Thursday, October 29, 2009

…but with a Whimper

…but with a Whimper

Many who have been advocating for drug law reform have visualized the War on Drugs ending in an Armageddon-like battle. We can see weeks of heated debate in both houses of congress with the media following and commenting like it was the super Bowl. We can visualize a signing ceremony in the East Room with Ethan Nadelman getting the souvenir pen and the Congressional Medal of Freedom being given posthumously to Brownie Mary. We can even dream of DEA and ONDCP officials shaking their cups on street corners as they ask for spare change.

But it’s beginning to look like we will win, but without the fireworks. The War on Drugs is ending, not with a bang, but with a whimper.

The Attorney-General’s memo to U. S. Attorneys this week shows the change in strategy. A-G Holder has directed the USAs not to initiate prosecutions involving state medical marijuana laws unless the cases involve more or more of a list of earmarks:

• unlawful possession or unlawful use of firearms;

• violence;

• sales to minors;

• financial and marketing activities inconsistent with the terms, conditions, or purposes of state law, including evidence of money laundering activity and/or financial gains or excessive amounts of cash inconsistent with purported compliance with state or local law;

• amounts of marijuana inconsistent with purported compliance with state or local law;

• illegal possession or sale of other controlled substances; or

• ties to other criminal enterprises.

The important feature of this list is that, with a partial exception of the fourth element, all of the elements require a criminal act in addition to the mere distribution or possession of marijuana. The fourth – financial – element is too vague to serve as a defense for the decision to prosecute except for the inclusion of money laundering. And rest assured, the import of this list is the pressure it puts on USAs to justify any decisions to prosecute with evidence tied to this list.

Anyone who stays reasonably close to state law and who avoids state prosecution probably is safe from federal prosecution unless they adopt an outrageously expensive and public life style.

Many have remarked that, in California at least, medical marijuana has served as a fig leaf, disguising outright legalization. If true, that situation will probably expand to other states; Colorado is giving indications of going the same direction. With the feds ignoring California, the roadblocks are down.

California is beginning to like the taste of marijuana taxes and is getting hungry for more. Other states also face the same kinds of budget crunch.

Many California growers are committed to growing as a matter of principle, and not just for profit. As they have been able to act more publicly, their prices have come down and they have diverted sales from the criminal cartels, who are unwilling, and probably unable, to cut prices. Law enforcement will soon begin to see a resulting savings, and the people will see a decrease in violence and environmental damage.

In approximately fifteen years, fourteen states have enacted medical marijuana laws, either through referendum or legislation. New Hampshire came close this year, with a bill passing in the legislature, but when the governor vetoed it, the state senate failed by two votes to override the veto. Connecticut has twice passed similar legislation, only to have the governor veto it each time.

Iowa presents a curious situation. The Iowa Supreme Court has ordered the Iowa Pharmacy Board to reexamine the classification of marijuana based on medical use in the United States considered as a whole. Testimony at the Board’s hearings, both medical and lay, seems to be overwhelmingly in favor of rescheduling.

This year, Wisconsin, Illinois, Ohio, Pennsylvania, New Jersey, New York, and Massachusetts all have bills pending. All three candidates for governor in New Jersey have pledged to sign the bill if the legislature passes it. In Massachusetts, which decriminalized possession of less than one ounce of marijuana by referendum last year, the latest poll shows 81% of the voters favor medical marijuana. Depending on the results of these legislative attempts, Texas could remain the only state with large population refusing to recognize medical use of marijuana.

Congress is also beginning to take notice. For several years, nation-wide polls have shown more than 70% of the population favoring recognition of medical marijuana. This term four bills have been filed and are awaiting committee action. Three of which would make federal law recognize state medical marijuana laws and the fourth would decriminalize possession of small amounts under federal law. If the easy passage of expansion of the federal hate crime law to cover sexual orientation and the lack of reaction against it are any indication, congress may be more comfortable with changes in this other morally sensitive area as well.

A reasonable prediction is that the end of the current legislative and congressional sessions will have medical use of marijuana nationwide accepted and legal. Details will have to be cleaned up as states with no current legislative sessions come into conformity, but those actions should be somewhat routine.

As California, and to some extent Colorado, is revealing, medical use can lead to more commonplace use. The first dominos have toppled, and the rest of the line is now shaky.

Saturday, October 17, 2009

All Drug Use is Self-medication -- Not

All Drug Use is Self-medication -- Not

Anyone following the drug law reform debate for very long will run into the slogan: “All drug use is self-medication.” The problem is that not only is this claim not supported by fact, it also works against several more legitimate claims.

