This update lists new material on the Addiction Science Network (ASNet) website including the ASNet Discussion Forum. Beginning with “Theories of Addiction,” podcasts will be available only as downloads for playing on your mp3 player. We thank Podomatic.com for providing storage for the earlier streaming audios which remain available from their website. Click on the links below for direct feed to the new material.
New commentaries added to the ASNet Discussion Forum:
New presentations available from the ASNet Podcast Channel:
This concludes update ASNet12J10.
There are a lot of speculations floating around Washington and the country regarding likely changes in America’s drug-regulation policies during a second term for President Obama. In fact, there’s talk even outside the U.S. boarders on how highly anticipated changes in America’s traditional hard-line, zero-tolerance anti-drug rhetoric may affect international relations. Those following the depth of the international political scene will recall that the U.S. entered into what threatened to be an all-out trade war with our friends and neighbors in the north over their apparent relaxed attitude regarding marijuana regulations and their progressive harm-reduction strategies in major Canadian cities such as Toronto and Vancouver. For many Americans this was a surprise—Canadians having such independent thought on a topic long dominated by America’s political views—and a wake-up message regarding Canada’s potential status as America’s 51st state. Why, isn’t Canada just a little (albeit geographically MUCH larger) U.S.? For those that don’t get out much, they’re even on metric, eh!
Anybody notice how both candidates are ducking the issue of reformed drug laws? Drug regulation or more aptly de-regulation is not a popular topic for anybody in politics, and either party reformulating a new national policy is slated to be the looser. Of course there is a growing grass-roots movement for medicinal marijuana and even decriminalization which would condone modest “recreational” use (presumably for “adults”), but no one running for office seems to be talking about abandoning “America’s (failed?) War on Drugs.” In fact, the Replications have suggested that they will step it up. What exactly does that mean? We invaded Afghanistan and now (i.e., post our military invasion) they’re the number one producer of heroin in the world. Estimates are that up to three-quarters of the entire world’s supply of heroin is coming from that region now ostensibly ‘under U.S. control.’ How much more could the Republications “step it up” (this merits repeating: we invaded Afghanistan militarily and look at the INCREASE in drug trafficking from that region now )?
There are some new players on the block, probably too poorly organized to make a significant impact in this presidential election but growing fast enough to perhaps enter into mid-term reelections and likely players in the NEXT presidential election. I’m referring, of course, to the baby-boomers who are now dealing with the increasing aches and pains of older, sometimes well-worn bodies as they move into their 60’s and beyond. Recent changes in prescribing guidelines for opioid-based medications are placing further, often harsh restrictions on people in need of this important pain-relieving medication. There is even some evidence that some are being driven to the illicit drug market (the very market the new restrictions are designed to better control) to acquire the drugs which help them endure the unrelenting pains of living with increasing medical ills. Eventually, as the numbers grow even larger with aging baby-boomers, this group is going to push back and push back hard. But that’s probably not until another presidential election or two.
One of the first acts of President Obama’s new administration was to issue orders that relaxed enforcement of marijuana laws by federal prosecutors and provided a de facto green light to medical marijuana for states that have passed such laws. The medical marijuana and the decriminalization lobbies (not always the same ultimate goal) both resonated with optimism on the progressive outlook of our new president, one in the new model needed for a New Millennium. According to many reports this wasn’t to last: federal prosecutors began resuming their prosecution of what would be deemed “medical marijuana” cases even in states which had voted legislature recognizing medicinal marijuana—so much for the short-lived progress.
For those who have read this far eagerly awaiting some prognostications, it seems only right to make a few predictions even if on such thin air as to be about as meaningful as those made by high-priced political analysts around the country. During President Obama’s second term in office, he will probably:
There does seem an interesting Supreme Court issue here: what constitutional right does the federal government have to regulate the medical practices of individual states? This is especially perplexing in an era where medical prescriptions are filled next to displays selling copper and magnetic bracelets and various medicinal elixirs reminiscent of the patent medicine era.
