Copenhagen to deal effectively with the climate crisis last week should not have been surprising, given the ambient disagreement over whether Planet Earth even has a climate problem. The US, although flat broke at the moment (blame it on Obama!), is still arguably among the more advanced and powerful nations “on the planet,” yet one does not have to look far to find “climate deniers;” they are even more common this year than Holocaust deniers and 9/11 deniers were in the past. In general they tend to be like those other naysayers: conservative religious fundamentalists who view coercion as the preferred solution to human problems. Beyond that, the main reason for the rest of us to worry about our future may be that a majority of scientists are climate change worriers.

Of course, scientists also have problems of their own, one of which is bickering over details; but fundamentalist non-scientists are used to that. Aren’t those pointy-headed scientists also notorious for flip-flopping?

Given the track record of the modern world for aggressive commercial and military exploitation of the latest scientific discoveries while also restricting their benefits on the basis of ability to pay, the prospects of finding a climate solution that won’t also leave a significant fraction of living humans scrambling to survive appear dim. All of which reminds me: denial has become as common as it is because we humans have never liked being bummed out by bad news.

Doctor Tom

Posted by tjeffo at 08:22 PM | Comments (0)

December 19, 2009

The Ubiquity of Denial

My experience with cannabis users convinces me that denial is not only a serious human cognitive flaw, but has become so pervasive and widespread that it can prevent our species from recognizing its serious problems until they are almost beyond solving. Thus we now find ourselves unable to deal effectively with a panoply of unprecedented disasters looming on the global horizon. It's precisely because a large fraction of living humans is either incapable of understanding them or acknowledging their existence. Lest anyone think the frailties of cannabis users are what led me to those conclusions, I hasten to point out that it was the overwhelming dishonesty of both America's drug war bureaucracy and the multiple national and global institutions it has intimidated so successfully. Individual pot smokers are refreshingly honest when treated with respect and the same degree understanding accorded to other patients.

Three current items in the news illustrate our national veracity problems as abetted by the essential contributory role of denial; two relate to medical marijuana, the controversial subject I've become most familiar with; however, there are innumerable others in the news on any given day.

With respect to pot prohibition: although Wisconsin will likely be joining the growing list of states allowing medical use of "marijuana," one looks in vain for any admission from the federal government that its rigidly enforced policy has been a counterproductive failure. Another example in the news is the most recent horror story about Mexican cartels. As for the attendant denial, one is equally hard pressed to find any hint from either the Mexican Government or the UN drug enforcement bureaucracy that their efforts are expensive failures. Ironically, as I was composing this entry last evening, I watched a DEA functionary named Strang try to convince a skeptical Michael Ware on CNN that Leyva's death was a "victory" for both the US and Mexico!

Finally, another report heard on NPR Friday morning while on my way to Oakland predicted the inevitable failure of the Copenhagen climate change summit, while an update on its immediate aftermath that same evening showed improbable video images of an exhausted American President trying to spin it as a partial victory before heading back to a Washington DC being buffeted by a huge snowstorm produced by an unseasonably warm Atlantic Ocean.

Oh, yes, I almost forgot: while driving back from Oakland Friday evening, I spent 5 minutes, or the duration of my tolerance, listening to a Right Wing jackass braying on AM radio (the Bay Area variety is as virulent as any other). He was bemoaning the "fraud" in Copenhagen and implying that it was just a Democratic Party conspiracy to give away American tax dollars.

Doctor Tom

Posted by tjeffo at 03:41 PM | Comments (0)

December 17, 2009

Mexican Standoffs

In a more rational world, California’s hotly disputed Proposition 215 might have been seen as an opportunity to settle what had become a protracted argument between the US federal government and supporters of drug policy reform: does cannabis (“marijuana”) have “legitimate” medical use? That essentially no agreement has been possible in the thirteen years since the initiative’s passage is but one of multiple ironies as we approach the anniversary of some of the initiative's early landmarks.

Another is that the Mexican Border has become the scene of an increasingly bloody turf war between criminal cartels competing to smuggle low grade Mexican marijuana into the United States. In striking parallel, news and opinion articles describing the burgeoning market for “medical” cannabis (“marijuana”) have been keeping pace with lurid descriptions of the increasing violence at the border. As if that weren't irony enough, there is an incongruous reluctance on the part of mainstream media to even notice the obvious connections between those phenomena; it's as if they were occurring in parallel universes rather than neighboring countries with a mutual history as long as the border between them.

In the meantime, delegates to the long awaited Conference on climate change in Copenhagen will undoubtedly agree to meet again, despite the opinion of many that climate change is a chimera and of others that the current effort has already collapsed.

Such widespread cognitive dissonance in a dangerously swollen human population that has already escaped several self-induced disasters and could not have grown to its present size without its recently developed capacity for spectacular scientific achievements should probably give us pause; at least long enough to ask: how much longer will it be possible to engage in fundamentally irrational denial, now that we are so imperiled by our own cleverness?

Doctor Tom

Posted by tjeffo at 05:17 PM | Comments (0)

December 15, 2009

California’s Booming Recommendation Industry

Although it's been more than thirteen years since California passed Proposition 215, there’s still a tendency to call the doctor’s statement patients require to use cannabis legally a “prescription,” rather than a “recommendation.” That the distinction was important is seen by the fate of Arizona’s Proposition 200, which has been in limbo for thirteen years, despite having received an even greater majority than Proposition 215 the same year.

Just as President Nixon’s 1972 rejection of the Shafer Commission's recommendation was the key to enabling today's booming illegal cannabis (“marijuana”) market to go forward, so was Drug Czar McCaffrey’s 1996 threat against physicians who dared to discuss its use with patients (applicants?) the key to creation of a new medical specialty of cannabis consultant, or “pot doc.” I do not claim to have been among the very first of such specialists, but I may have been one of the first to meet applicants at cannabis retail outlets, then known as “pot clubs” but now referred under the more medically respectable rubric of “dispensary.”

To return to the question of how the required physician's statement should be referred to, Arizona's experience suggests that terminology is crucial, a notion clearly anticipated in the pre-election analysis of California's initiative. Be that as it may, one of the consequences of General McCaffrey's 1996 threat was to scare most practicing physicians away from the recommendation process, thus leaving it to a relatively small number of activists, the most prominent of whom was the late Tod Mikuriya, a psychiatrist who had been championing its use since a brief stint at the NIMH in the late Sixties.

Tod was off and running as soon as the Ninth Circuit blocked McCaffrey's threat with an injunction. Therapeutic use of cannabis had been his passion for much of his professional life, thus he was already well prepared intellectually to hold clinics, evaluate applicants, and sign recommendations in multiple locations; thus provoking a blizzard of complaints from law enforcement to the Medical Board. They were accompanied by demands that the MBC conduct an investigation of Mikuriya. Although it was reluctant at first because complaints against physicians traditionally emanate from patients or their families, their delay did not signify approval of Mikuriya's practice; only that entrenched bureaucracies move slowly in dealing with unusual new problems.

Although the MBC's eventual solution was tardy, it was also grossly unfair, and obscenely hypocritical: an "investigation" that blighted what would prove to be the last few years of Doctor Mikuriya's life. However, it failed completely at its intended effect, which was clearly to frighten the other California physicians licensed by the MBC out of the recommendation business.

Quite the contrary; even as the daily press and TV were becoming glutted with articles and documentaries trumpeting the increased visibility of the medical marijuana industry and bemoaning the ease with which "patients" could obtain the required doctors' "recommendation," they neglected key questions they should have been asking: who are these doctors and what have they been learning from their encounters with people that have been punished with increasing severity by the drug war for the past four decades?

The alarming answers to those questions, if pursued logically, would lead directly to the same conclusions I have been both forced to consider and hinting at with increasing specificity for five years: our species has been pursuing a progressive course of delusional thinking from which there seems very little prospect of escape in time to avoid some catastrophic consequences.

Even as a small minority is now attempting to address the problems we face as a species, the great majority is either denying their existence or proposing partial solutions that would benefit only a limited percentage of the global population, while allowing the rest to survive as best they could.

Our underlying problems, greatly exacerbated by technology since the emergence of Empirical Science, have been overpopulation of the planet and unwise exploitation of its resources; unfortunately, our need to deny them seems to exactly parallel their severity.

Doctor Tom

Posted by tjeffo at 04:03 AM | Comments (0)

December 12, 2009

Annals of Denial

Denial is something we humans have become experts at. One of its most distinctive features is stubborn refusal to acknowledge an error long after it has become obvious to all except those with a vested interest in the status quo. A classic example from History is the Roman Catholic Hierarchy’s treatment of Galileo: after finally subjecting him to house arrest for heresy in the 17th Century, the Catholic Church didn’t get around to acknowledging its error until 1992, long after Science had radically influenced the world in ways the Church still has trouble accepting. One hopes it won’t take the federal government 360 years to take cannabis off Schedule 1, a move that would be unacceptable at any time to a DEA that would face drastic reduction in size and prestige if cannabis were merely legalized, and complete dissolution if all US drug prohibitions were to end for any reason.

Given those considerations, it's likely the drug enforcement bureaucracy created nearly four decades ago following Nixon's unexpected election is being stressed in ways that could not have been anticipated before the unexpected size and vigor of California’s medical gray market were revealed, however erratically, over the last thirteen years that Proposition 215 has been (disputed) state law. Even so, denial is still the order of the day as evidenced by the failure of both my “pot doc” colleagues and mainstream media to ask two obvious questions: how did "weed" become so popular? and why was the steady growth of its illegal market missed completely by those with a vested interest in tracking it?

Instead of dealing with such fundamental issues, dueling opinion pieces still focus on “medical” versus “recreational" arguments, even as news items report the inability of law enforcement to keep track of new retail outlets, let alone shut them down; not to mention the bloody disputes that market is inspiring South of the Border

There have also been significant shifts within the gray market itself that have yet to be seriously discussed. Once its economic potential was demonstrated, primarily in in the Bay Area and Emerald Triangle between 1997 and 2003, it began erratically spreading southward to larger population centers as hundreds of entrepreneurs scrambled to cash in on pot's popularity.

Although my ad-hoc studies of applicants seeking to use pot legally suggested that the distinction between "recreational" and "medical" cannabis is blurred and the modern market didn't begin growing until the first baby boomers started unwittingly medicating various symptoms of adolescent angst with "reefer," the rather profound implications of those observations have been studiously ignored by nearly everyone.

That neither government nor reform sources have opted to address the implications of the data I've been gathering through systematic clinical encounters with a large sample of the huge illegal market created by Nixon only supports my belief that those aggregated histories provide the best evidence yet about how and why today's market has evolved.

That's not to say the story of that evolution is at all complete; my data can't address its inaccessible components: those who still use cannabis without bothering to apply for a recommendation, those who tried it and then gave it up after a variable period of repetitive use, and those who simply tried it a few times and moved on.

On the other hand, just as imitation is the most sincere form of flattery, it may be that inappropriate silence be the most convincing evidence of earlier mistaken beliefs.

Doctor Tom

Posted by tjeffo at 03:34 PM | Comments (0)

December 08, 2009

A Quick Follow-Up & a Sign of Progress

My issue of the need for a lawyer seems to have been resolved; I have decided to take my chances with the judge and simply argue that he is free hear whatever rebuttal witnesses the prosecution wishes to call.

In the course of composing the recent spate of blog entries, I happened to notice an interesting change in the Google Ads with which it’s been festooned: when they first started, most were for drug treatment and rehab facilities, a point that annoyed me no end, because I certainly don’t agree with the basic predicates of what I’ve come to regard as a Treatment Industry.

However, lately (I don't know just when) the selection of ads has changed radically: most are now aimed at the thriving Medical Cannabis Industry, a development that would worry me greatly if I worked for the DEA.

Doctor Tom

Posted by tjeffo at 03:59 PM | Comments (0)

December 07, 2009

Worse Than I Imagined

Over the eight years I've been interviewing cannabis users, I've heard many second and third hand accounts of the unfairness and incompetence of the criminal justice system in its dealings with those suspected or accused of violating California's marijuana laws. My own experience in that area had certainly been frustrating, but also mercifully limited; I'd testified briefly at the disgraceful federal "trial" of Dustin Costa in Fresno three years ago, also at one Superior Court (state) trial in Woodland, near Sacramento.

Last Thursday, my trial experience was expanded in a way I could not have anticipated and am still finding difficult to accept. I traveled to San Jose to testify on behalf of a patient I'd first seen in April, 2002. I remember him particularly well because his history had been one of the first to suggest that cannabis has been used to treat anxiety for years. I'd seen him every year through 2007 for the required "renewals;" during that interval, he'd retired from his city government job in another Bay Area county. I later learned (from his attorney) that he'd been incarcerated for most of 2008 on cultivation charges because bail was originally set at a punitive $100,000. Ironically, he been in Elmwood, same jail where I'd examined another patient.

His attorney had called to ask if I would testify at his trial. I quickly agreed and have since waited out six months of the usual delays for it to actually begin. It's a court (non jury) trial that began with direct testimony intended to establish my eight years of clinical experience with over five thousand individual cannabis applicants. I had also entered a printed copy of the peer reviewed paper published in 2007 into evidence and given one to the prosecutor, who surprised everyone by interrupting my testimony with about five minutes to go with a request that the judge order me to supply all the raw data from that study. I had only about three minutes to point out that because the database is unique, and is in electronic form, his request would involve safeguarding the highly sensitive medical information of thousands of patients. If it were possible at all, it would be time consuming and expensive. It's probably just as well that didn't have time to add that, under the circumstances, his request both absurd and a confession of incredible arrogance.

On Saturday my patient's lawyer called to report that after meeting with both attorneys on Friday, the judge had decided to scale down the prosecution's request to three hundred or so redacted records selected from several different years of the study. I immediately decided that I would resist any such an order and was told I'd have to engage my own lawyer because his representation of my patient creates a conflict of interest

Such is the arcane state of medical marijuana prosecution in the Bay Area, renowned for its "liberal" attitude towards an initiative that's had the force of law for the past thirteen years. I went to court to testify pro bono as a good Samaritan and now must find my own lawyer.

Doctor Tom

Posted by tjeffo at 06:08 AM | Comments (0)

December 05, 2009

Mystery Explained

Although there's considerable discrepancy between the Obama Administration’s widely reported statements that federal raids on pot clubs in states with medical marijuana laws would cease and the occurrence of such raids, there’s been no explanation that I was aware of until interest generated by a somewhat different issue prompted me to Google “prosecutions of medical marijuana violations.” Prominent among the first hits was a recent Justice Department memo from a Deputy Attorney General showing how the federal Bureaucracy hedges its bets; notice the ambiguous escape hatch: "sales to minors," bulleted on the second page.

That's apparently more than enough ambiguity for the DEA to justify any raid it opts to carry out by referring to a federal law that defines 21 as the "legal" age for alcohol for the entire country. Never mind that annual federal statistics confirm that 80-90% of American teens routinely defy that law without being prosecuted as felons; also notice when the states' prerogatives were once again usurped by the feds, It was probably no accident that it was in 1984, on the "Just say no" watch of Nancy Reagan and the Gipper; both of whom expressed inflexible views on a number of social issues.

The final abuse of common sense is that there's abundant evidence that cannabis discourages excessive use of alcohol, particularly by the same youthful demographic that is most at risk from intemperate use of alcohol and operating motor vehicles. Go Figure.

Doctor Tom

Posted by tjeffo at 08:58 PM | Comments (0)

Annals of Coincidence

Although several other mammalian species seem to possess a capacity for cognition similar to ours by entertaining abstract ideas, accumulating knowledge, and thinking ahead, none can compare with how well humans do all those things and much more. Our highly evolved brains are clearly our principal survival organs in the fierce, take-no-prisoners struggle for survival first intuited by the youthful Charles Darwin during a brief stopover in the Galapagos almost two centuries ago and then refined by three decades of obsessive thought before publication. As important as his theory of Evolution has been to our modern understanding of "nature," it is but one of several components of the cultural explosion that began with Gallileo late in the Sixteenth Century and has been accelerating ever since. As it is, billions of the humans who owe their very existence to Science are only vaguely aware of that debt as they struggle for survival in the global economy. Ironically, that same ignorance not only adds to our noxious impact on planetary ecology, it is shared by a substantial fraction of working scientists. Even Albert Einstein seems to have nurtured a belief in "god."

How, one may well ask, does a retired chest surgeon who has spent the last 8 years taking histories from pot smokers dare claim such expertise? The answer, which now makes perfect sense to me, is that the opportunity to take medical histories from people regarded as criminals was a classic "natural experiment" requiring only the willingness to ask pertinent questions of its unwitting subjects. My own willingness to take advantage of that opportunity was more a function of past experience than of intelligence in that my very existence, like that of all others, depended on a long series of events I am unaware of and over which I had no control. Even starting with our birth, our survival of infancy and childhood is by no means guaranteed and the critical choices shaping our lives are far more path dependent than most realize.

To narrow the focus a bit, one of the more logical and erudite practitioners of "neuroscience," (a rubric incautiously applied to some blatantly unscientific nonsense) is William Calvin, an author I discovered in the late Eighties and have since had time to read only sporadically, but always with considerable profit. Little did I realize when I first read Calvin's informed speculations on the seemingly unrelated subjects of language, climate change, and the geology of the Grand Canyon that I would someday develop a heightened interest in the same phenomena, or that the link would be an opportunity to gather information of apparently little interest to few others.

Doctor Tom

Posted by tjeffo at 04:45 PM | Comments (0)

November 29, 2009

Improbable Changes, Grim Prognoses

From its beginning in 2005, this blog has been focused on various aspects of “medical marijuana” as a political campaign against America’s war on drugs. The relatively small, disputed, gray market that began evolving in scattered parts of California after 1997 had just sustained what many saw as a crippling blow in June: the US Supreme Court ruled against it in a decision that effectively allowed Californians to be prosecuted in federal court for following a state law both state and federal Supreme Courts had upheld; local California police were lobbying vigorously against business licenses for new cannabis retail outlets, and also cooperating in a spate of DEA raids.

Improbably, just over four-and-a-half years later, the disputed medical gray market has become a thriving multi-billion dollar industry, not only in California, but in a growing number of other states. One medical organization after another has expressed, albeit timidly, support for the concept of medical use. Although the DEA and NIDA retain their Congressional backing and state law enforcement agencies still openly support the drug war as policy, funding for its principle weapons: arrest, prosecution, and imprisonment, is increasingly limited by a sinking economy.

For the first time ever, it appears that pot’s days on Schedule One may actually be numbered, although in ways that hadn’t been predicted. Indeed, given the parallel incongruity of drug war developments with pressing global events, the most important question may be whether that happens before a nuclear strike by a rogue nation, the first unequivocal evidence of coastal inundation, or planetary shortages of oil, water, and food.

Their common denominator is human error; the burning question may now be one of the time remaining for their correction.

Doctor Tom

Posted by tjeffo at 06:52 PM | Comments (0)

November 25, 2009

A Blast from the Past

It’s been over five years since I analyzed data from about 625 selected cannabis applicants for presentation at a national conference of Medical Marijuana “reformers” in Virginia. Although the total applicant population has since become a registry of nearly fifty-five hundred individuals and much detail has been added, the general findings exhibited by that first group have remained remarkably consistent. I recently came across a column by Fred Gardner published just before that conference, which I also remember clearly because it was there that I received the first unmistakable signals of displeasure from presumed colleagues; for reasons they are still reluctant to discuss and I no longer bother to ask about.

Fred's column isn’t very long; slightly over 1000 words and just a click away. Because findings related to the role played by biologic fathers have also stood up remarkably well and weren’t emphasized in the subsequent peer-reviewed report, I’m pasting the relevant text here. It suggests that, even in their physical absence, the very idea of the biologic father is important to the emotional well being of their progeny; also that their physical presence may be far from benign.

Finally; more recent analysis, facilitated by the larger population and its enhanced comparison of birth cohorts, could, when published, eventually bring about the demise of the invidious "Gateway Theory."

"Looking for environmental factors that might explain such high rates of illicit drug use, I began taking increasingly detailed family histories. It soon emerged that there was a common pattern: the biologic father had not played a positive, supportive role in their lives between pre-school and the sixth grade — roughly ages four through 12.

The most common reasons were:

— an unknown father

— early (before 7) death or divorce

— an alcoholic/workaholic father

— a stern, punitive father.

There are other, less common scenarios involving an invalid or an elderly father, or a recent immigrant who cannot communicate in English.

Many of my patients reported early self-esteem problems which were made worse by the following: — any learning or reading disability

— being in a racial minority

— being teased ( for any reason)

— frequent moves and attendant school changes.

Quite a few of the younger ones were evaluated for/identified with ADD; many of the older ones would probably have qualified. The bottom line is that most of the people who use cannabis regularly and were forced to come to buyers' clubs for their "recommendations" — either because they don't have a doctor, or their own doctor wouldn't discuss it with them — were/are using seeking to control an emotional "disorder" rooted in low self-esteem.

Cannabis was clearly only one of several agents they'd tried — along with alcohol and tobacco. Any of these agents may be able to control the underlying emotional disorder for a while, but pot is — for them, at least — the safest and least harmful, especially over the long haul. "Initiating" heroin seems an unquestionable indicator that the underlying emotional disturbance is severe. Those who tried heroin also tried cocaine and mushrooms at rates over 90%, and had the highest rates of problem drinking... There's some preliminary data that access to cannabis predisposes against addiction to heroin. It appears that most adolescent drug use may be motivated by the same basic causative factor: low self-esteem in its many guises."

Doctor Tom

Posted by tjeffo at 06:18 PM | Comments (0)

November 24, 2009

The “Pot Doc” as (New) Medical Specialist

Although now nearly forgotten, both California and Arizona passed “Medical Marijuana” initiatives in 1996. Unfortunately, Arizona’s was nullified on a technicality that had been avoided when California’s authors referred to physician approval as a “recommendation,” while Arizona’s Proposition 200 carelessly used “prescription.” Because prescribing a federally illegal drug is a legal no-no, Arizona has been without a medical marijuana law for thirteen years, while its neighbors in Nevada, Colorado, and New Mexico were busy passing more acceptable versions.

On December 30, 1996, two days before California’s new law was to go into effect, Clinton’s drug czar, went on national TV to threaten the license of any California doctor daring to even discuss use of cannabis with a patient, a bureaucratic arrogation of power that was soon blocked by a Ninth Circuit injunction, thus granting Proposition 215 a two year reprieve.