The first issue is to look at the basis of this assertion. I have found no researcher who has claimed this proposition as the result of his studies. One generally accepted proposition is that a significant number of those with drug dependencies or who abuse drugs also have some personality, mood, or character disorder that causes them some degree of discomfort and for which they seek, consciously or unconsciously, some form of relief. (I use this weasely “significant number” as an admission that the data do not tell us whether that number is ten per cent, ninety per cent, or somewhere in between) Extending this proposition to the assertion that all drug use is an attempt to alleviate some mental disorder is unwarranted.

If this exaggeration stood alone, it could be shrugged off as the kind of rhetorical over breadth we all commit from time to time. But this concept has the effect of delegitimizing several other valid claims for recognition.

Drug use as a religious exercise is one of the claims competing against this self-medication concept. Religious use of psychoactive substances dates back to pre-history. Modern claimants use a variety of substances. Federal law recognizes the use of peyote by the Native American Church and yagé, or ayahuasca, by O Centro Espirita Beneficiente Unido do Vegetal and Santo Daime. Even the old Volstead Act allowed Christians and Jews to procure and use alcohol for religious purposes. The Rastafarians and Coptic Zionists are seeking legal recognition for their religious use of cannabis (so far only recognized by the U. S. Court of Appeals for the Ninth Circuit [Guam Terr.]).

Many of those using psychedelics do so for the purpose of enlightenment or self-awareness. While this claim may look similar to both the medical and the religious, it is really quite different. It is epistemological in nature, asking the questions “What can I know of the world and how can I know it?” During the 1950s and 60s, large numbers of outstanding figures in arts, literature, science, medicine, and politics tried – and many used repeatedly – psychedelics for this purpose.

By far the most popular use of drugs is for social or recreational purposes. While the beer with buddies after work or the joint when one gets home may serve to relieve some stress, their primary function is pleasure. A joint with a movie and a bowl of popcorn or Ecstasy pills shared by a couple at a dance club are used to enhance pleasure, and for no other purpose. Cocaine in its heyday was primarily a social drug, with lines being shared at parties.

One recent claim is related to, but distinct from, medical claims. Many are now using stimulants, particularly Ritalin and amphetamines, as “brain boosters”, or drugs to make them smarter, more alert, and more fatigue-resistant. Doctors and nurses discovered this effect of amphetamine when it was first introduced in the 1930s and by the 1940s, armed services around the world were using them, as they still are today. For at least a half a century truck drivers have used amphetamines to extend their driving hours. Today’s brain boosters are college students, professionals, and middle-management who get their drugs legally through doctors’ prescriptions, and some have been using them for over a decade. While traditionally medicine has been viewed as remedying a disease, disorder, or deficiency, this use of drugs does the opposite. It is aimed at helping the user attain the superior, not just to return to the normal. It is more like an athlete using steroids or human growth hormone or an aspiring starlet getting breast augmentation in order to outdistance the competition.

One claim I almost forgot because it is so far removed from the world of medicine. The Controlled Substances Act defines the prohibited drug marijuana as being any part of the plant Cannabis sativa, which includes the extremely low THC-content varieties grown as hemp for use as fiber, oil, or food. No matter how many hemp shirts one wears, they will have no medical effect.

In fact, the claim that all drug use is an attempt at self-medication is a claim for more, not less, regulation of those drugs. Diagnosis is a notoriously difficult art, and diagnosis of mental disorders particularly so. The prescription of anti-depressants is, at best, a trial-and-error process, with doctor and patient often going through as many as five or six different drugs before finding one that is effective and without unacceptable adverse consequences. The rate of failure of self-diagnosis and treatment, as evidenced by the high rate of resultant dependency, calls for more professionalism in the diagnostic process, not less.

The Jeffersonian appeal to the right of each to determine what food or medicine he ingests does not negate the intervention of medical professionals in the process. The growth of modern medicine since the days of Jefferson, with its potential for great help – and great harm – requires mitigation of an extreme libertarian interpretation.

We can all join together to seek the rights of those advocating medical, religious, enlightenment, and social uses of drugs as well as the right to grow and use hemp. In this struggle facts and rationality are the strongest weapons. We only hurt ourselves when we resort to easily falsifiable propaganda like the utility of self-medication.

Friday, October 9, 2009

White Rabbit Redux

White Rabbit Redux

Dust off your old Jefferson Airplane albums. Acid may be making a comeback.

