http://www.doctortom.org/ en 2008-06-29T19:59:06+00:00 http://www.doctortom.org/archives/2008/06/why_this_blog_a.html
This blog will focus on a conundrum that has developed since California passed its unique "medical marijuana" law (Prop 215) in 1996. Although in effect for over eight years, recent developments- including the execrable US Supreme Court, Raich "decision" and yet another overwhelming vote against a Congressional attempt to rein in the DEA, (the Hinchey Rohrabacher Amendment) demonstrate that the strategy of drug war opponents (using sympathy for medical use as a political tool) is still grossly unsuccessful at the federal level. In the past, that was arguably because supporters of the drug war had enjoyed such great success in preventing meaningful scrutiny of their policy; but an alarming new development,: rejection by the organized "drug reform" movement of credible evidence that federal policy has been both egregiously dishonest and indefensibly destructive, is now helping the feds avoid the kind of scrutiny needed to indict the drug war in the only court that matters: public opinion.

In that connection, it's important to realize that in 1969, newly elected President Nixon's "drug war" was a radical expansion of what had been a long-standing, but small and unimportant (in terms of the size of existing illegal markets), policy. Nixon's drug war, as implemented by the Controlled Substances Act of 1970, represented a huge legislative expansion of what had really been a carefully protected sixty-five year policy failure. The CSA quickly allowed drug policy supporters at the federal level enhanced control of drug-related research while simultaneously allowing them to conduct a tax supported propaganda campaign on behalf of their version of the truth: Although ostensibly one of Public Health aimed at protecting careless teens from addiction, the policy had taken diagnostic and therapeutic decisions away from physicians through Supreme Court decisions upholding the Harrison Act of 1914, thus leaving future control of "addiction" to police, prosecutors, and judges for the indefinite future. Both that power and the false sense of control promised by federal policy were greatly increased by Nixon's dug war, as implemented by the CSA in 1970. What (finally) allows some contrary opinions in the ever-contentious drug policy arena is information gathered from thousands of California pot smokers in compliance with Proposition 215. The new law relied on licensed physicians to evaluate those requesting a patient designation; the feds literally created cannabis evaluations as a (suspect) new specialty by immediately threatening any doctor trying to do so. Subsequent developments seriously impeded the ability of applicants to access compliant physicians while also reducing the willingness of both groups to publicly acknowledge such encounters; let alone reveal whatever personal information had been either sought or disclosed.

To cut to the chase; by late 2001, conditions in the Bay Area had devolved in such a way that it was obvious to me that most of the applicants trying to convince me they were "legitimate" pot users were claiming some form of chronic pain relief because they thought it would be their best tactic. They simply hadn't known (as I hadn't) how receptive I'd be to data suggesting that the same emotional symptoms that had made anxiolytics, mood stabilizers, and anti-depressants Big Pharma's most lucrative products had also inspired the modern pot market .

In other words, what I intuited from those early patient encounters was that inhaled pot had long been treating emotional symptoms more safely and effectively than Prozac, Paxil, Ritalin, or Adderall when those agents first came on the market. Analysis of patient responses, still incomplete, has now progressed to a point where it allows some very pejorative conclusions about pot prohibition itself and also casts serious doubt on any substance prohibition as responsible public policy.

A report, written in December, 2004 for the Winter/Spring 2005 O'Shaughnessy's, is still accurate. It was updated by "peer reviewed" publication of similar data from over 4000 applicants in 2007. What is even more recent is my evolving understanding of the rejection with which "reformers" greeted both articles. While not exactly positive, that experience was has proven as important as the data itself for the implications it allows; not only as to why drug policy evolved into a public policy monster, but also why our species may now be poised on the edge of an abyss of it own making.

I hope to continue commenting frankly on why I believe current observations should impact drug policy politics, and will not be shy in identifying both opposing opinions and those venturing them. However, I will try to deal only with the opinions themselves, and then only in settings where authorship is unmistakable.

Readers who disagree are, of course, free to e-mail me. If enough interest develops , a public forum might result.

Doctor Tom tjeffo@comcast.net]]> Dr. Tom's Blog tjeffo 2008-06-29T19:59:06+00:00 http://www.doctortom.org/archives/2008/06/notes_on_the_mo.html
Precisely because I’m so aware that such doom and gloom thinking has very little appeal, and also because my own acceptance of key false assumptions responsible for our present dilemma retarded my own recognition of those problems, I will attempt to illustrate them by comparing two real doomsday scenarios: one humanity has already avoided late in the Twentieth Century, albeit with little recognition of the risks then faced. The other one is facing us today.

