William Stewart Halsted, M.D.

William Stewart Halsted, M. D.

Imber, Gerald, M. D., Genius on the Edge: The Bizarre

Double Life of Dr. William Stewart Halsted,

Kaplan Publishing, 2010 (355 pp. and end materials)

Dr. William Halsted is known as the “Father of Modern Surgery”. Many of the techniques and devices he invented are still in use. He was one of the founders of Johns Hopkins Hospital and Medical School, where he was chief of Surgery for some thirty years.

And he was also addicted to morphine and cocaine during the whole period. He continued to use those drugs until his death at the age of seventy in 1922.

A new biography by Gerald Imber, M. D., thoroughly discusses the interplay between his genius and dedication to scientific medicine with his dependence on these drugs. It places both within the context of his times. In addition to being a biography of Halsted’s professional life, it is also a good introduction to the birth of modern surgery and medical education and tells the story of the world’s introduction to cocaine.

Halsted was a fresh rising star on the New York medical scene when cocaine appeared as a new miracle drug. He began experimenting with it and developed the technique of local anesthesia, including the concept of nerve blocking. His oral injection sites are still used by dentists today.

As was usual at that time, he experimented on himself and his students. Unfortunately, his experiments were so enthusiastic that he – and several of his students as well – became addicted. Halsted’s cocaine use became so excessive that his work deteriorated to an embarrassing level.

His mentor, William H. Welch, intervened to save his protégé. He took Halstead on a sea voyage to withdraw him, but that trip ended in scandal when Halstead broke into the ship’s medical locker. The next step was to admit Halsted to Bishop’s Hospital, an institution specializing in cure of addictions.

Bishop’s used the best and most medically accepted medical cure of that time for cocaine addiction. They treated Halsted with large, regular doses of morphine. The result was that Halsted, while not totally able to abstain from cocaine, was able to limit his use to binges during vacation times for the rest of his life. However, he also developed an addiction to morphine, injecting himself two or three times daily (totaling about 130 mg. per day).

Welch had become head of the new Johns Hopkins hospital and would soon organize the Johns Hopkins medical school. At that hospital he brought together the four men who would create modern scientific medicine and medical education: Welch, Osler, Halsted, and Kelly.

He knew about Halsted’s morphine addiction (it is unclear whether he knew about the continuing cocaine use), but hired him as chief of surgery anyway. After all, about ten per cent of the medical profession at that time regularly used morphine or opium.

“Osler’s concern at that time was Halsted’s dose management, and not his ability to function. In that regard, morphine was significantly less destructive than alcohol. Halsted’s condition, and his struggle to contain it, were seen as both tragic and heroic, but not incongruent with a productive life. To Osler and Welch, Halsted was a professional equal with a chronic, but not debilitating, disease. Halsted announced his shame by working to hide all evidence of his problem.” (page 181)

Halsted arranged his life so that his drug dependency did not interfere with his professional activities. He scheduled surgery, clinical rounds, and writing during the times he was most alert and lived privately the rest of the time. During the academic year, he refrained from cocaine, but from May through September, he left the hospital. He would spend several weeks at his wife’s family farm in North Carolina, growing prize dahlias, riding horses, and serving as veterinarian to the neighbors’ animals. He would then travel to the surgical centers of Europe. During these travels he would disappear for extended periods. These times are probably when he indulged in cocaine binges, but no direct evidence has surfaced.

This discipline enabled Halsted to stay at the pinnacle of his profession for over thirty years. He was still chief of surgery at Hopkins at his death in 1922. By any measure his career was outstanding.

And what a career it was. Halsted developed the doctrine of aseptic surgery, making possible invasion of the body cavity in that age before antibiotics. Every doctor or nurse who has donned scrubs or worn rubber gloves is following the rules first laid down by Halsted. He then devised radical mastectomy for breast cancer and the repair for inguinal hernia that was used until the invention of the laparoscope. His non-crushing clamps for blood vessels still fill the instrument trays in every operating room. He painstakingly developed the anatomy and physiology of the aorta through years of research, and while the supporting technology did not allow him to repair aortal aneurisms, his work was the basis of Dr. DeBakey’s success in the 1950s. His residents became surgical professors and chiefs of service at the schools in the forefront of modern medical education. “Father of Modern Surgery” is a reputation Halsted clearly earned.

