Web Log of Dr. Tom O'Connell

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May 20, 2006

I’ve now seen enough pieces of the big picture to understand that what I’ve doing for the past four years has been defining, one interview at a time, the huge illegal  ‘marijuana’  market which has been growing out of public view, one high school graduating class at a time, for thirty-seven years. That’s a study  which became possible only because a window was opened in 1996 by California’s Proposition 215 just widely enough to encourage a  fraction of those pot users  often dismissed as ‘heads’ or ‘stoners’ to apply for ‘medical’ status;  and even then, only because my own age made me just naive and curious enough to wonder how they had all become chronic users of an agent which had been so completely invisible to me during my own high school years ((‘45-’49) and then remained unknown to nearly everyone over thirty  until the world somewhat blatedly discovered how much ‘hippies’ liked ‘pot’ during 1967’s ‘summer of love.’

It further turns out that because the same differences in generational perspective which inspired my question are nearly incomprehhensible to 96% of the pot market participants born since 1946, I’ve had a particularly difficult time getting ‘experts’ with a vested interest in the ‘debate’ to even notice.

Also, because the great majority of buyers in what would only gradually become a huge illegal market weren’t born until well after 1945,  the market’s illegal status was enough to keep both them and those arresting them from an accurate understanding what was really happening. As more time has passed and new pot users have been born— and later become users tehmselves— the truth has been even more distorted by simultaneously evolving ignorant beliefs and dishonest 'research.' An especilly ironic result of that ignorance and fraud is that each side in the modern ‘pot debate’ is wedded to its own fairy tale; a situation which— even more ironically— makes the truth seem the least plausible explanation— and thus readily dismissed.

But it gets worse...

The 10 year evolution of Proposition 215 within California has also been a good example of blind men trying to describe an elephant to each other;  so prolonged, so complicated, so rapidly changing, and so ineptly reported that even those dealing intimately with one or more of its many aspects on a daily basis can remain unaware of developments in other areas— and their significance— for long intervals. It doesn’t seem to matter whether one's primary interest is political, legal, medical, or just shaping of public opinion.   

Sadly; my take on current trends is that although the reform position is much closer to the truth and retains considerable uninformed popular support, it’s  losing political ground because the feds’  simplistic message is being skillfully and aggressively sold to various City Councils and other entities making the key decisions that will directly affect the long term future of medical cannabis: namely, which— if any— of several petitioners hoping to open ‘dispensaries’ in their communities will receive  business licenses and how stringently they will be regulated?

One needs only to grasp that delay is a form of denial and over-regulation by a hostile bureaucracy a good way to prevent something that can’t be banned outright from ever happening to intuit the federal strategy.   Also its ultimate purpose:  forcing as much ‘medical’ pot distribution back onto the street as possible. The feds clearly hope that market participants can then be arrested as before with the same minimal outcry now heard in states with far more restrictive laws.

That scenario also assumes something else which remains to be seen: will all those Californians who have had recommendations for years and been (somewhat) educated by the experience become as docile as they they once were when the old order is re-established?

In another installment, I’ll report how a recent experience with the Richmond City Council provided me with the evidence that confirms this analysis; but first, I want to point out when and how present federal tactics were first revealed. It started with the infamous— and never rebutted— charges arising from the 2004 ‘Oaksterdam’ flap when ‘able bodied young men’ were filmed leavng a local club with large bags (of clones). They were portrayed as irresponsible ‘scammers’ of (what might be) a worthwhile program. The unanswered allegation that they ‘obviously’ weren’t ‘legitimate’ patients and the subsequent propaganda campaign have been cleverly coordinated with local police and is helping  convince many City Councils to either ban pot clubs outright of declare a ‘moratorium’ on licenses pending further study.  Things got a lot worse after Raich when the feds began arresting certain activists already out on bail on state charges. All but one remains buried as deeply in the federal gulag as if in Guantanamo. in fact, the public seems more aware of Guantanamo than of the Californians now mired in cruel double jeopardy within their home state.