Unfortunately, because global political leadership clearly hasn’t yet understood how lucky we were last century, nor that the mechanism by which we avoided disaster is no longer available, our modern problems are even more urgent.

In its own way, the Cuban Missile Crisis recapitulates the Cold War: the Soviet Union and its allies, always noticeably more willing to take risks, also took on the West under American leadership in a game of Nuclear chicken after World War Two. That game brought the world closest to a global nuclear war in October 1962 when a daring Soviet ploy succeeded in landing a formidable force of nuclear weapons within easy striking distance of the US mainland. US detection at that point placed President Kennedy and Premier Kruschev into crucial one-on one negotiations with the potential of creating Nuclear Winter two decades before that catastrophe had even been defined. We now know that both men had to reject the hawkish advice of key military advisers and that neither man would emerge intact: Kennedy was assassinated 13 months later, and Kruschev’s fall from political power a year after that was clearly related to the Russian loss of face in 1962.

A key modern realization is that the unique circumstances that prevailed in 1962 gave two men the power to save the world; the very different conditions prevailing today mean that significant correction of rapid climate change will require the active cooperation of billions.

Doctor Tom]]> Dr. Tom's Blog tjeffo 2008-06-28T20:49:18+00:00 http://www.doctortom.org/archives/2008/06/no_relief_in_sg.html Zimbabwe, still caught in the tyrannical grasp of Robert Mugabe, its only ruler since the country, then Rhodesia, gained its independence in 1980. Over the intervening 28 years, Mugabe has progressed from Prime Minister in a parliamentary system to President (since 1987). Events since then confirm that although Zimbabwe, under Mugabe’s rule, has degenerated into one of the cruelest and most ludicrous dictatorships in the modern world, both the nation and its President are apparently beyond the reach of the vaunted “rule of law.”

All of which prompts me to ask a rhetorical question: so long as their presidencies remain credible within their national borders, what’s the difference between Robert Mugabe and George W. Bush?

Two other straws in the wind: In an interview seen this morning on CNN, Michael Nutter, the outspoken mayor of Philadelphia, described federal presence as “invisible,” in his city's growing housing crisis. When I tuned in to CNN again during the noon hour, the news was interrupted by a bulletin reporting that a high ranking federal police official in Mexico had just been gunned down in a restaurant while having lunch with his bodyguard. Apparently, the public execution was in response to the planned extradition a leading drug dealer for trial to the US.

Shades of Colombia in the Twentieth Century... are we winning yet?

Doctor Tom]]> Dr. Tom's Blog tjeffo 2008-06-26T22:05:05+00:00 http://www.doctortom.org/archives/2008/06/a_personal_opin.html
Three glaring reasons to question the legitimacy of the Marijuana Tax Act that Harry Anslinger persuaded a bored Congress to pass by voice vote in 1937, were the deceptive transfer tax gimmick by which the criminal prohibition of all hemp products was to be implemented, the absence of any credible medical evidence supporting it, and the luridly improbable nature of its “reefer madness” propaganda.

]]> Dr. Tom's Blog tjeffo 2008-06-25T19:08:46+00:00 http://www.doctortom.org/archives/2008/06/more_on_ernest.html The Denial of Death, the work Becker completed while on his own death bed in 1973, one for which he is best known and received a 1974 Pulitzer prize.

I’ve now read enough of it to discover that although Becker and I had come to an almost identical conclusion about denial, namely that fear of death seems to play a major (and generally unacknowledged) role in human motivation, we got there from quite different points of departure, and by very different means. Another discovery was that Becker’s own short life provides evidence supporting another conclusion I've been closing in on: that the generation into which we are born plays an important role in shaping the constantly changing intellectual substrate of human history. Thus any understanding of how history itself has evolved is made even more difficult for reasons I will introduce toward the end of this entry and develop more fully at a later date.