However, he was fortunate to live when he did. Although the Harrison Narcotics Tax Act of 1914 allowed people to possess opiates and doctors to prescribe them, only in 1919 did the Treasury officials adopt the thinking of the alcohol prohibitionists and begin trying to prevent personal use or possession of opiates. In 1925, three years after Halstead’s death, they forced the closure of the last opiate maintenance clinic in the U. S., and then made the status of being an addict a crime (a statute held unconstitutional in 1962). Had Halstead lived two decades later, he would have likely ended up in prison or on the streets.

Imber’s book is a fascinating and informative look at an unusual man and a critical period in the history of medicine and drug policy. And for today, it makes us take a hard, critical look at the current attempts to regulate drug use. I recommend it for everyone.

Answers to Trivia Quiz

Answers to Trivia Quiz

Here are the answers to the Trivia Quiz I posted earlier. Each question is reposted so that you don’t have to click back and forth, and it is followed by a short answer, and usually, a brief annotation.

Some of you posted your answers as comments or sent them to me privately. Everyone did very well, all of you individually outscoring the class of graduate students answering as a group. But no one was perfect. Relax: grades will NOT be posted!

So here are the answers. I hope we learned a little bit. But mainly I hope we had some fun. Enjoy.

Questions and Answers

1. In his first term, President George Washington led federal troops against rebels in western Pennsylvania. Which psychoactive drug was at the root of the controversy?



Alcohol


The new government placed an excise tax on distilled spirits to pay off Revolutionary War debts. Western farmers grew corn, but had no roads to get it to market. They converted it to whiskey, which could be transported in barrels slung on horseback. They were afraid the tax would put them out of business, and grabbed their guns in rebellion.



2. In the period 1790 – 1805 the U.S. fought a war against the Barbary Pirates in North Africa. Why were American ships in the Mediterranean at this time?



Turkish opium was one of the most valuable cargoes brought to America before the Civil War.


Before the Civil War almost everyone needed opium for toothaches or water-borne intestinal diseases. Then, by about 1820, Yankee traders were buying opium in Turkey, selling it in China in competition with the British, and then selling Chinese silks, porcelain, and tea in New England. Many of the old Boston maritime fortunes were based on opium.



3. During the Civil War, where did the Confederate Army get its medical opium?



They grew it themselves.


Opium is easy to grow and grows almost anywhere. Jefferson probably grew some on his plantation. By 1872, the Massachusetts Board of health was complaining that Vermont, New Hampshire, and Connecticutt growers were flooding Boston with hundreds of pounds and that commercial growers in Florida and Louisiana were also shipping in large amounts. They said that California and Arizona Territory were the center of the trade and that a farmer with 10 acres in Arizona could produce 1200 pounds a year.



4. When and where was the first U.S. law against marijuana passed?



El Paso, Texas, 1915


El Paso may win by a technicality, being the first to use the term “marihuana” in their ordinance. I have found one source suggesting that California had banned “Indian hemp” a couple of years earlier, but I haven’t been able to track it down. Does someone with better access to California records have more information?



5. How many doctors testified to Congress concerning the proposed Marihuana Tax Act of 1937? Were they for or against the Act?



Only one doctor testified. The representative of the AMA said that the law was unnecessary and that it would block needed medical research.


The government’s only scientific evidence came from a pharmacologist who testified that all of his research was on dogs because, with a Ph.D. and not an M.D., he could not experiment on humans. The government later fired him when, testifying as an expert for the defense in a criminal case, he testified that he had taken the “active ingredient” in marijuana, turned into a bat, flew around his lab, and dived into an ink bottle.





6. How many people had used marijuana in 1937 according to the Government’s testimony to Congress?



100,000


This was Anslinger’s figure. He said the users were composed of Black jazz musicians, Puerto Ricans, and Mexican farm laborers.