What McCaffrey’s threat did do was guarantee that physicians without their own personal reasons for favoring cannabis as a therapeutic agent would be discouraged from signing pot recommendations; except perhaps for very special patients. It probably also served to discourage all but the most desperate patients from seeking them. Remember that the initiative effectively required all participants to start from scratch in the face of what quickly turned out to be hostile police scrutiny in most parts of the state.

Because I hadn’t been a “head” myself before learning to despise the drug war as policy, I was blissfully unaware of those details when I was recruited by an Oakland club owner seeking a physician to screen his would-be customers in November 2001, after the initiative had been in effect for nearly five years.

The owner who recruited me is now serving five years in a federal prison on a negotiated plea bargain; he is an honorable man who turned out to be as naive as a “club” owner as I had been as a brand new pot doc. Those details, except for the role played by our mutual naivete, are a story for another day. He, like me, hadn't been a “head” in his youth; thus his naivete led him to place too much trust in his compliance with the letter of the new law, while mine was focusing me on curiosity about pot's appeal for my applicants (patients).

When I was led to understand it had been the anxiolytic potency of inhaled cannabinoids, I couldn’t wait to tell my reform colleagues, and was shocked by their summary rejection of that hypothesis in 2004. It would take me a while longer to understand they were/are unwilling to cop to their own emotional reasons for becoming heads; in other words, they see chronic pain as somehow more manly than anxiety in its various forms.

What I have also learned, albeit more gradually over the past five years, is that when one has the relative luxuries of a well-tuned interview and enough time to administer it properly, it becomes more than a useful tool for extracting information, it's also useful in educating patients about their own pot use. Although the principles behind a given solution may be similar, no two scenarios are exactly alike; thus as my own experience in my new specialty has increased, so has my confidence in the advice I’m able to offer. In that respect, the follow-up mandated by the ad-hoc “renewal” requirement that was added after passage of the initiative has also been helpful.

Doctor Tom

Posted by tjeffo at 05:40 PM | Comments (0)

November 23, 2009

A Disputed Idea’s Erratic Progress

Earlier this month, a news item that- twelve years ago- would have been literally inconceivable, created barely a ripple of interest when an AMA committee timidly endorsed the idea that cannabis (“marijuana”) may have some medicinal value and recommended that “research” be done. This was the same idea Richard Nixon had summarily rejected when it was presented to him in March 1972 by his own blue ribbon committee. Although he was soon driven from the Oval Office by Watergate, Nixon’s rejection, nearly unnoticed by the press at the time, has allowed the “war” on drugs to evolve from its genesis in the 1970 Controlled Substances Act into a policy that would eventually quadruple America’s prison population, produce over twelve million felony marijuana arrests, and provide price support for several other illegal agents then barely known to Americans by name, or even discovered.

Thirteen years ago, the dispute over pot’s medical value produced a victorious California initiative, despite near-unanimous opposition from state and federal officials, 57 of 58 DAs and all its law enforcement organizations. By the end of 2001, after a threat from the federal drug czar that would have stymied implementation was stayed by the Ninth Circuit, the idea had overcome law enforcement hostility to the extent that there was a customer base for cannabis products estimated at about 20,000, mostly in the Bay Area.

By the second half of 2003, an unexplained increase in the number of Californians with the required recommendations from “pot docs,” had fueled a corresponding increase in retail outlets openly selling cannabis products. That number has continued to grow, especially in the LA basin and previously pot free locales, despite organized campaigns by local law enforcement agencies against business licenses for “clubs” (now known as “dispensaries”) DEA raids (often with local police help) and- despite a Raich Decision in 2005 that has generated increased federal prosecution of growers and distributors despite their apparent compliance with state law.

Last week in LA, as counterpoint to the timid AMA endorsement emanating from Houston, an improbable and very public battle between LA's City Council and its District Attorney points up the political confusion that is still being generated by the notion Nixon summarily rejected over 37 years ago.

Despite the now-sustained interest in "marijuana" California's initiative is producing, two related questions are almost never asked by "experts" on both sides of the issue: just how big is pot's illegal market and why is "weed" still so popular after all these years?

Doctor Tom

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

November 19, 2009

Help from an Unexpected Quarter

Although it’s long been clear to me that genetics play an important role in human behavior, I hadn’t expected much help from that quarter because I regarded my investigation as an opportunistic chance to study drug use as a reflection of “nurture,” rather than “nature.” Wrong. An article by David Dobbs in this month’s Atlantic focuses on an easily recognizable sub-set of the population I’d also become involved with through their illegal self-medication with cannabinoids. To my surprise, I hadn’t finished the first paragraph before I could have supplied the names of at least two famously troubled children whose behavior had been indistinguishable from those Dobbs’ article is about: one for her controversial death at the age of four, the other from a detailed case report I’d first heard presented at a national meeting of cannabis reformers in 2004.

Although the initial focal point of his article is a celebrated researcher at the University of Leiden in the Netherlands, Dobbs makes clear that support for the controversial notion summarized by the catch phrase “orchid children” comes from many respected academics in several nations. The basic notion seems to be that gene variants already known to be associated with serotonin transport are not only associated with early development of problematic behavior in toddlers and pre-school children, but there is solid evidence that improving the way mothers deal with those children can modify their problematic behavior in positive ways. Beyond that, and even more exciting: the same heredity that impels similar troubled behavior, when properly nourished at home, may unlock expressions of unusual talent.

What my own work has suggested to me is that when vulnerable adolescents have been fortunate enough to begin self-medicating with a drug that, although illegal, allows them to control certain destructive impulses, a vulnerable few will blossom as “orchids,” while the majority who represent the more common (and hardy) “dandelions,” also benefit from the protection cannabis confers against excessive use of its two legal alternatives which, sadly, an ignorant policy still prefers.

Perhaps we can wake up in time to save ourselves.

Doctor Tom

Posted by tjeffo at 06:04 PM | Comments (0)

November 18, 2009

Different Responses To Similar Information

We live in a constantly changing world ; one in which taking things for granted can have disastrous consequences, as was dramatically demonstrated in Minneapolis on August 1, 2007 when a relatively modern bridge collapsed during rush hour, killing 13, injuring over fifty, and shutting down a vital traffic artery for 18 months. In the aftermath, it was revealed that the bridge, in company with many others that are routinely inspected at intervals, had been known to have serious problems for years, but for one reason or another, hadn’t been either retrofitted or replaced, a non-decision that implicitly assumed there would be time to do one or the other before a collapse. We also know there are many similar bridges in daily use. The term commonly used for such avoidance is “calculated risk.”

A different type of calculated risk is involved in the recommendation announced on Monday by the U. S. Preventive Services Task Force, an official- but little known government agency, recommended changing long-accepted guidelines for performing routine mammography, a decision that, when implemented, would affect not only a large number of women, but the reimbursement of large numbers of health care providers.

The response was predictably rapid and intense. Given my interest in another controversial Public Health issue, I can't help comparing the open "debate" over mammography, which is legal, to the non-debate that frustrates users of "medical marijuana" (cannabis) my study clearly shows to be treating themselves safely and effectively for conditions that are otherwise far more damaging to both them and society when treated with pot's legal alternatives: alcohol and tobacco.

In fact, given the amazing responses, in California and elsewhere, in terms of the gray markets created by medical cannabis laws, one could reasonably claim that the adverse Public Health consequences of keeping cannabis illegal may be much greater than is presently either realized or imagined.

Doctor Tom

Posted by tjeffo at 04:25 PM | Comments (0)

November 14, 2009

Credibility and Cognitive Dissonance; testing the limits

Over the past several months, even as officials in the Obama administration were announcing there would be fewer raids on cannabis dispensaries, the LA City Council was preparing to crack down on them; thus it appeared that the level of cognitive dissonance might, after thirteen years, finally be reaching a level that could not be sustained. In the background, the usual glut of conflicting claims and counterclaims could be found in the media and on the internet. However. I also remembered feeling the same degree of frustration on several other occasions, especially after starting to publicize the admittedly unexpected findings of a study of the applicant population to an obviously indifferent world.

I’m now glad I have discussed them here in a generally careful, (albeit tedious) style, because I understood, almost from the beginning, that objective and reasonably complete medical records might be my best defense if the Medical Board of California (MBC) should ever elect to punish me for "recommending" the use of marijuana on behalf of thousands of patients.

In that same connection, it’s long been clear that “pot docs” had little to fear from zealous DAs, or even from the DEA itself; our greatest threat has always been from California’s medical licensing authority. I had watched in horror in 2004 as the MBC persecuted (there is no other word) the late Dr. Tod Mikuriya and then twisted the knife by making him foot the bill for their grossly unfair “investigation.”

I'm also glad I had chosen to attend an MBC quarterly meeting in 2005 and formally provided them with timely notice of the study I had become engaged in, but hadn’t yet published in peer-reviewed literature.

To cut to the chase, a new regulatory watershed may just have been reached; first there were rumors that Hany Assad MD had lost his license; then, those rumors were confirmed on Friday evening, when a Google search turned up Fred Gardner’s meticulous description in CounterPunch. Just as important from my perspective, was the text of the actual decision posted on a spiteful, anonymous site mocking not only Assad, but other pot docs who had chosen to defend him and Dr. Alfonso Jimenez, a peripatetic Hawaii/San Diego osteopath recently unfrocked by the Board of Osteopathy. The same anonymous source posted a similar attempt to smear Dr David Bearman, a Santa Barbara physician who’d testified on Jimenez’s behalf and Phil Denney MD a veteran pot doc, the current president of Mikuriya’s old organization , and a witness for Assad.


Typical of many authoritarian abuses of bureaucratic power, the cases brought by the MBC against both Drs. Mikuriya and Assad relied on the unsupported judgment of professionally incompetent judges to define reality in ways that are clearly at odds with both Science and competent professional observation, in this case my findings, which weren't available in time for Mikuriya's defense and weren't cited in Assad's. Over the past four years, the study's findings have been published or cited in a variety of locations.

To summarize only the most important points: the charges brought against "pot docs" by the MBC were based on invalid assumptions mede by the MBC and accepted by thr physicians it was prosecuting. For example, the key issue in the "medical marijuana" controversy is arguably the safety and efficacy of an herbal remedy that had been rendered illegal by legislative fiat in 1937 and remained relatively unknown to the public for another thirty years before becoming explosively popular with youthful initiates in the mid-Sixties.

In an interesting parallel, the current medical gray market that began developing thirteen years ago under the aegis of California's disputed initiative, has grown erratically, but its product is now surprisingly popular for reasons that have yet to be either questioned or examined (except in this blog).

I now think the available records would provide me with a powerful defense should the MBC choose to "investigate" my practice as cannabis specialist/investigator recommending its use within the intention of the initiative, in a manner consistent with data accumulated under its protection, from the user population encouraged by the amnesty implied by its passage to provide it. I have been advising all applicants of what I've learned and urge them to manage their own use accordingly.

In Science, the proper response to unexpected new data is not to reject them out of hand, but to consider them in light of what had been known from earlier studies. Unfortunately, the historical record with respect to cannabis fails to reveal that any unbiased studies of its inhaled form were ever done prior to 1937, or in the wake of the CSA in 1970, despite a specific official recommendation to do so in 1972.

Doctor Tom

Posted by tjeffo at 06:58 PM | Comments (0)

November 12, 2009

Good News, Bad News

An item in yesterday’s LA Times caused me a bit of surprise; the good news was that the AMA finally saw fit to endorse reclassification of “marijuana” thirty years after a federal Administrative Law judge working for the DEA had formally declared pot to be both safe and effective (before being summarily overruled by his administrative superior). The bad news is that a careful reading of the whole article shows how far the AMA remains behind the reality curve by clinging to the notion that “recreational” use can be accurately differentiated from medical use through casual observation by the medically untrained, and by implication, that it warrants arrest.

It’s difficult to fault the AMA for that belief, however; my own acquaintance with the usual suspects listed as applauding their decision confirms that they all share both the AMA's poor judgment and the lack of clinical experience required to have arrived at it.

Ironically, in defending their recommendation, the AMA also invoked the prescient 1937 warning of Dr. William Woodward to the effect that future research might show that cannabis offers considerable medical benefits, thus the Congressional Committee then discussing a bill that would preclude such research should think twice before recommending it.

The official record shows that the good doctor was then scolded by the committee chairman for his impertinence.

Doctor Tom

Posted by tjeffo at 07:21 PM | Comments (0)

November 11, 2009

How Should a Victorious Candidate lose a War?

In recent weeks, several of the issues I’ve struggled with since starting this blog have come together in ways that are both new and internally consistent with the different view of human nature forced on me since I started treating cannabis applicants like patients and research subjects in 2001. For one thing, I’ve had to seek answers in several disparate disciplines, something that shouldn’t be surprising because the drugs we humans self-medicate with reflect the same cognitive conflicts driving all our behaviors. In that respect, my education, training, and past experience were very helpful in some areas and left me at a disadvantage in others.

Before considering those areas in detail, (and future entries) I’d like to advance one of the key concepts that just came into focus: whether he realizes it or not, our rookie President is now struggling with a problem faced by several other national leaders since the end of World War Two: how does one lose a war gracefully; especially when the enemy won’t agree to a cease fire?

Starting with Viet Nam, several solutions have been tried unsuccessfully; Lyndon Johnson turned his back on the Democratic nomination in 1968, thus giving Richard Nixon a close victory. Nixon compounded the losing war in Viet Nam by attempting to shift the onus of defeat to the corrupt regime we’d agreed to prop up under Eisenhower and continued supporting under Kennedy. Unfortunately, Nixon also opted to punish his political enemies with what has ballooned into a global “War on Drugs,” in which surrender is also unthinkable to those charged with "winning" it.

Currently, Obama is pondering his limited options in two other losing wars in which the risks were seriously underestimated and “victory” was not defined by those who started them, exactly the same problems faced by Eisenhower, Kennedy, Johnson, and Nixon in Viet Nam and Bush-Cheney in Iraq and Afghanistan.

Doctor Tom

Posted by tjeffo at 06:12 PM | Comments (0)

November 09, 2009

I Told You So...

Every once in a while, it's nice to savor a small triumph, especially when one has pretty good evidence their main message isn't being received as well as they had hoped. Such was the case yesterday when I learned that Obama's new drug czar couldn't explain when, let alone why, pot had became so popular, something I'd have thought any drug czar would know. Hoping to rub it in a bit, I searched the archives and quickly found an item I'd posted three years ago:

October 27, 2006

Children of the Sixties; behind pot’s appeal to youth...

Analysis of the interviews of California pot applicants I’ve been conducting over the past five years (and, hopefully, soon to be reported in detail) confirms that pot smoking, as a youthful phenomenon, is comparatively recent, one which didn’t begin on a large scale until the mid Sixties, when youthful baby boomers who had fallen under the influence of Fifties "Beat" writers began using it. What happened next (and largely out of sight) was the rapid  expansion of an illegal cottage industry until it had literally saturated most American high schools with marijuana, an event that took several years to become complete nationally. It was most overt from the start on both coasts, where pot was associated with several events that still resonate powerfully: Monterey Pop, the Haight Ashbury, the Summer of Love, Woodstock, Altamont, psychedelic drugs, Bill Graham’s Winterland & Fillmore East, and the Stonewall riots. In the Seventies came Kent State, the premature drug-related deaths of several Rock icons, and a somewhat muted spill-over of anti-war protests and social unrest from the Sixties.

The tumultuous era ended with Watergate.”

Even as I was completing that task, I came across an interesting reference to an article relating PTSD and cannabinoids that had been published in Time last week. It seems that the PTSD like behavior of rodents conditioned to fear the dark could be improved by a THC agonist injected directly into their brains. Wow! Imagine that! If only those researchers had read my blog of November 17, 2006, they'd have had clinical confirmation from a human study; Time (pun intended) to go back to the archives; all of which brings up another point about the the CSA: by arbitrarily defining certain drugs as too dangerous and habit forming to be permitted, the framers of the CSA were unwittingly creating a natural experiment with the potential to shed important light of human behavior years into the future.

Not only did Proposition 215 permit the unwarranted assumptions made about each drug by the framers of the CSA to be tested; they also made their central idea- that prohibition works- to be tested as well.

Doctor Tom

Posted by tjeffo at 11:38 PM | Comments (0)

November 08, 2009

A Revealing Interview with Obama’s Drug Czar

On Tuesday, November 3, Rebecca Roberts of NPR conducted a thirty-minute soft-ball interview of current drug czar, Gil Kerlikowske, on Talk of the Nation. Kerlikowske, who has maintained a far lower profile than John Walters, his stridently uninformed predecessor, revealed that he is just as ignorant of many key details of marijuana use; thus I wouldn't look for much change in current federal “prohibition lite” (fewer DEA raids). What will be most interesting in the near future will be the official excuses offered for those that are carried out (you can bet there will be some).

Roberts’ interview, despite her failure to ask several painfully obvious questions, wasn't altogether useless, precisely because her subject was so much more affable than John Walters would ever have been. Thus Kerlikowske unwittingly revealed what he doesn’t know rather than simply repeating tedious drug war propaganda everyone has learned to tune out. A quick example was provided by a call from a female listener ("Kris") about 25 minutes into the program.

From the transcript:ROBERTS: Let's hear from Kris(ph) in Lincolnton, Georgia. Kris, welcome to TALK OF THE NATION. KRIS (Caller): Thank you. I was wondering - I'm 62 years old, and when I was in high school, I didn't even know what marijuana was. And I'm wondering why is it so rampant now, and it never used to be?

ROBERTS: You're listening to TALK OF THE NATION from NPR News.

Mr. KERLIKOWSKE: Well, I wish I had a good answer for that, Rachel. I am - I actually just about two years younger than you are, and so I'm afraid I would put myself in exactly the same mindset. But I think that marijuana is popularized on television shows. It is popularized in media. There is only one antidrug media message out there, and that's the one that the Office of the National Drug Control Policy actually funds, and that - the antidrug.com. There's an awful lot of information about drugs, and it's put forward in a very matter-of-fact and straightforward way that's very helpful to people. So I would tell you that there's more information available there.

My analysis: this is right in line with what I've come to recognize as the Generational Ignorance to which all humans seem prone: we tend to be blind to the social conditions that existed as few as fifteen years before we were born, primarily because our childhood memories are far more emotional than intellectual. Abstract thought doesn't begin in most children until around the age of twelve and is usually focused on local conditions in school and at home at first, although that may vary considerably, depending on intelligence and many other complex variables. In any event, both Kris and Kerlikowske were leading edge Baby Boomers who came of age in the early Sixties when pot first began appearing in American High Schools. I've consistently encountered the same ignorance among the pot smokers I've been interviewing for past eight years. When I tell them there was NO POT in American High Schools during my high school days ('45- '49). In fact, appreciation of that generational ignorance is key to any understanding of the genesis of today's enormous pot market; beyond that, the appeal pot had for boomer teens is critical to understanding its sudden surge in popularity from 1966 on, a surge that was clearly badly missed by the First Nixon Administration as it was hastily rewriting our drug laws without any scientific or medical inpupt at exactly the same time.

Since I know from painful experience that a number of "reform" luninaries share the same ignorance, I shouldn't be surprised when the drug czar admits he's just as ignorant of essential reality as the leadership of NORML and MPP (and, I suspect, as the Gang of Four, who are all of similar age).

Doctor Tom

Posted by tjeffo at 07:43 PM | Comments (0)

November 06, 2009

American Drug Policy; what ever happened to Skepticism?

I’ve long subscribed to Scientific American and often read its monthly columns, not because I necessarily agree with the columnists, but because they often make me think. One such is Michael Shermer, an academic from Southern California whose column is known simply as Skeptic. Shermer has literally made a career of skepticism, not only has he written extensively about it, he's also founded an organization dedicated to it, and publishes a magazine focused on it.

I recently caught up with his July column, and became intrigued with the esoteric concept of the Null Hypothesis, which, upon first reading, seemed to have some promise as a model for what had become a personal holy grail: the perfect argument for dispatching the drug policy monster once and for all in a way that would leave little doubt about its fundamentally evil and irrational nature.

After considerable time spent going back and forth between various Null Hypothesis explanations summoned by Google, I realized that holy grail, if it exists at all, is still out there waiting to be discovered and that Michael Shermer will probably always have work trying to explain the nature of truth to skeptics of all stripes.

On the other hand, the short essays I'd just posted do reveal how deeply rooted our drug policy is in two deceptive laws which, when taken together, reveal how faithfully it reflects the ambient ignorance of two bygone eras. That raises an important question: how could such limited views of drug use and addiction have remained almost unchanged over so long an interval?

The answer is that drug policy "science" was easily discouraged during the Anslinger era when Pharmacology was relatively primitive. Following Harry's departure, it was replaced by Nixon's CSA, which gave rise to two in-house agencies, the DEA and NIDA, that have protected their policy from scrutiny far more successfully than their policy has protected civilization from the evils of the global criminal drug markets it has sponsored.

In that respect, they have been aided to no small degree by an essential human weakness: that of denial. I expect that over the next few days we will see plenty of denial as our government and news agencies attempt to minimize and confine the obvious PTSD that is now afflicting an increasing percentage of our military, which, in turn, is being assiduously drug tested to detect the agent my study has revealed to be most effective in treating it.

Doctor Tom

Posted by tjeffo at 05:43 AM | Comments (0)

November 02, 2009

A Belated Assertion of Priority

Several recent entries reviewed the creation of federal marijuana prohibition (a.k.a. the Marijuana Tax Act of 1937) out of whole cloth via a deceptive transfer tax, the same mechanism that had been used 23 years earlier to launch its equally dishonest prototype, the Harrison Narcotic Act. Fifteen years after passage of the MTA, when Harry Anslinger, the man most responsible for that abomination, was approaching senility, he was allowed to end his career as the first-ever UN High Commissioner of Narcotics; thus his never-validated slander of a useful plant suddenly became (and remains today) global policy by default. In the same vein, the Supreme Court’s 1969 invalidation of Timothy Leary’s 1965 pot conviction proved another bit of execrable timing because it provided the Nixon Administration with an excuse to rewrite existing drug laws and thus arrogate enormous additional powers to the policy. Beyond the highly fanciful reasons used to justify Schedule One, the CSA’s inclusion of cannabis and several other potentially useful agents like LSD on the same list has blocked any study of them as therapeutic agents. Even worse, the CSA provided a simplified mechanism by which a scientific ignoramus like the average Attorney General (think John Ashcroft or his successor) is free to add additional agents to Schedule One without any need for legislative, let alone scientific, approval.

