Along the way to becoming one of America’s wealthiest individuals, Mr. Bloomberg has donated a remarkable amount of money to many worthy causes, notably in the field to improve public health in America and the world, most especially at his alma mater, one of the best universities in the world, Johns Hopkins in Baltimore.

With good health and continued good fortune, who knows what further impact Mr. Bloomberg will choose to make in national politics in his lifetime? He possess all the requisite skills and resources to become president if that’s what he chooses.

Today we find out that Mayor Bloomberg is once again demonstrating why he is one of the most interesting and charitable politicians in the modern era in reading today’s New York Times about his most recent donation of $30 million to help black and Latino youth get better integrated into the region’s economy, develop valuable skill sets and to find productive employment.

The Times reports that Mayor Bloomberg’s initial grant will be matched by New York City-based hedge fund manager and philanthropist George Soros.

Here is the ironic point to this blog post: If Mayor Bloomberg is genuinely serious about creating more favorable employment environs for black and Latino youth in New York City, he should converse with Mr. Soros, who, has donated more money than anyone on the face of the earth in favor of drug policy reform—notably for cannabis law reforms—who, I’m sure would insist that the good mayor stop arresting black and Latino youth in New York City en mass.

Regrettably, embarrassingly, for such an enlightened and civic-minded man, Mayor Bloomberg has largely maintained the shameful and starkly racially disparate cannabis law enforcement policies that he inherited from former Mayor (and drug prosecutor) Rudolf Giuliani. Mayor Giuliani exploded the annual cannabis arrest rate in the five boroughs of New York City from an average of about 2,000 arrests to an eye-popping 60,000 arrests per year.

Bloomberg’s administration has, on average, maintained an annual arrest rate for simple cannabis possession cases over 45,000, with a disturbing ninety percent of arrests happening to….black and Latino youth.

Mayor Bloomberg, please, listen to Mr. Soros and stop arresting and negatively effecting future employment opportunities for an entire generation of minorities in New York City who got caught doing the same thing you did in your more youthful years.

And look how well you turned out after using cannabis?

Why deny over 45,000 other New Yorkers (and tourists) annually the opportunity to pursue their life’s goals and dreams just because, like you, absent an arrest for your cannabis use, they chose to use a little ganja to relax? Unfortunately for them and New York taxpayers, they’re getting permanently scarred by your feckless and expensive Cannabis Prohibition law enforcement practices in Gotham.

Mayor Bloomberg, your generous and thoughtful donation of $30 million—and that of Mr. Soros’—will be working at cross purposes if you continue to give the green light to the NYPD to arrest 45,000 cannabis consumers annually into the criminal justice system, the vast majority of whom are the very population you’re concerned with.

Mr. Bloomberg, if you’re worried about saving face or “what does the NAACP think about all of this?”, don’t be. Because, hundreds of thousands of cannabis consumers and tourists in New York City will very much appreciate the change in policy and the NAACP now supports changing America’s antiquated Cannabis Prohibition laws.

Mayor Bloomberg, please magnify the positive impact of your philanthropy and concerns for civil society by ending the practice of ‘collaring’ cannabis consumers in New York City, and, instead, return to the cost effective and less detrimental practice to cannabis consumers (notably for minorities) by simply issuing a civil fine in the form of a written ticket for cannabis possession cases rather than employ valuable police time and resources unnecessarily arresting so many black and Latino cannabis consumers.

Now, all cannabis consumers in the United States—notably in municipalities and states that have reformed their cannabis laws with decriminalization laws and patient protections for medicinal use—should cite Ms. Rutkowski’s case settlement as precedent against overzealous law enforcement agencies who choose to physically arrest and detain minor cannabis offenders, rather than issue them a civil fine, similar to a speeding or parking ticket.

Kudos to Ms. Rutkowski and her attorney Joel Berger for 1) challenging the NYC police department’s infamous practice of arresting and detaining for many hours minor cannabis offenders and 2) for making it ironically clear that even an arrest on minor cannabis charges can create serious health concerns whereby an adult who chooses to consume a non-toxic and relatively safe recreational drug like cannabis (or, has the drug recommended to them to consume medically by their physician) can quite literally be placed into a life or death situation.

“They could have killed me over a joint,” Ms. Rutkowski said. “Something needs to be done.”

After thousands of years of human use, there is little-to-no scientific evidence that moderate cannabis use is harmful to the individual consumer or society in the whole. However, there is overwhelming and abundantly clear evidence that Cannabis Prohibition can be deadly for individual consumers, law enforcement personnel and those involved in the currently illegal and untaxed businesses of cultivating, transporting and selling cannabis.

Disgustingly, in a city that, since the late 1970s, is supposed to have true ‘decriminalization’ laws for cannabis possession cases, New York City continues to nearly lead the nation in per capita arrests for simple cannabis possession cases (approximately 43,000 cannabis possession arrests annually; constituting nearly five percent of all annual cannabis arrests nationwide) as well as having one of the most racially imbalanced arrest rates for minorities (approximately nine out of ten cannabis arrests in NYC are made against minorities).

End the War on Pot
via The New York Times

Our nearly century-long experiment in banning marijuana has failed as abysmally as Prohibition did, and California may now be pioneering a saner approach. Sure, there are risks if California legalizes pot. But our present drug policy has three catastrophic consequences.