7. What were the Government’s estimates of the number of people using marijuana in 2008?



Over 44% of adult American residents (over 100 Million people) had used marijuana at least once:


Over 15 Million used marijuana at least once a month


These figures come from voluntary questionnaires, and at least since the days of Kinsey, pollsters have known that surveys about illegal or disreputable activities under-report those activities.



8. Switzerland began providing free heroin to addicts in the mid-1990s. How many people in Switzerland have died of opioid overdose in Switzerland since then?



Zero [see comment]


Opioids are actually very safe drugs. Even overdoses develop slowly, allowing ample time for medical intervention. In the U.S., many of the so-called overdose deaths are law-related. They are caused by adulterated drugs, drugs of unknown potency, substitution of unknown drugs for the one the user expected, or reluctance to seek medical assistance.



9. How many people were arrested for simple marijuana possession in the U.S. last year?



Over 800,000



10. California adopted state medical marijuana by referendum in 1996. How many states now have medical marijuana laws?



14

Trivia Quiz

Trivia Quiz

I recently did a guest lecture spot in a graduate sociology class, and rather than merely subjecting them to just a boring history lecture, I started with a little trivia quiz. Those graduate students didn’t do too well on it and I thought you might do better. Have fun with it, and I’ll post the answers in a few days.



1. In his first term, President George Washington led federal troops against rebels in western Pennsylvania. Which psychoactive drug was at the root of the controversy?



2. In the period 1790 – 1805 the U.S. fought a war against the Barbary Pirates in North Africa. Why were American ships in the Mediterranean at this time?





3. During the Civil War, where did the Confederate Army get its medical opium?



4. When and where was the first U.S. law against marijuana passed?



5. How many doctors testified to Congress concerning the proposed Marihuana Tax Act of 1937? Were they for or against the Act?



6. How many people had used marijuana in 1937 according to the Government’s testimony to Congress?



7. What were the Government’s estimates of the number of people using marijuana in 2008?



8. Switzerland began providing free heroin to addicts in the mid-1990s. How many people in Switzerland have died of opioid overdose in Switzerland since then?



9. How many people were arrested for simple marijuana possession in the U.S. last year?



10. California adopted state medical marijuana by referendum in 1996. How many states now have medical marijuana laws?

Prohibition –Theory and practice: Part 3: Law Enforcement

Prohibition –Theory and practice: Part 3: Law Enforcement

A recent sociological study of street prostitutes in Chicago showed that 3% of their tricks were “freebies” performed for Chicago police officers. Both parties to these transactions considered them to be a “business tax”, paid by the women as the price for conducting their business unmolested. This case is a routine, if somewhat benign, effect of a prohibition on law enforcement.

Prohibition always has a corrosive, corrupting effect on law enforcement. These effects come in four forms. The large, unaccounted-for sums of money created by prohibition markets co-opt law enforcement personnel either as agents of the providers or as independent suppliers themselves. The lack of complainants in prohibited transactions leads enforcement to depend on untrustworthy and frequently untruthful methods like undercover operations and informants. The futility of attempting to quash prohibition leads to disinterest and slacking by those who see their efforts as useless. Contraband markets are always accompanied by an increase in violence, with police agents find themselves on both the delivering and receiving ends.

Traffickers run the double risks of arrest and violence. Fortunately for them, prohibition adds a premium of at least 90% to the price of the illegal commodity, providing them with ample funds to protect themselves.

As I have discussed previously, prohibition does not remove the prohibited good from the market. It does, however, increase the costs of providing that commodity by adding, among other costs, the risks of violence and imprisonment to those incurred by the supplier. A rational supplier will look for ways to offset those costs and will use the increased funds available from prohibitory prices to avoid them.

One simple way to avoid those costs is to purchase police officers. These purchased police may act directly by providing intelligence or protective services to the traffickers. They may also act indirectly to subvert the judicial process by destroying or suppressing incriminating evidence or providing false exculpatory evidence. During the brief thirteen-year life of the “Great Experiment”, over thirty per cent of the federal prohibition agents were convicted, fired, or forced to resign because they were corrupted. In 1930, the director of the Prohibition Bureau resigned when the public learned that both his son-in-law and his nephew were employed by Nicky Arnstein, one of New York’s biggest bootleggers and the man who first arranged heroin smuggling routes from Europe. In the mid-1930s, the Secretary of the Treasury was forced to step in and fire one-third of the Narcotics Bureau who were in the pay of drug smugglers. When the same thing happened in the 1960s, the Bureau was moved to the Department of Justice and became the Bureau of Narcotics and Dangerous Drugs. One week later, the head of the Miami office was caught taking a bribe and forced to resign.