So there it is, our “predictions,” or is it our “want list,” things we hope that our President will push once he’s done running for a second term? Yes, he’s likely to want an active post-presidency life and we wish him the best (see below), but he’ll be free soon to really start pushing some agendas that he has his heart in and which he (and hopefully, we too) fully support. Our “want list” is based on what we believe is demanded by the scientific evidence, and our “predictions” are based on our confidence that our President will strive to do ‘the right thing.’
Our list of predictions is sufficiently long as to increase the chances that we'll hit on at least one or two, and then we can use the epidemiologists logic of claiming cause-and-effect post hoc and brag about our influence on national drug-regulation policy. Of course we did slant our "predictions" (AKA "want list") towards a more rational drug-regulation policy and if we really wanted to ensure a few 'predicted' changes under the new administration we would cover both sides predicting a few more stringent measures too.
Anyone who has read through our predictions this far is probably wondering whether we blatantly and shamelessly exploited the name “Obama” and the keywords “presidential election” to receive more traffic on the ASNet Discussion Forum. Yes, we did! But it’s not as self-centered as it may seem. We noticed that our brief comment on Obama’s shift in marijuana policy was getting a lot of hits (surprise, surprise, it must be election time) and decided that we should exploit this opportunity to increase awareness and debate on the important issues outlined above. Do we have any more insight than the next person on President Obama’s likely changes in drug-regulation policies? Of course we don’t, but that doesn’t stop any number of would-be “expert analysts” from capitalizing on the presidential elections to promote their personal and financial interests (e.g., “look at me, I’m a big-time lobbyist,” “I was on national television”). And we sincerely hope that we effectively add another voice or two to a mandate to develop rational drug-regulation policies based on unbiased scientific evidence not begging-the-question science instructed a priori what to “discover” in the course of “scientific” research directed by some hidden agenda.
President Obama is energetic and driven by his youthful idealism. If he can survive the rigors of another 4 years without the stress-induced aging typical of young men leaving the White House as old men (check the hair colors for before and after photographs of Presidents Bush, Clinton, and yes, even Barack after his first term; there’s a definite aging effect of being president), he is most likely to remain visibly active in world politics in some important way. Perhaps like former President Jimmy Carter he will form an institute and take up a specific cause or two, supporting the rights of the disadvantaged and marginalized people around the world. It’s unlikely he’ll rest on his laurels as former President Clinton appears to have done, nor will he retire quietly to a ranch in Texas out of public life as has former President Bush. He has a long life and his youthful zeal and intellect just won’t let him stop. With this in mind, he has to be somewhat conservative in his reform of America’s drug policies and mindful of the retaliatory action of others once he’s lost the power afforded by the Presidency. Therefore, it’s unlike that we’ll see the ‘real’ Barack even after he’s elected to a second term. But then, hey, you never know; he might just take this last opportunity to try to change things from the top down and let the reformed policies ‘rock-n-roll’ into place (metaphor is to ‘going for it,’ pursuing a course of action with zeal, not to implied open season on recreational drugs in America).
For those expecting something other than a pure conjecture op ed, we recommend a recent article from the Huffington Post and offer their analysis of likely upcoming policy changes for a second-term Obama administration.
Despite our President’s popular portrayal as someone who has substantial soft-drug experience and knows how to party well, he’s a responsible parent and above that a very, very bright person. He is likely to temper his youthful experiences with the concern of a parent balanced by a careful, well-thought-out (and hopefully well advised) course of action. We can only hope that his source of “scientific” information is truly credible and not from the usual “zero-tolerance” camp of agency scientists. President Obama knows how to think and work outside the box of usual Washington politics, and we are optimistic that he will apply his talent and skills to addressing America’s drug problem with an intelligent, coherent plan of action after election to a second term in office.
Now Rock the Vote!