First, it squanders billions of dollars that might be better used for education.

… Each year, some 750,000 Americans are arrested for possession of small amounts of marijuana. Is that really the optimal use of our police force?

In contrast, legalizing and taxing marijuana would bring in substantial sums that could be used to pay for schools, libraries or early childhood education. A Harvard economist, Jeffrey A. Miron, calculates that marijuana could generate $8.7 billion in tax revenue each year if legalized nationally, while legalization would also save the same sum annually in enforcement costs.

That’s a $17 billion swing in the nation’s finances — enough to send every 3- and 4-year-old in a poor family to a high-quality preschool. And that’s an investment that would improve education outcomes and reduce crime and drug use in the future — with enough left over to pay for an extensive nationwide campaign to discourage drug use.

The second big problem with the drug war is that it has exacerbated poverty and devastated the family structure of African-Americans. Partly that’s because drug laws are enforced inequitably. Black and Latino men are much more likely than whites to be stopped and searched and, when drugs are found, prosecuted.

Here in Los Angeles, blacks are arrested for marijuana possession at seven times the rate whites are, according to a study by the Drug Policy Alliance, which favors legalization. Yet surveys consistently find that young whites use marijuana at higher rates than young blacks.

… The third problem with our drug policy is that it creates crime and empowers gangs. “The only groups that benefit from continuing to keep marijuana illegal are the violent gangs and cartels that control its distribution and reap immense profits from it through the black market,” a group of current and former police officers, judges and prosecutors wrote last month in an open letter to voters in California.

I have no illusions about drugs. One of my childhood friends in Yamhill, Ore., pretty much squandered his life by dabbling with marijuana in ninth grade and then moving on to stronger stuff. And yes, there’s some risk that legalization would make such dabbling more common. But that hasn’t been a significant problem in Portugal, which decriminalized drug use in 2001.

… One advantage of our federal system is that when we have a failed policy, we can grope for improvements by experimenting at the state level. I hope California will lead the way on Tuesday by legalizing marijuana.

Win or lose, there can be little doubt that Prop. 19 has elevated marijuana legalization to a national, and rational, discussion at the highest and most respected levels of public discourse — as these recent pro-reform editorials from heavy-hitters like The Washington Post, Chicago Tribune, and Financial Times (just to name a few) illustrate.

For too long, proponents of the status quo — criminal prohibition — have argued that marijuana law reform should be a national issue, not a state issue. Well, if prohibitionists’ want a national debate, it’s clear that we now have one.

With unmistakable juxtaposition, Politico’s printed tabloid available in Washington, D.C. featured two informative items married together. First, a column from constitutional scholar and salon.com contributor Glenn Greenwald underscoring the political significance, public health benefits and taxpayer savings if Prop 19 is passed by California voters in a few weeks based on his recent research paper for the Cato Institute examining the benefits of Portugal decriminalizing all drugs in 2000.

Additionally, Politico wickedly notes that 28-years-ago today President Ronald Reagan declared a ‘war on drugs’, yet these days, the current drug czar is uncomfortable employing the now broadly derided term, deeming it “counter-productive”.

RIP David Musto, MD

Today’s New York Times does justice in honoring the recent death of Dr. David Musto, a well respected professor at Yale Medical School, an author of many notable books and expert in the history of drug control policy.

Before there was an Internet…from 1991 to 1993, David and I frequently corresponded about cannabis use, policy making and law enforcement via letters and faxes. His books (notably for me, The American Disease: Origins of Narcotics Control, along with other very important scholarly works researched and penned by Drs. Lester Grinspoon, Norman Zinberg, Andrew Weil and Consumer Union’s Edward Brecher; along with the writings of law professors Charles Whitebread and Richard Bonnie) quite definitely helped form my political and sociological views about cannabis.

I note from the Times’ obituary that David passed away in China whilst visiting to deliver his academic papers to Shanghai University. I trust somewhere in what must be an immense collection of papers and correspondences will be our exchanges, and a rare conceit from David in a correspondence to me, replying to my frustration that he was not more of an advocate for reforms rather than a genuine ‘Ivy League’ academician, he noted, I recall, something like: I seem best equipped to point out the history of drug use and government’s efforts to control for such…and let the public and elected policymakers make of my work what they will…I’m not an activist or a solutions person  per se.

As noted by NYT book reviewer James Markham correctly predicted that The American Disease would “probably become mandatory reading for anyone who wants to understand how we got into this mess”.

True then. True now. You can purchase a copy @ Amazon, or you can get the flavor of David’s writing from his 1972 essay, The History of the Marihuana Act of 1937 at druglibrary.org.

But it took until now for the federal government to finally admit it.

A spokesperson for the U.S. National Institute on Drug Abuse (NIDA) told The New York Times last week that the agency does “not fund research focused on the potential medical benefits of marijuana.”

Why is this admission so significant? Here’s why.

Under federal law, NIDA (along with the U.S. Drug Enforcement Administration) must approve all clinical and preclinical research involving marijuana. NIDA strictly controls which investigators are allowed access to the federal government’s lone research supply of pot – which is authorized via a NIDA contract and cultivated and stored at the University of Mississippi.

In short, no NIDA approval = no marijuana = no scientific studies. And that is, and always has been, the problem.

But to the folks over at NIDA, there’s no problem at all.