Ironically, just as ratification of the Single Convention treaty was taking place in the mid-Sixties, American and British baby boomers were discovering the unique appeal of “reefer” as an inhaled anxiolytic, a phenomenon that would not be identified and documented by my clinical research for another thirty years. Finally, and perhaps most ironic from my point of view: Nixon’s rejection of any study of pot’s medical potential, as recommended by his own select committee in 1972, meant that my opportunistic study of pot use by Proposition 215 applicants in California would become the first such study ever published in "peer-reviewed" literature.

Doctor Tom

Posted by tjeffo at 04:21 PM | Comments (0)

October 31, 2009

Some Different Perspectives on a Failing Policy

The most recent entry recounted how the fanciful, scientifically ridiculous assertions of a medically uneducated bureaucrat named Harry Anslinger became the Marijuana Tax Act in 1937; also how, following World War Two, the same law essentially became global policy after he was named the first UN Commissioner of Narcotics. Ironically; in 1969, after the Supreme Court ruled that the MTA was unconstitutional for reasons completely unrelated to its scientific shortcomings, it was rewritten as the CSA, thus endowing it with far more sweeping powers.

Even more ironically, ever since an inattentive press allowed President Nixon to bury the unexpected recommendation of his own special committee to study pot's potential medical benefits in March 1972, drug war apologists have routinely cited the completely unsubstantiated Congressional "Findings and Declarations", originally intended only to claim the new Constitutional basis required by the CSA, as absolutely inviolable reasons why there could be no revision of what has always been a failing policy of dubious Constitutional legitimacy.

As is now also painfully obvious: thirteen years after California’s medical marijuana law passed easily despite the protests of the federal government, there has been no diminution in stubborn federal opposition to voter intent. Despite recent conflicting signals from the Obama Administration, DEA raids have continued, albeit at a reduced rate, while the Agency's supporters have continued to urge their continuation. Almost a full year since his election, as President Obama's Administration struggles with Health Care reform, it will almost certainly remain refractory to any serious consideration of cannabis legalization; nor is it possible to imagine any Congressional retreat from our war on drugs in the near future.

That is particularly unfortunate because our study suggests that in a more rational environment, legal cannabis might be a big winner. Despite its undeniable limitations as a criminal or gray market product, pot has been consistently safe and effective in treating the anxiety disorders and related symptoms of its chronic users, while clearly reducing both their medical costs and the damage done to to their health by alcohol, tobacco, and other illegal drugs; benefits that have been unrecognized for years.

The possibility that legalization could enhance those effects while conserving much of the tax money now wasted on enforcement and incarceration, is nothing short of mind-boggling, not to mention the additional possibility of converting what are now criminal receipts into legitimate profits and tax revenues.

Unfortunately, the most basic requirement of an "evidence-based policy" is a willingness to look at the available evidence, rather than rejecting it out of hand, simply because it isn't consistent with the ad-hoc assertions of a failing policy that has always been based on ideology and false assumptions.

There is a glimmer of hope: hearings are being conducted in Sacramento, but the problem at the state level is that most of the reform organizations with a seat at the table are backing federal policy by agreeing that legal use should be restricted to those over 21. Perhaps the only finding solidly established by federally sponsored research over the past thirty-four years is that kids begin trying drugs in Junior High School and most adults will have tried all the drugs they will ever use well before the age of twenty-five.

Finally, the ability of California's pot smokers to support the impressive growth of their gray market has been well demonstrated. Remembering that at least half of all Americans born since the Baby Boom have been trying pot during adolescence, do we have an accurate idea of how many are still using it?

Doctor Tom

Posted by tjeffo at 11:30 AM | Comments (0)

October 25, 2009

Pot Prohibition’s Ultimate Absurdity

On several occasions, this blog has asked the same rhetorical question: how could a policy as ludicrous and destructive as marijuana prohibition have been endorsed by the whole world? The answer turns out to be critically important, embarrassing, and even more absurd than the policy itself.

In 1937, the “reefer madness” fantasy of a single uneducated bureaucrat named Harry Jacob Anslinger, with a big assist from the Hearst Newspaper chain, became the basis of a deceptive tax law that had the net effect of subjecting all the products of the hemp plant to criminal prohibition. The excuse used to justify that legislative sleight-of-hand was both highly imaginative and totally bereft of pharmacological validation, even by the comparatively primitive standards of 1937. Most notably missing was any clinical research on the effects of either inhaled or orally ingested cannabis on humans; nor were there any economic or demographic data on the use of what was then a legal product listed in the US Pharmacopeia.

The subsequent history of the Marijuana Tax Act and the drug war it eventually gave rise to is that neither was ever subjected to any more official scrutiny than the MTA received in 1937. Thus, billions of words of empty rhetoric, millions of felony arrests, and thousands (perhaps hundreds of thousands) of avoidable deaths are traceable to Anslinger's imagination and Hearst's propaganda, as they have been interpreted and enforced by the US Federal Government over the next seventy two years.

Following passage of the MTA in 1937, several states were persuaded to pass matching legislation, most notably in the South, where excessive penalties for illegal drug possession became legendary, especially in the case of minorities. Nevertheless, overall "marijuana" arrests remained so infrequent that no statistics were kept, a situation that persisted beyond Anslinger's retirement in the early Sixties, just after JFK's election. He was next appointed the first UN High Commissioner of "Narcotics," a position from which he promoted the Single Convention Treaty, which, upon ratification, had the effect of making his deceptive MTA, still bereft of clinical and pharmacological support, the basis of a policy binding on all UN member nations.

But the travesty didn't end there; indeed, the worst was yet to come: the election of Richard Nixon, a calamitous event, inspired at least partially by adult fears provoked by a youthful, cannabis-influenced Counterculture.

In the mid Sixties, what had started as a flurry of interest provoked by a literary genre critical of US culture and publicly extolling use of marijuana and several new psychedelic agents, resonated enough with the first Baby Boomers to encourage many of them to try marijuana. In 1965, Timothy Leary, an associate of many Beat authors, was arrested for marijuana possession at the Mexican Border and sentenced to 30 years in prison, a verdict that was finally overturned by the Supreme Court, which declared the MTA unconstitutional; not for lack of scientific validity, but because it required self-incrimination. The almost immediate response of the Nixon Administration and Congress was the Controlled Substances Act of 1970, essentially rolling all existing drug prohibitions into a single omnibus package; still without benefit of any research that would support its multiple erroneous assertions.

Even as the CSA was setting the stage for what would soon become infamous as the War on Drugs, a long overdue and non-binding review of 1972 evidence, by a committee Nixon himself had appointed, reported that cannabis possessed enough therapeutic potential to be decriminalized so as to permit appropriate medical studies. Once again, fate intervened when Nixon personally buried their report immediately after its release in March,1972, an event hardly noticed (and never protested) by the same "mainstream" press that would hound him from office two years later.

The MTA's lack of justification is now painfully obvious; Anslinger's faith in the power of arrest to "control" illegal drugs was never really tested until after the explosion in drug use that characterized the youthful Counterculture. By that time, so much political capital and administrative infrastructure had been invested in the belief that prohibition is a viable policy that admitting its failure is the last thing those responsible for it are likely to do without considerable external pressure.

One thing that might help get the ball rolling would be if the Gang of Four were to be challenged to modify their positions by a few well-known citizens with impeccable reputations for integrity.

Doctor Tom

Posted by tjeffo at 05:00 PM | Comments (0)

The Drug War and Academe

Last week’s discovery that the clinically ignorant representative of a brand new academic discipline would be given an authoritative voice in a forum on the medical use of cannabis was a reminder that the leading academics of drug policy are also bereft of clinical experience; yet they exert an important influence by protecting the policy against exposure of its many failures. Although few in number and relatively unknown to the general public, they are based at reputable universities and have become critical to the policy's survival.

In fact, the drug war probably could not tolerate honest scrutiny of even a third of its failures were it not for the cover provided by key respected academics I've come to think of as the drug war's loyal "Gang of Four."

All have published extensively, often in collaboration, and are accorded considerable respect within the academic community: Mark Kleiman of UCLA, Peter Reuter of Maryland, Jonathan Caulkins of Carnegie Mellon, and Rob MacCoun of UC Berkeley. Their considerable influence is dependent on their skillful use of rhetoric which allows them to sound sincere and reasonable while carefully avoiding the criticism appropriate for a policy of perennial failure, avoid evaluation by reasonable standards. refuses to allow its victims to be studied objectively. Instead, their possession of forbidden agents (drugs of abuse) automatically labels them mentally ill, criminals, or worse.

The Gang typically also cites the unreliability of data from criminal markets but never admits the obvious: that the markets were created by the policy and corrupts all market participants. beyond that, by generating excessive profits, the illegal markets eventually ensnare law enforcement and other government agencies. This reticence to criticize drug policy, has preserved it as the federal default since Nixon (four decades) and rendered any admission the policy may have been mistaken almost impossible. In that sense, it's path dependence in action; the world's default is r\that whatever its flaws, the drug war is on a par with the global economy: too important to fail.

That the hard evidence behind my contrary assertions is unique can't be denied; however that it's been collected from admitted drug users makes it vulnerable, also that it contradicts long-held beliefs that have been tacitly endorsed by highly esteemed policy "experts" doesn't help.

Also the fact that applicant demographics and initiation ages, provide a historical context for the expansion of a small criminal market that suddenly began to expand rapidly in the mid Sixties is data that can't be denied and has always been conspicuously absent from official accounts.

Of course, that will be met with claims that my data isn't representative of the whole criminal market, calim with which I have to agree. In fact, I suspect if that market could be measured, it might prove bigger than the feds have ever realized; or would dare to admit.

Doctor Tom

Posted by tjeffo at 12:49 AM | Comments (0)

October 21, 2009

A Dishonest Forum

in conjunction with the spate of interest in “Medical Marijuana” generated by the Justice Department’s Sunday memo on pot raids, KQED, the Bay Area's NPR station devoted the first hour of Tuesday's Forum to the issue. I wish I could report it was enlightening or helpful, but it was just the opposite. I happened to be on my way to Oakland for a clinic and became so distressed after listening for a few minutes that I had to turn off the radio and wait to download the broadcast for more leisurely (and safer) listening.

That demonstrated the panel to be remarkably unqualified; its participants were long on uninformed opinions, but short on actual experience, clinical or otherwise. It was bad enough that a former federal prosecutor and a current police chief were given an opportunity to assert non-existent clinical expertise, but the people who were apparently supposed to balance them were timid and uninformed.

Worst of all, however, was the self appointed "medical" expert, a USC professor in a new and highly suspect discipline who quickly demonstrated that he is just as bereft of pharmaceutical and economic knowledge as he is of intellectual honesty.

That he could compare cannabis to both alcohol and tobacco and claim it is equally dangerous is simply wrong; beyond that, my study of California applicants published two years ago, shows that pot initiates consistently exhibit sharply reduced use of both once their use of cannabis becomes chronic. Dogmatic assertions contrary to published evidence do not deserve much respect, especially when made by an industry shill on behalf of the most lucrative products of the most inflationary segment of the Health Care Industry.

A good case could be made that chronic marijuana use has been a potent force in reducing health care expenses and might be even more helpful to Public Health if the unjustifiable witch hunt against it were to be replaced with a more rational and evidence-based policy.

Doctor Tom

Posted by tjeffo at 10:25 PM | Comments (0)

October 19, 2009

Pot In The News

In a late-breaking item on Sunday,the AP reported that unnamed Justice Department officials had announced the Obama Administration would clarify its guidelines on the DEA’s controversial practice of raiding California marijuana dispensaries. As usual, the story listed all the states with medical marijuana laws without explaining why California has been the only one to experience such raids. As someone who has been following the medical marijuana issue since California's initiative made the ballot in 1996, I've learned to take all such claims with a large grain of salt.

Yesterday, even as the AP story was being aired prominently on NPR in the Bay Area , a trusted source e-mailed the actual text of the "official" Justice Department announcement; it emphasized that the CSA is the law of the land and that certain conditions would be sure to trigger "DEA interest." Among them was "sales to minors."

The rat I smelled on Sunday was suddenly a lot more noticeable.

Meanwhile, the detailed Newsweek account of a 2007 DEA raid on someone I'd come to know when he operated a dispensary in San Francisco in 2002 confirmed what I'd come to suspect from various sources: both the DEA and local cops use such raids as opportunities to trash the premises while plundering them. A fraction of seized money may be returned, but the illegal product never is. The victims are usually so happy to escape formal charges that they don't make too much of a fuss and often resume selling, even as they realize that they may be targeted for another official robbery in the future.

Doctor Tom

Posted by tjeffo at 04:11 PM | Comments (0)

October 18, 2009

Continuing Border Woes Confirm Illegal Market is Huge

In September 1958, I began what would become five years of military service in El Paso as a dispensary officer at Fot Bliss, formerly the Army’s anti-aircraft artillery school; then transitioning into anti-aircraft missile systems. After an interesting year at Bliss, I moved across the highway to William Beaumont General Hospital for four years of training in General Surgery, my original goal in joining the Army in the first place. After completing the residency in September ‘63, I left El Paso for Japan. Although I haven’t been back to the Border, my pre-drug war memories are of peaceful cities on opposite sides of the Rio Grande. Both were safe at night; although parts of Juarez were honky-tonkish and could be less so for the belligerently intoxicated, they were generally OK for everyone else. That’s why lurid reports of extreme violence associated with the drug trade are, for me, utterly convincing evidence that American drug policy is contemptibly stupid.

That the commodity now generating the most income (thus the most violence) is low grade Mexican weed (“bammer”) is astounding, but should convince anyone with a bit of analytical ability and a modicum of intellectual honesty that America’s illegal marijuana market has become enormous; exactly what one would predict after half of all high school kids have been trying it since the early Seventies, particularly if a substantial fraction of the initiates had remained loyal consumers.

In fact, from the standpoint of a rational public policy, it shouldn't make much difference whether their chronic use is considered "recreational" or "medical," so long as smoking it was demonstrably less risky than cigarettes (and particularly if chronic users reduced their consumption of both cigarettes and alcohol).

What it all adds up to is an illegal pot market far larger than policy wonks dare to admit. If pot remanis illegal, its market should continue growing until the oldest Boomers are about 80 before stabilizing. For me, the only uncertainty is how long current pretenses can be maintained; in other words, how much longer can such a failing, lame-brain policy be taken seriously?

Doctor Tom

Posted by tjeffo at 06:58 PM | Comments (0)

October 16, 2009

Lessons Learned: Historical Context

Any serious attempt to evaluate the impact of America’s “War on Drugs” on the world at large should begin with an appreciation of the depth and complexity of our drug policy’s dishonest federal roots and the degree to which all three branches of American government have been cooperating for nearly a century to shield it from objective scrutiny. That statement isn’t intended as an allegation of conspiracy; rather it's an invitation to think seriously about how substance prohibition, a policy with an unbroken record of failure, both here and abroad, remains the global standard for dealing with the "drug problem."

The policy’s original key assertion— that federal agents should be empowered to arrest physicians for the way they were prescribing certain pharmaceuticals— was affirmed by a medically ignorant Supreme Court in the course of interpreting the deceptive 1914 Harrison Narcotic Act at a time when the science of Pharmacology was still in its infancy and there had been very little clinical experience with “addiction.” Harrison was passed in December 1914, the same year lurid special editions on heroin and cocaine had been published in the New York Times ten months earlier. Finally, the federal agents arresting physicians under the new law often didn’t bother to distinguish between those trying to treat "addicts" and those simply profiting from them; thus the new policy had an immediate and chilling effect on legitimate research while giving credence to the false, but resilient belief that addiction is a “disease” for which patients bear criminal responsibility. In a real sense, the underlying injustice has only intensified over the intervening ninety years as a failing and irrational policy has evolved into a major cause of felony arrest that has brcome responsible for increasing human misery every year it is in effect.

Over that same interval, the police powers awarded under Harrison have been increased several times in the absence of any relevant pharmacological or clinical research that would justify their expense or collateral damage. Heavily armed SWAT teams now routinely conduct raids on medical marijuana dispensaries in California while non-medical federal agencies pretend to an expertise on human drug use, a practice already evident when the first director of the FBN attempted to discredit an academic for criticizing his agency's tactics. The FBN's successor agency was later empowered (under the CSA) to block scientific studies of specific drugs; ironically because they were illegal and thus any use for research had been placed under the agency's sole control!

The adverse impact of a failing policy worsened significantly after the largest generation in history began coming of age in the mid-Sixties. As they discovered several newly available psychedelics and acquired a taste for “reefer,” their drug use and other disaffected behaviors frightened their parents into electing a feckless president for whom intensification of America’s policy of criminal prohibition made perfect sense; as may be inferred from his misplaced confidence in Operation Intercept in September, 1969.

Even after his own commission recommended a different approach in the Spring of 1972, Nixon buried their report and proceeded with his drug war. Unfortunately, the ensuing surge in pot arrests was all American police needed to become avid supporters of the intensified policy. A decade later, increased Congressional and public support "just say no" stimulated by a crack "epidemic" helped push our scientifically flabby "Behavioral" Sciences into an orgy of complicit guilt-by-association research in support of the never-validated Gateway theory. In many respects, Gateway became for cannabis prohibition what Eugenics theory had been to Nazi racial doctrine: superficially plausible, but terribly misleading.

The grotesque failure of the "War on Drugs" is certainly not the only such example of collective human cruelty and dishonesty; but it is a convenient example of several of our species' key failings. Ironically, the pattern established since our discovery of the cornucopia of wealth enabled by Science has been one of even more repressive control of their greatly expanded populations by fiercely competitive national governments.

The outcome of the Disaster Movie we are now living through will depend on how quickly well we are able to recognize the problems we have created for ourselves and how efficiently we can deal with them.

Doctor Tom

Posted by tjeffo at 02:04 AM | Comments (0)

October 12, 2009

Lessons Learned in 8 Years as a Pot Doc

What I’ve been privileged to learn from pot smokers has been both fascinating and troubling; this is the beginning of what I hope to continue as a (more or less) organized report.

After starting to screen Prop 215 applicants in 2001, the first thing I realized was that I didn’t have a clear idea of what to ask them. I was so naive that I was even surprised none of them were cannabis naive and thus began asking them when they first tried it, etc. It wasn’t too long before I also became curious about their experience with alcohol and tobacco, and later with other drugs.

The pattern that began emerging after about 4 months convinced me to organize a study by developing a menu of questions and spend more time on each interview. That led the club owner to recruit more MDs. I can say unequivocally that he supported everything I did and didn’t protest my reduced output.

In any event, information provided by all patients seen between July and December 2002 was later presented at the 2004 Patients Out of Time Meeting in Charlottesville, VA in May 2004 and eventually reported in a local Bay Area journal devoted to Proposition 215. It was at the Charlottesville meeting meeting that the strong hints of unhappiness with my work that originally surfaced in e-mail discussions became unequivocal. Nothing overt was said, but the signs were as unmistakable as the current absence of any mention of my participation from the P.O.T. website.

As the study continued, it became increasingly clear that my pot doc colleagues were resistant to incorporating similar questions in their histories, a reluctance that continues to this day. They also wouldn’t (and still won’t) engage in discussions of possible self-medication for psychotropic symptoms. I am so offended by that denial that I now avoid their company whenever possible. It was sometime around the end of 2004 that I decided to separate myself from the “movement” and simply do my own research. Somewhat ironically, it was also then that some funding became available for the creation of a database dedicated to the study. Peer-reviewed publication (November 2007) would have been impossible without the database. Equally ironically, its almost unavoidable presence on Pubmed searches involving “marijuana” made its prolonged omission from related reports all the more noticeable; however, I'm now in a position to report that the discussions I'd hoped to provoke are finally beginning to appear.

Managing a large ongoing study in a setting of professional isolation and without funding has been daunting, but it has also provided me with my biggest challenge: understanding the uncanny degree to which recognition of the obvious psychological benefits of inhaled cannabinoids was avoided by just about everyone writing on the subject. As of this writing, that avoidance finally appears to be waning, a development that should please the twenty or so patients I have contact with each week who continue to confirm that inhaled cannabis, despite the limitations imposed by its illegality, is so safe and effective they prefer it over heavily advertised pharmaceuticals.

Doctor Tom

Posted by tjeffo at 04:58 PM | Comments (0)

How I Became a Pot Doc

As mentioned previously, I hadn't learned anything about cannabis during my Forties high school daze because the tiny pot market then in existence was for "hip" insiders and almost completely invisible to straight adolescents. Thus to understand how I would find myself screening pot smokers at an Oakland cannabis club in 2001, one has to start with my reasons for despising the drug war: first, its interference with pain relief for surgical patients, and second, I simply couldn’t understand how a government that had been forced to abandon alcohol prohibition in the Thirties because of its failures could remain blind to the failures of its drug war for exactly the same reasons. In short,it was a growing disgust with the intellectual dishonesty of American drug policy that eventually led me to discover its nearly invisible political opposition in 1995. By pure chance I was then living in the Bay Area and the unexpected passage of Proposition 215 was about to create, albeit in slow motion, a huge new gray market for marijuana, two additional developments no one could have predicted in 1995.

As I became more seasoned in the “movement,” I quickly learned that a majority of my fellow activists were pot smokers; that was because its redolent odor filled hotel corridors at every national meeting I ever attended. Even so, I had no way of knowing then that they were really self-medicating in the same fashion as the Prop 215 applicants I would begin interviewing in November, 2001.

I now also realize how irritating my profiles of pot use must have seemed to most of those same activists; here I was, someone they knew to be a novice, suddenly telling them things they didn’t want to hear (and considered unflattering) about an activity they'd long been engaged in. An e-mail from one summed it up neatly: “when I read your stuff, I feel like someone is holding a mirror up to my face-- and I don’t like it.”

One phase of my early policy explorations me led to a small, elite coterie of drug policy academics at leading universities, often in prestigious schools of ”Public Policy.” I soon realized they provided critical intellectual cover for the policy I'd come to despise. Obviously very smart and committed to (at least) an appearance of neutrality, they always took extreme care in their writings to avoid outright condemnation of certain critical items of drug war dogma, the most important of which is the idea that illegal drugs are "bad” because of "addiction." A critical, but unspoken, corollary is that drug control is a moral imperative; thus designated drugs of abuse must be controlled to the extent possible.

I realized through that early scrutiny of a policy I hadn’t ever paid enough attention to, that their academic standing was providing important cover for the drug war; also that refuting them would not be easy, if for no other reason than “science,” as it pertains to illegal drugs, has always been tightly controlled by the policy’s official minders.