To return to Becker, the subject of denial, and how he and I differ: he turns out to be a Freudian maverick who was also heavily influenced by some maverick Nineteenth Century philosophers as well. Although Becker makes frequent use of the terms clinical and science, he does not employ them the way I would, and although we were born less than a decade apart, his military service in World War Two, his early death in 1973, the flowering of his academic career during the tumultuous Sixties, would have, if considered in conjunction with my own late-bloomer chronology, served to focus us on two very different eras. For him, it was clearly the first half of the Twentieth Century; for me, it's been the second half plus the first decade of this one. The critical dividing line of the Sixties played an important role for both of us: Becker career was directly affected in ways he never had an opportunity to either process or respond to. On the other hand, I've had almost forty years to catch up with the Sixties and a unique opportunity to debrief the casualties of Nixon's drug war. That said, some of Becker’s penetrating insights are timeless and stated in such arresting prose that I can readily understand why they caught and held the attention of a cluster of influential contemporaries who have been subsequently moved to create a foundation honoring his work that, even as this is written, is preparing to meet in Seattle to continue discussing his influence.

As for me, although I’ve only just discovered Becker (and learned he was a colleague of Thomas Szasz at Syracuse), I consider his early death a tragedy. I’m also reasonably sure he’d find his modern adulation somewhat distracting and find myself wondering instead, what more he might have contributed if he’d been blessed with Szaszian longevity. How would such a gifted intellect have adapted to the modern information age? What would be his present take on the Sixties? What he have thought about the DSM and the current pharmaceutical management of anxiety? They are but a few of the questions for which, sadly, we’ll never have Becker's answers.

Doctor Tom]]> Dr. Tom's Blog tjeffo 2008-06-22T21:23:00+00:00 http://www.doctortom.org/archives/2008/06/what_if_persona.html The Denial of Death into my Kindle and begin reading it. Although not exactly in the way I’d anticipated, Becker’s opus is proving both eminently readable and an extremely valuable addition to my understanding of human cognition, one I hope to be blogging about soon.

In the meantime, the news is providing an endless supply of less complicated ideas to write about, especially the pummeling we are now receiving from the weather: record heat on both coasts at the same time the Midwest is experiencing both unusual tornadoes and record flooding. As anyone with a TV set can see (and hear) for themselves, dramatic footage of widespread levee breaks and flooded farmland is accompanied by the usual saccharine voice overs focusing on the heartbreak of the victims and the noble efforts of volunteers (often also victims) to rescue their neighbors and fill sandbags.

It’s in that setting that I’m posing the following hypothetical question: suppose the Bush Administration, in its first two years in office, had taken a more rational course in the two critical areas of climate change and foreign policy? If they had heeded the warnings of a majority responsible scientists, they might have considered the potential consequences rapid climate change posed for the two areas that have been devastated by flooding since 2004: New Orleans and the Midwest. The Army Corps of Engineers has always been under their direct control, as has been funding for repair of long neglected infrastructure. The urgent repair of levees, even then recognized as inadequate, might have avoided the tragedies of Katrina and the current flood (amply foreshadowed by the Flood of 1993, which, although triggered by a different mechanism, revealed the pattern now being followed with a vengeance).

That question becomes particularly pertinent (and poignant) in the light of the manpower, fiscal, and policy bind the Bushies were warned against before invading Iraq at the behest of the intellectually dishonest Neocons, profiteers, and assorted religious whackos now dominating the modern GOP (not that the Dems offer much of an alternative).

If that sounds angry, it is. If the feds want to punish me for my impertinence, it would at least bring some long overdue attention to the damage being done by the nation’s longest running bipartisan folly, a.k.a. the War on Drugs.

Doctor Tom ]]> Dr. Tom's Blog tjeffo 2008-06-20T17:24:08+00:00 http://www.doctortom.org/archives/2008/06/an_unexpected_d.html
The history of ideas, especially since the advent of scientific thought, reveals that our most important discoveries were almost entirely unexpected and were initially resisted, often savagely, by both the temporal and religious authorities of the time.

Anyone following this blog, even casually, must have noted that its recent emphasis has been on denial as a major element of human cognition; in fact the search function quickly reveals how much I’ve been complaining about denial and the degree to which I’ve been led to suspect it has become the modern world’s greatest problem, simply because our lack of focused response to disasters already in progress or looming in our immediate future may have painted us into a corner from which escape will be difficult, if not impossible.

