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.)
After only 5 postings (and two of them hardly count because they are administrative announcements), we have our first ‘oops.’ The “Position Statement on Medical Marijuana” was posted as if it were a significant change in policy when in fact it actually wasn’t anything new. Yes, it should have been obvious to many that the ASNet tacitly supported the medicinal use of marijuana from the mere absence of any mention on the ASNet website of the alleged high addiction liability of marijuana. And yes, those privy to an advanced copy of “Fundamentals of Drug Addiction” are abundantly aware that marijuana is not considered a prototypic addictive drug and in fact not even discussed until over half way through the book. But surely the public announcement endorsing the medicinal use of marijuana was new, wasn’t it? Well, not exactly.
Hidden among the pages of the ASNet website is a page describing the advocacy of rational drug-regulation policy as being an objective of the ASNet. Surprise, surprise—prominently displayed on the corresponding page is a recommendation to “Relax the current Federal laws regarding medicinal marijuana, permitting its use for a limited number of conditions where its psychoactive as well as its clinical effects are beneficial. Follow the progressive lead of several states (e.g., California) and Canada where medicinal marijuana is currently permitted.” The copyright date on that page is 2004.
And now you have the secret as to why the Google AdSense material appears on so many of the ASNet web pages. Google provides real-time counts of visitors to the pages where these advertisements appear. Relax, no tracking information is collected (we wouldn’t know what to do with it if we had it); only the number of page visits to each corresponding page is updated in near real-time and logged for later reference. This helps direct the work on this website to the pages where the most interest is being shown as evidenced by the number of page visits. And of course, we make a few cents when you click on the links provided by the Google Ads (at least I think we do; I’m not really sure because the ‘cash register’ isn’t ringing much). But most importantly, we get feedback and encouragement to resume work on this website which is all the ‘pay’ really needed and perhaps more than sometimes deserved. The previous policy statement was re-discovered when exploring the pages that needed to be ported from the old Addiction Research Unit website hosted by the University at Buffalo. That website has been defunct for some time; it was developed to support the neuroscience research facility which was closed shortly after the start of the “New Millennium.” A number of Addiction Research Unit web pages remain in limbo or as URL markers directing viewers to the phoenix version found on the ASNet.
The nice thing about being a scientist is that one can acknowledge and correct their ‘mistakes.’ Science is said to be ‘self correcting’ in the sense that new evidence or even re-interpretation of existing data often prompts a revision in theory, policy, or simply the assertions promoted by the scientific entity be it an organization or an individual. The ASNet will undoubted have to correct or even recant some statements found on these pages from time-to-time. Hopefully, it won’t happen often, but if the worst ‘oops’ is in the past we certainly would be very, very lucky.
One last note in case you look for this post in the somewhat distant future (tomorrow?). The nice thing about being the blog ‘owner’ is that one gets to rewrite history, to correct the glaring mistakes, to fix to awful omissions and the embarrassing blunders as well, of course, to correct ones position when found to be incorrect. A few snips with the text editor and the reference to “coming out of the closet” (it was a very bad pun anyway ) will be lost forever, and the ASNet will proudly display its position endorsing the use of medicinal marijuana while subtlety mentioning that this position has been publically advocated since 2004.
“The (sometimes absent-minded) Professor”
The scientific evidence overwhelmingly favors the medical use of marijuana. After ‘sitting on the fence’ for over a decade (i.e., since the beginning of the ASNet), it’s past time to ‘come out of the closet’ (there’s a pun in there somewhere ) and endorse the medical use of marijuana. The evidence has been compelling for a long time; in fact, several Presidential Committees spanning several decades have uniformly concluded that there is substantial evidence for medicinal effects from marijuana, and heightened interest in the past decade has prompted considerable study both empirical and theoretical. The overwhelming conclusion remains the same as purported over three decades ago with added emphasis on decriminalizing small quantities of marijuana for personal use.
