ASPECTS OF DRUG ABUSE
By: Tod H. Mikuriya, M.D
PRESENTED AT DRUG ABUSE - MENDOCINO SERIES FEBRUARY 6-8, 1970
The current drug abuse problem is Contemporary American Society's denial of the dangers of certain drugs while over reacting to the use of others.
This cultural ulcer is aggravated by bureaucratic group cowardice, which is rationalized as conservatism in the face of ignorance.
Most of my impressions acquired in the context of health and educational committee meetings, have been that the participants are nice, pleasant people. They would just hate to displease anybody and want to do the correct political thing.
When I was back at NIMH in charge of pot research in 1967, none of the DHEW employees wanted to offend any of the Bureau of Narcotics police. One also had to worry about antediluvian congressional positions and pedigrees are really picked for their low risk liability for offending others. Understandably, the research approved and funded by their recommendation could not help but reflect this inoffensiveness, non-controversy ethic. The fiscal years 1968 and 1969, NIMH grantees in the area of marijuana research include nine animal studies, 28 social voyeuristic designs, 10 chemical experiments, 4 pharmacological studies and only 2 clinical human studies.
I suspect the joint committee to pass on marijuana research made up of representatives from NIMH, FDA, DHEW and FBNDD and from the justice department will continue to follow similar standards for research. We can expect animal, vegetable and voyeur work with a minimum of human clinical studies.
With all of the difficulties at DHEW, at least they have had the guts to say that the only thing dangerous about pot is getting busted for it and ruining ones career.
Other more scientific and rational statements on the subject have been rewarded by hostility and extreme political pressure: why is Dr. James Goddard now working for an Atlanta computer company instead of heading up the FDA? Instead of being kicked off the establishment's team, researchers with offensive characteristics of honesty and forthrightness may be put on the bench.
Dr. Andy Weil, while a senior at Harvard Medical School, after much difficulty with governmental educational agencies, was finally able to perform some double blind psychological studies on pot. SCIENCE magazine felt they were of adequate quality to meet their standards of publication in their December 13, 1968 issue.
Andy tried to continue his work during his internship at Mt. Zion Hospital in San Francisco but failed because the newly formed California Research Advisory Panel (CRAP) initially deemed him not sufficiently qualified to do marijuana research. He made, however, a stink and with the backing of his hospital got them to reverse their decision. By May 5th of 1969, however, it was too late in his internship to do the study as internships usually end on June 30th.
Dr. Weil had been slated to go to work for the USPHS in the Division of Narcotics Drug Abuse Studies at NIMH. A month or so before his journey to the swamp along the Potomac he learned that he had been reassigned to the NIMH office of Program Evaluation, a section far removed from the study of drugs.
Here in California, trying to obtain approval for clinical marijuana studies is like dealing with the Keystone Cops. Before our very eyes we can watch bureaucratic cowardice and non-communication subvert constructive legislative efforts to get going on needed marijuana research.
In November 1968, the governor signed Assembly Bill 194 into law setting up the California Research Advisory Panel comprised of representatives form academic, health and safety agencies.
In January of 1969 I asked the Governor's office (through the Attorney General's office) of the whereabouts of this legislation. If had been misplaced in the shuffle somewhere. It was finally found and invitations were then issued. After an organizational meeting March 28, 1969, the committee finally convened on May 2, 1969. My two proposals to study the possibly therapeutic effects of cannabis in the treatment of alcoholism were turned down without comment. At the same meeting they gave Andy's proposal the axe. I could not marshal forces at that time to intercede on my behalf, being then preoccupied with starting my private psychiatric practice.
Since then the CRAP has met several times and has decided on a procedure protocol for all prospective pot researchers. Because only one of the six panel members knows anything about the topic and since the Governor neglecting to provide necessary operational funds to carry out its mission drastically limited their functioning, they decided to be extra cautious about whom they would authorize as researchers. Whey not laterals the ball to the Feds? The CRAP thus decided to make an approved IND form the FDA as a requirement for state approval.
Meanwhile, back in Washington, the Feds have always deferred to the sates in this area, requiring that state approval be given before they would issue the required tax stamps under the 1937 Marijuana Tax Act.
Somehow, at this writing, there has been no communication between the CRAP and the Federal Joint Committee (no pun intended) of FDA, NIMH and BNDD for this area of common interest and responsibility.
This current condition caused by CRAP's decision to require an approved IND
application creates the same impossible state/federal "Alphonse-Gaston"
bureaucratic loop that first motivated our legislators to create the law in
the first place.
If the California State Attorney General Hadn't interpreted the state narcotics laws in such an extra cautious way, this administrative obscenity never would have happened.