This corruption is not just ancient history. The Border Patrol, responsible for interdicting both contraband drugs and illegal aliens, has a continuous history of agents convicted of corrupt acts. When Homeland Security began its new program of placing Sky Marshals on domestic flights, two of its first marshals dispatched from Houston were arrested for attempting to smuggle cocaine on their flights. Both had just transferred from their earlier jobs as DEA agents.

The chain of corruption has extended upward from field officers to elected sheriffs and prosecutors. Even one federal district judge was convicted and removed from office for accepting bribes from traffickers. As a series of investigative reports on the New York police, beginning with the Wickersham Report in the 1930s and continuing until the Serpico affair in the present, show, no police agency, large or small, has been exempt.

The combination of ready money and the relative impunity of drug dealers has tempted many police officers into going into business for themselves. Every police department has had problems of drugs, money, and guns “disappearing” from secure evidence lockers or less drugs and money turned in after arrests than the arrestees claimed to possess. Police have used this diverted contraband themselves, as planted evidence in other cases, or as merchandise to sell themselves.

When Texas banned smoking in prisons, cigarettes became the new contraband. The twenty cigarettes in a pack, then costing about two dollars, could be cut into thirds, each selling for five dollars. That opportunity to turn a two-dollar investment into three hundred dollars of tax-free income was more than many $20,000 a year prison guards could resist. The firings and convictions have continued at a steady pace. Studies in prisons have shown levels of drug use inside to be the same as those outside – circumstances that would be impossible without the cooperation of corrupt staff members.

Neither the seller nor buyer will file a complaint or willingly testify in a typical drug transaction. The police therefore are impelled to use undercover agents or informants to make cases. These methods carry with them three major vices.

Informants are inherently untrustworthy. They are providing evidence in return for either money or leniency in their own cases. A scandal in the Boston FBI office involved agents turning a blind eye to murders committed by their informants in return for information about organized crime. Maybe all informants do not lie every time they open their mouths, but lies are by far their most common product.

The same pressures to produce evidence exist for undercover police. Three major drug task force scandals in Texas – Tulia, Hearne, and the Dallas Drywall cases – all involved undercover police making up evidence to make cases. In Tulia, one lying cop convicted 37 innocent people before his scheme unraveled. All were ultimately pardoned on the basis of actual innocence. Forty years ago when I started practicing law, the cynical courthouse joke was to speculate about how many times the same matchbox full of marijuana was introduced into evidence.

Violence is the third major risk of undercover operations. Often the officers are not good enough actors to sell their performance to wary dealers, and the deal goes sour. Alerted dealers, facing decades in prison, frequently try to shoot their way out of trouble. The result in many cases is dead or wounded police officers or innocent by-standers.

A civil society cannot exist with a corrupt law enforcement system – or even one that is merely perceived to be corrupt. Ineffective prohibition schemes like bans against some drugs or prostitution lead inevitably to the visible corruption of law enforcement. While the vast majority of police officers, prosecutors, and judges remain honest, the handful who succumb to these corruptive influences is enough to destroy both public confidence in law enforcement and public confidence. The only way to preserve the integrity of law enforcement is to remove the prohibitory laws that are eroding it.

In the Dark Depths of Winter

The winter solstice is here: the day on which the night stops growing and the days start lengthening with their promise of eventual spring. From the beginning of history, cultures in the European tradition have marked this date with festivals of hope and renewal. The Romans had their Saturnalia that the Christians turned into their Christmas. The heathens and Druids – and the modern Wiccans – celebrate this date with lighted fir trees and mistletoe. They all looked forward to a growing light and a hopeful future.

Those drug law reformers who have found themselves in the deepest chill of winter since the early 1980s may finally passed their solstice and find the warming rays of dawn breaking early. The thaw seems to be on the horizon.