Speaking to The New York Times in a January 19, 2010 article entitled, “Researchers Find Medical Study of Marijuana Discouraged,” NIDA spokeswoman Shirley Simson said: “As the National Institute on Drug Abuse, our focus is primarily on the negative consequences of marijuana use. We generally do not fund research focused on the potential beneficial medical effects of marijuana.”

Since NIDA presently oversees an estimated 85 percent of the world’s research on controlled substances, the agency’s ban on medical marijuana research isn’t just limited to the United States’ borders; it extends throughout the planet.

Previous legal attempts to break NIDA’s bureaucratic logjam have failed to weaken the agency’s iron grip.

In 2007, U.S. DEA Administrative Law Judge Mary Ellen Bittner ruled that NIDA’s monopolization of marijuana research is not “in the public interest,” and ordered the federal government to allow private manufacturers to produce the drug for research purposes. But in January of last year, DEA Deputy Administrator Michele Leonhart set aside Judge Bittner’s ruling – stating that NIDA possesses “adequate” quantities of cannabis to meet the needs of clinical investigators, and that the agency monopoly on the distribution of marijuana for research is compliant with America’s international treaty obligations. (Notably, on January 26, 2010 President Barack Obama selected Leonhart to be the DEA’s full time Director.)

Most recently, in November 2009 the American Medical Association’s (AMA) Council on Science and Public Health declared, “Results of short term controlled trials indicate that smoked cannabis reduces neuropathic pain, improves appetite and caloric intake especially in patients with reduced muscle mass, and may relieve spasticity and pain in patients with multiple sclerosis.”

However, the Council lamented that despite these encouraging preliminary results, “[T]here is a contrast between the relatively small number of patients who have been studied over the past 30 years in controlled clinical trials involving smoked cannabis and survey data from patients with chronic pain, multiple sclerosis, and amyotrophic lateral sclerosis that indicates a significant use of cannabis for self management.”

And just what is the precise reason for this “contrast?” The AMA failed to specify, but to anyone who has followed this issue, the answer is painfully obvious.

Nevertheless, the AMA still resolved, “[The] AMA urges that marijuana’s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines.”

But since any future clinical trials would still require NIDA approval — approval that the agency admits won’t be coming any time soon — it remains unclear what effect, if any, the AMA’s declaration will have on facilitating medical marijuana research. If history is any guide, it’s unlikely that the AMA request — much like the cries of tens of thousands of patients before it — will have any effect on NIDA at all.

[FYI... You can also comment on this essay on Alternet.org's newly launched SpeakEasy blog here or on the Huffington Post here.]

RESEARCHERS FIND STUDY OF MEDICAL MARIJUANA DISCOURAGED
by Gardiner Harris
January 19, 2010
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Despite the Obama administration’s tacit support of more liberal state medical marijuana laws, the federal government still discourages research into the medicinal uses of smoked marijuana.  That may be one reason that — even though some patients swear by it – — there is no good scientific evidence that legalizing marijuana’s use provides any benefits over current therapies.

Lyle E.  Craker, a professor of plant sciences at the University of Massachusetts, has been trying to get permission from federal authorities for nearly nine years to grow a supply of the plant that he could study and provide to researchers for clinical trials.

But the Drug Enforcement Administration — more concerned about abuse than potential benefits — has refused, even after the agency’s own administrative law judge ruled in 2007 that Dr.  Craker’s application should be approved, and even after Attorney General Eric H.  Holder Jr.  in March ended the Bush administration’s policy of raiding dispensers of medical marijuana that comply with state laws.

“All I want to be able to do is grow it so that it can be tested,” Dr.  Craker said in comments echoed by other researchers.

Marijuana is the only major drug for which the federal government controls the only legal research supply and for which the government requires a special scientific review.

“The more it becomes clear to people that the federal government is blocking these studies, the more people are willing to defect by using politics instead of science to legalize medicinal uses at the state level,” said Rick Doblin, executive director of a nonprofit group dedicated to researching psychedelics for medical uses.

On Monday, his last full day in office, Gov.  Jon S.  Corzine of New Jersey signed a measure passed by the Legislature last week that made the state the 14th in the nation to legalize the use of marijuana to help with chronic illnesses.

The measure was pushed by a loose coalition of patients suffering from chronic illnesses like Lou Gehrig’s disease and multiple sclerosis who said marijuana eased their symptoms.

Studies have shown convincingly that marijuana can relieve nausea and improve appetite among cancer patients undergoing chemotherapy.  Studies also prove that marijuana can alleviate the aching and numbness that patients with H.I.V.  and AIDS suffer.

There are strong hints that marijuana may ameliorate some of the neurological problems associated with such degenerative diseases as multiple sclerosis, said Dr.  Igor Grant, director of the Center for Medicinal Cannabis Research at the University of California, San Diego.

But there is no good evidence that legalizing the smoking of marijuana is needed to provide these effects.  The Food and Drug Administration in 1985 approved Marinol, a prescription pill of marijuana’s active ingredient, T.H.C.  Although a few small-scale studies done decades ago suggest that smoked marijuana may prove effective when Marinol does not, no conclusive research has confirmed this finding.

And Marinol is no panacea.  There are at least three medicines that in most patients provide better relief from nausea and vomiting than Marinol, studies show.

