Three takes on weed

First, USA Today did it's best to create the impression that there is still a raging debate about marijuana and the gateway theory:

Most users of more addictive drugs, such as cocaine or heroin, started with marijuana, scientists say, and the earlier they started, the greater their risk of becoming addicted.

Many studies have documented a link between smoking marijuana and the later use of "harder" drugs such as heroin and cocaine, but that doesn't necessarily mean marijuana causes addiction to harder drugs.

"Is marijuana a gateway drug? That question has been debated since the time I was in college in the 1960s and is still being debated today," says Harvard University psychiatrist Harrison Pope, director of the Biological Psychiatry Laboratory at Boston's McLean Hospital. "There's just no way scientifically to end that argument one way or the other."

That's because it's impossible to separate marijuana from the environment in which it is smoked, short of randomly assigning people to either smoke pot or abstain — a trial that would be grossly unethical to conduct.

"I would bet you that people who start smoking marijuana earlier are more likely to get into using other drugs," Pope says. Perhaps people who are predisposed to using a variety of drugs start smoking marijuana earlier than others do, he says.

Besides alcohol, often the first drug adolescents abuse, marijuana may simply be the most accessible and least scary choice for a novice susceptible to drug addiction, says Virginia Tech psychologist Bob Stephens.

No matter which side you take in the debate over whether marijuana is a "gateway" to other illicit drugs, you can't argue with "indisputable data" showing that smoking pot affects neuropsychological functioning, such as hand-eye coordination, reaction time and memory, says H. Westley Clark, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration.

The article ends up hedging its bets and qualifies just about everything she says. I find it hard to argue with the facts presented, but the emphasis and the selective inclusion suggest that the writer might be guilty of hype.

Next, a Canadian publication advocates legalizing and regulating marijuana:

Because of crimes that are related to the drug trade—most notably the killing of the four police officers in Mayerthorpe two years ago—many have been pushing for increased punishment for drug-related crimes recently. While a tactic such as increased jail time would theoretically make criminals think twice before becoming involved in the trade, there’s no statistical evidence that supports this claim.

The fact remains that it’s just too profitable an industry to be deterred by harsher punishment. Instead we need to end this failed experiment called prohibition and regulate most, if not all, drugs.

...The regulated sale of drugs would mean that one of the biggest dangers of drug use, drugs that are laced with more dangerous substances, would be systematically eliminated. As well, it would allow people to find a more accurate description of what they are taking, what it does to them, recommended doses and possible negative side effects. A more honest approach on the effect of these drugs would work better than just saying that drugs kill.

If there’s a demand for illicit drugs, like any other product, why should criminal elements be the ones who profit from it? Marijuana, for example, is more profitable than any other crop in Canada. Instead of letting criminals sell it, using the profits for other nefarious purposes, why doesn’t the Canadian government make it and sell it, eliminating the criminal element in the process? People are still going to buy it either way, after all.

Variations of this proposal a published frequently. At least this version eliminates profit potential. Most versions of this proposal suggest legalizing and regulating private sale, which raises the specter of a marijuana industry with the promotional and lobbying power of the alcohol and tobacco industries. While all variations of legalization models have an uphill battle, one that puts the government in the role of manufacturer and sales seems DOA.

Finally, STATS was riled by the USA Today article. They make several strong rebuttals to the points in the USA Today - if there is a gateway drug it's alcohol; alcohol causes more harm; there's lots of evidence against the gateway theory; most marijuana users experience little or no harm, etc. However, she also inserts her bias and misrepresents the USA Today article:

So, where’s the evidence that marijuana is more harmful than other substances?

The USA Today article didn't argue that marijuana is more harmful, just that it's not harmless. There were enough problems with the article that the straw man tactics we're needed.

Does marijuana contribute to psychotic illness?

Current Psychiatry on marijuana and schizophrenia:

Cannabis and psychosis: 4 clinical pearls Cannabis use increases the risk of developing psychosis and is estimated to double the risk for later schizophrenia (5 to 10 new cases per 10,000 person-years) The association is not an artifact of confounding factors such as prodromal symptoms or concurrent use of other substances (including amphetamines) The risk increases with the frequency and length of use (a dose-effect relationship) Self-medication is not the connection between cannabis use and schizophrenia, according to empiric evidence

I'll keep an eye out for responses to this. It's so hard to know what to trust on something like this. This article seems reasonable, but it feels a little reminiscent of Reefer Madness. Also, the increased risk of schizophrenia may be statistically significant but I find it difficult to get too alarmed about the risk going from 1 in 2000 to 1 in 1000. (Maybe I should be more alarmed. I suppose that you start talking about large numbers when you multiply these numbers by large numbers of users.)

In utero marijuana exposure alters infant behavior

The Journal of Pediatrics has a new study suggesting in utero marijuana exposure may cause behavior changes in newborns. I'll look forward to attempts to replicate these findings:

Infants exposed to marijuana in the womb show subtle behavioral changes in their first days of life, researchers from Brazil report.

These newborns were more irritable than non-exposed infants, less responsive, and more difficult to calm... They also cried more, startled more easily, and were more jittery. Such changes...have the potential to interfere with mother-child bonding.

Barros and her team looked at 561 infants born to adolescent mothers. Twenty-six of them had been exposed to marijuana, as revealed by tests on the mother's hair and the infant's stool. Just one of the mothers had reported smoking pot while pregnant.

Trained examiners, who did not know a child's marijuana exposure status, tested the neurobehavioral responses of all infants. On average, marijuana-exposed infants scored differently on measures of arousal, regulation and excitability compared to the non-exposed infants.