Typically (as it turns out), just as I was beginning to think I might be the first one to have arrived at such a novel conclusion, I discovered that at least one other person has beaten me to it. Not only that, his ideas had been recognized with a Pulitzer prize in 1973. Tragically (and ironically), he then died of cancer the following year at the age of 49 and the attention of the denial-prone intelligentsia of our denial-prone world quickly shifted to more comfortable areas.

As is so often the case, the premature loss of promising intellectual leadership has probably had dire consequences, but we’ll never know. That was certainly true of my near contemporary named Ernest Becker, a man whose name was completely unknown to me, but who had already arrived at conclusions about denial eerily close to mine well over thirty five years ago, and from an entirely different starting point.

I discovered Becker and his ideas only hours ago by simply Googlng a pair of words: “denial & death.”

That’s all I have time for now: I’ll obviously be returning to Becker and his revolutionary ideas ASAP... all I need is a little time, and some sleep.

Doctor Tom
  ]]> Dr. Tom's Blog tjeffo 2008-06-17T13:03:34+00:00 http://www.doctortom.org/archives/2008/06/e-mail_exchange.html The following e-mail exchange with a stranger took place late last year because one of my remaining allies in the “movement” put me in touch with someone he met at the NORML conference in Los Angeles
 
What follows is a composite of the e-maill he sent me (blue) and my response (red).

And yes, the disaster in Iowa continues its rapid fade from media consciousness, which continues riveted on the coming election.

On 10/15/07, J___ R_____ wrote:
I really need to talk to someone (probably a psychiatrist). I am hoping you might have recommendations about someone that would not only understand marijuana but would also know that it is possible someone can experience improved breathing using marijuana. It is also important that they understand the relief and ramifications that happen because of fuller deeper breathing. I am hoping to find someone that will  listen to my struggle with this drug. I will be 55 in Dec. and I did not start smoking cannabis until about 4 years ago. I tried it for asthma after reading about it on the Internet and reports some people had gotten significant relief. Unlike the many other asthma drugs I had taken and tried over 40 years, the marijuana gave me significant relief. Life changing relief. I could breathe in a way I never thought possible.


Dear J____,
I'm not a psychiatrist, but I am well qualified to tackle the questions you've posed, which are even more complex than you may realize. The only reason I'm so qualified is that I've been listening patiently to thousands of pot smokers seeking to use marijuana medically in California for the past six years and finally think I understand what they've been saying well enough to explain it to others; especially people like yourself who have their own reasons for being curious about a scorned illegal drug.


This did not fit my world in any way. It definitely did not fit my family's world. I am from a conservative Christian background. Please don't write me off as a mental midget or decide I can't be trusted, please. My world is upside down.

I also have come to understand some of the many ways that  the beliefs a child grows up with influence  both the emotions and thinking of the adult that child will gradually become over their first twenty-five or so years. Those attitudes seem especially dependent on two things: one is their experience at home between 4 and 12 when capacity for abstract thought is not fully developed; the other is the array of drugs available for them to try from Junior High School on.

 
I attended the NORML conference on a soul searching mission to determine how important marijuana was to me and hopefully to get information to help persuade my family that marijuana really was beneficial for me and my asthma. I have a great family. I am not only talking about my wife that I have been married to for 37 years, but my son in college in PreMed and 37 year old married daughter. I have a wonderful son in law and 4 fabulous grand kids. I also have a father and mother, and three brothers and their families that live in Amarillo. They are really great people and I love them all. They are convinced that marijuana is satanic.

What you have just described is the setting for conflict between two opposing ideas: one is that because marijuana is sinful, it can't possibly be medicine. This is not a medical idea, although the US federal government has spent literally billions of taxpayer dollars trying to convince the world it’s responsible Public Health. Their campaign has succeeded best in those areas where the kind of religious beliefs you describe are strongest.

On the other side of the conflict is knowledge that cannabis ("marijuana") a complex herbal medicine, has the ability to relieve the symptoms of a wide variety of conditions, one of which is asthma. Cannabis predictably does two things asthmatics find valuable: it directly reduces bronchospasm and also helps mobilize the sticky secretions that must be coughed up. For at least some asthmatics, it does those things  better and more predictably than the gamut of "approved" asthma medications. As with several  other debilitating illnesses, even a little bit of relief can make a huge difference in one's day-to-day ability to function.