The first ray of light was California’s adoption of a medical marijuana referendum in the mid-90s, now followed by thirteen other states. Two more states have passed medical marijuana bills, only to see them vetoed by recalcitrant governors. At least six states now have bills under active consideration.

By 2004, California had seen the need to regulate a system for the medical marijuana the people had mandated. The legislature created laws governing marijuana dispensaries. In Los Angeles today medical marijuana dispensaries outnumber McDonalds or Starbucks. Three other states – Colorado, New Mexico, and Michigan also have dispensaries operating, and Rhode Island and Maine have passed a law enabling them, although the first one is yet to open in either state. At least one governor has vetoed a dispensary bill. Their rate of growth in Colorado seems to be following that in California.

Public opinion has followed the spread of medical marijuana. By 2005, opinion polls nationwide had swung so that medical use was favored by a majority of voters. The favorable opinion has continued to grow since then. Michigan voters in 2008 approved medical marijuana by 62%.

Opinion also is swinging toward legalizing the possession of marijuana even without medical need. Surveys now consistently show around 45% in favor of legalization; and in California, where legalization will probably appear on the 2010 ballot, 56% of the voters are in favor.

In fact, state action on legalization is the hot topic of conversation. In addition to the referendum petition, the California legislature has a legalization bill before it this session. A similar bill, but with more sponsors, has also been filed in Oregon. Passage of either of these bills is unlikely, but they have generated editorial page conversations across the country. This topic was unheard of just a few years ago, and now it is discussed as a routine matter, with a surprising part of the comments being favorable.

Massachusetts is a bit of a wild card when it comes to legalization. It decriminalized possession of less than one ounce through a 2008 referendum. All of the other states that have decriminalized did so in the mid- to late-1970s, so one has trouble deciding whether Massachusetts is showing a liberalized attitude tending toward legalization or a retrograde move to the past.

But the real crack in the cold grip of Drug War winter is happening in Washington, D.C. Both the executive and the legislature seem to be loosening their death-holds on prohibition.

The executive branch has moved on three fronts. Shortly after his appointment, the new Attorney-General announced that the United States would abstain from prosecuting those acting in compliance with state medical marijuana laws and followed that with a formal memorandum so instructing U.S. Attorneys. So far, the USAs seem to be acting in compliance with that memorandum. The new head of ONDCP quickly announced that the concept of “War on Drugs” would no longer be used. So far, he has refused to go further in public, but his new assistant director has a professional background in treatment and rehabilitation, not in enforcement. The State Department has also lowered the temperature of discourse and seems to be looking at international alternatives to the failed source suppression policies.

The administration’s main failure has been its neglect in filling judicial vacancies and replacing U.S. Attorneys. However, Obama’s reluctance to face Senatorial filibuster battles over these lower level appointments is understandable.

Congressional action this year has been the most surprising. With no fanfare and little dissent, both houses approved funding for needle exchange programs as part of the pending health care bill and removed the legislative obstacles to medical marijuana in the District of Columbia. Both houses have pending bills to establish National Commissions, the Senate bill covering penal law and policy, including drugs; and the House bill aimed specifically at drug policy. In addition, bills have been filed in the House to decriminalize possession of personal amounts of marijuana and to recognize state medical marijuana laws. Some of this activity should result in some kind of more progressive drug legislation in this session.

The solstice of the long winter of drug prohibition has passed. Light is creeping back into some of the dark corners of oppression. Soon spring will be here. It is time to celebrate.

Happy holidays!

Drug-Free Communities?

One of the callers to my television show this week asked what those people like him who wanted to live in drug-free communities should do. I brushed him off by pointing out that every known human society (except for some Arctic groups living in extremely impoverished environments) has used some kind of intoxicant. But then as I was driving home and passed a municipal sign declaring the town to be a “drug- and gun-free zone”, I started wondering what these people mean by “drug-free community”.