Posted by tjeffo at 11:27 PM | Comments (0)

May 16, 2006

Viewed from the proper perspective, a recent drug warrior claim can be seen as revealing the same weakness as the FDA 4/20 announcement: their increasingly desperate need to 'prove'  that pot is 'bad.'

Unfortunately, because the subtleties and implications of both  messages seem also to have eluded many drug policy reformers, they aren't yet taking full advantage of the wonderful political possibilities offered by their opponents’ desperation.

The FDA's 4/20 'announcement' was actually a restatement of Barry McCaffreys' almost illogical response to the (weakly stated, yet decisive) finding of the 1999 IOM report that pot is medicine.My real time analysis of McCzar's statement was written 2 days after his spin first appeared (click on 'feature article).

Parenthetically, his 1999 'support' of 'deep lung delivery (via) aerosol' could be devastatingly compared to  contemporary hypocrisy if only the involved reformers were aware of what McCzar had said back in 1999. The hypocrisy I refer to is the DEA’s fight to uphold NIDA's denial of an application to grow the pot which would allow its aerosolized delivery to be studied in more detail. I’ve read a lot about that case, have yet to see one reference to McCzar's damning statement.

You can bet neither NIDA nor the DEA will ever mention it.

Several main stream columnists were far quicker than ‘reform’ icons to point out the out the intellectual absurdity of FDA’s position-- and its telling violations of the canons of science... yet, clinical data supplied by applicants in California casting doubt on many never-confirmed drug war assumptions has been stubbornly ignored by many ‘reformers’ for three years.

With respect to the 'new' claims linking pot to mental illness, an interesting paper by Morral, et al in 2002, offered elaborate
mathematical 'proof' that positing some 'common factor' other than a gateway' effect actually provides a better explanation of MTF data collected since 1975.

Interestingly; after some initial furor,  that paper has been largely ignored. The most obvious explanation of my own data
(pointed out in 2004) that the 'common factor' hs been  the large scale self-medication by juveniles with pot; a phenomenon which can now be precisely traced to its historical origins in the late Sixties...

The drug warriors can't  be hoisted on their own petards if their political opponents are unwilling to light the appropriate fuses; to do that, one must first know that such fuses exist— and where to find them.

Tom O'Connell

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

May 09, 2006

The feature article in the current (June) of Atlantic magazine concerns what its author (Jeffrey Rosen) thinks is likely to be an imminent development: the overturning of Roe V. Wade by a newly configured SCOTUS. Although Rosen's careful parsing of the various possibilities doesn't mention the drug war-–– even tangentially–– the situation is laden with significance for the intermediate future of drug policy to a degree that suggests reformers would very quickly be presented with a variety of important political opportunities by any significant resurgence of the abortion issue at the Supreme Court level.

For one thing,  the national policies now controlling both contentious issues were created by–– and to a degree, remain dependent on––   medical decisions made by medically ignorant Supreme Court Justices. That fact alone would allow drug policy activists to capitalize on any debate prompted by a move against Roe from the far Right; especially if were tp involve 'partial birth' abortion. Unfortunately,  it would also require reform leadership to demonstrate considerably more knowledge of drug policy history than they have to date.

A very interesting variation with respect to the abortion controversy is that even if Roe were to  be struck down by the Court, abortion would not automatically become illegal; rather the policy would be up for grabs. Given how national attitudes toward abortion are now being expressed, it's very unlikely that a national top-down, rigorously enforced  general ban would ever gather the support needed to pass. What is far more likely is that abortion would be decided by the individual states and probably remain legal for a numerical majority of American women. A similar outcome with in the case of drug use would represent a huge victory for drug policy reform and such an argument might be made very effectively as the dust from Roe was starting to settle. Of course, a more enlightened attitude toward the medical use of cannabis (especially by 'reformers') would be a big plus in any event.

The more one reads Rosen's analysis, the more uncannily it echoes dilemmas similar to those which confound the drug policy stand-off, including the political risk each side runs by rejecting all compromise on  doctrinal grounds. Although there are obvious differences, the article deserves careful attention from people with a serious interest in 'medical marijuana.'