Scientific American reports that two new clinical studies are underway examining the use of LSD in psychotherapy [1]. One of these is in Switzerland, funded by Multidisciplinary Association for Psychedelic Studies. The second is at U. C, Berkeley, funded by the Beckley Foundation of England.

The 1950s were the glory days of psychedelic research. Hundreds of studies, involving thousands of patients and hundreds of thousands of doses of LSD were published  [2]. Mescaline (peyote) and psilocybin (magic mushrooms, or ‘srooms) also received a lot of attention.

The study of psychedelics blossomed in the ‘50s. Investigators flourished in literature, art, medicine, basic science and politics.

Aldous Huxley led the way in literature. His Doors of Perception was seminal. He introduced Dr. Hofman to mescaline and psilocybin, resulting in their synthesis. He then took LSD to Harvard, where Leary was researching with psilocybin and also introduced Leary and Allen Ginsburg to each other. William Burroughs failed with his Texas marijuana farm and moved to Mexico, where he lured Ginsburg onto his South American quest for yagé. On the West Coast, Ken Kesey met LSD as an experimental subject at a mental hospital where he worked. When One Flew Over the Cuckoo’s Nest made it big, Kesey and his Merry Pranksters tried to turn the Nation on with their “acid tests”.

(FUN SIDE NOTE: Neal Cassady was the model for Dean Moriarty in On the Road, the novel that introduced many of us to the idea of drugs. He was also the driver of Kesey’s bus, named “Furthur”, when the Pranksters made their cross-country voyage to meet Leary. I have sometimes said that Kesey put a bunch of Beats on the bus, Cassady drove them around the country, and the first hippies disembarked.)

By 1950 Sandoz was sending samples of LSD to interested doctors – the standard way of testing new drugs and building markets for them before the FDA started requiring proof of efficacy in 1962. This surprising new drug created quite a buzz.

Several doctors, following the lead of the literary adventurers, tried to study the effect of acid on creativity and the arts. However, no good theories of the brain existed at the time, and modern methods of study, including scans, were still some thirty years in the future. So after watching painters paint while tripping and afterward and talking to poets who were buzzed, these experiments didn’t really lead to anything.

But the fifties was also the time when the first real psychopharmacological breakthroughs were made. Many doctors were therefore willing to try LSD as an adjunct to the kinds of therapy they were already doing. It demonstrated some success in several areas.

Grief and transition counseling was one of the most promising. Those who had experienced the loss of a spouse or close relative or those facing a terminal diagnosis in themselves or a family member seemed to cope with the situation much better after one or two counseling sessions involving acid.

Couples therapy, or working with those having relationship problems, also progressed better when the work involved doses of acid.

Therapists working with disorders now classified as Post Traumatic Stress, panic disorder, and obsessive-compulsive disorder also tried using LSD with their patients. These efforts, too, showed marked success.

Researchers in Canada used LSD in treating alcoholics who had not been successful in earlier attempts at treatment. They reported cure rates without relapse of around fifty per cent, levels no other therapy has reached.

Over all, several thousand studies were published. First, they demonstrated the drug to be remarkably safe. Almost no significant adverse effects have been noted. They also indicated high levels of successful treatment. However, measured against the stringent standards for drug testing that have developed since 1962 under the changed FDA protocols, few of these studies would be considered sufficiently rigorous today.

But the dark side experimented with acid as well. Even before 1945, the OSS was looking at mind-altering drugs, and when the CIA took over the job, it continued the research. Both the CIA and Army Intelligence became interested in LSD early and started experiments that continued for over a decade. The CIA first tried acid as a truth serum. When that didn’t work, they experimented with the ideas of secretly dosing enemy commanders or politicians so that they would act crazy and lose credibility or with dosing water supplies so that populations would become uncontrollable. These experiments involved secretly dosing unknowing subjects, including drafted soldiers and hospitalized mental patients. Almost all reports of adverse incidents come from these experiments on unknowing subjects.

These failures led the military to pressure Congress to outlaw LSD. In 1968 acid became illegal under federal law. But doctors continued using mescaline and psilocybin until they were banned with the passage of the Controlled Substances Act.

Soon after that, MDMA became available, and doctors quickly adopted it with good results. When the DEA began its process to place MDMA in Schedule I, the CSA classification for drugs that have no medical use and which may not be possessed legally, over 250 therapists filed protests, stating that it was essential to their practice.

When the DEA placed MDMA in Schedule I, The Multidisciplinary Association for Psychedelic Studies was formed. Partly in response to MAPS’s urging, the FDA convened a Technical Panel in 1995 to establish guidelines for research on psychedelics.