The reason that marijuana is unlikely to ever be approved for medicinal use in the United States is obvious -- so why isn't anybody discussing it? The first step in resolving a problem is usually acknowledging the problem, but the medical community is totally ducking this issue. Do they have a vested interest in it?
This commentary is currently only available as a podcast (length: 24 minute). Click here to listen to the discussion through streaming audio without downloading. Click here to down load the presentation directly. Or click here to visit our full podcast directory.
Usually the written commentaries precede the audio programs on this website, but this one is an exception. I've been discussing this topic for the past 12 or 15 years in my course on drug addiction in relationship to the CSA/DEA Drug Regulation Schedules. A printed version (in rough draft form) has been available for my students' use for probably the past decade. So why haven't I commented on this issue before, especially if "I know the secret"? Simple, I wanted to save SOMETHING for my book. The bigger question is, why hasn't the medical community or even NORML and other marijuana-related lobby groups been discussing it? The first answer to this two-part question is perhaps because the medical community has something to loose. I'll post NORML's reply here when I receive it. OK, you have to listen to the podcast if you want to know more. Or perhaps you already knew this too.
The only reason I'm letting the 'cat out of the bag' here is because I've decided to include the information in a podcast excerpted from one of my impromptu classroom lectures. And once it's out, it's out.
Please be advised that the presentation picks up discussing off-label prescription writing privileges currently enjoyed by American physicians. The context of the presentation is discussing the CSA/DEA Schedules for Controlled Substances in the United States. I was having a bad day, everything had gone wrong up to the presentation including running off to lecture and forgetting to copy the updated slide material I had just hastily finished for my morning lecture. (It wasn't quite [but almost ] as dumb as it sounds -- I thought I was logged onto my USB memory stick, but the file was still being saved on my hard drive.) So, an unscheduled discussion of an 'old topic' (for me) stalled off a little time to ensure that I wouldn't need the forgotten slides (other lecture material was also presented and is included in a separate podcast, part of the Addiction Science Network Addiction Training Series; the class will get the regularly scheduled material during the next lecture period).
OK, I see yet another issue and you won't have to wait for a commentary or even a podcast for this one: if there is no evidence for the medicinal use of marijuana, why did the FDA approve dronabinol (synthetic THC) for medicinal use? Replies from the FDA welcomed and will be posted here.
The FDA has argued that dronabinol can be substituted for smoked marijuana, but this isn't really true for the reasons partially described in the podcast. (And why would the FDA even argue that dronabinol substitutes for something that doesn't work according to them?) Hint: the problem with substituting orally administered dronabinol for smoked marijuana has to do primarily with how pharmacokinetics influence a drug's psychological impact (including its mood-elevating and potentially its pain-relieving properties as well). But a full explanation of how that works is in another podcast (Click here if you really want to learn about how pharmacokinetics affect a drug's psychological impact. Warning: you have to listen through a lot of material before reaching the part which addresses this topic; the presentation is a little over an hour long.)
This post was actually planned for a later date after the groundwork was laid by exploring basic topics regarding drug abuse and addiction on the ASNet Discussion Forum. However, the recent post on Salvia Divinorum (and to a lesser extent the medical marijuana post) propels this topic to the forefront a bit ahead of schedule. When discussing this topic it is essential to keep in mind the differences between drug abuse and drug addiction and their underlying causes (i.e, the biological basis of addiction vs. the psychosocial factors that often govern drug abuse). A lot of confusion arises from simple problems in semantics when discussing psychoactive drug use, the effects of such drugs, and the rights of individuals. Some of the essential concepts have been presented already on the ASNet Discussion Forum or the Addiction Science Network website (see Related Topics on the ASNet below), but others have not yet been explored adequately. Thus, this topic is a somewhat premature.
The question open for comment is: “does the individual living in a free society have the right to use psychotropic substances?” There are a number of secondary questions that arise from this topic.