They can’t mean it literally. An inspection of their houses would almost certainly turn up aspirin or acetaminophen and some kind of cold or sinus remedy. Most of the houses would have at least one bottle of prescription drugs. The kitchens would have (unless the residents were members of the Latter Day Saints) coffee, tea, chocolate, and cola drinks. Their children are vaccinated and most of them got flu shots this year. When these drug protesters go to the dentist, they are probably grateful for his use of nitrous oxide and the follow-up prescription for Vicodin. The children most likely attend schools where almost ten per cent of the students take stimulants (including the methamphetamine the DEA scares everyone with) to treat some Attention Spectrum Disorder. Their world is far from drug-free.

Perhaps they mean free from dangerous drugs. But that can’t be true either. All of the communities from which my call might likely have come allow the sale of alcoholic beverages in restaurants, clubs, and bars; and cigarettes, beer and wine are sold in their grocery stores and drug stores. Alcohol and tobacco are by far the most dangerous drugs in our society. (And I say “tobacco” rather than “nicotine” because the smoke inhaled from burning the whole plant is much more problematic than is the nicotine it contains.) Tobacco-related illnesses cause over 400,000 deaths each year. Alcohol only kills about 150,000 by alcohol-related illnesses and acute intoxication each year, but it manages to score another 15,000 or so deaths in alcohol-caused car wrecks. These drunk-driving deaths each year total more than the deaths resulting from all of the illegal drugs combined. Alcohol is also the only drug whose consumption has been causally connected to any violent crimes. Aspirin and acetaminophen can’t even reach 1 % of the number of alcohol deaths, and yet they kill more than any of the so-called dangerous drugs. Marijuana has never been shown to have caused a single death, and Switzerland has not had an opiate overdose death in the ten years that the Swiss have been giving heroin to addicts.

Perhaps they are making the lesser claim that they are keeping illegal drugs out of their community. But that claim doesn’t stand up to scrutiny. Making drugs illegal does not make them unavailable. It just makes them more expensive and less pure and makes society more dangerous and corrupt. Stimulants (amphetamines and Ritalin) are now used, legally and illegally, by at least as many people as they were in their legal heydays of the 1960s. The percentage of the population addicted to opioids today is greater than it was before passage of the Harrison Act in 1914. Millions of doses of MDMA – outlawed by a panicked congress in 1986 – are used in the U.S. each week. And marijuana? The government claimed that fewer than 100,000 people used marijuana when it asked congress to outlaw it in 1937. Now the government claims that over 100,000,000 people have used marijuana and that almost 15 million use it at least once a month. These numbers add up to a lot of drugs being used in communities that claim to have banned them.

These statements of “drug-free communities”, whether made as claims of fact or as aspirations for the future, are doomed to be false. The problem is that they all use the term “drug” to refer to harmful chemicals with biological effect. They seem to be creating a dichotomy between drugs and medicines.

The chemicals themselves are neither good nor bad: they just are. Some can be used beneficially; some (often the same ones) can be used detrimentally. The methamphetamine the DEA has been scaring people with for years is the same Methadrine that is prescribed for kids with ADHD and substantially the same as the Dexedrine the Air Force gives to its combat air crews for increased performance. One recent survey showed that twenty per cent of working scientists used these or similar “brain boosters” to improve their work.

Medical practice would be severely hampered without morphine and other opioids to control pain. But heroin (diacetyl morphine) is converted back to morphine in the body. In fact, long-term experienced addicts cannot distinguish between injections of these two drugs. Heroin can be used as a pain killer in some patients who are allergic to morphine.

In addition to heroin, the DEA has many other “evil” drugs in Schedule I, classified as having no significant medical use. Of these, marijuana, LSD, MDMA (ecstasy), mescaline (peyote), and psilocybin (magic mushrooms), among others, have well-documented histories of medical research and use.

Both the drug-free community wishers and the law because they focus on the chemicals instead of the users. The first American drug laws – the Pure Food and Drug Act of 1906 and the Harrison Narcotics Tax Act of 1914 – were reasonably effective in decreasing both drug dependency and harms resulting from drug use. But when alcohol was prohibited in 1920, the emphasis shifted from the users to the chemicals themselves; and the heroin acts of the 1920s started the country down the disastrous road of drug prohibition.