...

Marijuana's active ingredient, tetrahydrocannabinol (THC), does cross the placenta into the fetal circulation, Barros and her team point out. The drug also has been shown to trigger the expression of the neurotransmitter dopamine, they add, and this could result in long-term alterations in nervous system function.

"It is necessary to counter the misconception that marijuana is a 'benign drug' and to educate women regarding the risks and possible consequences related to its use during pregnancy," Barros and colleagues conclude.

Marijuana Policy

This morning's post on the evolving sentiment toward marijuana policy reminded me of this interview with Bill White from Bill Moyer's Close to Home PBS series. I always thought that medical marijuana advocacy was a joke was an ineffective way to promote policy change, but I now think that they're having success in changing who we associate with marijuana.

White: ...you would be hard-pressed to build the case why in certain cultures opiates are celebrated and in other cultures alcohol is celebrated. I would suggest that it has little to do with science or pharmacology in either culture. It has much more to do with the historical niche that a drug fills within that culture. Most importantly, drug policy depends on whom we associate with that drug [emphasis added]. We almost always confuse our feelings about drugs with our feelings about the people we believe to use those drugs.

...

Moyers: How, then, were our drug laws developed?

White: They grew out of racial and class struggles, particularly on the West Coast and in the South. The first state laws were based on this sort of "dope fiend" caricature -- showing somebody of a different race and a different culture. In California, it was Chinese railway workers smoking opium; in the South, it was black men using cocaine. The reality is that the vast majority of people addicted to narcotics in the late 19th century were white affluent women, who were primarily addicted through traditional medicine or over-the-counter "patent" medicines. The caricature which drove the prohibition campaigns in the late 19th century bore little resemblance to reality. And, to give you a modern version of that, in the mid-1980s, when cocaine was overwhelmingly a white phenomenon in America, the images which began to appear on television were overwhelmingly of African-Americans, particularly young African-Americans enjoying crack cocaine on a street corner. If you look at all the exposes of drug exposed infants, we see young African-American infants, trembling in neonatal intensive care units. But that image was not the reality of cocaine addiction in the United States in 1985.

Moyers: Why?

White: At that exact point in time, those who were addicted to this drug were overwhelmingly white and affluent. The best predictors of cocaine use at that point were education and income. As years of education went up and annual income went up, the probable use of cocaine went up. Yet the image was and still is that we have poor inner-city African-Americans involved in all of these criminal illegal markets. Much of the anti-coke rhetoric and the changing of laws it generated was based on that early image. But in 1985, it had little relationship with reality.

Weed, weed, weed.

The LA Times reports on the DEA's efforts to target California's large, higher profile "medical" marijuana businesses.

The conservative Washington Times runs a UPI story that these larger business are claiming that they are unfairly targeted.

The conservative Pittsburgh Tribune-Review ran a scathing anti-drug war editorial and a letter to the editor on the recent NORML report about marijuana as the U.S.'s largest cash crop.

Finally, a DEA press release from earlier this year on some dealer's creative packaging of marijuana. Includes photos.

I've seen some year-end commentary on failures in efforts to change marijuana policy in 2006, but I think there's little doubt that it gained traction as a political issue. Growing numbers of conservative ideologues are joining libertarians and liberal ideologues in calling for radical reform in drug policy. The issue may be placed on the back burner as we approach a presidential election cycle, but I don't see it fading. What's interesting about this is that the conservatives involved see it as a conservative issue, liberals involved see it as a liberal issue, and libertarians see it as a libertarian issue. If these groups can form a functional coalition, they could be pretty effective in advocating greater latitude for states to experiment with drug policy and organizing support for state-level legislation and ballot initiatives.

Vendor's reefer sadness

The LA Times reports on municipalities wrestling with the growth of the medical marijuana trade and how this trade should be conducted:

Kevin Reed launched his medical marijuana business two years ago, armed with big dreams and an Excel spreadsheet.

Happy customers at his Green Cross cannabis club were greeted by "bud tenders" and glass jars brimming with high-quality weed at red-tag prices. They hailed the slender, gentle Southerner as a ganja good Samaritan. Though Reed set out to run it like a Walgreens, his tiny storefront shop ended up buzzing with jazzy joie de vivre. Turnover was Starbucks-style: On a good day, $30,000 in business would walk through the black, steel-gated front door.

Today, the 32-year-old cannabis capitalist is looking for a job, his business undone by its own success and unexpected opposition in one of America's most proudly tolerant places. Critics in nearby Victorian homes called Reed a neighborhood nuisance. Although four of five San Francisco voters support medical marijuana, the realities of dispensing the contentious medicine have proved far more controversial.

It has been 10 years since California approved Proposition 215 — the Compassionate Use Act — becoming the first state to define marijuana as a medicine. The 389-word act aimed to ensure seriously ill Californians the right to use marijuana. But it said nothing about how they might get the drug — and left ample regulatory ambiguity.

Today, about 200,000 Californians have a doctor's permission to use cannabis, which they can obtain through more than 250 dispensaries, delivery services and patient collectives — 120 of them in Los Angeles County alone. Medical marijuana, activists say, has become a $1-billion business.

Biggest U.S. Cash Crop: Marijuana

This report has gotten a ton of press this week. The report says that marijuana follows only corn and soybeans in Michigan with a value of $324 million.

I'll be interested in seeing analysis from disinterested third parties. NORML's interests are obvious and I'm suspicious of the federal estimates that this report is based on due to a history of hyping statistics to shape policy and fight for funding. If the federal estimates are correct, there is almost 1.2 ounces of weed grown for every man, woman and child in the U.S.