Thus the dilemma you are hung up on is between your family's faith-based belief in an irrational policy masquerading as public health and the practical realities of the clinical pharmacology of pot.

They are wrong. If I had been in their shoes I probably would have thought the same thing. It does not appear that I am going to be able to convince them of the benefits of this medicine for me at this time. I have hope they will come around sometime in the future, although it doesn't appear to be any time soon.

I agree. The next question you have to answer for yourself is whether you are willing to defy their beliefs or will continue to suffer from symptoms that can be safely relieved.

I feel like an astronaut who returns from a trip to the moon and when he gets home, there is no one to relate to regarding the life changing experiences he has gone through. That is how I feel about my experience with marijuana.

Well put. I had a similar experience when I returned to San Francisco in August 1967, ten years after I'd come here for an internship in July '57. What I found was that the city I'd come to describe as the alcohol capital of North America had become its pot capital. How that happened in such a brief interval is the untold story of the drug war...

I have tried to figure out how to explain what I am going through. Basically with my family, it is renounce the marijuana and go forward acknowledging that mistake or lose my family.

As I said earlier, this has been a real soul searching time for me. I had to know if marijuana is worth this great a price. I have decided it is something I have to do.

You are the only one who can make that cruel choice; All I can do is give you some background. To put it as simply as possible, what adolescents who have come of age since the Baby Boom have discovered when they reach Junior High is a well developed illegal pot market that began in the late Sixties and has made pot as easily available to "kids" as alcohol and tobacco. What we know from the government's own statistics is that pot has remained third among all drugs tried by kids all over the nation. No other illegal drug comes close; either  in terms of those who try it or go on to long term use.

Nevertheless, there are many kids, often from family backgrounds like yours,  who didn't try pot, precisely because they were nurtured by loving parents. However, if they develop a medical condition helped by pot, they can  find themselves facing the difficult choice you’re struggling with now. Limited experience with others who tried pot in HS, but didn’t become “chronic” users also suggests that trying it while still a teen is like giving yourself permission to use it as medicine later on.

It appears that I am going to have to separate from my family and move to a more marijuana friendly city, and hope that in the future as more information comes out they will understand they are wrong. It is a long story regarding this path I have been traveling, but I have hope. I also know that I can live a better life than I have in the past. I can be a better kinder person. I am not a criminal and I am excited about the future. I can breathe and that is a fantastic thing to be able to do.

I am also hoping you are not wishing you had not given me your email address.

J____ R_____

I can't think of any of the 4000-plus patients I've seen in the past six years  (all seeking my recommendation to use medical marijuana) who has stated the problem any more succinctly; Cannabis is safe and effective medicine precisely because when it's inhaled, it allows for very precise user control. It also works so well against such a wide variety of symptoms that people with a limited knowledge of its clinical pharmacology and a belief that all non medical use is wrong often end up supporting the arrest and prosecution of users I know to be "legitimate".

The only antidote I know of for such political/religious ignorance is the truth.
 
Tom O'Connell MD ]]> Dr. Tom's Blog tjeffo 2008-06-15T17:59:42+00:00 http://www.doctortom.org/archives/2008/06/denial_after_th.html
My wife is still in a local hospital, an ordeal I intend to blog about at a more appropriate time. Thus this entry is simply a follow up on yesterday and will be similarly short. What struck me most was that by this morning, such a signal event was already being minimized, even allowing for a plethora of other bad news from the nation and world. For example, the NYT gave  Iowa  second billing to mere speculation that Saudi Arabia may be growing nervous enough about the high price of crude oil to pump more. Now that I’m becoming more aware of how important denial is to human behavior and how seamlessly it can be woven into disaster reports, I wasn’t that surprised that a major media outlet featured the opinion of the Army Corp of Engineers, an organization at least partially responsible for Katrina's  devastation of New Orleans. Sure enough, their spokesman was quick to cite the flood of 1993 as worse than yesterday, with no reference to several other factors that clearly make it more worrisome: the rains of ‘93 were probably seeded by the eruption of Mount Pinatubo, while today's is probably related to global weather change. Also, the resultant farm damage and agricultural shortages from yesterday will be superimposed on global grain shortages and food riots.

Most significant of all, yesterday's damage occurred in a setting of global climate change that can't be effectively  addressed while concern over the price of gas and crude oil dominate the national consciousness.