The ASNet drug-regulation policy stands firmly behind the strict control of highly addictive drugs. These substances (e.g., 'hard drugs' such as cocaine and heroin) compromise the individual's ability to 'choose' whether to use the substance or not by altering the individual's motivational hierarchy in such a way as to thrust the addictive drug near the top of the person's motivational priorities (see A Primer on Addiction). On the other hand, some psychoactive substances (e.g., caffeine) clearly do not compromise the individual's self-control in a significant way and therefore can be considered part of 'life's little pleasures.' Between these two extremes lie substances that cause considerable alteration in perception, cognition, and/or affect (e.g., 'soft drugs' such as marijuana and LSD) that potentially pose a risk for the individual and for society by impairing judgment and impulse inhibition of the individual while they are experiencing the psychotropic effects of the substance (e.g., intoxication, hallucinations). This is in contradistinction to truly addictive drugs where the risk to the individual and to society is primarily when the individual is not experiencing the psychoactive effect of the drug.
Addiction science can contribute to the development of rational drug-control policy by differentiating drugs that a large proportion of individuals might be expected to ‘lose control’ of their ability to regulate their own drug-using behavior from substances that most individuals experience little difficulty in regulating their own substance use. Other issues that determine society’s acceptance of its citizens’ use of psychotropic substances involve safety (a rational consideration) and moral control (usually a non-rational consideration). Addiction science and the reporting of experimental findings should not present biased information to conform to moral control issues dictated by society or by its government agencies—it should clearly present the facts as the facts, letting individuals make rational decisions regarding personal use on the individual scale and regarding the development of rational drug-control policies on the societal scale.
Related Topics on the ASNet
A Primer on Drug Addiction
The Nature of Addiction
Distinguishing Drug Abuse from Drug Addiction
Distinguishing Drug Dependence from Drug Addiction
Biological Basis of Addiction
Hard and Soft Drugs
A new category for commentary on the ASNet Discussion Forum is being introduced to address drug use other than addictive drug use. Specifically, this category includes the use of psychoactive substances to which the individual hasn’t developed an addiction. In some cases this will involve the use of substances to which addiction is unlikely; in other cases this will involve early-stage use of an addictive substance before an addiction has actually developed.
It is not the intent of the ASNet to encourage illicit substance use by openly discussing this topic. However, it is rather obvious that people do use illicit substances, often in a “recreational” fashion, and that such substance use will continue despite relentless government efforts for social control. It is also possible that the regulations regarding some substances that are now illicit should be relaxed and individuals should be permitted to use these substances freely or under somewhat restricted circumstances.
Before posting or commenting in this category please read the materials recommended below to learn how addiction is defined on this discussion forum, the important difference between drug abuse and addiction, and the relationship of drug dependence to addiction and to drug abuse. Misunderstanding fundamental concepts and breakdown in simple semantics contribute much to the confusion regarding the discussion of these issues.
Addiction science should withhold moral judgments regarding the use of licit or illicit psychoactive substances. Science should provide the unbiased data from which others can make rational decisions regarding their own personal use and regarding the development of formal drug-regulation policies. Within this context, the forum ‘owner’ will occasionally offer comments relevant to the science of addiction or to psychopharmacology in general, but the moral issues regarding psychoactive substance use is left for debate elsewhere (or at least confined to a single, specific ‘thread’ and not interwoven through the pages of the other topics). The topics of interest here include:
(This latter topic is related to the ASNet harm-reduction initiative and comments may be incorporated into the ASNet webpage listing “safer practices for using unsafe substances.”)
Recommended Readings on the ASNet
A Primer on Drug Addiction
The Nature of Addiction
Distinguishing Drug Abuse from Drug Addiction
Distinguishing Drug Dependence from Drug Addiction
Biological Basis of Addiction
Hard and Soft Drugs
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An open, unmoderated discussion forum for the Addiction Science Network, promoting free and open exchange of evidence-based information and promoting scientific analysis of drug addiction and related topics.