In that connection, there have been two important historical eras of federal "control" (the word "prohibition" is never used). The first was dominated by Harry Anslinger, the first director of the Federal Bureau of Narcotics, appointed as its first Director by Herbert Hoover in 1930 and ruled by him with an iron hand until he was forced into retirement by JFK in 1962 for reasons that remain uncertain. The obvious comparison is between Anslinger and J. Edgar Hoover who not only ruled a rival federal police agency for a longer interval during the same era (1935-1972), but died in harness.

To get back to Anslinger, he was such an obvious fraud and so unscrupulous in protecting both his agency and its contrived mandate that no serious biography has ever been written, a shortcoming I have attributed to the difficulty of doing so and still presenting his policy in a positive light. In that connection, it is important to remember that most UN member nations maintain agencies like the FBI and CIA, but because the concept that drug prohibition must be a global mandate was so obviously Anslinger's, our American fingerprints would be all over its failures, were they ever to be publicly acknowledged.

Doctor Tom

Posted by tjeffo at 04:51 AM | Comments (0)

October 09, 2009

Age of Anxiety

We live in times best described as paradoxical: never before has our species been more numerous or knowledgeable about its extended environment, yet never before has its future seemed more bleak. We remain at each others’ throats in the same murderous ways as our first powerful civilizations thousands of years ago, yet we are armed with high tech weaponry of unimagined destructive capacity. Even so, our scientists are discovering a cascade of new, uncontrollable forces that have been lurking within our home planet and its solar environment for millions of years, any one of which could render the most powerful weapons in modern arsenals puny by comparison.

Although we are historically loathe to blame ourselves for our predicaments, any search for a culprit in our present problems must ultimately lead directly to the age-old question of “free will.” To what extent are we humans responsible for our own problems? The corollary is, of course, what can be done about them? Underlying those questions are two more: are those claiming to have answers sincere? Do they even know what they're talking about?

For the past several years I've been privileged to study a population characterized by their use of a complex herbal remedy in an often unwitting attempt to deal with the same existential uncertainties. That it provides them with benefits far superior to those claimed for their products by our Pharmaceutical Industry, and that the official formulations of US policy on the same issues are nonsense, should be as apparent to most knowledgeable observers as their own craven reluctance to say so.

My apparent temerity is inspired by the degree to which those tacitly supporting US drug policy are unwilling to acknowledge reality. A good example can be found in the recent publication that I hope to tackle in the next entry.

Doctor Tom

Posted by tjeffo at 02:43 PM | Comments (0)

October 04, 2009

Human History as a Disaster Movie

Because it permits us to consider a wide range of possibilities, language has become a critical component of human cognition and behavior. When we compare ourselves to social insects like bees, their cooperative division of the hive's chores into separate tasks is mediated neuro-chemically by pheromones. Unlike the automatic, unquestioning response of drones, human workers use their brains to consider working conditions and a variety of other factors before agreeing to perform repetitive tasks on a schedule. Even so, the highly variable interpretation of similar evidence by individual humans is such that all modern societies must have extensive mechanisms for resolution of the labor disputes and myriad other civil conflicts that characterize our behavior.

Human history and its study both originated with the first writing systems. It's now well accepted that we are a single species that originated in Africa and were then widely distributed in a series of migrations that occurred before the last Ice Age. It's thus quite likely that most of the physical characteristics exhibited by different “races” were adaptations to the variety of climates the survivors of those original migrations have had to contend with over the intervening millennia.

Only after empirical Science gave us the tools to do so, have we been able to add significantly to our knowledge of pre-literate humans. The physical and biological sciences have allowed us to study and hypothesize about the evolution of our planet, its solar system, and the universe itself, but because a multitude of religious beliefs had already developed from pre-literate myths based on what appears to be a universal human curiosity about our origins and purpose, the most recent scientific theories are only incompletely accepted by the political and religious interests that have retained control of the "civilized" world since Galileo's early Seventeenth Century challenge to Pope Urban VIII.

The above reference to a "disaster movie," although intended as provocative, is also accurate; particularly as it relates to events since the Industrial Revolution that began about the time 13 British colonies rebelled against the world's dominant power. Their subsequent exploitation of North America has since allowed US population to grow relatively faster than the rest of the world, thus outstripping (for the moment) all other nations in both wealth and military power, even as we forget that the rest of the world is also growing.

At the same time, it was only recently that enough was learned about the 1815 eruption of Mt. Tambora to understand the much greater disaster it would have caused a century or two later. Nor is much concern expressed over the fact that global population growth since 1800 has locked us into a host of similar potential problems, or that our narrow escapes from comparable phenomena suggest such events are neither rare, nor avoidable.

That very lack of concern raises key questions: Is human denial a basic evolutionary flaw? If so, what can be done about it?

Only in the movies are looming disasters inevitably avoided at the last minute. Banking on either divine intervention or some unknown deity's final judgment to deal with the statistical certainty of eventual human catastrophes seems indefensible to this observer.

That's particularly so since I've come to understand that cannabis prohibition has been following a similar course as it has progressed from a set of unproven assumptions into a full scale social catastrophe, one still largely unrecognized by the world at large.

Doctor Tom

Posted by tjeffo at 05:19 PM | Comments (0)

September 28, 2009

Another Take on Legalization

Willie Brown was a poor black youngster in rural Texas before he came to live with an uncle in San Francisco in the early Fifties so he could go to college. Working his way through school, he soon earned a BA from San Francisco State and a law degree from Berkeley. Entering politics, he went on to become one of the most influential members of California's Assembly, which he led as Speaker for a record fifteen years. He was next elected as San Francisco's first black mayor just in time to guide the City to dot com prosperity while gaining national prominence for his charisma and political savvy. He's also had his share of criticism for questionable deals and controversial decisions. Now in his mid seventies, he’s a widely read columnist who is not shy about offering opinions on key issues.

He’s also just become the latest (in Sunday’s paper) to weigh in on pot legalization. While it takes courage to disagree with Willie on a political issue in California, I thinks he’s wrong for the vexing reason of juvenile use. Since the most troubled “kids” start trying pot as early as twelve; arresting them nearly 10 years short of an arbitrary limit is simply irrational, yet so long as the age of 21 is enshrined in federal law, you can count on the current bureaucracy to defend it to the death and Congress to go along.

Thus I think it will take some additional factor before Congress is finally persuaded to second guess its tragic four decade blunder.

Doctor Tom

Posted by tjeffo at 02:35 PM | Comments (0)

September 27, 2009

More on Legalization

The theme of the just-concluded 38th annual NORML Convention in San Francisco was “Yes, we cannabis,” clearly expressing the hope our embattled new chief executive will somehow find the time and political capital to support pot “legalization” between bruising battles over medical care, our economic woes, and worsening problems in Afghanistan.

On Friday evening, I was a guest at a private dinner traditionally hosted by a wealthy reform supporter; thus I had a few minutes to sound the same cautionary note as in the last blog entry: don't assume the economic strength of the medical gray market is tantamount to political support for legalization. I could tell it wasn’t that well received by all, but felt obligated to deliver it anyway.

Ironically, the same message was delivered by a local columnist in yesterday’s SF Chronicle, but for different reasons. He also considers conferee enthusiasm misplaced and unrealistic; not for lack of support from Washington, but from Fresno. While I may decry the reasons, there’s no denying he's right. As long as "recreational” pot use by adolescents is feared by the general public, they won’t support its “legalization.”

In other words, they have to understand that their offspring are at least as likely to try drugs during adolescence as they were themselves. The unlikely truth, still distorted by forty years of federal propaganda, is that of all the drugs adolescents might try, cannabis is clearly the safest; especially in comparison with the two that are legal: booze and cigarettes.

Doctor Tom

Posted by tjeffo at 01:40 PM | Comments (0)

September 25, 2009

Painted into a Corner?

Since passage of the Marijuana Tax Act in 1937, the American Federal Government has referred exclusively to the herbal remedy then known medically as cannabis and agriculturally as hemp, by the pejorative slang term, “marijuana” in all official documents. That practice has been followed so uniformly it’s now observed not only by supporters of cannabis prohibition, but also an overwhelming majority of those claiming to be neutral, and even a majority of the policy's bitter opponents.

The policy itself, still supported as ardently as ever by our federal bureaucracy, is now being implemented under the 13th presidential administration elected since the MTA became law on October 1, 1937. When its Constitutionality was threatened on Fifth Amendment grounds in 1969, the policy was immediately rewritten by the Nixon Administration in more punitive form as the Controlled Substances Act of 1970. Once signed by Nixon, the CSA also became global drug policy retroactively through an international UN treaty promulgated nine years earlier by none other than Harry Anslinger, the troll-like sponsor of the original MTA.

Since 1996, our marijuana policy, now considered a major component of American “Drug Control Policy,” has come under increasing attack from non-government organizations known collectively as the Drug Policy Reform movement. Organizations specifically supporting marijuana “reform,” have the most members and are the most visible (no surprise: more marijuana “crimes” have been treated as felonies in every year year those statistics have been kept) in campaigning for "medical marijuana” legislation, but it would be an mistake to think all successful state laws are equivalent.

Only in California has a powerful medical gray market developed, and that development has been quite erratic. More recently, it has been in concert with the brutal violence of Mexican Drug Cartels now operating along our southern border. Even so, there has been little recognition that the two phenomena are convincing evidence that an enormous illegal market of unknown dimensions has been developing steadily in parallel with our failing drug war for four decades.

Perhaps the most probable, but least appreciated, implication of the pot market's enormous, but unknowable size may be that the only legislative body capable of "legalizing” marijuana is the one least likely to do so: The Congress of the United States.

That's a reality few now looking far a quick change in US policy seem to have considered. In theory, anything can happen, but a quick reversal of US marijuana policy seems very unlikely in the near future.

Doctor Tom

Posted by tjeffo at 11:04 PM | Comments (0)

September 22, 2009

Omens of Change?

The September 13 entry alluded to two reasons for thinking drug war minders may feel threatened as never before by the commercial success of medical marijuana in California. One was the degree to which my study of cannabis applicants has been ignored for two years; the other, a pair of documents that surfaced recently. Before considering them, I’d like to cite a prescient passage from the last pages of Drug Crazy, Mike Gray’s cogent 1998 analysis of America's drug policy published within two years of California's unexpected approval of Proposition 215.

Correctly anticipating that the controversy could only be intensified at first, and prudently avoiding any time estimates, Gray wrote: ”The coming engagement promises to be bloody because the outcome of the whole war is at stake. Prohibition, as policy, can only ratchet in one direction. Each failure must be met with more repression. Any step backward calls into question the fundamental assumption that repression is the solution. Ultimately, every available gun will be brought to bear because marijuana is the pawl on the ratchet, the little catch that keeps the drum from unwinding. For sixty years, Harry Anslinger and his successors have put their backs to this wheel, laboring to hoist drug prohibition to the level of a national crusade. But if somebody jiggles that pawl and the drum slips, support for the current policy will plummet like a loose cage in a mineshaft because it cannot sustain a serious evaluation.”

I always considered Mike's pawl analogy particularly apt. Ironically, when I first read it, I had yet to meet him and no idea I might someday do the study he anticipated; or that he'd play key roles in both its completion and publication.

That study relied on the initiative itself to recruit its own subjects, all cooperative users; a circumstance that could not have been anticipated. Analysis of their previously unavailable data exposes the profound ignorance of the drug war bureaucracy and the degree to which American drug policy has based its dogma on false assumptions. For example, while a “gateway" effect was one of several possible interpretations of the data gathered from the first baby boomers to try cannabis, it was revealed as the direct opposite of reality by the histories of younger cohorts.

Another unexpected finding is the precise time-line followed by the modern illegal market, which, in turn, is powerful evidence that its steady growth has been related to the unique ability of inhaled cannabis ("reefer") to relieve certain distressing emotional symptoms of adolescence more safely and reliably than other agents, whether illegal or pharmaceutical.

Finally, the most important implication of the study may be that by pushing vulnerable teens toward more dangerous agents, Nixon's "drug war" has probably been a forty-year disaster. In the face of that possibility, calculated indifference by either side of the policy “debate,” is both astonishing and irresponsible. Most bizarre is the silence of the “reform” movement. Because its principals have not discussed it publicly or privately, I'm forced to conclude it's because they are still convinced their own use is “recreational.”

As for hard-line drug war supporters, two recent moves now suggest how worried they have become; one is an elaborate “Friends of the DEA” report pleading with the Obama Administration to continue raiding dispensaries. Nothing new there. The other is far more ominous; a draft proposal, soon to be considered by the Medical Board of California at its October quarterly meeting in San Diego, for sweeping revisions of its disciplinary procedures.

Even a cursory reading reveals the proposal as a breath-taking attempt to do bureaucratically what Drug Czar McCaffrey was unable do by fiat in the waning days of 1996: nothing less than premeditated murder of the new law by unfrocking the physicians needed to implement it.

How well the public will accept such a naked revision of recent history remains to be seen. Whatever happens, cannabis will almost certainly continue to be a growth industry.

Doctor Tom

Posted by tjeffo at 02:22 AM | Comments (0)

September 18, 2009

Further Evidence of Cluelessness and a Powerful Gray Market

Apropos of the last entry’s contention that the feds are being undone by the commercial strength of the gray market enabled almost 13 years ago by Proposition 215, was this item in the NYT on pot’s growing popularity on the small screen.

Just by chance, it was gleaned from today's e-mail, which also led me to another item demonstrating the lack of comprehension of their own specialty my psychiatrist colleagues betray on a daily basis, courtesy of the combined malign influences of the drug war and the DSM. Trevisan is right that the oldest boomers will start turning 65 in 2011, but he fails to appreciate that a significant fraction will be chronic users of marijuana who have been benefiting from their 'behavioral disorder" for decades, or that one of the benefits experienced by most has been a reduction in alcohol consumption to safe levels.

Doctor Tom

Posted by tjeffo at 06:22 PM | Comments (0)

September 13, 2009

Background of a Peer-Reviewed Study 2

The last entry described how I'd become involved in a continuing study of medical marijuana nearly eight years ago. I should emphasize that before I began interviewing applicants as required by California’s then five-year-old-law, I had little idea of what that review process would involve, let alone what it might reveal. I’ve since come to understand that going to High School in the Forties made me different from my "pot doc" colleagues. Although their defiance of the drug czar in the initiative's first year had been crucial to the eventual development of today's state-wide retail distribution network, their acceptance of chronic musculo-skeletal pain as the most common basis for "valid" use of cannabis had obscured pot's historically important anxiolytic function in assuaging the adolescent angst of baby boomers. That difference is perhaps best explained by our different focus: as boomers themselves, my younger colleagues were seeking reasons to justify their contemporaries' current pot use; as a cultural outsider, I was unwittingly trying to understand why the largest adolescent generation in American history had found a relatively unknown illegal drug so attractive.

The small gray market that developed slowly in the wake of Proposition 215 became a nucleus of clubs in the Bay Area and a few other locations; from late 2003 on, it entered a growth spurt that attracted attention from local governments, law enforcement, and the media. The Raich decision in June 2005 was soon followed by an increase in both federal raids and local prosecutions. Although intense police lobbying produced a temporary reduction in the number of "dispensaries," a second surge in the medical gray market produced the hundreds of retail outlets now operating in populated parts of the state and generating articles in influential publications that, for the first time, raise doubts about the long term future of America's huge drug war bureaucracy.

In other words, despite the drug war’s best efforts, the commercial success of California's admittedly flawed medical model is forcing many local police agencies to accept the law, albeit grudgingly; and a gray market that barely survived the first few years of Proposition 215 is now robust and continuing to grow, albeit erratically.

I'm often asked by applicants if I think pot will become legal soon. Because I know how deeply entrenched the drug war bureaucracy has become over the past four decades, and how reluctant all politicians will be to admit such a huge national mistake, I don't think the death of our drug policy will be quick or easy; let alone, pretty. However, two circumstances now encourage me to think it may be sooner than I would have guessed, even a few years ago. One is the almost total silence with which my paper has been received in the two years since publication.

The other is a set of documents I just became privy to. they reflect the extreme desperation of the drug war bureaucracy after thirteen years of quasi-legal "Medical Marijuana" in California.

The next entry will look at both as omens of an uncertain future.

Doctor Tom

Posted by tjeffo at 03:49 AM | Comments (0)

September 06, 2009

Background of a Peer-Reviewed Study

After I began screening pot smokers at an Oakland “buyers’ club” in November 2001, it took several months for me to understand that Proposition 215 had created a unique opportunity for studying pot use. By then, it was April, 2002, and I was briefly embarrassed that it had taken me so long to “get it.” May and June were spent deciding which areas of personal history to focus on and what questions to ask about them. It was a busy time because I’d also started seeing patients at 2 other Bay Area locations on alternate Thursdays. Once I started organizing the data in early 2003, I quickly understood that a database would be needed and population demographics might be important.

Also in 2003, I began informally discussing my findings with reformers in two e-mail discussion forums I’d participated in for years, and subtle, but unmistakable signs told me that a significant fraction were upset by what they were reading. But it wasn’t until May '04, when I reported on 620 consecutive patients to a reform audience in Virginia that I discovered that at least a few reformers were dismissing my applicants as mere “recreational” users and their body language confirmed that the mild hostility I’d sensed from the e-mail discussion groups had been real, but- significantly- at no point was my data ever challenged, and all attempts to seek out specific objections to its accuracy failed .

Two new developments dominated the news in California after my return from Virginia: the Oakland City Council had gone ahead with its plans to restrict business licenses for pot clubs, and police agencies around the state had begun urging their local governments to restrict or deny them completely. Soon the Oakland club where I’d been working had lost its license and consequently had to renege on its offer of space in their San Francisco branch. I was suddenly without a practice location and office help, but Dustin Costa, a former patient, who was out on bail after being arrested for growing, and was starting to organize the Merced Patient Group as part of his defense, invited me to interview its applicants. That was helping to sustain my practice in June, 2005, when the Raich verdict suddenly changed California’s political climate once again.

For Dustin, the cost of Raich was enormous; in August he was summarily re-arrested on a federal warrant by a posse of California police officers brandishing guns and then taken to the Fresno County jail, where he was held without bond for 15 months. In November, 2006, he was convicted by a federal jury that was kept from hearing any relevant testimony; next, in February, 2007, he was sentenced to fifteen years and packed off to to serve his time in a prison in the Texas Panhandle.

My personal experiences with his ordeal, plus the crudely dishonest federal efforts to subvert Proposition 215, have convinced me that American drug policy is even more cruel, unjust, and stupid than I had imagined or (like most people) want to believe. Thus the reasons why such a travesty is still the world’s drug policy by UN Treaty should be a far more urgent item of interest to our species then is now the case.

In a nutshell, that’s also why I now see denial as the greatest threat to humanity's well being.

Doctor Tom

Posted by tjeffo at 07:17 AM | Comments (0)

September 04, 2009

Cannabis and Insomnia

Michael Jackson’s funeral reminded me that on December 30, 1996 drug czar Barry McCaffrey went on national TV to deliver the federal government’s rejection of California’s medical marijuana initiative. Among other things, he ridiculed the idea that insomnia could possibly be an indication for pot use.

The initiative survived his threats against California physicians, but only because the Ninth Circuit of the Supreme Court saw it as a First Amendment violation and issued an injunction. Thus did Proposition 215 narrowly survive and ultimately allow me to gather data explaining why millions of American adolescents have continued trying pot year after year and why so many have continued using it as adults despite the risk of felony arrest and other harsh penalties added during forty years of unrelenting drug war.

As for insomnia being trivial, Michael Jackson, perhaps the most famous (and poignant) insomniac on record, was interred yesterday. His initials are not only shorthand for “marijuana;” they should remind us he might still be alive if it were legal; instead he was given a fatal sequence of legal benzodiazipines to help hm sleep. If his unfortunate physician is ever charged, it won't be because of the the drugs he prescribed, but because of the way they were administered.

Only occasionally in the weeks of uninformed discussion since Jackson's untimely death, was his well-known childhood abuse at the hands of his biological father linked to the obvious symptoms of anxiety he manifested throughout his adult life. While there may be no better illustration of the tragic consequences of dysfunctional parenting during childhood; Jackson is by no means, the only shy celebrity remembered for a troubled childhood, problem drug use, and a premature drug-related death.

I don't know if Michael Jackson ever tried pot, but I'm fairly certain he was subject to too much scrutiny to self-medicate with it. By the time his early success and that string of electrifying music videos made him a huge international icon, he was already trapped by childhood demons and limited to dangerous, but legal drugs for his intractable insomnia.

Have you been paying attention, General McCaffrey?

Doctor Tom

Posted by tjeffo at 03:47 PM | Comments (0)

September 02, 2009

3 More Book Recommendations

A little over a month ago, I listed six books I’d found helpful after becoming seriously opposed to the drug war. All were primarily concerned with policy; three had been written in the early Seventies and three in the mid Nineties. Today I’d like to add three more; all with a focus on the drug culture that began in the Sixties and were written by authors who freely admit their own drug use. That's why I found them so valuable; for one thing, they educated me on several aspects of the counterculture I'd been only vaguely aware of, for another, they will educate readers with open minds by demonstrating the differences between their authors' generally liberal points of view and those of well known drug policy hawks like William Bennett, who still regards "addiction" as evil, but can't understood that he has publicly embraced at least three (ditto Rush Limbaugh, with two to his credit).

Another reason for listing these books together is that they appeared at intervals after Nixon’e drug war; thus they also illustrate generational differences similar to those exhibited by the applicants I’ve been interviewing (which adds to my suspicion that the adult humans psyche is far more intensely influenced by childhood experiences than ls commonly realized).

The three books, in order of original publication:

Reefer Madness, by Larry “Ratso” Sloman.

Focused on the late Seventies and early Eighties and well researched, it contains a lot of info on Harry Anslinger and the Marijuana Tax Act. One example is a more nuanced reading of Dr. Woodward's prescient objections to it than I have ever seen; there's also a useful 1998 Afterward by Michael Simmons.

Acid Dreams Extremely well sourced review of the Sixties; more focused on psychedelic drugs than on marijuana per se, but a useful reminder that the two categories should always be considered within the same general context.

The Cannabis Companion by Steve Wishnia.

The most recent, and (by far) best illustrated of the three; also the one with the weakest historical point of view. The author is a formal editor of High Times.

Doctor Tom

Posted by tjeffo at 08:23 PM | Comments (0)

August 24, 2009

A Message from the Gulag

As some may remember, Dustin Costa, out on bail in Merced County after an arrest for growing medical marijuana, and while still defending himself against those charges, was the first Californian arbitrarily arrested, held without bond, and tried in Federal Court for the same offense. His federal arrest took place within weeks of the predictable Raich verdict in 2005. Following a federal trial in Fresno he was given a punitive 15 year prison term to be served in Texas. I’ve remained in close touch with him since his sentencing in February 2007, as he continues to seek a pardon.