Buddy Coolen, 31, of Warwick, R.I., said he tried or continued to use some of those medicines.  “Smoking for me is as good as any medicine I have,” he said.

Eight years ago, Mr.  Coolen contracted gastroparesis and cyclic vomiting syndrome.  He lost 50 pounds and, despite being 5 foot 11, weighed 120 pounds.

His doctors gave him myriad anti-emetics, many of which he still takes.  They also prescribed Marinol, but it did not work for him, Mr.  Coolen said.

“My stepdad is old school and was really against marijuana, but then he saw what it did for me and totally changed his way of thinking,” Mr.  Coolen said.

Some doctors and law enforcement officials say such anecdotes should not drive public policy.  Dr.  Eric Braverman, medical director of a multispecialty clinic in Manhattan, said legalizing marijuana was unnecessary and dangerous since Marinol provided the medicinal effects of the plant.  “Our society will deteriorate,” he said.

Patients who call Dr.  Braverman’s clinic are, when put on hold, told that the clinic may prescribe supplements and other alternative treatments that have even less scientific justification than marijuana.  Dr.  Braverman said such alternatives rendered marijuana unnecessary, but his embrace of alternatives is a reminder that medicine has long been driven by more than science.

About 20 percent of drug prescriptions are written for uses that are not approved by federal drug regulators; about half of the nation’s adults regularly take supplements; herbal and homeopathic remedies are popular.

The nation’s growing embrace of medical marijuana has stemmed from these alternative traditions.

The University of Mississippi has the nation’s only federally approved marijuana plantation.  If they wish to investigate marijuana, researchers must apply to the National Institute on Drug Abuse to use the Mississippi marijuana and must get approvals from a special Public Health Service panel, the Drug Enforcement Administration and the Food and Drug Administration.

But federal officials have repeatedly failed to act on marijuana research requests in a timely manner or have denied them, according to a 2007 ruling by an administrative law judge at the Drug Enforcement Administration.  While refusing to approve a second marijuana producer, the government allowed the University of Mississippi to supply Mallinckrodt, a drug maker, with enough marijuana to eventually produce a generic version of Marinol.

“As the National Institute on Drug Abuse, our focus is primarily on the negative consequences of marijuana use,” said Shirley Simson, a spokeswoman for the drug abuse institute, known as NIDA.  “We generally do not fund research focused on the potential beneficial medical effects of marijuana.”

The Drug Enforcement Administration said it was just following NIDA’s lead.  “D.E.A.  has never denied a research registration for marijuana and/or THC if NIDA approved the protocols for that individual entity,” a supervisory special agent, Gary Boggs, said by e-mail.

Researchers investigating LSD, Ecstasy and other illegal drugs can use any of a number of suppliers licensed by the Drug Enforcement Administration, Dr.  Doblin said.  And if a researcher wants to use a variety of marijuana that the University of Mississippi does not grow – — and there are many with differing medicinal properties — they are out of luck, Dr.  Doblin said.

Law enforcement tends to emphasize the abuse potential of medicines without regard to their positive effects.  Bureaucratic battles between the D.E.A.  and the F.D.A.  over the availability of narcotics – — highly effective but addictive medicines — have gone on for decades.

So medical marijuana may never have good science underlying its use.  But for patients in desperate need, the ethics of providing access to the drug are clear, said Dr.  Richard Payne, a professor of medicine and divinity and director of the Institute for Care on the End of Life at Duke Divinity School.

“It’s not a great drug,” he said, “but what’s the harm?”

* * * * * * * * * * *

IS MARIJUANA A MEDICINE?
by Anna Wilde Mathews, (Source:Wall Street Journal)
19 Jan 2010
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United States
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Charlene DeGidio never smoked marijuana in the 1960s, or afterward.  But a year ago, after medications failed to relieve the pain in her legs and feet, a doctor suggested that the Adna, Wash., retiree try the drug.

Ms.  DeGidio, 69 years old, bought candy with marijuana mixed in.  It worked in easing her neuropathic pain, for which doctors haven’t been able to pinpoint a cause, she says.  Now, Ms.  DeGidio, who had previously tried without success other drugs including Neurontin and lidocaine patches, nibbles marijuana-laced peppermint bars before sleep, and keeps a bag in her refrigerator that she’s warned her grandchildren to avoid.

“It’s not like you’re out smoking pot for enjoyment or to get high,” says the former social worker, who won’t take the drug during the day because she doesn’t want to feel disoriented.  “It’s a medicine.”

For many patients like Ms.  DeGidio, it’s getting easier to access marijuana for medical use.  The U.S.  Department of Justice has said it will not generally prosecute ill people under doctors’ care whose use of the drug complies with state rules.  New Jersey will become the 14th state to allow therapeutic use of marijuana, and the number is likely to grow.  Illinois and New York, among others, are considering new laws.

As the legal landscape for patients clears somewhat, the medical one remains confusing, largely because of limited scientific studies.  A recent American Medical Association review found fewer than 20 randomized, controlled clinical trials of smoked marijuana for all possible uses.  These involved around 300 people in all–well short of the evidence typically required for a pharmaceutical to be marketed in the U.S.