Doctor Tom

Posted by tjeffo at 01:30 AM | Comments (0)

May 08, 2006

Why the 'Serious Illness' Notion has been a Serious Mistake

In the last entry I promised to discuss why I think the notion that permission to use cannabis on medical grounds should be granted only to those with ‘serious’ diseases  is 'unrealistic.'

Actually; I think it's both silly and self defeating

Although several good reasons for thinking that way might become apparent to  an experienced clinician after a bit of critical analysis, most working doctors have already been so intimidated by the drug war they have long since excused themselves from thinking seriously about cannabis. Thus, even the most cogent clinical arguments I might make (and there are several) wouldn’t help much-- and would be Greek to non-clinicians.

No problem; a perfectly good case can be made from basic human nature if we simply consider the almost universal bans on two other human behaviors widely regarded as ‘sinful:’ gambling and prostitution. Those proscriptions have also tended to survive in secular democracies despite their perennial failure. Although cloaked in the garb of Public Health from the time of the Harrison Act, our drug war had its roots in the same quasi-religious logic that led to bans on commercial sex and wagering; they simply had much longer histories in Western society.

One key to understanding the underlying connection between the three bans is that, from the outset, they all relied heavily on the state’s powers of arrest and prosecution. The biggest difference was that, in the case of drugs, the first clamor for a ban came from the top down. However, that difference is also readily understood: our drug policy, like many others, had complex origins. Early in the Twentieth Century there was a desire to curry favor with China; along with an increasing public awareness of ‘addiction’ as an exotic problem. Combining them under the circumstances that existed at the time was both logical and effective.

The next point to be made is that historically,  policies criminalizing specific behaviors which were not regarded as directly threatening by a significant fraction of the affected population have tended to fail. Beyond that, increasing attempts at top-down enforcement in the face of such failure has usually tended to corrupt both law enforcement agencies and the affected society. One would think that such a history— especaiiy if repeated several times— might have triggered some recognition among politcal analysts that moral prohibitions do not make good policy; but such critiques are noteworthy for their absence. All one has to do is search for academic treatises either analyzing or condemning moral prohibitions as failures to be struck by their relative absence–– either in the past, or in the modern glut of books dealing in detail with every imaginable subject.

The only possible conclusion also applies directly to the drug war itself: morality-based policies, no matter how irrational they prove to be, tend to be treated with undue deference at every level of society. Once understood as an intrinsic part of human nature, that scruple goes a long way in explaining both the  persuasive nature of ‘politically correct’ ideas, and the undue deference accorded certain notions in the absence of evidence that they are at all realistic. Examples are the ‘will of the people,’  the 'essential' nobility of humanity, and the idea that we humans were intended to 'rule' over other species.

It thus appears that the ‘seriously ill' scruple is simply the logical default for (typically human) critics of the drug war; the down side of such thinking is that it has prevented them from understanding— and promulgating— solid clinical evidence that our drug policy has actually had far worse consequences than most people imagined.

It also explains why I must rely on this blog to communicate with the demonstrably small nucleus of drug war resisters that 'gets it.' I am still forced by history (and basic human optimism) to believe that truth and logic are ultimately contagious; however, the process is usually erratic and was always been unpredictable. Whether modern IT will accelerate full recognition of the drug war's social consequences is still an unsettled question.

Doctor Tom

Posted by tjeffo at 05:32 AM | Comments (0)

May 04, 2006

Whether cannabis (marijuana) has any medical value key has become a key social and political issue now dividing America. Those with either a vested interest in the drug war or a fundamentalist religious point of view usually agree with the federal government’s emphatically stated opinion that it doesn’t. Although constituting only about 35% of the nation’s population, their extreme views have dominated how all the ‘medical marijuana’ laws and initiatives passed over the last decade have been both written and implemented in every state where they exist. That’s especially true of California, where the first such law was passed in 1996 and everyone agrees its provisions are the most ‘liberal.’
   