The following essay, with significant edits by myself, is based on our lengthy correspondence and frequent phone calls.

Can Marijuana Prevent Substance Abuse by Treating Childhood Mood Disorders?

The Gateway Theory, more properly a hypothesis, posits that “soft” drugs like marijuana somehow lead to “harder” ones like heroin. Despite its shaky scientific underpinnings, Gateway’s basic assumptions remain a cornerstone of drug war propaganda, and apparently accepted by a majority of Americans. But what if it could be shown that marijuana, contrary to Gateway beliefs, actually prevents substance abuse problems?

Through its ability to substitute for more harmful agents like alcohol and tobacco, marijuana has long enjoyed anecdotal fame among activists as a “harm reduction” agent; however, what I’m suggesting here goes well beyond that. I’m asking if marijuana could actually prevent substance abuse problems.

Dr. Tom O'Connell's published study of medical marijuana applicants suggests it could, and If replicated by others, might turn the Gateway Theory inside out. According to Dr. O'Connell, the earlier a vulnerable adolescent becomes a repetitive marijuana user, the less likely they are to have problems with alcohol, tobacco, or other drugs, including heroin. Important to an understanding of his study is that until the 1960s, marijuana was relatively unknown to most Americans, especially adolescents; before then very few “kids” had ever tried it. By interviewing thousands of marijuana applicants about their drug and alcohol use, Dr. O'Connell has gathered data on marijuana use during adolescence that have long been obscured by federal policy as it was becoming America’s most popular illegal drug.

Essentially all seeking the “recommendations,” required by California law are experienced users; when considered as ten-year birth cohorts, there were few in the 60- 80 age range. The first numerically large cohort were older Baby Boomers born right after World War II (between 1946 and 1955). When questioned about their initiations of a standard list of illegal agents, and the details of their experiences with alcohol, tobacco and marijuana, they reported trying marijuana for the first time at an average age of 17.6, well after their initiations of alcohol and tobacco. Most importantly,their chronic use of cannabis hadn’t begun until an average age of 22.7. Almost a third (31.16%) of that oldest Boomer cohort later tried heroin, closely agreeing with similar data provided by their contemporaries in the Seventies that generated the Gateway hypothesis.

O'Connell's more longitudinal data show that conclusion was premature; even as it was being cited in support of ‘zero tolerance” during the Eighties. That's because the younger siblings, cousins, and more recently— the children and grandchildren— of the oldest Boomers have continued trying cannabis during adolescence; but with quite different results than predicted by Gateway theorists.

For example, the next cohort (born between 1956 and 1965), first tried marijuana at an average age of 15.8 years. Still a it older than their trials of alcohol and tobacco, but their rate of heroin initiation decreased by a third to 20.8%, thus highlighting a key trend, one that has remained steady throughout four decades of illegal marijuana use: the interval between "trying and buying" (initiation and chronic use), or what O'Connell refers to as the "gap." It has declined steadily since hippie days, in parallel with each cohort's rate of heroin initiation.

According to an article in Time Magazine by John Cloud, prevention of substance abuse is possible through early identification of precursor signs, such as childhood mood disorders, like Attention Deficit Hyperactivity Disorder (ADHD), depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). These are all conditions for which adults often self-medicate with marijuana. In children, these conditions are treated with drugs, and the many of those used been found to have have harmful side effects. The difference with marijuana may be that not only is it safe and effective, but it may also prevent future substance abuse. The late Dr. Tod Mikuriya certainly thought so, and recommended marijuana as a first-line treatment for childhood mood disorders.

I spoke with Dr. O'Connell before sending him this this essay; his comment was: “Basically, we've been on the wrong track for 40 years, but the drug war has become a sacred cow.” I think he's right. There have been problems with the Gateway Theory ever since its introduction, Now, through an emerging picture of substance use patterns, it appears as though the Gateway had it all backwards. Rather than leading the way towards greater harm, marijuana appears to have had a role in preventing hard drug use.

By Dustin Costa

Posted by tjeffo at 11:08 PM | Comments (0)

August 23, 2009

Denial, Depression, and Drugs

As the nation (and the world) slide ever deeper into economic depression, the nearly complete absence of the D word from discussions of the present "financial crisis” (or "economic meltdown,” if you prefer) have struck me as bizarre. But then, my recent preoccupation with the “war" on drugs may have made me more aware than most of the myriad ways by which unpleasant truth is avoided by our species. By far the most common is simply pretending not to notice; a practice known as "denial."

Examples abound; a recent front page item in the SF Chronicle, reported on a proposal in the state Senate to reduce California’s prison population by discharging 27,000 sick or elderly and non-violent inmates, a move that could save $525 million/year. It predictably evoked outrage from Republicans, who have traditionally been both more "tough on crime," but opposed to "big government" than Democrats; apparently without realizing that criminals created by tough drug laws must be cared for at public expense.

It was thus ironic when the feature of this week-end's Insight section of the Chronicle turned out to be a comparison of California and Michigan prison systems within the context of an offer (so far declined) from Michigan's governor to make some of her state's surplus prison capacity available to California, a move that could benefit both states.

There are, of course, difficulties in implementing such an offer that would have to be negotiated, not the least of which would be making up for the hardships imposed on families by the greater distances involved, but the opportunity for constructive change should not be dismissed out of hand.

On the subjects of denial and prisons, I can't resist adding that both are big anomalies in the nation that claims to be the "Land of the Free," but leads the world in incarceration (both per capita and in absolute numbers).

Doctor Tom

Posted by tjeffo at 08:44 PM | Comments (0)

August 22, 2009

Still Popular, after all These Years

From California, yet another article on a subject no one seems at all curious about: what has made marijuana so popular forty years after Nixon fired the first shot in his war on drugs by launching Operation Intercept? Are we really that stupid, or is it simply that we don't want to recognize how stupid our nation was when we followed an insecure Trickster's lead into a war that couldn't be won and shouldn't have been fought?

However one might answer that question, there can now be little argument with certain facts: we are in the midst of a recession (depression) and yet California, also facing its worst budget crisis ever, is paying through the nose for both its annual campaign against marijuana planting (CAMP) and to fight the forest fires that have been made more likely and more destructive by drought, which in turn, is probably a consequence of the global warming right wingers scoff at, but is also getting worse (at least by temperature measurements) every year.

One is forced to ask: at which point will denial and wishful thinking finally be replaced by a willingness to subject certain old beliefs to critical re-examination?

Doctor Tom

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

August 19, 2009

Can This Species be Saved?

To anyone with the capacity for logical analysis, the futility of America’s war on drugs should be obvious; take just two recent developments: first, the emergence of rogue Mexican military personnel as competitors of the drug cartels in the bloody turf war along the Mexican border has now been confirmed by both Wikipedia and CNN.

The other is the continued insistence, by American federal agencies most concerned with defending the drug war as policy that “marijuana” (cannabis) has no “redeeming” medical value, even as Californians attempting to comply with a law both their state and federal “supreme” courts have upheld on appeal, continue to be selectively arrested, prosecuted and sentenced.

Each of these situations is, of course, complex, but their glaring incongruity speaks for itself and points up another fact made increasingly obvious by headlines from all over the world: a significant fraction of our species is now behaving more and more like murderous children by killing themselves, each other, and any other life forms that happen to stand between them and their perceived needs of the moment.

Doctor Tom

Posted by tjeffo at 10:46 PM | Comments (0)

August 16, 2009

An Inconvenient Anniversary

Next month will mark the 40th Anniversary of Operation Intercept, a unilateral initiative by the Nixon Administration to “control” the smuggling of illegal drugs, especially marijuana, across the US-Mexican Border. As recounted in Edward Brecher’s unsurpassed contemporary analysis of late Sixties US drug problems published three years later, the operation itself quickly became a fiasco and had to be abandoned in early October.

Unfortunately, we seem to have earned nothing from that experience because today— seven US presidents, forty years, and uncounted billions of dollars later— the world remains deeply committed to the same failing policy by UN Treaty.

The denial needed to pretend that such a treaty, and the global drug war it calls for, are both reasonable and possible is still prevalent throughout the world, a circumstance that does not auger well for the ability of our species to deal with its other serious problems: overpopulation, a blighted global economy, progressive desertification, and looming shortages of water, food,, and oil,, to name several of the most obvious.

In that respect, the drug war can be seen as an excellent indicator of both the degree to which we have been trashing our home planet and the likelihood we will wake up in time to effectively mitigate our most predictable self-imposed disasters.

Doctor Tom

Posted by tjeffo at 05:31 PM | Comments (0)

August 13, 2009

Unhealthy Debate

That we live in unsettled times is hardly news, but here in the republic aspiring to leadership of the "free world,” we seem to be setting new records for political agitation: witness the mobs of generally overweight, affluent-appearing, sign-toting, red-faced, over-fifty citizens intent on disrupting “town hall” meetings hosted by Democratic lawmakers in support of their party’s bid to “reform” our admittedly ailing health care by providing coverage for a large fraction of the soaring millions now without any health insurance whatsoever.

Forget about fair play, or even ordinary civility in this one, as Iowa’s Senator Charles Grassley demonstrated yesterday when he responded to President Obama’s attempt to praise his “bipartisanship” with an outright lie. What the charade told me is that Grassley, an unreconstructed drug war hawk, was simply running true to form, and Obama still has a lot to learn about day-to-day politics inside the Beltway.

In that respect, he’s a lot like Jimmy Carter, who couldn’t learn the required political skills fast enough to save us from the dozen Reagan-Bush years that followed his earnest, but politically naive presidency. I suspect Obama is also an honorable man, but his lack of appreciation for the benefits of pot and his inability to quit his own deadly tobacco habit are worrisome signs that he’s not as astute as I had hoped. He’s in for even more outrageous GOP nonsense on health care; one real possibility is that Republican hubris will finally become so apparent to the small fraction of genuine swing voters in America that the GOP will be hoisted on their own petards in November.

At least, let’s hope so.

Doctor Tom

Posted by tjeffo at 06:51 PM | Comments (0)

O’Shaughnessy’s Now Online

One of the unsung heroes of the (still) relatively unknown drug policy reform movement is the late Tod Mikuriya MD, a psychiatrist of about my own vintage who once worked for the federal government at the NIMH shortly before the drug war began in earnest following Nixon’s election in 1968. Tod, already very much aware that cannabis is medicine, went on to devote his entire professional career to that cause before succumbing to bile duct cancer in May, 2007.

One of Mikuriya’s heroes was Dr. William B. O’Shaughnessy, an Irish physician and polymath who did the first clinical research on cannabis while in India and introduced its use to Western Medicine in 1839. O’Shaughnessy later returned to India where he made significant contributions to telegraphy and communication. He was Knighted by Queen Victoria in 1856.

Mikuriya was one of several authors of Proposition 215; his decisive contribution was the crucial, “any other condition” phrase that has made California’s pot initiative the nation’s most important because it has allowed so many to qualify as medical users. As California’s premier medical cannabis pioneer, Tod also pushed for publication of clinical results and, together with his friend Fred Gardner, helped found the California Cannabis Research Medical Group (CCRMG) and launch O'Shaughnessy's as its medical journal. First published in tabloid form, it was made available to patients through buyers’ clubs, dispensaries and doctors’ offices and later online. Always a shoestring operation, it has soaked up a lot of unpaid labor from its editor, unsung volunteers and contributors. The most recent edition, also the largest and most informative, has just been made available online in pdf format, meaning that activists around the world can see it in the same form its readers in California do.

Doctor Tom

Posted by tjeffo at 03:30 AM | Comments (0)

August 10, 2009

Unintended Consequences

The complex "natural" method by which plants acquire the nitrogen required by animals (including humans) dependent upon them for nutrition involves soil bacteria. It has been estimated that without supplementary fertilization, the human population would be limited to between 3 and 4 billion.

Thus an estimated 40% of the world's human population owes its existence to nitrogen fertilizers, without which the calories necessary to sustain them could not be produced. Less well known is the story of their inventor,Fritz Haber the German chemist who discovered the process used to fertilize plant growth by adding free nitrogen to the soil. Haber's story, an amazing sequence of triumphs and tragedies, is less well known than that of his contemporary and friend, Albert Einstein, who was also awarded a Nobel Prize and whose work also led to the development of weapons of mass destruction. Einstein's legacy was nuclear weapons; Haber, who invented both chlorine gas and Xyklon B, left us chemical warfare.

However, the supreme irony may be that Haber's discovery of nitrogen fertilization, which also prevented the Malthusian warning of widespread famine from being realized, may be his most deadly legacy. By enabling the human population to grow beyond its "natural" limits, the increased agricultural production enabled by nitrogen fertilization has allowed us to pursue energy consumption to a point that may "control" the human population through a combination of the dire consequences now being debated (but not effectively addressed) by our species.

If that should happen, let us hope that the survivors will be chastened enough by their experience to learn from it, and diminished enough in numbers to do so.

Doctor Tom

Posted by tjeffo at 05:17 PM | Comments (0)

August 09, 2009

Mystery Explained

In an earlier entry I called attention to the outrageous treatment of a straight-arrow Morro Bay dispensary operator named Charlie Lynch whose life was turned upside down by a DEA raid and federal prosecution carried out while the feckless Dubya was still disgracing the Oval Office, but whose sentence was to be imposed under Obama shortly after Eric Holder had "confirmed" there would be a new approach to Medical Marijuana on his watch.

But apparently common sense and justice cannot be retroactive, even under "change you can believe in." Holder's Justice Department turned down a judge who was obviously seeking some leeway and had already demonstrated uncommon courage by imposing a comparatively light sentence.

However, given the extraordinary medical circumstances in this particular case, just the raid and prosecution were abominations. That they were instigated by a remorseless and arrogant sheriff was recently made abundantly clear when he was interviewed by John Stossel. What's now also clear is that we have some truly evil people in California law enforcement.

Doctor Tom

Posted by tjeffo at 02:06 AM | Comments (0)

August 06, 2009

The Belly of the Beast (Personal)

Yesterday I had an experience I won't soon forget; one I have been unwittingly prepping for since opposition to America’s war on drugs became a personal cause in late 1995. I was brought to a new level of understanding of the phenomena I’ve been studying for fourteen years by visiting the Elmwood Correctional Facility, a division of the Santa Clara County Jail. The opportunity itself was unusual, perhaps even unique; it came about when a judge issued a court order to perform a medical evaluation on an incarcerated marijuana user for the purpose of assisting his personal attorney (not a public defender) with his defense. I now realize that a number of unusual circumstances had to combine for that to happen, but rather than confuse this account with tedious detail, I’ll go right to the visit itself, because it demonstrated unequivocally that not only is our criminal justice system a travesty, its continuing reciprocity with the drug war is trapping us in a pattern of institutionalized cruelty that will be difficult to undo.

The Elmwood facility is in Milpitas, only a few miles from several of Silicon Valley’s premier companies, something I discovered by getting lost long enough to discover unmistakable signs of economic blight, even there: new properties with empty parking lots sporting ‘For Sale” or For Rent” signs.

Elmwood turned out to be a sprawling, forbidding complex of two story buildings surrounded by an enclosed chicken wire run that gives away its mission. Separate men’s and women’s divisions had their own parking lots. The men’s was much larger, as was its entrance complex, bristling with signs reminding visitors of a list of forbidden items & behaviors, also that anyone entering is subject to search.

The staff were armed and uniformed in quasi-military blue uniforms with combat boots and baseball caps. They were, with few exceptions, remote and unfriendly. Once inside, its low security level was apparent because prisoners, unmistakable in their wide striped uniforms were not escorted. Visitors wore large numbered plastic ID badges that are returned upon leaving. What struck me immediately was the oppressive mood inspired by the sprawling facility’s sheer size, drab architecture and narrow windows. Also how much it must cost to operate, even for a rich county like Santa Clara (Pop. 1682585 in 2000), Hard information about the county's jails is surprisingly hard to come by at its website, probably the best overview is supplied by a self-serving video narrated by a uniformed officer that revealed it's the fourth largest in California (fourteenth in US) and how hard they must struggle with overcrowding.

The most important emotional revelation from my visit (which I’ll return to in future posts) was also unexpected: the degree to which I was made to feel the same humiliation and dehumanization prisoners must experience and which have become so much a part of our system of criminal “justice;” also, the degree for which our patently absurd "drug control" policy bears responsibility.

What was brought home to me yesterday is that although I had interviewed many people who had spent time in jail for marijuana offenses and had participated vicariously in Dustin Costa’s imprisonment in the Fresno County Jail, (I now receive phone calls from his Texas prison a couple of times a week), nothing had prepared me for the feeling of being inside such a place, even one as comparatively “easy” as Elmwood.

That we routinely incarcerate young men who have been victimized by their upbringing and are "guilty" only of treating their troubled emotions with an effective medicine proved even more depressing than I could have imagined.

Doctor Tom

Posted by tjeffo at 07:06 PM | Comments (0)

July 29, 2009

Follow-up to Book List

While researching the book list I posted yesterday, I came across the review of Drug Crazy I’d written for Amazon.com just over eleven years ago. It’s posted below with a few minor edits and my current e-mail address. I also learned from Mike himself that it can be read on-line at Libertary.com

Drug Crazy has special significance for me because while still caught up in the thrill of discovering the drug policy reform movement, I’d decided I was uniquely qualified to write a modern history of the drug war and had actually started doing so. Mike’s book (which I read in galleys) shocked me into reality; especially when I realized he’d had a six year head-start and had not only done all the research, but also the job I was beginning to dread: editing an amophous mass of information into a coherent, readable book. Drug Crazy can still be read with profit because to date, no one has written a better overview of the folly our endangered world still remains improbably committed to enforcing.

Doctor Tom

A long-overdue indictment of a lunatic national policy., June 2, 1998

  Tom O’Connell tjeffo@comcast.net (San Mateo, CA, USA) Book Review : Drug Crazy by Mike Gray (Random House, N.Y.- June, 1998)

America's War on Drugs, declared originally by Richard Nixon and waged with varying degrees of enthusiasm by every President since, has become a nearly invulnerable monster, thriving on its own failures and seemingly capable of destroying anyone reckless enough to speak out against it. Its simplistic central premise- drugs pose unthinkable dangers to our children, and therefore must be prohibited- has helped elect legions of politicians who then cite the latest drug scare as reason for tougher crack-downs, harsher laws, and more prisons. So completely has this idea of "illicit drugs" become society's default setting, and so beholden are politicians and others to it, the policy itself receives no critical scrutiny from government and little from academics dependent of federal funding. "Legalization" is a deadly brickbat hurled indiscriminately at all critics without thought that in a society based on capitalism, it is the illegal markets which are abnormal.

Although several scholarly, historically accurate books have pointed out shortcomings of this policy since the late Sixties, not one author has effectively attacked drug prohibition as a policy based on a completely false premise, incapable of preventing substance abuse problems; indeed, certain to make them worse. None, that is, until Mike Gray. A professional from the film world, Gray may have written the book no one else has yet been able to: a concise, readable, historically accurate, and well documented indictment of our drug policy. Very few reading his book all the way through will see the drug war the same way they did before. A major question then becomes: how many people will read it? Will it sink without a trace, overlooked like so many earlier criticisms of official policy- or will it be discovered by a public growing increasingly disillusioned by a perennial policy failure which is jamming prisons, impoverishing schools and colleges and effectively canceling many Constitutional guarantees of personal freedom? Read by enough people, "Drug Crazy" could do for drug reform what "Silent Spring" did for the environment in 1962.

Like the film maker he is, Gray opens with a tight close up: Chicago police on a drug stake-out. The view quickly expands to the futility of enforcement against Chicago's massive illegal market. first from the perspectives of an elite narcotics detective and then through the eyes of a dedicated public defender. A comparison with Chicago seventy years ago during Prohibition reveals that police and the courts were equally unable to suppress the illegal liquor industry for exactly the same reasons: the overwhelming size and wealth of the criminal market created by prohibition. This beginning leaves the reader intrigued and eager to learn more; he's not disappointed.

The rest of the book traces the history of our drug crusade from its idealistic populist origins in 1901 when McKinley`s assassination thrust a youthful TR into the White House. The 1914 Harrison Act, purportedly a regulatory and tax law, was transformed by enforcement practice into federal drug prohibition with the assistance of the Supreme Court. Drug prohibition not only survived the demise of Prohibition, but emerged with its bogus mandate strengthened.

Thirty years of determined and unscrupulous management by Harry Anslinger, the J. Edgar Hoover of the Federal Bureau of Narcotics, shaped drug prohibition into what would eventually become a punitive global policy. Anslinger was dismissed by JFK in 1960, but not before politicians had discovered the power of the drug menace to garner both votes and media attention.

Illegal drug markets have since thrived on the free advertising of their products which inevitably accompanies intense press coverage of the futile suppression effort and dire official warnings over the latest drug scare. This expansion was accelerated when Nixon declared the drug war in 1972. Gray covers that expansion beyond our borders Colombia ("River of Money"), Mexico (Montezuma's Revenge"), and at home ("Reefer Madness"). He also describes how some European countries have blunted the most destructive effects of our policy forced on them by the UN Single Convention Treaty ("Lessons from the Old Country").

In his final chapter, Gray opines that the push to legitimize marijuana for medical use may have exposed a chink in the heretofore impregnable armor of drug prohibition. Beyond that, he believes that the policy, having thrived on relentless intensification, can't allow relaxation without risking the sort of scrutiny which might reveal its intrinsic lack of substance, therefore, any change must come from outside government. He doesn't offer a detailed recipe for a regulatory policy to replace drug prohibition; rather he suggests that it will be very similar to that which replaced alcohol Prohibition after Repeal in 1933- a collection of state based programs, sensitive to local needs and beliefs.

There is a desperate need for this book to be read and discussed by hundreds of thousands of thinking citizens. The pied piper of drug prohibition has beguiled our politicians and led us dangerously close to the edge of an abyss. Mike Gray's warning has hopefully come just in time and could itself be a major factor in initiating needed change of direction toward sanity. Thomas J. O'Connell, MD

Posted by tjeffo at 06:53 PM | Comments (0)

July 28, 2009

An Unexpected Request

"The other morning I received an unexpected "thank-you" e-mail of the kind that can suddenly brighten an otherwise drab day. It ended with a request for something I've long been considering, but never quite got around to: put up a list of books I think all serious drug policy reformers should read:

"I was also wondering what recommendations you would have regarding literature on cannabis (I'm already reading your blog). As a student of the social sciences I am more inclined towards books on law, policy, history, psychology, etc. although I do have a casual interest in the medical/scientific side as well. I am formulating a "reading list" for myself. Can you think of any must-have titles for that list? I respect your opinion very highly, and I appreciate the input... My answer: There were several early Seventies books that took on the drug war, shortly after its inception:

The Drug Hang-up by Rufus King, a lawyer, was one of the first to see through Harry Anslinger and earn his enmity. A classic; it can be read online at: http://www.druglibrary.org/special/king/dhu/dhumenu.htm

Consumers' Union Report on Licit & Illicit Drugs, Brecher. ditto: http://www.druglibrary.org/Schaffer/LIBRARY/studies/cu/cumenu.htm

High in America; Patrick Anderson ditto. http://www.druglibrary.org/special/anderson/highinamerica.htm The inspiration for Anderson's 1981 chronicle of the foundation of NORML begins with the author's attendance at a party mourning Nixon's 1972 election.