Doctors say the studies that have been done suggest marijuana can benefit patients in the areas of managing neuropathic pain, which is caused by certain types of nerve injury, and in bolstering appetite and treating nausea, for instance in cancer patients undergoing chemotherapy.  “The evidence is mounting” for those uses, says Igor Grant, director of the Center for Medicinal Cannabis Research at the University of California, San Diego.

But in a range of other conditions for which marijuana has been considered, such as epilepsy and immune diseases like lupus, there’s scant and inconclusive research to show the drug’s effectiveness.  Marijuana also has been tied to side effects including a racing heart and short-term memory loss and, in at least a few cases, anxiety and psychotic experiences such as hallucinations.  The Food and Drug Administration doesn’t regulate marijuana, so the quality and potency of the product available in medical-marijuana dispensaries can vary.

Though states have been legalizing medical use of marijuana since 1996, when California passed a ballot initiative, the idea remains controversial.  Opponents say such laws can open a door to wider cultivation and use of the drug by people without serious medical conditions.  That concern is heightened, they say, when broadly written statutes, such as California’s, allow wide leeway for doctors to decide when to write marijuana recommendations.

But advocates of medical-marijuana laws say certain seriously ill patients can benefit from the drug and should be able to access it with a doctor’s permission.  They argue that some patients may get better results from marijuana than from available prescription drugs.

Glenn Osaki, 51, a technology consultant from Pleasanton, Calif., says he smokes marijuana to counter nausea and pain.  Diagnosed in 2005 with advanced colon cancer, he has had his entire colon removed, creating digestive problems, and suffers neuropathic pain in his hands and feet from a chemotherapy drug.  He says smoking marijuana was more effective and faster than prescription drugs he tried, including one that is a synthetic version of marijuana’s most active ingredient, known as THC.

The relatively limited research supporting medical marijuana poses practical challenges for doctors and patients who want to consider it as a therapeutic option.  It’s often unclear when, or whether, it might work better than traditional drugs for particular people.  Unlike prescription drugs it comes with no established dosing regimen.

“I don’t know what to recommend to patients about what to use, how much to use, where to get it,” says Scott Fishman, chief of pain medicine at the University of California, Davis medical school, who says he rarely writes marijuana recommendations, typically only at a patient’s request.

Researchers say it’s difficult to get funding and federal approval for marijuana research.  In November, the AMA urged the federal government to review marijuana’s position in the most-restricted category of drugs, so it could be studied more easily.

Gregory T.  Carter, a University of Washington professor of rehabilitation medicine, says he’s developed his own procedures for recommending marijuana, which he does for some patients with serious neuromuscular conditions such as amyotrophic lateral sclerosis, or Lou Gehrig’s disease, to treat pain and other symptoms.  He typically urges those who haven’t tried it before to start with a few puffs using a vaporizer, which heats the marijuana to release its active chemicals, then wait 10 minutes.  He warns them to have family nearby and to avoid driving, and he checks back with them after a few days.  Many are “surprised at how mild” the drug’s psychotropic effects are, he says.

States’ rules on growing and dispensing medical marijuana vary.  Some states license specialized dispensaries.  These can range from small storefronts to bigger operations that feel more like pharmacies.  Typically, they have security procedures to limit walk-in visitors.

At least a few dispensaries say they inspect their suppliers and use labs to check the potency of their product, though states don’t generally require such measures.  “It’s difficult to understand how we can call it medicine if we don’t know what’s in it,” says Stephen DeAngelo, executive director of the Harborside Health Center, a medical-marijuana dispensary in Oakland, Calif.

Some of the strongest research results support the idea of using marijuana to relieve neuropathic pain.  For example, a trial of 50 AIDS patients published in the journal Neurology in 2007 found that 52% of those who smoked marijuana reported a 30% or greater reduction in pain.  Just 24% of those who got placebo cigarettes reported the same lessening of pain.

Marijuana has also been shown to affect nausea and appetite.  The AMA review said three controlled studies with 43 total participants showed a “modest” anti-nausea effect of smoked marijuana in cancer patients undergoing chemotherapy.  Studies of HIV-positive patients have suggested that smoked marijuana can improve appetite and trigger weight gain.

Donald Abrams, a doctor and professor at the University of California, San Francisco who has studied marijuana, says he recommends it to some cancer patients, including those who haven’t found standard anti-nausea drugs effective and some with loss of appetite.

Side effects can be a problem for some people.  Thea Sagen, 62, an advanced neuroendocrine cancer patient in Seaside, Calif., says she expected something like a pharmacy when she went to a marijuana dispensary mentioned by her oncologist.  She says she was disappointed to find that the staffers couldn’t say which of the products, with names like Pot ‘o Gold and Blockbuster, might boost her flagging appetite or soothe her anxiety.  “They said, ‘it’s trial and error,’ “she says.  “I was in there flying blind, looking at all this stuff.”

Ms.  Sagen says she bought several items and tried one-eighth teaspoon of marijuana-infused honey.  After a few hours, she was hallucinating , too dizzy and confused to dress herself for a doctor’s appointment.  Then came vomiting far worse than her stomach upset before she took the drug.  When she reported the side effects to her oncologist’s nurse and her primary-care physician, she got no guidance.  She doesn’t take the drug now.  But with advice from a nutritionist, her appetite and food intake have improved, she says.