Just why the most conservative possible structure and implementation of pot laws should have been the rule isn’t that difficult to understand; it’s because those who voted for them originally were also deeply divided in their opinions over what should qualify someone for the privilege of using cannabis and how to deal with those who don’t pass muster. ‘ One extreme was apparently that pot should be allowed only for certain ‘serious’ or terminal diseases; thus people ith that view continue to have have no problem with arresting and prosecuting people  seen as having ‘trivial’ complaints. At the other extreme was what may now be a slowly increasing fraction—   perhaps thirty to forty percent— of the general population who think pot should be ‘legalized’ for all adults and regulated like alcohol and tobacco.

 Since most professional law enforcement officers and prosecutors continue to be numbered among the hard core minority supporting the most punitive federal position, it’s not difficult to understand why implementation of medical marijuana laws has been so one sided; nor is it difficult to understand why California has emerged as the battleground in what has really been a ten-year, to-and-fro guerrilla war between patients and law enforcement.

Unfortunately, for a variety of complex reasons, most practicing physicians, including those who think of themselves as ‘pot docs,’ and a majority of cannabis activists have not played a very constructive role; that’s because they have either activley or passively supported the most conservative  (and unrealistic) definition of medical use: that it shoud be restricted to the ‘seriously ill.’

In my next entry I’ll explain exactly why I regard their position ‘unrealistic’ and how it must change if we are to take full political advantage of the brilliant master stroke the first medical marijuana initiatives actually represented.

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

May 03, 2006

On April 20, the FDA released what was clearly intended as an authoritative 'advisory' explaining that ‘marijuana’ shouldn’t be taken seriously as medicine because it must be smoked! That statement has since been parsed more exensively— and critically— than any comparable official statement of drug war dogma I can remember. While I still haven’t read all the critical comments, I’m disturbed that I have yet to see one clearly stating what seems to me its most shocking (albeit unintentional) disclosure: the degree to which ’science’ has been distorted to defend a destructive policy of failiure.

An inescabable collateral realization is that many of  our ‘leading scientific institutions’ have been bullied into grossly compromising their supposedly hallowed scientific principles— without a peep of protest.   

For those still in denial, the drug war’s remote origins were a series of judicial decisions made nearly 100 years ago when the US Supreme Court was sufficiently persuaded by superficial and misleading analysis of what— even then—  was incomplete and biased evidence, to embrace three key fallacies. The first was that ‘addicition’ is the most important risk of using  ‘narcotics’ (that term then applying only to opiates and cocaine) the second, was that abstinence is the only acceptable goal of addiction treatment. The third was that physicians can’t be trusted to prevent addiction in their patients or to treat it properly when it occurs; thus police and criminal sanctions are essential elements of the nation’s Public Health.

The subsequent history of our drug policy is that its inflexible nature— and the prerogatives conferred by the Court on its enforcement bureaucracy — were protected by a single bureaucrat for over three decades after he took over the FBN in 1930. Other than skillfully protecting the Bureau’s intellectual turf, Harry Anslinger’s most important contribution was the 1937 MTA, which added cannabis as a third proscribed agent on scientifically absurd grounds.  Otherwise, his tenure can now be seen as most noteworthy for what never happened: any significant expansion of the three illegal markets created by the policy.

However, his departure in 1962 was followed by three events which would soon dramatically reshape and enlarge all illegal drug markets within a single tumultuous decade: the introduction 'psychedelics' and several other new psychotropic agents, the discovery of cannabis by a significant fraction of American youth, and the 1968 election of Richard Nixon.

 Even before Nixon’s ‘drug war’ was  empowered by the CSA (1970), reinforcd by the DEA (1973), and another agency (NIDA) created to defend its ‘scientific’ purity in 1975, it had been on an upward trajectory. Some momentum was lost following the Watergate disgrace; but it was quickly recovered— and then some— after Reagan’s election in 1980. Since then, the policy has becme so dominant in Washington that its major political risk may be that unwitting revelations like the clueless 4/20 FDA proclamation could trigger enough public recognition of its foolishness to bring about insight and repudiation

In that context, one wonders just when— and if— the leadership of the drug policy reform movemment will ever ‘get it.’

Posted by tjeffo at 11:22 PM | Comments (0)