Agency of Fear; Ed Jay Epetein 1978; Story of the Nixon Administration's push for its own federal police force (which became the DEA) online at: http://www.mega.nu:8080/ampp/epstein/index.html

Three mid- Nineties books very worth reading:

Smoke & Mirrors, by Dan Baum. 1996. Excellent update of Epstein, with greater focus on the politics of pot prohibition.

Drug Warriors & their Prey Richard L. Miller Compares drug war to Nazi techniques.

Drug Crazy: Mike Gray 1998 Very accurate and succinct overview of war on drugs just as 215 was going into effect. Last chapter is especially prescient on how medical MJ has potential to end prohibition.

Doctor Tom

Posted by tjeffo at 04:56 AM | Comments (0)

July 26, 2009

Knowledge vs Belief 3 (Personal)

Saturday's entry promised to explain how current media interest in the medical marijuana controversy suggests that the drug policy reform movement may be close to its original goal of marijuana legalization. That seems likely even though the policy's supporters and opponents are still unable to discuss its essential features, a situation I have come to see as indicative of a pervasive human cognitive fiaw. To state it as directly as I can: the same preference for denial that has allowed the UN to impose a grotesquely unscientific, destructive, and failing drug policy is reflected in our species' obvious reluctance to take decisive action against the plausible threat of accelerated climate change.

In each case, the problem can be seen as an irrational preference for an institutionalized behavior in the face of abundant credible evidence that such behavior has been damaging to the environment, grossly unjust to human populations, or both.

An Example of Drug Policy Denial

Friday morning, on my way to Oakland, I happened to catch the last half-hour of a discussion of medical marijuana on the local NPR station. I soon became so distressed at its content in that setting that I was forced to turn it off. Fortunately, the broadcast was available online, so I was later able to listen to it in a more settled state of mind. That experience confirmed I had been right to turn it off; also that the composition of the panel itself is another subtle clue that, barring some unforeseen national emergency, we are headed toward marijuana legalization.

What the less distracted hearing revealed is that although the discussion was superficially congenial, each participant was taking such a decidedly different position on key issues, there was essentially no discussion at all because none made an honest attempt to recognize or explore their differences. The only consensus reached was actually a cop-out: that a large, but unknown fraction of applicants for a doctor's recommendation are “recreational users” who must be cheating. No participant mentioned federal opposition to legalization, which despite the lack of a federal presence on their panel, had just been been reasserted within California by none other than the new drug czar who, along with the new AG, and new President have been sending their own mixed messages on medical marijuana since taking office.

When I belatedly realized I couldn’t recall a similar panel discussion of medical use without at least one representative from law enforcement, I grasped the extent to which the drug czar’s role and voice have been diminished by the Obama Administration. It also became clear that, on Friday, the default "official" policy representative had been academic Mark Kleiman from UCLA's school of Public Policy. He is one of an elite coterie of such specialists tenured at our most prestigious graduate schools. Although few in number, they have played an essential role in validating American drug policy by failing to criticize it as it deserves. When one considers the over-the-top bombast of John Walters, one has to be impressed at the rhetorical and literary skill required of an academic drug policy critic who has to come across as thoughtful and intelligent, but can't afford to be seen as too disdainful of ONDCP. It didn't surprise me that Professor Kleiman had little to say on Friday.

Doctor Tom

Posted by tjeffo at 09:47 PM | Comments (0)

July 25, 2009

Knowledge vs Belief 2 (Personal)

The crescendo of media attention being lavished on medical marijuana confirms it was a good ploy for attacking America’s obscene drug war, even as the arguments of various “experts” now holding center stage can only hint at the eventual end-game. What definitely couldn’t have been predicted back in 1996 when California voters passed Proposition 215 to the consternation of the federal establishment and its law-enforcement toadies, was the improbable evolution of the initiative, or how its course would be impacted by the “election” of an unqualified candidate like G. W. Bush and that his eight inept years in power would force the election America’s first nominally black President.

I now expect that the various complex elements of the drug war, like similar chapters in human history, will be parsed, picked over, and misrepresented for decades, perhaps even centuries, unless some cataclysmic natural disaster suddenly erases a majority of our species or we wither away progressively from the accumulated injuries we are now inflicting on the planetary ecology.

To return to a more mundane level, one of this bog’s themes has long been that both sides in the medical marijuana argument have been relatively clueless. Since I’d been influenced by my own previous education and experience, I shared many of the same misconceptions of my era until chance led me to become an enthusiastic recruit in the drug policy reform movement in October 1995.

At the time I was unaware that a medical marijuana initiative was being prepared for the ‘96 ballot, let alone that it would pass and I would ultimately be recruited to screen applicants. From there, once I tumbled to the opportunity I'd been handed to conduct an opportunistic study of illegal drug use, it seemed entirely logical to do so. When I suspected the validity of its unexpected findings, I couldn’t wait to report them to presumed allies in the reform movement. What I would gradually discover in a series of unwelcome insights, was that the claimed default presumption of most human organizations: that individual humans are “naturally” honest, and sincerely, aspire to get along with their fellow beings, is seriously flawed. Further, that unless we find a way to correct that assumption, we are in for big problems.

In fact, we may have already progressed sufficiently along the path of self-destruction to render recovery from the combined effects of our current energy consumption, water pollution, and accelerated climate change doubtful, at best.

The next entry will return to the recent spate of media interest in medical marijuana and attempt to show how far behind the curve of current reality both its (probably successful) sponsors and (probably unsuccessful) adversaries are lagging, and, eventually, how that relates to the glum assessment offered above.

Doctor Tom

Posted by tjeffo at 08:25 PM | Comments (0)

July 23, 2009

Knowledge vs Belief 1 (Personal)

That we live in perilous times is being underscored ever more clearly by scientific “progress” in ways most have trouble imagining. Even as the discoveries of Science were adding to the convenience of everyday life, they were revolutionizing commerce in ways that many are now finding increasingly difficult to adjust to. Those same advances have also been allowing knowledgeable specialists to uncover details of past planetary and galactic events with significant implications for traditional religious beliefs, while also suggesting that planetary life may be facing additional mass extinctions that would include us. Closer to the present, the current political squabble over CO2 emissions and climate change reflect how thoughtlessly our species has been both proliferating and consuming the planet’s resources as if there were no tomorrow.

To put it somewhat simplistically, the impact of Science on humanity may have moved so far beyond the ability of our species to either comprehend or "control” that our existence is now seriously threatened by our cleverness. For any who might wonder why a "pot doc" of my age and background would have the temerity to discuss such profound issues, I would simply say that my study has given me a window on human thought and our highly evolved brains are the organs most responsible for our present predicament. For those who consider that a confession of Atheism, I would further submit that Atheism is a religious belief just as deserving of protection under our Constitution as any other.

I would further submit that we have reached a point in human cultural evolution that is unique in that we finally know enough to behave more rationally as a species; thus the most compelling issue we now face is the irrationality of our own mass behavior.

Our primary problem, I would suggest, is that the emotional centers which had been evolving as intrinsic parts of our brains have long been in conflict with its more recently developing rational centers. The consequences of that conflict didn't begin to threaten survival until our knowledge of the environment (universe, cosmos) was suddenly accelerated by the discovery of empirical science, and then only because a peculiar set of circumstances had contrived to render science subordinate to its less rational competition, both within the brain and on the planet.

That seems like quite enough heresy for today; I must now get back to the increasingly challenging task of my own survival in the greedy and dishonest American economy.

Doctor Tom

Posted by tjeffo at 05:44 PM | Comments (0)

July 22, 2009

Groping for Insight

Marijuana’s appeal and the remarkable resilience of its modern market, even in uncertain financial times, are very much in the news. Last week, pot was featured in articles in the still-proud New York Times Magazine and the Insight section of the struggling San Francisco Chronicle. Both reported a melange of opinions from the usual "experts," which tempted me to compare a few of them to what I've learned during seven years spent interviewing self-medicating pot smokers seeking my agreement that their use is "medical."

That experience allows me to point out how key comments by those experts unwittingly reveal their own ignorance. One such was NIDA Director Nora Volkow’s comparison of whiskey and beer in trying to make a rhetorical point; the potency of alcohol has nothing to do with that of marijuana and the effects of each drug on cognition are so different as to invalidate any comparison. Smoking pot allows a rapid, accurate titration of its potency, thus protecting users against overdose, while oral preparations do not. Volkow’s ignorance, although shocking, is understandable: prevention of any research that might be favorable to pot use is the mission of her agency by Act of Congress. That also explains her ignorance of another easily demonstrable finding: that pot smokers’ alcohol consumption and use of other problematic agents were consistently diminished whenever they began self-medicating with inhaled cannabis.

Bruce Mirken of the Marijuana Policy Project provided an example of unwitting expert ignorance by the other side with his characterization of the recent surge in LA pot dispensaries as “an absolute freaking disaster" in the Insight article. What was actually revealed was Mirken's displeasure at learning that his cherished beliefs about “medical” and “recreational” use weren’t reflected by the behavior of the pot users he claims to represent, while his follow up statement shows that he has yet to understand that in the modern world, the markets for all popular products, are subject to manipulation by criminals.

Doctor Tom

Posted by tjeffo at 04:53 PM | Comments (0)

July 12, 2009

Sounds of Silence

Several important implications can be drawn from our study of medical marijuana applicants. One is that prior to the Sixties, American youth had shown remarkably little interest in inhaled cannabis, which is interesting because “reefer” had been banned as "marijuana" at the behest of Harry Anslinger in 1937, allegedly because it led to homicidal mania in at least some adolescents. Another implication is that inhaled marijuana hadn’t become well known to adolescents until after many hundreds of thousands had tried it within the span of few years in the mid-Sixties, but once that happened, its market began growing steadily to soon transform it into the most popular of all “drugs of abuse;” indeed, the only one ever to approach alcohol and tobacco in number of adolescent initiates year after year.

Another implication of the study is that once “reefer” had been discovered by leading-edge Baby Boomers, its steadily growing market had been sustained by millions more "kids" who continued to try it by getting “high” between the ages of 12 and and 18, as faithfully documented by annual MTF studies since 1975.

By way of ironic coincidence, the phenomenon of anxiolysis had been articulated and the first effective anxiolytics were being discovered, patented, and aggressively marketed by the Pharmaceutical Industry as Miltown,Thorazine and Valium.

The ultimate result was that Nixon’s drug war against marijuana users became easy to sell to the "silent majority" that elected him, thanks largely to a generation gap exacerbated by the Baby Boom, an unpopular war, and the behavioral indiscretions of idealistic pot-smoking “hippies.” Despite its multiple failures, the drug war still retains a measure of undeserved credibility, precisely because of pot’s continued popularity in junior Highs and High Schools.

The quasi-religious restraints of drug war doctrine seem to have prevented anyone in a position of responsibility from asking some very obvious questions: why did pot suddenly become so popular in the first place? Why has that popularity been so stubbornly maintained? Why is it the only "drug of abuse” to have developed its own legalization lobby?

That those questions haven’t been asked throughout the first four decades of a failing drug war is a matter of record; that they are still neither asked nor even discussed 18 months after publication of a widely read profile of pot users confirms that humans have a penchant for denial.

Another facet of drug initiation and use brought up by our study is the possible role of biological fathers in producing anxiety syndromes in their children, a prominent example of which is currently in the news. As I’ve noted earlier, those syndromes shouldn’t be confused with diseases because they lack characteristic anatomical and chemical features, but they are real, nevertheless. That so many are clearly expressions of “anxiety” and have responded well to self-medication with cannabis should not be ignored (but it is).

One is forced to wonder when, or even if, the world will finally wake up. Will it be before or after wishful thinking and “green” propaganda fail to prevent runaway climate change and widespread coastal inundation?

Doctor Tom

Posted by tjeffo at 07:13 PM | Comments (0)

July 05, 2009

History Lessons (Personal)

Once I discovered that the major attraction of the “high” produced by inhaling, but not by eating, herbal cannabis is a rather predictable user-controlled anxiolytic state, I was in a position to understand why it had become so popular with “leading edge” baby boomers who began trying it in large numbers in the mid-Sixties. A related understanding was why the youthful excesses of the first “hippies” had frightened their parents into giving “Tricky Dick” Nixon a narrow victory in the pivotal 1968 Presidential Election.

Beyond that, I was also in a position to use drug initiation and YOB data supplied by pot applicants to support a view of recent history quite different from that long insisted upon by the DEA, NIDA, and other drug war supporters with obvious agendas.

All of which introduces a related idea about History: in its broadest definition, it’s a strictly human study, but starting in the early 18th Century, History's reach was gradually extended retrograde to permit detailed study of eras long predating the arrival of our species. The disciplines responsible: Geology, Paleontology, and Archeology, didn’t even exist until 18th Century observers became curious about the marine fossils they began noticing on mountaintops; yet by the early Nineteen-Sixties, we had arrived at a coherent Tectonic Plate Theory that not only explains modern Geography, but is also entirely compatible with the Evolutionary Theory that began developing with Darwin’s 1831 visit to the Galapagos. Through intensive study of Genomics, a science made possible after the molecular structure of DNA had been elucidated in 1951, we now have a better understanding of human evolution, migrations, and current behavior.

Nevertheless, it’s still not difficult to find other viewpoints, some of which adamantly oppose any scientifically informed time line that conflicts with scripture, and others seeking to place a more “scientific” spin on traditional religious beliefs.

Given the fact that most living humans still support, and are bound by, belief systems that don’t accept either Tectonic Plate Theory or Evolution, one can postulate that our species’ greatest challenge may be developing a decision making mechanism able to substitute for the destructive quasi-military competition that may now have also become our modern (human) world’s de facto determinant of survival.

Doctor Tom

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

June 29, 2009

Annals of Validation

News sources are suddenly overflowing with items endorsing what I’ve been hearing from pot smokers for well over seven years. Just as I was just about to cite the Michael Jackson tragedy in an entry about the key role played by biological fathers in their children’s mental health, I came across Debra Saunders’ column in yesterday’s SF Chronicle on last week's “drug-related” Supreme Court decision. Deciding the Jackson story will linger considerably longer in the public consciousness, I opted for the equally instructive, but somewhat more convoluted, story from Oregon.

It involves a ninth grader who, in 2001, had been clinically diagnosed with ADHD, but was not “tested” for it and later developed “depression” and “cannabis use disorder” which led his parents to send him to a private school. In 2003, they sued for “equal education” under the Americans with Disabilities Act and after several affirmations and reversals along the way, were finally heard by the Supremes, who ordered, 6-3, that they be reimbursed for the cost of tuition at their son’s (outrageously) expensive boarding school.

True to the “anti-drug” bias of American media, most accounts fail to mention, as Saunders does in her first paragraph, that the unnamed juvenile was self-medicating his ADHD with pot. The “Supreme” irony for me is that our highest court sided with physicians over cops by unwittingly endorsing, albeit indirectly, the treatment of an emotional disorder with cannabis.

That’s a practice I know to be safe and effective, but the DEA regards as a felony and NORML considers “recreational.”

Doctor Tom

Posted by tjeffo at 04:25 PM | Comments (0)

June 28, 2009

Lessons from Pot’s Past; Implications for Its Future

The major unexpected benefit flowing from my curiosity about pot culture and leading me to interview applicants seeking a “recommendation” to use cannabis medically was a study challenging a US policy based on popular misconceptions and targeting a population falsely characterized as deviant and criminal for over seventy years.

That study, now over seven years old and still in progress, did so primarily on the basis of emerging applicant demographics and by uncovering multiple shared characteristics suggesting that the pot market’s steady growth was based on marijuana's safety and efficacy in self-medicating a wide variety of physical and emotional symptoms.

With respect to the demographics, the lurid Hearst-Anslinger “reefer “madness” campaign preceding the Marijuana Tax Act of 1937 had been so famously camp that few seem prepared for one of the study’s most important implications: whatever illegal market for “reefer” existed in 1937 must have been tiny. Also, it had remained that way for another three decades before exploding in the Sixties. That it was tiny is confirmed by infrequent news about busts; however such negative evidence tends to be overlooked; particularly in a world overburdened by information and anxiety.

However that may soon change in ways that will be hard to ignore. A seldom-acknowledged characteristic of the silent majority responsible for electing Richard Nixon in 1968 has been their pot avoidance. Although small compared to the boomers they sired and nurtured throughout the late Forties and the Fifties, they have been relatively long-lived, thanks to modern medicine. What has always distinguished them has been the relative infrequency with which they try pot themselves.

A clinical observation I’ve made just often enough to have some confidence in (but have no statistics to support) is that older adults who never tried pot tend to resist using it, even after developing conditions that it should help. They will refuse to try it until late in the game; if they do so at all, it’s only after all other measures have failed and it’s been recommended by someone they trust.

People who tried pot as adolescents, on the other hand, seem to have given themselves permission to use it if they need it; even if they haven’t been recent users. In other words, adolescent pot initiation seems to carry with it lifetime permission for medical use. Thus does my demographic profile of the applicant population suggest that when the first Boomers reach Medicare age in about three years, we should see a steadily increasing demand for “medical” marijuana for the same reasons they eventually came to dominate American society: so many were born after World War II.

Doctor Tom

Posted by tjeffo at 04:15 AM | Comments (0)

June 22, 2009

Paradoxes in the News

As my recent posts on the Lynch case show, I’ve become considerably more critical of Obama for the outright dishonesty of his “Justice” Department in its handling of medical marijuana cases in California than anything he has (or hasn’t) said about fraudulent elections in Iran. In fact, my personal choice of low point among Obama’s many video moments is still his derisive snicker at the idea that taxing pot might be a fix for the budget crisis. Why? Certainly not because I thought the suggestion had merit, but because I’d hoped Obama knew better; also because his answer suggests a mindset I now recognize as one that will prove difficult to correct.

To return to Iran: for me, the very issue illustrates why conservatives tend to oversimplify complex situations; it allows them to blame others for any adverse consequences of their “faith-based” convictions while also tending to absolve them from any responsibility for similar consequences. Also, their frequent references to faith and religion reinforce the notion that they are on the side of good and that the “godless” liberals and atheists they have designated as sworn enemies should not be trusted.

It has also helped their cause that the most flamboyant pot smokers often come out of the closet early, while the those with the most to lose have tended to remain anonymous during life.

Thus does the pot our president once got high on, but had to quit to realize his political ambitions, remain more “evil” than the tobacco he still struggles with (not quite) out of sight.

On a more personal level, that our profile of pot use has elicited so disproportionately few comments is both annoying and a confirmation of the denial America's (stupid) pot policy has been thriving on.

Doctor Tom

Posted by tjeffo at 06:30 PM | Comments (0)

June 20, 2009

Iranian Digression

It’s now just over a week since Iran’s Presidential election, widely expected to show popular discontent with the incumbent, managed to do just that; but in ways that were unpredictable and potentially destabilizing. Even more significantly from my point of view, the past week’s events can be seen as a remarkably accurate metaphor for the systemic malaise plaguing our species.

From a strictly logical point of view, the fact that Iran’s President Ahmadinejad is an outspoken Holocaust denier who had received his government’s official endorsement for that view should have prepared us for the enormity of the claims surrounding that same government's report of his “re-election” a day later. While it was clear to all that the claims had to be bogus, what was left unresolved was whether they reflected ineptitude or contempt on the part of the power structure's "supreme leader".

As for the much debated political wisdom of Obama’s muted response, it’s still too early to know whether those who claim it’s just right, or his right-wing critics, who claim it’s craven, will prevail for reasons that are both similar and quite straightforward: not enough is known in the West for accurate predictions.

Similarly, does yesterday’s announcement by the “supreme leader” represent an accurate prediction of victory or wishful thinking? Can he rapidly crush the demonstrations? If he can’t, his grip on power may continue to weaken; even so, any new government that emerges will still be Islamic and predominantly Shiite, and thus hardly pro-American.

One truth most seem to (silently) agree on: thanks to Dubya’s war on terror, the US has neither the military nor the economic strength to intervene in Iran (or even North Korea, for that matter) thus we are reduced to a spectator role.

Given the present state of global affairs; that may be the safest course, but even that is uncertain.

Doctor Tom

Posted by tjeffo at 09:49 PM | Comments (0)

June 18, 2009

Amazing!

It seems that every time I‘m about to give up on the possibility of spontaneous drug policy enlightenment, a column like one in today's NYT appears. Even though Kristof’s thinking about the issue is almost identical to that of the late Wm. F Buckley, Jr. when he provoked so much furor in 1996, the context has been changed significantly by what has happened since, as contemporary comments (and the speed with which they have appeared) make clear.

Unfortunately, there is still the same deep division between religious type control freaks who believe a coercive prohibition policy is essential and those who are more realistic. The good news is that thirteen years later, the latter seem less inhibited and are more outspoken; but a critical question remains: can they wrest control of the world fast enough to save it from their fear-driven fellow humans who have been dominating governments throughout history?

Doctor Tom

Posted by tjeffo at 06:01 PM | Comments (0)

Darwin and Lincoln

The discovery, some time in ‘06 or ‘07, that both Charles Darwin and Abraham Lincoln had been born on the same day in 1809 was very exciting for me. My own rejection of any sort of “divine” intervention in human affairs leads me to consider it a mere coincidence; even so, coincidence in this case becomes a convenient device for learning from the lives of two men who exerted such enormous, and generally benign influence on the lives so many others— indeed, on our modern world as we now know it.

Although born on separate continents into very different economic and social circumstances, the two shared a common language and both went on to become famous during their own lifetimes and to influence the lives of contemporaries and all posterity. Indeed, it is difficult to conceive of how our modern world might now look had both not lived.

It’s also significant that both became objects of hatred during their lifetimes and that both the positive and negative emotions they inspired have continued growing unabated since their deaths.