Other marijuana users may experience the well-known reduction in ability to concentrate.  At least a few users suffer troubling short-term psychiatric side effects, which can include anxiety and panic.  More controversially, an analysis published in the journal Lancet in 2007 tied marijuana use to a higher rate of psychotic conditions such as schizophrenia.  But the analysis noted that such a link doesn’t necessarily show marijuana is a cause of the conditions.

Long-term marijuana use can lead to physical dependence, though it is not as addictive as nicotine or alcohol, says Margaret Haney, a professor at Columbia University’s medical school.  Smoked marijuana may also risk lung irritation, but a large 2006 study, published in Cancer Epidemiology, Biomarkers & Prevention, found no tie to lung cancer.

First of all, let’s explore the various connotations evoked by the word “legal.” After all, without proper context this term can mean many different things to many different people.

Oranges are legal. So are alcohol and tobacco. Aspirin is legal, as are thousands of prescription medications — including highly dangerous drugs like oxycodone. Yet while all of these products are ‘legal’ — in the sense that they may be lawfully produced and purchased by certain consumers — their distribution and possession are governed by vastly different regulatory controls.

Oranges, for instance, are widely available to all consumers, regardless of age. People can even grow their own, if they so desire. Aspirin is also readily available to the general public as an ‘over-the-counter’ medication, whereas prescription drugs may only be purchased at a state-governed pharmacy by those who possess written authorization from a licensed physician.

The sale and possession of alcohol and tobacco are also legal, yet both substances are heavily taxed and tightly controlled. State-imposed age restrictions place limits on who can legally purchase and use both products, and federal laws also specify how and where these products may be advertised. Federal, state, and county laws also impose strict controls regarding where these products can be legally purchased. Adults may legally produce certain types of alcohol, like beer and wine, privately in their home — if their production is intended for their own personal consumption and not for sale to the public. By contrast, federal and state laws tightly regulate the commercial production of any type of alcohol.

So then, when the NYT‘s headline asserts that drug possession in Mexico is “legal,” do they mean that marijuana is now legal like oranges are legal? Or like alcohol? Or like prescription drugs?

Unfortunately, the answer is ‘none of the above.’ In fact, no definition of ‘legal’ that I’m aware of resembles Mexico’s new drug possession scheme. The Associated Press explains:

The new law [Editor's note: NORML initially reported on Mexico's impending legal change this past May.] sets out maximum “personal use” amounts for drugs, also including LSD and methamphetamine. People detained with those quantities no longer face criminal prosecution.

… The maximum amount of marijuana for “personal use” under the new law is 5 grams — the equivalent of about four joints. The limit is a half gram for cocaine, the equivalent of about 4 “lines.” For other drugs, the limits are 50 milligrams of heroin, 40 milligrams for methamphetamine and 0.015 milligrams for LSD.

Anyone caught with drug amounts under the new personal-use limit will be encouraged to seek treatment, and for those caught a third time treatment is mandatory.

… “This is not legalization, this is regulating the issue and giving citizens greater legal certainty,” said Bernardo Espino del Castillo of the attorney general’s office.

So let’s review, shall we? Under Mexico’s new law:

* The private production of cannabis will remain a criminal offense;

* The commercial production of cannabis will remain criminal offense (and this production will continue to be monopolized by criminal enterprises/drug cartels);

* The commercial distribution of cannabis to consumers will remain a criminal offense (and this distribution will continue to be monopolized by criminal enterprises/drug cartels);

* The private possession of cannabis in quantities greater than “four joints” will remain a criminal offense;

* The private possession of cannabis in quantities under “four joints” will no longer be a criminal offense, but the marijuana will continue to be classified as contraband (and therefore seized by police), and the user will be strongly urged to seek drug treatment (or coerced to do so if it is one’s third ‘offense.’)

Does any of this sound like “legalization” (or even “regulation,” to quote the Mexican attorney general’s office) to you? I didn’t think so. A small step in the right direction, perhaps — but legalization? Not a chance — no matter how you define it!

If Marijuana Is Legal, Will Addiction Rise?

By The Editors
July 19, 2009, 7:00 pm

A New York Times article on Sunday discussed the debate over whether more and more potent types of cannabis affect the levels of addiction to the drug. This particular issue has become part of the larger debate over whether marijuana should be legalized or decriminalized.

Antidrug activists say that if the drug is legalized, more people will use it and addiction levels, made worse by the increased potency, will rise too. Legalization advocates note that pot addiction is not nearly as destructive as, say, abuse of alcohol. What would be the effect of legalization or decriminalization on marijuana abuse and addiction?

*Roger Roffman, professor of social work

*Wayne Hall, professor of public health policy

*Mark A.R. Kleiman, professor of public policy and author

*Peter Reuter, University of Maryland professor

*Norm Stamper, former Seattle police chief

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More Honesty Needed
Roger Roffman

Roger Roffman is a professor of social work at the University of Washington.

Marijuana dependence occurs in 9 percent of Americans who have ever used the drug, and between 33 percent and 50 percent of those who smoke it daily. Approximately 3.6 million Americans are daily or near daily users. In 20 years of marijuana dependence counseling studies at the University of Washington, those who’ve sought help averaged 10 years of daily or near daily use and had unsuccessfully tried to quit more than six times.

Surveys indicate increasingly positive attitudes in the U.S. for liberalizing marijuana policies. Two ways of doing this are: (1) legalization, which would involve lawful cultivation and sale of marijuana, and (2) decriminalization, which would retain criminal penalties for cultivation and sale while removing them for possession of small amounts.