A future entry will describe the cognitive tools of denial and how they have always been used to sugar-coat inconvenient truth and thus facilitate repression.

Doctor Tom ]]> Dr. Tom's Blog tjeffo 2008-06-14T22:37:37+00:00 http://www.doctortom.org/archives/2008/06/katrina_in_iowa.html
I was working on another entry, but decided to switch subjects after turning on the TV and seeing CNN footage of the rapidly rising waters in Iowa made me wonder what it will take to get Americans past the extreme denial that allowed them to re-elect the Bush Administration in 2004 despite overwhelming evidence of its incompetence and the fiasco that propelled it into office in 2000.

I’ve since realized that such denial is neither purely American nor modern; it's quintessentially human. That realization, as perusal of just a few recent entries will show, has been supplied by data provided by my study of pot smokers and, even more directly, my need to understand why the study itself was so profoundly and uniformly misunderstood by people who consider themselves supporters of “medical marijuana.”

The reason is now glaringly obvious to me: denial of unwelcome reality is a universal human characteristic. Of even more concern; it’s the one most responsible for our current global problems.

CNN news is still in progress and growing worse by the minute; it's now covering the switch in Pakistan's attitude toward al Quaeda in Afghanistan..

Doctor Tom
]]> Dr. Tom's Blog tjeffo 2008-06-13T15:05:58+00:00 http://www.doctortom.org/archives/2008/06/fraud_enabled_b.html
This entry will have to be quick because, right now, I have even more to do than ever and even less time than usual. Yesterday evening, quite by accident, while returning from a hospital visit to my (very sick) wife, I happened to catch the entire Terri Gross interview of someone I had never heard of before: Elizabeth Pisani is an articulate epidemiologist with a charming British accent who has just published a scathing denunciation of the Bush Administration's program for combating HIV/AIDS overseas.

What immediately called my attention to Pisani’s message was its brutal candor and the accuracy of her analysis; while giving our government full credit for its program’s (unexpected) therapeutic success in funding AIDS treatment, she was also very efficient in explaining how its moralistic insistence on “abstinence only” education is working to undo that success and helping spread infection with HIV, as well as uncertainty regarding the ultimate fate of those seemingly able to lead “normal” lives on what amounts to life-long, treatment (with expensive drugs produced by the American pharmaceutical companies now receiving a subsidy for producing them).

 What especially caught my attention was her recognition that the same bullying and arm twisting support characterize both our HIV/AIDS program overseas and our drug war at home; also that both have a similarly well-documented lack of success. Also impressive was her recognition that both frauds rely heavily on what I have recently come to recognize as humanity’s greatest cognitive weakness: a seemingly built-in willingness to prefer denial to reality as well as the lies we are forced to tell each other in order to sustain faith in such irrational beliefs.

More later,

Doctor Tom

]]> Dr. Tom's Blog tjeffo 2008-06-11T13:01:57+00:00 http://www.doctortom.org/archives/2008/06/pertinent_quest.html
The last entry frankly acknowledged using Nicholas Carr’s complaint in Atlantic about Google-induced symptoms as a vehicle for calling attention to evidence that admitted pot users have provided: that they’ve been successfully self-medicating for Carr’s list of symptoms for years. In fact, the weight of their evidence, plus data yet to be published, is so convincing and was so easily obtained that I know my fellow “pot docs” have, by not asking the right questions,  been missing the prevalence of anxiety among their patients, to say nothing of the various anxiety syndromes they were either diagnosed with or treated for in the past.

Also; given the American scientific community’s reluctance to challenge our drug policy, I might perhaps be dissuaded from my increasingly radical (and lonely) position on pot prohibition, were it not for three discrete phenomena. First, the unanimity with which most reformers avoid discussing my findings; it tells me that, like the feds, they are also in denial and just as bereft of evidence supporting their notion of “personal” use as  the government is for its claim that their archaic, never-validated notions of “addiction” confer legitimacy on an incoherent policy.

 Then there’s the intense interest of Big Pharma in cannabinoids following discovery of an intrinsic (“endocannabinoid”) signalling system in the early Nineties, even as it curries favor with the same dishonest federal policy with a genuflection toward “drugs of abuse” in their scientific abstracts. That the only agent the industry has developed for human use without a federal subsidy was an antagonist is further  evidence of compliance with federal supidity; ordinary logic should have told them that agonists of a helpful substance would be safer and more likely to offer therapeutic benefits than an antagonist. Sure enough: the antagonist is proving troublesome and one is left to wonder whether its developers were greedy as well as stoopid.