What I now see both lives as demonstrating is the power of the human brain to interpret and respond to information in ways that have a unique and lasting impact on both the intellectual and physical environment. In a sense, any who survive to maturity also have an impact that outlives us, but, in most cases, to a far more modest degree, and in ways that, except for progeny, can’t be traced. Did their great fame and notoriety bring Darwin and Lincoln (henceforth, D & L) happiness? The answer seems to be no; in fact quite the opposite. What those of us who admire them can hope is that they each gained a measure of intellectual satisfaction and peace from their accomplishments.

Why am I switching styles so abruptly? It's because Inow accept that although the unlikely research project with pot smokers I've been blogging about for over three years has provided me with clinical information known to very few others, it's also information very few seem to want, and there's not a lot I've been able to do to change that.

Given both the size of the growing blog universe and the ease with which one can now upload text, its use as a publicly maintained personal journal has never been easier. Also, the efficiency with which web content can be searched means that whatever readers I do attract can always find me. Finally; the gamut of emotional responses that seem to be inspired by any discussions of cannabis, its users, and its phenomenal modern market is so bizarre I've decided to just say what I think rather than pretend that I'm writing for people with an honest interest who are looking for an intelligent discussion.

Another way of putting it is that perhaps the least likely subject upon which one can provoke an informed, intellectually honest discussion is pot. Although I know there are many bright, well educated people with a serious interest in all aspects of its use, public pronouncements about that use are most noteworthy for the incredible silliness of policy advocates and the reticence of others with an interest to discuss salient issues honestly.

Thus I've decided to simply present what I believe to be true based on an ongoing analysis of my clinical encounters with pot smokers and let the chips fall where they may.

Doctor Tom

Posted by tjeffo at 04:21 PM | Comments (0)

June 13, 2009

Embarrassing Reminders of Drug War Crimes

Two items on smoking and health appeared in the New York Times on Friday, June 12. While either one by itself should deeply embarrass our federal war on drugs, the two, when taken together, add up to a startling revelation of how feckless and destructive our drug policy has been, and just how empty our claim to adhere to the “rule of law” really is.

The first reported the Senate vote to transfer tobacco regulation to the FDA, a move that belatedly admits cigarettes are drugs and not the “recreational” products their manufacturers have always claimed. I was immediately reminded that the first solid medical link between cigarettes and lung cancer was established when I was a first year medical student in the Fall of 1953. The resultant drop in cigarette sales was eventually countered by Big Tobacco's cynical, well financed, and ultimately successful effort to delay acknowledging obvious truth for decades while allowing it to reap more profits from its deadly products. Given the circumstances that existed in 1953, an immediate ban on cigarettes would have been impossible; also, there is ample evidence that simply banning a popular drug is ineffective. However, neither consideration can justify the pathetic failure of the government to sponsor honest research of its own, while also permitting a powerful Tobacco Lobby to spread confusion and market its deadly products to juveniles thus causing millions of additional deaths over a span of five decades. Tobacco-related deaths are not only a result of lung cancer; but are also caused by cardiovascular disease, several other malignancies, and chronic obstructive pulmonary disease (COPD).

The second Times report was on the sentencing of cannabis dispensary owner Charles Lynch to a year and a day in federal prison. That the sentence was so short was mostly due to the judge, who had clearly been requesting more help from the Obama "Justice" Department than he received. The apparent excuse from Justice for not intervening: its current interpretation of policy requires federal enforcement in cases where, in their judgment, state law has been violated!

Presumably, the sin was sale to an underage minor in this case, a particularly odious canard because cannabis facilitated successful treatment of a rare and aggressive bone cancer that typically attacks adolescents. If such contrived logic is the Obama Administration's ultimate defense of the DEA, it's a position that is medically, morally, and logically indefensible; far more typical of the usual Democratic Party pandering to conservatives many have come to loathe and not the “change” we wanted to believe in.

But, far beyond that, the juxtaposition of the two reports emphasizes the profound intellectual dishonesty of a drug policy that consistently allows our government to cut excessive slack to a variety of well-heeled corporate killers, while demanding the arrest and harsh punishment of millions of young people self-medicating with a safer alternative to alcohol and tobacco.

The moral failure of the drug war has been total: first they declined a 1972 recommendation to study pot honestly, then they spent billions justifying the arrest of millions of pot users, thus pushing others into self-medicating with its two deadly, but legal, alternatives.

Complicit “research” purchased by NIDA from willing behavioral scientists in an obvious effort to support federal policy errors will not stand rigorous scrutiny indefinitely. Similarly, the failure of both Big Pharma and Academia to acknowledge the potential therapeutic benefits of cannabinoid agonists after discovery of the endocannabinoid system in the early Nineties will be increasingly difficult to explain to our descendants in decades to come.

Doctor Tom

Posted by tjeffo at 08:25 AM | Comments (0)

June 11, 2009

Back to the Future

Although “recorded” human history implies written language and we tend to think of the first humans to devise writing systems some six thousand years ago as “ancients,” modern science has revealed that Homo sapiens, a species that's been around for only a few hundred thousand years, and is thus new as species go, are probably descendants of Miocene Apes that didn't make their appearance until about nine million years ago. Beyond that, the techniques of Science are such that much of what we now consider “progress” had to wait until certain widely believed assumptions about the physical world could be subjected to critical scrutiny, a process that has been shaping the modern world at an increasing rate since the beginning of what we now call the Industrial Revolution.

In other words, most of what we now (think) we know about the Universe (Cosmos, Metaverse) has been learned since George Washington was born in 1732, not quite three hundred years ago. To belabor that example a bit further: just as we now realize he was just another fallible human, Washington's limitations didn’t prevent him from leading an improbably successful rebellion against the dominant imperial power of his time. Further, like every other major historical figure, his impact on history depended mostly on chance, in the sense that it could not have been accurately predicted in advance. Beyond that, the consequences of his leadership have become inextricably intertwined with countless other events. Yet; somewhat paradoxically, to the extent we do understand the cosmos, the evidence that it behaves in discernible repetitive patterns (“natural laws”) has been growing, as has the influence of our own species in shaping events on our home planet.

The origins of what is now loosely defined as the Scientific Method go back to the work of Galileo and Newton in devising experiments by which the then-heretical postulates of Kepler and Copernicus could be tested. In essence, the beliefs of Science and (monotheistic) Religions have been in conflict ever since then, and can be seen as foreshadowing much of the strife that has plagued the world since before the turn of the Twentieth Century (and well before).

Our modern paradox is that ever since humans became the only species able to employ cognition to make choices and fabricate complex tools, we have been exerting a significant impact upon our planet's other life forms. Through Science, that impact has been magnified to a point where we may now be altering the weather patterns those life forms depend on for sustenance.

At the same time, the continued domination of human cognition by religious thinking, together with our appetite the artifacts made possible only through science, are competing in ways that are forcing human behavior into directions that do not auger well for either short or long term species survival.

One may well ask why a "pot doc" who only recently became preoccupied with the human use of cannabis would be writing about such abstruse concepts. An answer is hinted at in two recent periodicals; first the July-August issue of Atlantic (not yet online) that arrived only yesterday. What caught my eye was Jamais Cascio’s response a question Nick Carr raised in the same magazine just a year ago: Is Google was making us “stoopid.” Cascio's answer, seems to be, far from it; but Google, and the web in general, are definitely having an impact on how we choose to exert our cognitive influence.

To frame the issue in terms of cannabis, its popularity as an illegal drug has clearly increased in parallel with the incidence of the ADD behavior Carr so eloquently describes and Cascio refers to repeatedly. From my clinical perspective, the absurd federal insistence that pot must remain forever illegal was first tested by California’s Proposition 215 in 1996 and is still staunchly defended by most police agencies and the Obama Administration. In the second timely item, the San Francisco Chronicle reported that "legalization" may well be tested more directly in 2010.

Thus, we may still be on track to accomplish the general intent of Proposition 215; although by a route its 1996 backers could not have predicted. In another entry, I’ll explain why whatever initiative voters get to vote on will probably be “stoopid.”

Doctor Tom

Posted by tjeffo at 10:54 PM | Comments (0)

June 10, 2009

More of the Same

One of the more glaring examples of denial in our modern world is the degree to which the failure of America's war on drugs has been either ignored or systematically misinterpreted; not only by our own government, but by those of the UN nations bound by treaty to enforce it. With the exception of the Netherlands and Portugal, drug war heresy has been rare, and even where it has emerged, often been timid and reversed by American arm-twisting. Witness: Australia, Great Britain, and Canada.

Given the mountain of available evidence, any pretense that the drug war has been even occasionally successful, or represents rational public policy, simply cannot stand serious scrutiny; yet the official pretense continues. Although the latest example of failure is again Mexico, one need not stop there; Colombia has been ravaged by violence since the cocaine trade began to expand in the Seventies while people in other “producer” nations, notably Burma and Afghanistan, are each paying a high price for their involuntary participation in illegal drug markets. In every instance, the violence and political instability can be related to one factor: huge revenues generated by thriving criminal markets.

Although I recently had hopes that the “change” being touted by the Obama Administration might include a measure of sanity with respect to marijuana prohibition (the crown jewel of police agencies surviving on their drug war failures), I am now convinced that hope was forlorn. However, I’m still curious as to how we will respond to the latest challenge from Mexico, a long-suffering nation where a repressive government is trying to please its obtuse Northern neighbor by enforcing a policy no one wants to admit is so unbelievably stupid.

Sooner or later, someone will have to wake up to reality; one hopes there will still be time to save us from our multiple other follies.

Doctor Tom

Posted by tjeffo at 05:30 PM | Comments (0)

June 04, 2009

Going Back in Time

One of several themes I’ve been harping on with little visible effect is that the modern mass market for marijuana didn’t start developing until young adults and their adolescent brothers, sisters, and cousins began trying it in the Sixties. Once it caught on with youthful baby boomers, it became an overnight sensation, but only with them.

Characteristically, the pot market that began growing in the Sixties has remained a youth market; nearly all its new customers tried it while in High School or Junior High, and with at least half (perhaps more) of all new students admitting to trying pot since Monitoring the Future surveys began in 1975, it hasn’t taken long for the modern market to dominate all illegal drug markets.

The percentage of youthful initiates who continue to use pot on a regular basis can’t be measured directly, but the increasing appetite for "medical" marijuana here in California, despite the vigorous opposition of both federal and state narcs, can no longer be hidden by the inept reporting of the state's newspapers nor the dissembling of police agencies. The reasons are obvious: once a substantial number of retail “medical” outlets opened, growers were able to sell to the same buyers through either a black or a gray market. It combines the convenience of multi-level marketing with price support by the police (compare today's with those given in the Time article).

Now that Google is making our past more accessible, it’s literally possible to go back in Time (Magazine) and read a revealing account of how marijuana was perceived and used around the time of the Marijuana Tax Act. One of the more famous pot busts of that era was drummer Gene Krupa in San Francisco in 1943. An unexpected bonus from Time’s account was then-contemporary lore, amply confirming there was appreciation that pot was a healthier and more peaceful alternative to alcohol; also that law enforcement was just as unfair as it is now. The major difference between then and today is a big one however; our modern failure is much more costly and destructive.

Doctor Tom

Posted by tjeffo at 05:42 AM | Comments (0)

May 31, 2009

Annals of Misanthropy

In today’s New York Times, there are not one, but two items that promised a marginal understanding of prohibition reality, but sadly; soon devolved into the usual law enforcement sermons on the evils of drugs and addiction. During the first video, I wanted to grab the speaker’s expensive lapels and shout, “it’s not the drugs, you knucklehead; it’s the money!”

The second item, bemoaning the impact of Mexico’s drug war on Ohio, was just as clueless. Although it also mentioned the complimentary illegal arms market through which American gun dealers balance our expenditures on illegal drugs from Mexico, it, like the first one, barely mentioned what is a third facet of an illegal trifecta: aliens who pay to be smuggled across the border for work, which predictably, will turn increasingly illegal and violent if the economies of both nations continue to falter.

The only good news on our Mexican horizon may be that those worsening Economies could force the fools running both governments to reduce their law enforcement budgets and hopefully, coerce some of the cops now busting dopers into either an unemployment line or more honest lines of work; perhaps even “protecting and serving” the people they work for, rather than just ripping them off.

Doctor Tom

Posted by tjeffo at 08:26 PM | Comments (0)

May 30, 2009

Worst Fears Confirmed: Obama doesn’t get the drug war either.

After months of mixed signals that began when the DEA raided a South Lake Tahoe dispensary in January, the Obama Administration finally admitted it is continuing the disgraceful federal war on medical marijuana in California; apparently using the tortuous logic that it's simply upholding California law banning sales (of alcohol?) to minors. At least that’s the most logical interpretation one can glean from recent events and the Obama Administration's response to a request for clarification from an openly distraught Judge Wu in the Lynch case.

To understand the well-documented injustice so openly exposed by the Lynch case, one has only to browse any of several videos. Sadly, the latest federal statement is entirely consistent with several pusillanimous non-decisions the Obama administration has made on other contentious issues: gays in the military, Guantanamo detainees, and support for the failed Bush war on terror, to name but three.

That there can’t be an abrupt break with a failed policy of the past, especially one as thoroughly institutionalized as the drug war, is obvious; however that doesn’t excuse the performance of this administration to date; nor does it auger well for its approach to governance, one that seems based more on political maneuvering than on any clear sense of integrity, reality, or history.

There’s more to leadership than besting one’s political opponents, particularly a crew as inept as today’s GOP; one should also have a firm grasp of the major issues of the day.

Any notion the drug war is a failure we can still afford should have long since been discarded.

Doctor Tom

Posted by tjeffo at 06:00 PM | Comments (0)

May 25, 2009

Message from the Gulag

The following was OCR'd from a typed message received from Dustin in yesterday's mail. When we spoke on the phone this morning; he was still optimistic and in remarkably good spirits, even though he had already heard of Eddy Lepp's obscene sentence.

I know he would be delighted if anyone reading his message took the trouble to let him know; and that he's remembered.

SEIZE THE MOMENT

For a moment, I thought I was hallucinating. Sure, there have been a number of clues lately that there could be a sea change afoot in the war on drugs: the recent Zogby Poll showing 52% of Americans now support outright legalization of marijuana, Assemblyman Ammanio's bill in California to legalize marijuana, and all the other support it has received; Hillary Clinton's comment in Mexico that the American appetite for illegal drugs is helping drive the drug war violence in Mexico; the call for decriminalization of all drugs by several former Latin American Presidents; the promise of Attorney General Holder to stop the D.E.A. raids against Medical Marijuana care givers. and the President's call to end the disparity in sentencing between crack and powder cocaine. But none of this was as stunning or as helpful as the new Drug Czar's call for an end to the War on Drugs in his first interview after his confirmation only hours before, which was the page three Headline in the May 14th, 2009 Wall Street Journal.

As the realization sunk in that this was no mirage, and even before I actually read the article, I excitedly showed it around to other inmates here at Big Spring, most of whom are doing time behind drugs. This is a place where rumors of relief, of a return to sanity in government, have circulated since the beginning of the prison system. For years we've heard rumors of a return of parole, an end to Mandatory Minimums, wiping out the disparity between crack and powder cocaine sentencing, and a move toward a common sense drug policy; so I wasn’t surprised when my enthusiasm was greeted with the occasional cynical response, "so what, it don't mean nothin' . . . , but most of the inmates I showed it to were mildly, to very enthusiastic. I think this time the cynics are wrong. I think when America's Drug Czar says the War on Drugs isn't working and it’s time for a new approach, it means something.

For instance, Drug Czar Kerlikowske believes drug policy should shift in emphasis from enforcement to medical, this is an opening for Harm reduction strategies for which medical marijuana is ideally suited! This could be an opportunity for Medical Marijuana to show its effectiveness as a substitute for alcohol, tobacco, cocaine, methamphetamine or heroin addiction. Pot Docs have been recommending marijuana for years as a Harm Reduction strategy with excellent results. Perhaps now we can become a recognized and potent force in helping to wean the addicted away from the monkey on their backs.

The door is not only open now for Harm Reduction, but also for rescheduling marijuana.

Further, as more states come on line with Medical Marijuana laws of their own, (perhaps as many as 20 or more will have Medical Marijuana laws on their books by the end of 2009) there will be a move to legalize it nationally.

Much of what is positive now in opposition to the War on Drugs is due to the relentless and courageous efforts of people in the Medical Marijuana community, but none of it would be possible were it not for Marijuana's tremendous popularity. Of all the illegal drugs, Marijuana is not only the most popular and least harmful, it is also safe and effective medicine.

Sitting here in this Federal Gulag in Big Spring, Texas, witnessing the changes going on on the outside, I only wish I could be there for the final push. This is an ideal time to organize and lead and actually make a difference - unfortunately for me, I won't have that satisfaction - but I urge anyone with a talent to lead and organize to seize this moment. Make a difference!!

Dustin R. Costa 62406097

Federal Correctional Institution

1900 Simler Ave

Big Spring, Tx 79720

Posted by tjeffo at 02:20 AM | Comments (0)

May 24, 2009

Still Connecting Dots: Science, Religion, and Drug Policy

Although Science has only been an instrument of human cognition for about five hundred years, the theory and information thus accumulated have had more impact on our species and its environment than occurred in the previous six thousand; roughly the interval since our ancestors began domesticating animals, practicing agriculture, and communicating in abstract symbols.

Nevertheless, the belief systems still dominating modern governments, whether acknowledged as theocracies or nominally sectarian, are predominantly religious in nature; thus in continuing conflict with Science, and with each other.

Despite nearly continuous background warfare throughout human “civilization,” recent scientific progress has been so quickly translated into ever-accelerating expansion of the human population, that we now depend more than ever on fresh water, petroleum, and commerce for essential commodities, a major reason why today’s economic crisis may represent an unprecedented threat to human survival.

In that context, the fact that the poignant description of Autism in today’s NYT makes no mention of cannabinoids should be disturbing, given the fact that all the Californians I’ve seen because they were seeking a recommendation to use cannabis had been illegally self-medicating with it and many had been diagnosed and/or treated for a “high functioning” “Autism Spectrum Disorder.”

Since learning to approach pot applicants minus the prejudices still clearly so prevalent in most of society, I’ve been trying to understand the kind of thinking that would allow a federal judge to sentence Eddy Lepp to ten years in prison with a snide quip. Perhaps one day, she will explain the “justice” of her decision, or the physicians specializing in related conditions will also explain why so many of their patients with “high functioning” variants seek solace from drugs during adolescence. Perhaps other professional scientists will explain their passive forty year acceptance of a blatantly unscientific and unfair drug policy.

Doctor Tom

Posted by tjeffo at 09:15 PM | Comments (0)

May 23, 2009

Thanks, Google!

One of many frustrations I’ve encountered in trying to educate people about what I’ve been learning about the drug war from the structured interviews of pot applicants I’ve been conducting for over seven years is that most people are too distracted by their own problems to focus on what they are hearing; it’s a problem that has been increasing in both scope and intensity as culture accumulates, one which, for those of us who spend too much time on the web, is epitomized by Google.

For the great majority who aren’t obsessed by information and don’t have the time to conduct endless searches, talking about an abstraction like the “illegal marijuana market” just doesn’t cut it; precisely because it can conjure up completely different images from those intended.

While composing the most recent entry, I came across a new Google feature called Timeline, which can literally create a graphic image from the enormous amount of material already entered in Google archives.

When I googled marijuana arrests, and then selected Timeline view from among the options, I was rewarded with both a graph and a linked collection of relevant web pages. While not the whole answer, it does go a long way toward simplifying the main message I’m trying to get across: any policy as obviously unable to confront its own history must eventually lose all credibility.

Our main problem then becomes one of endurance: how long can our society tolerate such an obviously stupid and dishonest public policy as the war on drugs?

Doctor Tom

Posted by tjeffo at 05:48 PM | Comments (0)

Yet Another Take on Guantanamo

Yesterday was eventful; at least in terms of an issue that could define the Obama administration's first term: what to do with the “detainees” still being held in varying degrees of anonymity at Guantanamo?

In terms of the evening political line-up that's been evolving on cable TV since the war on terror began in 2003, MSNBC’s Rachel Maddow and Keith Olbermann can be thought of as liberal counterweights to the unabashed fascism of Bill O’Reilly and Sean Hannity, with Anderson Cooper holding some fuzzy middle ground at CNN.

Although Maddow had been an Obama supporter, she has, of late, been critical of his backsliding on gays in the military and failure to emulate Harry Truman by solving that problem with an Executive Order. Yesterday she surprised me a bit by firmly taking him to task because his position on Guantanamo actually extends their (illegal) detention. Thus, while claiming to correct the Bush Cheney “mess,” it compounds it by accepting its major premise (I don’t recall if she mentioned Lincoln’s suspension of habeas corpus).

I completely agree more with Maddow’s impeccable logic. On the other hand, I would also point out that the model for such legal (and “scientific”) schizophrenia has long been Nixon’s drug war, which has sold its particular brand of pseudo-scientific nonsense so successfully that one of the few things every nation in our deeply divided world now agrees on is that any traveler daring to bring a minute amount of herbal cannabis into one of their ports of entry will be arrested forthwith and treated as a criminal.

When Maddow, who hails from San Leandro and went to Stanford, is able to spare some outrage for the federal medical marijuana “criminals” from her home state who have been unfairly prosecuted and are still being imprisoned for obeying a valid state law, maybe I’ll find her quest for federal Judicial purity a bit more credible. Until then, America’s vaunted "Rule of Law" is nothing but politics: whatever one is able to get away with.

Doctor Tom

Posted by tjeffo at 02:13 AM | Comments (0)

May 21, 2009

A Classic Example of Getting it Wrong

Of all federal agencies, those most obligated to follow the erroneous road map supplied by drug war policy makers would be the uniformed services; which was the main reason a headline in today’s USA Today caught my eye as I was leaving the local super market

The obvious (to me) reason commanders aren’t punishing those who test positive is almost certainly because there are simply too many of them and although the article carefully avoided naming the drug most frequently found in positive urines, there’s little doubt in my mind it’s marijuana, because I also know with considerable conviction that pot is probably the most effective drug for treating PTSD, a condition already identified as a major cause of depression, suicide, and “substance abuse,” problems among those returning from overseas deployments.

By the way," I also see “substance "abuse"” as a synonym for "self-medication; thus I might be amused at the basic cluelessness of the article, if I weren't so upset by the needless suffering and avoidable mortality it (typically) fails to recognize.

Doctor Tom

Posted by tjeffo at 10:33 PM | Comments (0)

Is Obama Starting to Live up to Expectations?