Click here to listen to a podcast discussing why it's unlikely that medical marijuana will ever be approved in the United States. (length: 24 minutes)
ASNet drug-regulation policy recommendations and interpretations of extant scientific evidence are generally concordant with the major themes adopted by the National Institute on Drug Abuse (NIDA) and by the mainstream medical community except for two prominent issues: the “nicotine addiction” hypothesis” and “medical marijuana.” ASNet strongly disagrees with the assertion that nicotine is a highly addictive substance comparable to cocaine and heroin and that marijuana is similarly addictive. It further advocates the use of marijuana medicinally for appropriate cases and objects to the continued stigmatization and repressive regulation of tobacco products for use by adults. These two discordant positions are not intended to undermine the staunch support ASNet expresses for most NIDA research and policy recommendations: ASNet remains concordant with NIDA on most other issues and continues to respect the many friends and colleagues working for NIDA’s intramural program and those supported by NIDA’s extramural grant program.
The primary reason for remaining silent on these two issues of discordance with the prevailing government opinion is that both positions seem to discredit each other. That is, the pejorative assertions that “not surprisingly ASNet advocates marijuana use because they encourage tobacco smoking too” or “naturally ASNet disagrees with the idea of nicotine addiction because they also recommend marijuana use.” Of course, both statements are false distortions of our actual position. ASNet simply disagrees with the opinion that nicotine is highly addictive like cocaine and heroin and further disagrees with the opinion that marijuana is similarly highly addictive while advocating medicinal use of marijuana. Nonetheless, adopting both of these positions seems mutually discrediting; therefore ASNet has retained a low profile on the “nicotine addiction” issue and has not previously advocated the use of medical marijuana. With this current policy statement, ASNet now ‘steps forward’ and explicitly supports the medical use of marijuana.
We respect the decision displayed by many of our fellow scientists either working for various government agencies or supported by government grants who find it politically inconvenient to similarly ‘come out of the closet.’ Yes, there are many scientists who concur with the ASNet on both of these topics but fear repercussions should they express their opinions publically. And while we refuse to redefine “integrity” to meet the currently popular usage of this term, we do respect their decision to protect and further their careers. (“Integrity” is traditionally defined as “firm adherence to a code of especially moral or artistic values, incorruptibility [Merriam-Webster’s Online Dictionary].”) After all, it’s only tantamount to the Nazi book burning and not really persecuting any specific group of people; or is it?
The ASNet specifically:
(1.) endorses the medicinal use of marijuana for compassionate use including non-terminal but chronic illnesses such as multiple sclerosis, fibromyalgia, and other conditions involving neuropathic pain unresponsiveness to conventional medications,
(2.) firmly disagrees with the National Institute on Drug Abuse (NIDA), the Food and Drug Administration (FDA), the Drug Enforcement Administration (DEA), and other government agencies that purport marijuana to be a highly addictive substance similar to cocaine and heroin (in fact, we consider this assertion to be particularly irresponsible and call upon these government agencies to soften their rhetoric regarding marijuana and to recognize its actual status as a ‘soft drug’),
(3.) supports the decriminalization of marijuana and applauds progressive state legislative bodies such as that seen in our home state of New York who have already de facto decriminalized marijuana, and
(4.) while not advocating the recreational use of marijuana presently withholds opinion on this popular activity.
However, ASNet does not endorse the legalization of marijuana for the reasons outlined in Bozarth (2009).
For more information, check our webpage on medical marijuana.
[Note: The comments regarding the “nicotine addiction” hypothesis were included in the current policy statement only because this view is a matter of public record (e.g., 1994 FDA testimony transcribed in the Federal Record) that could be used to undermine the current advocacy of medical marijuana through ad hominid attack (e.g., “of course they don’t think marijuana is addictive, they don’t think nicotine is addictive either”). That’s right! But ASNet is not currently prepared to debate this second topic further than the public comments already posted on the subject. We feel that opening one ‘can of worms’ at a time is sufficient controversy and distraction from our overall mission. ]
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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.