While perhaps, scientifically incorrect, the state narcotics laws in their introduction define marihuana to be a narcotic. Next follows a section regulating prescribing, handling and otherwise using narcotics in medical treatment. In a succeeding section dealing with what may be done with seized illicit narcotics, the law states that marihuana can only be given to a highly restricted set of people: heads of medical schools, heads of departments of pharmacology and medical superintendents of state prisons or state hospital. Our attorney general decided that his latter section pre-empts the earlier portion of the state law where cannabis is concerned while morphine and other more dangerous drugs are allowed to be used by the physician. I am, however, not a legal expert and therefore cannot understand how this seeming violation of the intent of the California narcotics law actually came to pass.
Being a dues paying member of the Public Health League, I sought assistance from the California Medical Association's political mouthpiece in Sacramento in this matter as well as with my difficulty with the FRAP. I wrote them over a year ago, but have received no reply. I was really not that surprised considering the CMA's attitude toward pot was less than friendly. At least two members of their Drug Abuse committee encouraged and counseled the Nixon administration to go ahead with "Operation Intercept" which preceded a lesser-publicized "Operation Repent" involving the U.S. State Department and the Mexican Government.
The CMA is liberal compared to the American Medical Association oligarchy that engages in actual censorship in addition to the dissemination of false and misleading information to its members, the doctors, traditionally a group looked to for enlightened leadership.
When Al Crancer, the Director of Research for the Washington State Highway Department submitted his findings of the comparison of the effects of smoked marijuana, alcohol and no drug to the Journal of the American Medical Association, the article was rejected while SCIENCE accepted and published it on May 16, 1969. The JAMA editors had such comments as "It simply shows that when a non-user of marihuana smokes two marihuana cigarettes he isn't any more prone to driving error than if he hadn't indulged" and "All in all, although research in this area is certainly needed, I fell that nothing of value can be gained by publishing this paper."
Nevertheless, JAMA is highly interested in individual reports of "cannabis psychosis" and publishes any such story it can get its hands on even though the reporting physician may not be a psychiatrist and there are neither longitudinal follow-ups nor descriptions of pre-morbid conditions.
The AMA leadership committed itself to an impossible unscientific stance when it published its position paper on pot showing its traditional inappropriate response pattern to social chance. Unfortunately it is more damaging to the physicians their patients because of police and politics entering the physicians' office via their own leaders of organized medicine.
Not only is it damaging to the credibility of the medical leadership but also these viruses of ignorance are transmitted to educators and legislators that amplify and expand them to further pollute our sociopolitical ecology.
The "who can be offended the least" ethic was also reflected in State Senator Grunske (R) who, when he read the findings of the panel code revision committee headed by Professor John Kaplan of Stanford Law School and Professor Philip Johnson of Boalt Law School, fired the group because they recommended removal of criminal penalties for pot possession. This social autodecerebrative act by this sheep in leaders clothing was probably motivated by the seeming political unsalability of the reports findings to the legislature.
Governor Regan's recent declaration of war on drugs will sadly only make the situation worse as the secret narcotics police budget is increased by two thirds to make more drug arrests. As more drug arrests are made, the courts and probation will find themselves with more cases to process. Current enforcement of the marijuana prohibition laws gives the courts and probation at least 20% of their business. Overworked judges and probation officers will need more help and therefore more money. The jails will get more inmates.
The cost of enforcing the marijuana laws in 1966 was $30,000,000 with 18,243 arrests. Assuming similar patterns of dispositions of the over 60,000 arrestees for 1969, the cost to California taxpayers will be over $100,000,000 in direct costs alone.
I do not consider this to be judicious utilization of public money, nor an appropriate ordering of priorities.
Aside from the fiscal and tangible costs of this domestic Viet Nam, the governor seems to want to escalate, what about the broken careers, mental anguish and resentment toward authority all this will create?
I thought the Republicans were for the rights of individual property with a minimum of central control, but this war on drugs further increases the power of state government with more bureaucracies to control our lives with the aid of computerized methodology.
The war is not just confined to pot and other illicit drugs but prescription drugs as well. I and other physicians may look forward to added paperwork from the state as well as can the pharmaceutical company and corner druggist. Hospitals and clinics will also be the recipients of the "benefits" of the Parkisonian "spin-off" form Governor Reagans war on drugs.
Looking over the drug scene, generally we seem to be moving much more in the direction of the Elliott Ness - Frank Nitti games of the 1920's rather than into an age of reason. I am somewhat pessimistic about the '70's' unless there are some rapid and appropriate shifts in policies of drug laws and administrative fiats.
PRESENTED AT DRUG ABUSE - MENDOCINO SERIES FEBRUARY 6-8, 1970
SANTA ROSA, CA