Will more people use marijuana and become dependent if marijuana is decriminalized? Probably not. A number of U.S. studies tell us decriminalization would not likely have an effect on the rates of marijuana use by adults or adolescents.

What if marijuana is legalized? No one can say for certain. Using one country’s reform example to estimate what would happen in another is very risky. How countries differ (cultural, social, political, economic) makes a big difference.

However, the Dutch ‘coffee shops’ example might give us a little insight. The de facto legalization policy in the Netherlands did not, in itself, affect rates of marijuana use among adults or young people. But rates of use among young people increased when the number of coffee shops increased and the age of legal access was 16. Then these rates declined when the numbers of coffee shops was reduced and the age of legal access became 18.

A cautious conclusion, as I see it, is that any consideration of legalization should include careful planning for how those who are most vulnerable to harm from marijuana use, children and adolescents, can be protected.

I support finding alternatives to criminal penalties for marijuana possession. Those penalties have costs (being jailed, having a criminal record, barriers to employment, loss of scholarships, to name a few) and may accomplish little in deterring use.

However, our debates need more honesty. Those favoring liberalizing marijuana policy ought to stop inferring that marijuana is harmless; it is not. Those who believe possession should remain a crime need to acknowledge that most adult occasional users are not harmed, and should be prepared to defend with data the belief that criminalizing possession is the best way to avoid harm.

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Mitigating Dependence
Wayne Hall

Wayne Hall is a professor of public health policy at the School of Population Health at the University of Queensland in Australia.

What effect would marijuana legalization have on dependence?

Some people remain skeptical about whether marijuana dependence exists but let’s assume that it does and that it affects around 1 in 10 of those who use marijuana. The effects that legalization has on marijuana dependence depend critically on what we mean by the term.

If we mean replacing imprisonment with a fine as the penalty for using marijuana then legalization would have little effect on dependence. Evaluations of this policy in 11 U.S. states in the 1970s and 1980s found little or no effect on rates of use among adolescents and adults.

There is more debate about the effects of allowing a de facto legal marijuana market as the Netherlands has done since 1983 in tolerating the sale of small amounts of marijuana in coffee shops. Marijuana use increased in the Netherlands in the 1990s, but this was also the case in the rest of Europe, and policy analysts disagree about whether rates of use increased faster in the Netherlands than elsewhere.

If by legalization we mean making it legal to use, grow and sell marijuana then our task becomes more speculative because no modern country has adopted this policy. It seems common sense that legalizing marijuana use and sales would lead to more people using it regularly and this would probably mean more marijuana dependence.

Nonetheless it is difficult to say how much use may increase because there are options for reducing use under a legal market that are not now available. For example, we could tax marijuana to set the price at a level that discourages casual use, regulate its THC content, restrict sales to minors, include a health warning on packs and advise users on ways to reduce dependence risks (e.g. by using less than weekly). These possibilities make it difficult to predict the effect that a legal market would have on rates of marijuana dependence.

Marijuana dependence should be taken into account in considering whether we should legalize marijuana in any of these ways. But this concern also needs to be weighed against the costs of current policy, that is, the creation of perverse incentives to produce more potent marijuana, the widespread disregard of legal prohibition on marijuana use that could contribute to a decline in respect for law and policing; the unregulated access of minors to marijuana; and the social and economic costs of a large marijuana black market.

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Not Your Grandfather’s Pot?
Mark A.R. Kleiman

Mark A.R. Kleiman is a professor of public policy at U.C.L.A., the editor of the Journal of Drug Policy Analysis and the author of ‘Against Excess: Drug Policy for Results’. His new book, ‘When Brute Force Fails: How to Have Less Crime and Less Punishment’ will be published later this summer.

One of the standard arguments against the legalization of cannabis is that ‘this is not your grandfather’s pot: cannabis, say the drug warriors, is much stronger now than it was a generation ago. It is, therefore, much more dangerous, and must remain prohibited.

That argument is a few bricks shy of a full load. Here are some of those bricks.

1. The average gram of cannabis sold today contains much more 9-trahydrocannabinol (THC) than the average gram sold in 1970, though there has always been some highly potent product available.

2. Emergency-room visits and treatment admissions related to cannabis have increased, though the number of self-reported cannabis users hasn’t.

3. If the only change were in potency as measured by THC content, users could (and do) compensate by smoking smaller quantities.

4. But contemporary cannabis also has a much higher ratio of THC (which tends to induce anxiety) to cannabidiol (CBD, which tends to relieve anxiety). That would be expected to create a higher rate of panic attacks.

5. Whether high-THC, high-ratio pot is also more habit-forming than other pot remains unknown. Increased treatment admissions might come from increased enforcement pressure against users. Or perhaps a cannabis habit is harder to live with than it used to be because the cannabis experience is more disturbing.

6. If cannabis were made legal, restrictions could be put both on potency and on the THC/CBD ratio. So rising potency makes no sense as an anti-legalization argument; if anything, less-potent legal pot would be expected to substitute for the more-potent pot that would remain
illegal.

7. Any sort of flat-out legalization would risk a large increase in the number of very heavy users. A legal cannabis industry, like the legal alcohol industry, would derive more than half its revenue from people with diagnosable substance abuse disorders. Telling marketers they can get rich by creating disease is dangerous.