Now is the time to recover from that disastrous, vicious, and corrupting attempt to create drug-free communities, and instead start looking at the users. Now is the time to create communities free from the harms of irresponsible drug users.

Where Are the Bodies?

Where Are the Bodies?

For more than forty years Drug Warriors have argued that smoking cigarettes causes lung cancer and that since marijuana is also smoked, it must cause cancer too. The most effective response to that argument has been to ask: “Where are the bodies?” because there are no bodies. Thirty-five years of documented heavy marijuana smoking by millions have not produced a single case of lung cancer that doctors are willing to attribute to marijuana. That statistic conclusively rebuts their argument.

Another Drug Warrior argument is now ripe for a “Where are the bodies?” rebuttal.

Prohibition zealots, from the very beginning have argued that drugs must be made illegal because drug use is associated with increased crime. The more rabid even repeat the 1930s “Reefer Madness” idea that a single puff on a joint will send a nice, innocent young man off on a rampage of rape and murder with a wild glint in his eye. The less extreme still show up at city council meetings and write letters to the editor protesting medical marijuana dispensaries because they will increase crime in the area. They don’t seem clear about whether all marijuana users, including those who use it to combat illnesses, are criminals who will knock over a convenience store when they pick up their meds or whether marijuana itself is a crime magnet that, by its very presence attracts all the miscreants who learn of its location.

Enough hard data now exists to rebut this argument. It’s time to start looking for the bodies.

California now has had legal medical marijuana for over a decade and several years of open operation of marijuana dispensaries. Colorado, Oregon, and Michigan also allow dispensaries, although for shorter periods of time.

Almost all of those dispensaries operate in towns or cities that participate in the FBI’s Uniform Reports of Major Crimes. For even finer scale analysis, police reports in most towns and cities are either open to the public or available through some kind of open records request. These reports show every crime reported to the police and even the address at which it occurred.

In cities like Los Angeles, San Francisco, or Oakland, with large numbers of active dispensaries, longitudinal comparisons within the cities can be made. How was crime different in San Francisco in 1980-89 and 1999-2008? Comparing a decade before medical marijuana with one after it has been established should show whether it has affected either the rate of crimes or their locations. Los Angeles, like many cities, has followed New York in basing its police posting procedures on weekly statistical reviews of incident reports around the city. Those reports should be available and should provide a detailed picture of the relationship, if any between marijuana distribution and the incidence of crime.

Comparisons between cities could be even more telling. While Los Angeles and San Francisco have been liberal in their approach to medical marijuana, San Diego has resisted allowing any legal marijuana outlets of any kind. Comparing the crime report data between San Diego and the other two cities should be very revealing.

Other sources of data should be available as well. Numbers of court-ordered admissions to marijuana rehab programs is one statistic that should be available over an extended period of time. The number of marijuana-related DUIs should be publically available and is probably a surprisingly low total.

Local regulation of marijuana dispensaries is creating civil litigation in both California and Colorado. All of these public safety records should be obtainable through the discovery process, and their use as evidence would require the same kinds of statistical analysis discussed below.

These kinds of data are almost meaningless in their raw state. Intensive sophisticated statistical analysis is necessary to make them meaningful. That kind of analysis is normally done in universities. But certainly some sociology professor is looking for a tenure piece, and the data holds the potential for many Ph.D. dissertations. The mountain of numbers will provide meaningful employment for generations of graduate students. Universities are, as a rule, also experienced in open records access and are willing to fund the search for them.

Although this kind of detailed statistical analysis may take years, the where’s-the-body argument is useful now. The “Marijuana causes crime” argument belongs to the prohibitionists. Since they advance that argument, they also have the burden of proving it. And they cannot. Anytime that argument is advanced, the response should be: “What do the crime reports show?” One can point out that the police have the data and can provide the answers. A city council can be pushed to study their own records to determine the truth about crime and marijuana. They can be asked to delay repressive actions until the records are examined.

Health care has made fantastic advances by insisting on evidence-based medicine. Now is the time to insist on evidence-based laws as well. Facts are the sharpest tools in any reasonable argument. The facts are on the side of ending prohibition. It’s time to wield them vigorously.