Have just heard Obama’s speech on closing Guantanamo and am now listening to Cheney’s rebuttal. Since I’ve also lived through the last ten years as a sentient human being, there’s no question in my mind who’s version of “truth” deserves more respect.

As a nation, we’ve been here before; it’s known as the “ends justifying the means,” with each man laying out reasons why such is occasionally necessary: Lincoln did suspend habeas corpus during the Civil War and Roosevelt imprisoned Japanese-American citizens in California (but not in Hawaii) during World War II. However, historians have not defended either of those actions as consistent with our values in retrospect.

Both Obama and Cheney are asking that we trust them and their judgment. For me, Cheney was still using the unmistakable reasoning of Nixon, Limbaugh, Reagan, and Anslinger. I’m still not certain about Obama because his Presidency is mostly in the future; but I am sure about the past administration, because their repetition of so many classic errors of the past, together with their equally classic justifications, are still fresh in my mind.

I’m waiting to see if Obama will apply similar reasoning to our grievously mistaken war on drugs.

Finally; a comment about the fear expressed by a Republican Congressman from Colorado that the the federal supermax prison in his district might be ued to house Gitmo detainees: I can't think of a sillier argument- or a better example of Cheney's despicable "logic."

Doctor Tom

Posted by tjeffo at 05:00 PM | Comments (0)

May 20, 2009

Annals of Uncertainty

In addition to its recent mixed signals on medical marijuana, the Obama Administration seems to be rethinking another controversial policy: the awkward “don’t ask, don’t tell” position on homosexuality in the Military that became policy in 1993 when Bill Clinton was unable to keep a campaign promise and demonstrated that he lacked the political courage of a Harry Truman.

Since DADT became policy, about 12,500 service members have been outed; however, the rate has declined significantly since the military has been fighting in two protracted wars started by the Bush Administration in response to 9/11. In addition to the well-known conservatism of Republicans and flag officers, two other subtleties may be hinted at in that statistic.

One is that retention of younger gays who have have already demonstrated their willingness and ability to do the job makes perfect sense in a setting in which recruitment has become a problem and rank and file service personnel seem untroubled by their presence.

Another is suggested by the otherwise irrational decision to cashier an outstanding Lieutenant-Colonel two years short of retirement: his potentially expensive lifetime benefits would be saved.

All of which raises more troubling questions. If; as they have been hinting, the Obama people plan to wait for a more propitious time to seek certain changes once “believed in,” would those changes be retroactive? Would medical marijuana offenders arrested, convicted, or sentenced by the feds in California either be pardoned or have their sentences commuted? Would gay service members swindled out of their retirement benefits have them restored?

Doctor Tom

Posted by tjeffo at 05:52 PM | Comments (0)

May 17, 2009

Sea Change or Trial Balloon?

It’s fitting that I didn't learn that our newly confirmed drug czar had hinted at a radical change in the policy he’s paid to support in a WSJ interview last Thursday until Dustin Costa called from the federal prison (in Texas) where he’s serving an obscene fifteen-year sentence as a political prisoner of the drug war.

Although many media outlets either didn’t bother to report it or pretended Kerlikowske’s bombshell was just some minor heresy, its muted reception was further evidence to me that we are starting to see a modern replay of the phenomena that brought down Prohibition in the early Thirties: the Depression had simply made it too expensive to enforce as national policy and its central myth was no longer believable.

That doesn’t mean that de-emphasis of the drug war will follow quickly or won’t be fiercely resisted by current beneficiaries; only that any criticism or suggested modification is no longer the political third rail it once was, itself itself a huge, and essential, step forward.

Still to be resolved in the relatively near future are some vexing details: how will the Obama Administration’s Department of “Justice“ proceed with several grossly unfair federal cases now stuck in the pipeline between conviction (or plea bargain) and sentencing?

We Americans pride ourselves on fairness; yet our media routinely covers trivial injustices far more intensely than those inflicted in support of our failing drug policy.

Doctor Tom

Posted by tjeffo at 07:01 PM | Comments (0)

May 13, 2009

The Human Paradox

Some have called the human brain the most complicated device in the universe; so long as we remain the only species with our degree of cognition, that judgment can’t be challenged; however it doesn’t answer the troubling question at the heart of humanity’s most mportant dilemmas: are we in more trouble from our incompetence or from our dishonesty?

In late 1995, I became intrigued by the drug war as a prime example of a failing policy. A little over seven years later, that same interest, together with my medical training, provided me with an unexpected opportunity to study the drug war’s relentless campaign against cannabis from a unique perspective. I soon discovered that, like all other unresolved scientific issues, it was much more complex than it appeared from the outside; also the more questions one answers, the more it’s necessary to ask.

Not all is frustration, however. Such efforts do hold the implied promise that since all our behavior depends on our complex brains, understanding ourselves might allow us to avert, or at least mitigate, the looming disaster of climate change, and associated shortages of food, water, and energy.

As it happens, there are useful parallels between the drug war and another fraud in the news: that of Bernard Madoff’s breath-taking Ponzi scheme, which like marijuana prohibition, had been undermining a host of worthwhile institutions and claiming countless innocent victims for about the same interval, while also receiving undeserved respect from the very agencies that claim to protect Society’s vital interests.

In the Madoff case, Frontline has assembled an impressive indictment of the SEC and Madoff associates hinting at several prosecutions to come. The most compelling evidence turns out to be the pathetic statements of participants unwise enough to explain their behavior on camera. One does not have to be a sophisticated investor or an economic pundit to realize how much Madoff’s cronies had looked the other way while lining their own pockets; especially after specific charges brought by Harry Markopolos and Frank Casey were first aired over ten years ago.

The situation with the drug war and the federal agencies created to prosecute and defend it is even worse. Both the DEA and NIDA are still carrying on a tax supported campaign that trashes the canons of Science while attempting to protect a policy widely known for its grotesque failures.

But help may be closer than we think, and in a form that has yet to be widely considered: just as the realities of the Great Depression finally made all thought of suppressing America’s thirst for alcohol easy to brush aside in 1933, so may the realities of today’s economic collapse allow us to finally recognize the greater psychotropic benefits of pot over alcohol and tobacco.

One can always hope.

Doctor Tom

Posted by tjeffo at 06:25 PM | Comments (0)

May 09, 2009

Doing the Right Thing for the Wrong Reasons

The push to legalize marijuana in California is motivated primarily by a growing awareness of two separate realities; one is the tsunami of debt that has engulfed the state over the past year. The other is the stubborn popularity of pot’s medical gray market since Proposition 215 was passed back in 1996.

While I have come to believe that we should allow marijuana to be freely grown, sold, and used under adult supervision, I’m realistic enough to accept that some more restrictive form of “legalization” is more likely and would still be preferable to the status quo. Thus I’m hopeful California will push for legal pot sometime in the next few months.

I’d also like to point out that it couldn’t be the quick fix its advocates hope for because that belief is, like much of what is now believed about pot itself, profoundly mistaken. To keep it as simple as possible, today’s huge illegal market didn’t start growing until "kids” discovered the emotional (anxolytic) advantages of pot over alcohol and tobacco in the Sixties. Unfortunately, the excesses of the “kids” who made that discovery frightened their elders into electing Nixon in 1968, thus creating the drug war that has plagued us ever since.

One of several consequences of having a thriving illegal market develop in the nation’s schoolyards for forty years has been a chronic user population that had to discover pot’s advantages over alcohol and tobacco for themselves while still avoiding the punishments mandated by Nixon. It was that population my study of California pot applicants has discovered and (loosely) characterized. Under ideal circumstances, several residual loose ends should be studied before the modern (criminal) product is embraced as medicine, but because I’m now painfully aware of how dishonest we can be in setting public policy, I’ll simply point out the most obvious traps: the cannabis now reaching the US market is a criminal product originally developed by amateurs and long neglected by academic Pharmacology. That situation should be reversed with as little political interference as possible, while still maintaining pot’s availability to the public.

Over the next several weeks I hope to develop these themes more coherently; for the moment I’ll end by suggesting that, now that we may finally have a chance correct the errors of such insecure mediocrities as Hamilton Wright, Harry Anslinger, and Richard Nixon, in creating our current drug policy mess, let’s take care not to repeat them.

Doctor Tom

Posted by tjeffo at 06:08 PM | Comments (0)

May 02, 2009

Is the Lynch case the Ultimate Drug War Sell-Out?

I’m now nearly certain that within the past two weeks, the Obama Administration has been quietly signaling its intention to continue the federal war on medical marijuana in California through Attorney General Eric Holder's failure to answer the request of an obviously distraught Judge George Wu for direction in the sentencing of Charles Lynch. For me, it is both a sickening development and a clear sign that, for all his bright promise, Barack Obama is just another politician.

For those still unfamiliar with the case, Lynch was running a squeaky clean pot dispensary in the coastal community of Morro Bay when he was arrested by the (Bush) DEA in 2007 with the collusion of his local sheriff. The case is well summarized in a video narrated by Drew Carey. What I hadn’t emphasized when reporting it here was that the underage patient featured in the video is such an unequivocal example of the medical benefits of cannabis and the sentencing of Charles Lynch to prison such an unequivocal example of drug war dishonesty that I could not support any government that would excuse it.

The lesion leading to amputation in the case was almost certainly an osteogenic sarcoma, a relatively rare, but well-known form of bone cancer that typically affects teens and often presents as a broken leg following minor trauma, as it did here. During my medical school and surgical training, most such cases died shortly after amputation because tumor cells were already present in one or both lungs when the diagnosis was made. During my senior year in college a popular young fraternity brother broke his leg before Thanksgiving, returned in February minus the leg, but full of hope, but soon had to go back home when he began coughing up blood. News of his death shortly before Graduation in June had been the shocking finale.

That sequence remained typical of osteosarcomas in young people throughout my next several years in medical school, surgical training, and military service. However, just as I was entering private practice in the early Seventies their outlook was greatly improved by adding two aggressive new therapies to the standard amputation. One was what would normally be lethal chemotherapy to treat the invisible spread to the lungs, followed by a “rescue” agent to keep the patient alive. Because some lung lesions did survive, a tight schedule of follow-up x-rays and prompt removal, by multiple operations if necessary, was added. Although controversial when first advocated, those aggressive additions were deemed justified by the youth and generally good condition of most patients, and overall survival rates quickly increased from a dismal 5% to over 50% after they became the standard. One of my more gratifying cases in early private practice was just such a patient, treated at about the same time as Senator Ted Kennedy’s son Teddy.

Thus I know multiple aspects of this particular case from personal experience: the therapeutic ordeal, the unique benefits of cannabis, the amazing dishonesty of the drug war in justifying the conviction of Charles Lynch, and the outrageous courtroom behavior federal prosecutors routinely get away with in these cases.

The sequence of events in the Lynch case suggests Holder has already embraced what is clearly a desperate and despicable new DEA strategy; whether Obama knew those details or has simply accepted them as his staff’s best judgment is unimportant. Right now the only chance of keeping it from becoming a humanitarian disaster for the cause of Medical Marijuana and a political disaster for the Obama Administration would be a prompt course reversal by the Attorney General.

I’m not holding my breath.

Doctor Tom

Posted by tjeffo at 02:56 PM | Comments (1)

April 26, 2009

Epistemology, Irony, and a Paradox

Epistemology is a technical term for the study of knowledge; the basic questions dealt with are, “what do we know and how do we know it?” Thus, although it’s a term few use comfortably, many of us devote considerable time and energy to its basics, a fact underscored by the frequency of certain constructions: “to tell the truth,” “in truth,” In point of fact,” as a matter of fact,” etc..

Nevertheless, most of what we humans now know reliably about our home planet and its universe has only been learned over the last five centuries. Among the more salient epistemic facts is that although we know we’re not the only cognitive species, we’re the only one capable of accumulating and retrieving today’s vast array of useful knowledge. Less well appreciated is that profligate exploitation of that knowledge has trapped us in a series of problems requiring urgent resolution, but sadly, our chronic inability to reach agreement casts doubt on whether we can even define them in time to solve them .

To use an overworked medical metaphor: without an accurate diagnosis, effective treatment is unlikely. An equally critical corollary is that it’s better to begin definitive therapy short of cardiac arrest. Several of the most pressing problems we now face as a species, climate change and the global economy, to name but two, have progressed to points that demand action, yet a host of unsettled problems preclude constructive international discourse, even as disruptive unconventional warfare is being waged on a global scale by non-national actors .

At this point, one might reasonably ask what gives a lone, obscure physician the chutzpah to discuss such issues? My answer is one Darwin could have offered: after starting from a series of chance observations in 1831, he’d followed an obsessive train of thought that led him to several novel conclusions he felt impelled to share with the the world in 1859.

150 years after publication of The Origin of Species, Darwin’s basic insights are still probably unknown to a majority of living humans and would likely be rejected by most who know something of them; yet they have been essential guides for the generations of scientists who have reduced biological inheritance into ever smaller, yet exquisitely related, components retaining an innate coherence at the molecular level.

Thus does Darwin’s life work also resemble that of another great scientist who preceded him by less than two centuries and famously noted that he'd stood “on the shoulders of giants” in ways that are (ironically) still disputed.

To return to my chutzpah, it comes from seven years of doing something that’s been actively discouraged for almost forty: discussing drugs with scorned drug users in an effort to understand their behavior. To my great surprise, that activity and the conclusions it leads to have elicited little overt interest from the very people one would expect to be curious, a circumstance that itself demands an explanation.

In essence, those same histories, and the lack of response they have provoked, add up to a refutation of America’s “war” on drugs that will be outlined in the next issue of O’Shaughnessy’s, a journal chronically on life support, but with an '09 issue almost ready for the printer.

An ironic, even paradoxical, item suitable for interim consideration appeared in today's column by a local pundit, one I’ve praised for her support of medical marijuana and criticized for her (doctrinaire) scorn of “tree huggers.”

Doctor Tom

Posted by tjeffo at 09:20 PM | Comments (0)

April 25, 2009

Progress, too late for some

Just as I was starting to lose all hope, the following link was forwarded to me in this morning’s e-mail. It leads to the abstract of an about-to-be-published Canadian study that sounds like it will substantially confirm that adolescents become cannabis users because it relieves symptoms of anxiety.

What that represents to me is the first small crack in the huge dam of official denial that exists on this issue. I’m now more confident than ever that it will eventually have to give way. The (bitter) irony is that I know of die-hard state and federal prosecutions of bona-fide medical users in my study that are still grinding away in California, even as this is written.

Doctor Tom

Posted by tjeffo at 04:52 PM | Comments (1)

April 19, 2009

Rehab for Pot Smokers? Say it isn’t So, Barack!!

It’s becoming increasingly difficult to remember that back in November, I was actually hopeful that we’d see some intelligent changes in the corrupt and destructive American policy known as the "War" on Drugs. It’s not as if the drug war had ever done anything but fail in the nearly four decades since Richard Nixon’s unexpected election and a surprising Supreme Court decision combined to allow his administration to rewrite what had been a bad drug policy to begin with. The rewrite produced a greatly expanded version of the old policy that soon made things infinitely worse by retaining and intensifying all its erroneous assumptions while creating several new illegal markets for agents that had become available during and after the Second World War.

The result has been been an unmitigated disaster; by expanding the role of police agencies in the practice of Medicine, the Omnibus Controlled Substances Act (CSA) has been responsible for countless deaths and blighted lives; it has corrupted law enforcement, Psychiatry, and the Behavioral Sciences, while quadrupling our prison population, debasing Education and creating business opportunities for powerful transnational criminal organizations that now have the power to destabilize sovereign nations.

Sadly, since taking office in January, the Obama Administration's drug policy initiatives have been disappointing; first, it sent a confusing series of mixed signals on medical marijuana in California; more recently, when faced with resurgent Mexican drug cartels, it dusted off all the old shibboleths favored by past administrations.

The latest is an announcement, seconded by his new drug czar, that we will be relying on rehab to “control” the murderous cartels now competing for a share of the lucrative US marijuana market.

A far more intelligent approach might be to ask why that market has grown so steadily since the Sixties despite all the money spent to suppress it.

Because our study of chronic users in California strongly suggests that inhaled cannabis protects troubled teens from problematic use of alcohol and other drugs, I can't imagine a move more likely to fail. Talk about being trapped in the ignorance of the past!

Nevertheless, our new President was (by far) the most intelligent and open of all candidates in the last election, as he demonstrated again today at a press conference in Trinidad. Perhaps what would help most would be for some members of the press to ask some intelligent questions about pot for a change.

Doctor Tom

Posted by tjeffo at 07:32 AM | Comments (1)

How Drug War Lies Threaten the Policy

Yesterday evening as I was driving home on the Nimitz Freeway, a DEA stooge I’d never heard of was interviewed by an NPR person ( Robert Siegel on All things Considered, I think) about the recent flare-up in Mexican border violence. My jaw dropped when he announced that not only was -marijuana the most commonly smuggled drug, despite its bulk and tell-tale odor, it also rewards its distributors with the highest profit margins. Think about that for a while: pot, the pacifist drug of peaceful stoners and the subject of inane word play has matured as the bloodiest illegal drug market and earns Mexican cartels, their biggest profits.

A few moments later I nearly went ballistic when the DEA stooge claimed that overall illegal drug use in the US is down significantly and only 4 percent of all Americans are repeat users. I became even more upset when Siegel seemed to accept those answers without question. I remained angry for most of the evening over what I’d heard because I’d just had my own beliefs reinforced by a second straight day of patient histories and was thus acutely aware of just how lame the federal position really is.

By this morning, I’d calmed down enough to think a little more constructively and could discover no mention of either the DEA stooge or his message. That allowed me to realize the potential for pot’s popularity, it’s role in provoking bloodshed, or the illegal profits it generates for turning both the drug war and the DEA into objects of ridicule. All it would take is for someone to begin asking the right questions; like “how long can you guys miss stuff that’s right out in front of you?”

At some point DEA absurdity has to embarrass its academic defenders; whether it’s the phony Pharmacology, imaginative Economics, or Psychiatry’s reliance on the absurd DSM is less important than breaking a malignant policy’s grip on power,

Doctor Tom

Posted by tjeffo at 02:03 AM | Comments (0)

April 18, 2009

Enough, Already!

For almost four years, I’ve been using this blog to describe an ongoing study of Californians applying for “recommendations” to use marijuana as allowed by Proposition 215 in 1996. When the study began in late 2001, I was almost as clueless as everyone else then arguing over whether there was "valid' medical use, let alone how to define it. What I soon learned was a result of following a long established clinical technique of treating applicants as patients. Thus I soon discovered that the great majority had been self-medicating their emotions safely and effectively with pot for years–– which was the very reason it had become so popular with baby boomers in the Sixties. That part was relatively easy to understand and paved the way for many additional, and equally unexpected, insights.

What soon became much more difficult for me to grasp was why my attempts at relaying that information to colleagues in the medical marijuana "movement” were almost immediately and uniformly rebuffed without explanation. I would only later discover that most people, (I have to include myself in the indictment), would rather shrink from “inconvenient” facts than deal with intense disagreement. There is also a smaller minority who apparently can't bring themselves to admit ever being wrong.

A related reason was that the earliest "pot docs," had entered the federally contested pot recommendation arena long before I had. As heads themselves, they were largely unaware that they had been suggesting the conditions I would find in vogue as acceptable excuses for pot use when I started. My sin had been the (largely unconscious) invasion of an alien culture. That I was also unschooled in that culture didn't help my credibility.

A variety of denial devices are illustrated by the “good" Germans of the Thirties most of whom eventually discovered during the war, but others were never able to admit, that all Germans had become victims of Hitler’s earliest rhetoric. In other words, the transient comfort provided by denial may someday command an enormous price.

That same weakness has allowed America’s Drug War to evolve incrementally from a relatively small 1914 exercise in legislative chicanery into today's transnational disaster, one of very few laws being enforced across all political boundaries in today's divided world. Possession of pot in any International port of entry risks being identified as a “druggie” and treated as harshly as local custom allows. While we can't be certain all die-hard drug warriors believe their own dogma, we can be reasonably sure most never got high on pot, and those who did can't admit it.

I'm considering publishing a list of those I think are most culpable in America's drug war follies, along with my reasons. I have been moved to speak out this forcefully by an NPR broadcast to be described in the next entry.

Doctor Tom

Posted by tjeffo at 11:33 PM | Comments (0)

April 16, 2009

More on Pot Legalization

Continuing interest in a possible change in the status of marijuana was reflected by two more items in yesterday’s San Francisco Chronicle. On the front page, but probably of less immediate interest, was one about a local politician urging the City to go into business as a pot distributor. He's a well known advocate who is also considered out in front of his support, even in San Francisco.

For me, the story on ASA’s suit and the Ninth Circuit has greater potential for positive change because what my clinical study of pot applicants shows so clearly is that as soon as large numbers of adolescent baby boomers were able to try pot in the mid-Sixties, many of them began using it for its anxiolytic (anxiety relieving) properties. That many continued using it safely and with satisfactory results for over thirty years was the reason they eventually discovered its additional medical benefits.

Thus the dirty little secret neither side of the “debate” that sustains the drug war is one they've both been unwilling to acknowledge: virtually all chronic repetitive use of cannabis could easily qualify as “medical.”

At some point, hopefully sooner than later, there will be a lot of red faces. The great tragedy is that so many lives have been lost or ruined by ignorance, malice, or misplaced self-righteousness.

That such a situation has long been recognized as a Mexican Standoff simply adds a degree of irony that’s nearly unbearable to someone who remembers Juarez and El Paso as they were when he last saw them in August, 1963. The big local news was that then- President Kennedy had just visited to meet with President Lopez-Mateos of Mexico and the two had agreed to settle the long-standing Chamizal Dispute between the two nations.

Doctor Tom

Posted by tjeffo at 04:15 PM | Comments (0)

April 15, 2009

Somali Piracy and Mexican Cartels

At first glance, the disturbing news from two widely separated parts of the world may not seem that closely related; but both are, in fact, good examples of why crime is becoming the world’s most successful business model, one with the power to drag our overheating and overpopulated planet into a high-tech reprise of the Dark Ages from which emergence will be difficult at best and certainly can’t be assured.

The US is widely acknowledged to be both the richest, and militarily, most powerful nation on earth; yet many of our most successful corporations are teetering on the brink of bankruptcy, we are squabbling over an ad-hoc “bail out” with dubious prospects of success, and pundits from both extremes of the political spectrum are finding it difficult to avoid the D word.

While our European colleagues may blame us for many of their own woes, the more responsible ones are forced to admit a degree of complicity and the others have to admit to another harsh reality: their own prosperity is unlikely in a world dom