Since then, research has picked up. Most of us are aware of the large number of studies on marijuana, but the other drugs have experienced resurgence as well.

MDMA has completed clinical safety trials, and Phase III trials on treatment of PTSD have been going on for several years. These look to be very successful.

Ibogaine is being tested in Mexico as an adjunct to treatment of opioid addiction. This use look similar to the work using LSD with alcoholics conducted in Canada in the 1950s. Incidently, those researchers were the ones to coin the term “psychedelics”. Also, the Native American Church has had very good results working with alcoholics in its peyote rituals. The active ingredient in peyote is mescaline.

So, the bus is freshly painted, and Jerry and The Dead are cued up on the iPod. Get those wildly colored outfits out of the back of the closet and dust them off. Let’s all get on the bus: it’s time to go "Furthur".

[1] Stix, Gary, “Return of a Problem Child: LSD makes a comeback as a possible clinical treatment”, Scientific American, October, 2009, p. 18. See also Marsa, Linda, “The Acid Cure”, Discover presents The Brain, Fall 2009, p. 54.

[2] Lee, Martin A. and Bruce Shlain, Acid Dreams: The Complete Social History of LSD: The CIA, the Sixties, and Beyond, Grove Press, 1994, is the standard history of LSD studies, although much significant information about the CIA has come to light since its publication. I recommend it to anyone looking for more information on the topics I cover here.

Sunday, October 4, 2009

Marijuana Comes to the Americas

Marijuana Comes to the Americas

If you read my postings on “The Prehistory of Marijuana”, you know I presented two theories of how marijuana came from the old world to the new: from sub-Sahara Africa to Brazil with slaves or from North Africa with Moorish sailors on Spanish ships. You also know I was not enthusiastic about either of them.

I have now stumbled over a third theory that fits the facts much better. Indian hemp came to the Americas from (drumroll) India .  I found it in Grim, Ryan, This Is Your Country on Drugs: The Secret History of Getting High in America, Wiley (2009), pp 44-45.  Grim is a journalist, now writing primarily for Slate.  He also spent a few years working for MPP.  This book is a fun and informative read.

Great Britain eliminated slavery in all of the British Empire in the 1830s. The Jamaican sugar plantations had been highly profitable, but they needed large amounts of cheap labor to continue their operations. Relations within the Empire made India the best place for them to find workers.

Those Indian workers brought their families with them when they immigrated to Jamaica. And they also brought Indian hemp for relaxation, medicine, and religion. As their numbers grew, they expanded into the coastal areas of Central America, especially Panama.

This theory explains some mysteries and makes good connections with known historical points.

The “aha” moment for me was that this theory explains why Jamaican cannabis is called “ganja”, an Indian name. If the other theories were correct, one would expect the use of “hashish” from North Africa, “cannabis” or “hemp” from Europe, or some name from Southern or Central Africa. We do know from the debates leading up to the criminalization of marijuana in the U.S., that most Americans at that time were not aware of the identity of cannabis, hemp, and marijuana.

When the U.S. began work on the Panama Canal, it brought large numbers of workers from Jamaica and Cuba, believing them to be more resistant to yellow fever. These workers mingled with North Americans working on the canal. Panama became the direct source of three of the marijuana routes into the U.S. and the indirect source of the fourth.

Sometime between 1900 and 1920, marijuana became common in the Port of New Orleans. From the time of the California gold rush starting in 1849 (about when Indian workers first started appearing in Panama), a large part of New Orleans shipping originated in Panama, and as the Canal was being built and finally opened, that traffic increased.

In the early 1940s, Detroit Red (later Malcolm X) was selling reefers in New York to musicians. His source of supply was crewmen on Caribbean freighters, most of which came from New Orleans or Panama.

The army stationed troops in Panama beginning in 1904. The use of marijuana by these troops grew to the point that the Surgeon-General of the Army did a study of it in 1931, leading to publication of his report on marijuana use in 1932, in which he concluded no regulation was needed.

The fourth source of American marijuana, and the largest, was Mexico. Historically, Mexico has always had a strong flow of immigration from Central America, a migration that still continues. Mexico is probably where the name “marijuana” – “Mary Jane” arose. The turmoil of the Mexican Revolution of 1910 led to a large increase of people moving across the border into the U.S., where they found work, primarily as agricultural laborers. The presence of these Mexican immigrants led to the first anti-marijuana laws, beginning with the infamous El Paso ordinance.

This India-Jamaica connection is the most satisfactory one I have seen so far. I have begun looking for sources to try and nail it down. If any of you know of, or run across, anything that might bear on this issue, please help me out.