 The third phenomenon reassuring me I’m on the right track is sustained federal opposition to any cannabinoid research with a human application, along with their punishment of marijuana activists in California to the full extent of federal law. While not quite so blatant as the Nazis’ continuation of the Holocaust, it signals the same die-hard mentality.

In any reasonable system of government, particularly one claiming to honor the canons of Science, NIDA and ONDCP should have long ago been forced to bear the burden of explaining the intellectual gap between the drug war’s never-validated assumptions about addiction and the growing mountain of evidence challenging those assumptions. The ability of Congress, acting through NIDA and the DEA to block human research for four decades has been crucial in protecting that policy; as has their ability to prosecute people self-medicating with marijuana as ‘druggies” or “addicts” while respected “researchers” callously promulgate  “truth” for profit and receive a slap on the wrist.

What makes US policy even more reprehensible is that its enforcement automatically encourages troubled youth to use more dangerous agents. Thus it has both juvenile and adult blood on its hands and blights other lives by unjustly sending people to prison. Almost as an afterthought, it also creates violent markets that kill people, corrupt society, and siphon tax money from worthwhile projects.

Given current US  political calculus and the likelihood other glaring policy errors will be exposed, a change in attitude toward the drug war could come about at any time between now and election of our next  President.  Which of the two survivors is likely to win? An additional question: will the chaos of the modern world America has helped to create be enough to get us past the racism embedded in our original Constitution and still openly practiced after all efforts at correction?

Doctor Tom



]]> Dr. Tom's Blog tjeffo 2008-06-09T19:22:59+00:00 http://www.doctortom.org/archives/2008/06/more_evidence_o.html
The cover of the July-August Atlantic that arrived by snail mail yesterday (but is not yet on line) was cleverly designed to resemble the ubiquitous Google logo. It asks provocatively if the search engine might not be making us “stoopid.” The cover worked as intended; I began reading Nicholas Carr’s piece almost immediately. The litany of complaints he lists in his first few paragraphs added interest because, although not recognized by Carr as such, they are symptoms of ADD (Attention Deficit Disorder), an entity that has commanded my interest for nearly seven years because so many of the pot smokers I’ve been interviewing have either been diagnosed with it or have easily recognizable variants.

To cut to the chase, Carr’s piece provides additional support for my growing belief that humanity is at a cognitive fork in the road: the decisions (choices?) now facing us represent a fleeting opportunity to mitigate the pain so obviously threatening the next several generations.

The entity  now known as ADD ADHD has been recognized since (at least) the mid- Nineteenth Century,  but wasn’t called that until the Nineteen Seventies when Paul Wender, MD, then a professor at the University of Utah, named it and reported its response to the stimulant methyl phenidate (Ritalin).  Since then it has been mistakenly (in my view) popularized as a “disease” for which an increasing number of patients of all ages are being treated with a growing list of pharmaceuticals.

At first mostly male primary school children, so many of both genders and all ages are now being treated for it and other Autism Spectrum Disorders that both the entities and their pharmaceutical treatment have given rise to backlash and controversy.

What I find especially disconcerting is the obvious failure of both intelligent pundits like Carr and all respected scientific institutions to note obvious connections between population growth, the increasing prevalence of anxiety syndromes, and the undeserved respect accorded to a globally enforced lunatic US drug policy.

I will have more to say about Carr’s important article later; my own ADD is forcing me to deal with some essential details needed for survival on this desperately overcrowded planet...

Doctor Tom ]]> Dr. Tom's Blog tjeffo 2008-06-07T18:19:15+00:00 http://www.doctortom.org/archives/2008/06/approaching_ann.html
As the twelfth anniversary of Proposition 215, the fortieth year since Richard Nixon’s election to the Presidency, and the end of Dubya’s calamitous eight year reign draw ever closer, the San Francisco Chronicle finally took appropriate notice of the medical marijuana issue with a front page, above-the-fold story complete with color picture.

The bad news is that, as usual, the story missed the background reality that’s been driving the medical marijuana controversy since 1996 by focusing on the usual clueless arguments being offered by each side.