8. Instead we could choose a ‘grow your own’ policy that would allow production for personal use or by small nonprofit cooperatives, but forbid commercial sales.

Cannabis policy is fascinating because so many people smoke the stuff, but whatever we do about cannabis will leave us with most of the nation’s drug abuse problems, which center on alcohol, and most of the nation’s drug-market and drug-enforcement problems, which center on cocaine, methamphetamine and heroin.

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Lessons From the Dutch
Peter Reuter

Peter Reuter is a professor at the School of Public Policy and the Department of Criminology at the University of Maryland.

Experimenting with marijuana has long been a normal part of growing up in the U.S.; about half of the population born since 1960 has tried the drug by age 21. Perhaps one out of six has used it for a year or more.

This statement is increasingly true of other Western countries such as Australia and Britain.

Over the last decade most of these countries have seen three trends; sharp increases in the number of marijuana users seeking treatment, in the potency of the marijuana consumed and in the number of arrests. For example, in the European Union the number of people entering treatment programs for marijuana dependence tripled between 1999 and 2005. In the U.S., the potency of seized marijuana has steadily increased since the late 1970s, while arrests for simple possession have tripled since 1991 to 750,000.

Are these trends connected? Given that marijuana research is almost as scarce as drug-free communities, all that is available is moderately informed speculation. A recent book that I co-authored, ‘Cannabis Policy: Moving Beyond the Stalemate,’ identifies five other factors that may play an influence in this. There is also no direct evidence that potency makes a difference to how much the drug hurts users’ health; most users titrate their dose with higher THC.

What would happen if the drug were legalized? The Dutch de facto legalization of sale through coffee shops is the closest available experience. The most striking observation is that marijuana use in that country is lower than in many other European countries and a lot lower than in the United States; 6 percent of 15- to 64-year-olds in Holland had used marijuana in the past year, compared to 11 percent in the U.S.

Legalization in the U.S. might be a much more commercial matter than in pragmatic Holland, where the government created a legally ambiguous regulatory system with minimal court oversight. The U.S. might find it hard to prevent producers from using their First Amendment rights to actively promote the drug. A way of avoiding this would be to remove prohibitions on growing for your own use and for gifts to others. No doubt there would still be a black market but it would allow access to marijuana without creating a full commercialization. Probably this would lead to a modest increase in the number of people who use the drug, which needs to be weighed against the elimination of 750,000 arrests for simple possession.

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The Tobacco Precedent
Norm Stamper

Norm Stamper was Seattle’s police chief from 1994 to 2000. He is a member of Law Enforcement Against Prohibition and the author of ‘Breaking Rank: A Top Cop’s Expose of the Dark Side of American Policing’.

Any law disobeyed by more than 100 million Americans, the number who’ve tried marijuana at least once, is bad public policy. As a 34-year police veteran, I’ve seen how marijuana prohibition breeds disrespect for the law, and contempt for those who enforce it.

Let’s examine arguments against legalizing marijuana: use and abuse would skyrocket; the increased potency of today’s marijuana would exacerbate social and medical problems; and legalization would send the wrong message to our children.

It’s reasonable to expect a certain percentage of adults, respectful or fearful of the current prohibition, would give pot a first try if it were made legal. But, given that the U.S. is already the world’s leading per capita marijuana consumer (despite our relatively harsh penalties), it’s hard to imagine a large and lasting surge in consumption. Further, under a system of regulated legalization and taxation, the government would be in a position to offer both prevention programs and medical treatment and counseling for those currently abusing the drug. It’s even possible we’d see an actual reduction in use and abuse, just as we’ve halved tobacco consumption through public education–without a single arrest.

Potency? Users, benefiting from the immutable law of supply and demand, have created huge market pressure for ‘quality’ marijuana over the past few decades. Legalization opponents are correct that today’s weed is not your old man’s weed. But the fear-mongers miss the point, namely that stronger strains of marijuana are already out there, unregulated by anything other than market forces. It’s good that responsible consumers know to calibrate their consumption; they simply smoke less of the more powerful stuff. But how about a little help from their government? Purchase booze and you have access, by law, to information on the alcoholic content of your beverage, whether it’s .05 percent near-beer or 151-proof Everclear.

Perhaps the biggest objection to legalization is the ‘message’ it would send to our kids. Bulletin: Our children have never had greater access to marijuana; it’s easier for them to score pot than a six-pack of Coors. No system of regulated legalization would be complete without rigorous enforcement of criminal laws banning the furnishing of any drug to a minor.

Let’s make policy that helps, not handcuffs, those who suffer ill effects of marijuana or other drugs, a policy that crushes the illegal market–the cause of so much violence and harm to users and non-users alike.

Two years ago we ran a quorum debating the pros and cons of decriminalizing marijuana. Since then, a largely theoretical debate has moved quite substantially toward the realm of reality, with a growing number of states and municipalities having changed their laws.

… So we asked a group of people — Paul Armentano, Mike Braun, Joel W. Hay, Jeffrey Miron, and Robert Platshorn — to think about a national decriminalization of marijuana … and answer the following: What would be some of the most powerful economic, social, and criminal-justice effects?

Here are their answers.

You can read all of the responses, including mine, and leave your feedback for the New York Times here.