To be blunt, the federal position on the “marijuana” issue has been a lie ever since a Democratic Congress and President agreed with the absurd “reefer madness” campaign orchestrated by a Hoover Administration holdover named Harry Anslinger. The 1937 MTA was a total ban on both cannabis and hemp thinly disguised as a transfer tax. Whatever its “real” purpose, the law arguably violated the Tenth Amendment by expanding federal power; whether the responsibility for licensing physicians is regarded as “explicit” or “delegated.”

As has been inevitable with other prohibitions of desired products, that ban was ultimately followed by a lucrative criminal market; however in this instance, its development was unique: it wasn’t until the Sixties that the “reefer” banned by the MTA would be discovered as “pot” by millions of Baby Boomers who hadn’t been born until nine years after after the MTA was passed. That neither ONDCP or NORML take note of that delay is revealing.

Although the Chronicle story began by describing how ubiquitous and lucrative marijuana cultivation has become in Mendocino, it exhibited no curiosity about either its delayed market development or still-increasing popularity. I can’t fault them for that because I didn’t understand them myself until I started to take histories from market participants hoping to take advantage of Proposition 215.

Discovering that pot appeals to troubled teens because it’s a safe, effective, and user-controllable anxiolytic was relatively easy; what is proving more difficult has been understanding the surprisingly uniform and spontaneous denial exhibited by a reform community that seems just as taken with irrational doctrinaire arguments as their federal opposition. 

An afterthought: manipulating parental fear of "addiction" has long been the mainstay of drug war propaganda; an articulate industry insider relates how she discovered that commonly prescribed anxiolytics can also exhibit a "potential for abuse"

Doctor Tom



]]> Dr. Tom's Blog tjeffo 2008-06-01T18:27:44+00:00 http://www.doctortom.org/archives/2008/06/cognition_cultu.html
The last entry suggested that American drug policy exemplifies an intrinsic anomaly peculiar to human cognition, one that probably affects us all to some degree and has now evolved sufficiently to threaten our well-being. In that case, a rigid drug policy that has been immune from scrutiny since 1914 should be seen as urgently needing honest scientific assessment and correction to the extent possible.

Yet, any call for such a review seems very unlikely. The possibility it could happen at all is probably more contingent on how rapidly the planet’s established weather, economic, health, and behavioral threats  continue to evolve. Prolonged denial and resistance can be expected from a variety of sources with opposing interests.

The cognitive anomaly referred to is most likely an internal conflict produced by the separate evolution of two brain centers with critical roles in cognition, the amygdala and the neocortex. The conflict is manifested as the strong preference by both individual humans and human organizations for maximizing profits and prestige while minimizing failure and evading responsibility to the extent possible.  Such practices, whether by organizations or governments, are praised as healthy competition by some and damned as malfeasance by others; dishonest competition has long been the human default and is now more widespread than ever. It’s particularly dangerous in  our modern world because both the consequences of a hostile nuclear exchange and the likelihood one will occur are increasing and we are also being reminded that the economy of an overcrowded planet is more fragile, unequal, and interdependent than ever.

Murderous new resentments are also being generated daily.

Ironically, once it’s accepted that cheating, violence, and dishonesty dominate human interactions, understanding how that came about and its partial control could be efected by designing a policy designed to take maximum advantage of scientific objectivity while consciously trying to reduce the introduction of bias. It should be superior because it would reduce the influence of faith and authority. Science attempts to predict the future by studying the past. Historically, the religions that promulgated elaborate dogma in complex agricultural societies had a paucity of solid information from the past on which to theorize,  but they did have the inside track with the power structure, which gave their religious beliefs plenty of time to consolidate power and status before the arrival of Copernicus, Galileo, and Newton.

Historically, the scientific knowledge that led to the Industrial Revolution also facilitated a huge two-century spurt in human numbers and wealth. However recent recognition of overpopulation’s danger to the ecology and political stability have yet to generate any serious discussion of population control and opinion is clearly split. China, the only nation enforcing a population control policy;  is not reporting results systematically, and the social consquences are still unknown. It’s also fairly clear that birth control measures would be anathema to many and, to be effective, would have to be practiced by a majority of humans on a voluntary basis.

Doctor Tom







]]> Dr. Tom's Blog tjeffo 2008-06-01T08:48:21+00:00