In a recent Huffington Post article, "Ending the Drug War: Top Stories of 2011" we find a chronicling of the changing perceptions, both by the public and also policymakers and leaders, of the "War on Drugs" that was started 40 years ago by President Nixon. We discuss some of the aspects including the range of successes seen in Portugal from its 10 year experiment in decriminalization of all drugs, and the need to keep a strong focus on treatment, regardless of the various changes in legal status.
HOWARD: Welcome to the CNS Podcast. I am Howard LaMere here with Dr. Darryl Inaba and we are reviewing the week's news as it relates to drug use and abuse, substance abuse, addiction. I found a piece on Huffington Post - “Ending the Drug Wars. Top stories of 2011” and I thought this was interesting, Darryl, to run them down really quickly.
- World leaders make international news by calling for marijuana legalization and the end of the drug war.
- The 40 year anniversary of Nixon’s launch of the drug war is met with nationwide protests.
- Gallop poll shows historic support – 50% of Americans favor ending the marijuana prohibition.
- NYPD commission directs police to stop improper marijuana arrests.
- Thousands in Mexico take to the street to protest the drug wars that have been going on for 5 years and killed 50,000 people or so.
- Colorado and Washington to vote to legalize marijuana this year.
- Portugal celebrates the 10 year anniversary of decriminalizing drugs – not just marijuana, but all drugs and the impact that has had.
- Drug war critique all over TV and popular culture.
- New and powerful voices join the movement to call for ending the failed drug war.
- Despite progress, the drug war grinds on as viciously as ever.
Darryl, what’s your take on that list?
DARRYL: Well, I think it is interesting. It’s analogous to the prohibition era when criminalizing the use of alcohol resulted in just as fervent criminal activity and violence. It had a devastating impact on society, but at the same time had a real positive effect in terms of decreasing the medical consequences and the addiction problems that existed with alcohol. I think that’s where we are now. Crime and drugs and violence are so connected to drugs because of the tremendous profits to be made. Decriminalization of drugs will still yield profits, but the focus will switch from the criminal aspects or illegal aspects to the merchandizing and commercialism that exists in our country and elsewhere in the world.
HOWARD: Especially along the lines of the medical marijuana growers and the various controversies around that.
DARRYL: Well, it's a tossup - a tug-of-war in terms of what bothers me more. Are the health consequences and medical costs related to any drug of abuse, including marijuana more expensive than the criminal costs of policing it? I think we’re at a watershed - people are evaluating this and coming to conclusions - some are polarizing - on what they think. The Portugal Experiment happened almost 10 years ago - when they decriminalized all drugs. It was decriminalization, but it wasn’t legalization and many people looking at ending the drug war are calling for total legalization. But in Portugal, I have to remind people, it is still a criminal act to possess and traffic those illegal substances, but instead of an automatic jail sentence, the actions are evaluated. Each case is individual, evaluated by a panel of health experts, addiction experts and a law enforcement expert. They assess whether or not the person has an addiction, whether they are recreational or social users and the sanctions are dependent upon what they find. If the person is a social recreational user, then they are fined and warned not to traffic
around kids, around schools and stuff like that. If the person is an addict, then treatment is mandated and paid for with the monies saved by decriminalization. My biggest worry about the direction we are going - which seems to be legalization, is no one is pushing for using the savings for medical treatment and addiction treatment for those who are involved heavily with the drugs. That’s what I would like to see. If we move in that direction, we should move very much in the way Portugal did - that country has had success, not only with a decrease in instances of HIV and other societal problems, but there has been an actual decrease in most drug use - except for marijuana of course - marijuana use increased and that’s the major drug we are looking at here. I just reviewed an article in the International Journal of Drug Policy, which was startling because it talked about the effect of law enforcement on drug market violence. They did a systematic review of several studies on this and their conclusion was that contrary to what most people thought, the prohibition of drugs and the increased law enforcement to control drug trafficking actually results in a lot more violence than would occur if government didn’t prosecute and wasn't heavily involved. So that’s another nail in that coffin - saying, maybe we should relook at this whole drug policy thing and come up with different ways of handling drug offenders. The big issue that must be accepted is that some people, not everybody– only 30% of the U.S. population at some time in their life - would meet the diagnostic criteria for a drug dependence or a major drug abuse problem. So, the vast majority of people won't fall into that category, but for the 30%, it is not a matter of choice. It’s not a matter of what they want to do, it’s a matter of a medical condition, which robs them of their ability to control their intake of drugs resulting in major consequences. We must pay attention to that population as we move forward and determine how to deal with them should we decriminalize or legalize or …take a different stand on how we deal with these addictive substances.
HOWARD: Well, I do think it’s important to stress the need for more treatment options. It was determined that a portion of monies realized by states from gambling would fund prevention and treatment and we've seen that reduced with the money going to the general fund. Now, legalizing marijuana is perceived as a possible boon to our economic problems. And both of these things, I think, are short sighted and likely incorrect.
DARRYL: I think you are correct about that, Howard. The Huffington article lists 10 reasons why it is time to legalize drugs but I think the real motivation for legalization is the potential source of revenue, another source of income to deal with our economic woes. When that is the intent - the monies are usually misused and we often end up with much greater problems. It is a sad thing but … it does seem to be one of the quirks of how humans and governments operate. It could be motivated by economics rather than compassion - more money.
HOWARD: I think there’s a good possibility that that is the case. And in the case of marijuana - early in the 20th century, William Randolph Hearst used his newspapers to discourage use not because of morals, but because he saw hemp as competition for his paper making business. Now, again, that’s all about the money. What was the usage of marijuana before that period? Before the depression? Before the demonization?
DARRYL: It was much less than the use of alcohol and still is - nicotine, alcohol and then marijuana have held the same rank, I think, forever. And it’s a good analogy, because William Randolph Hearst really created the refer madness mentality. He sensationalized marijuana, not out of any kind of real moral intent or any kind of health intent. He did it purely… so that marijuana would be prohibited in order to save his monopoly over paper. So, again, it’s the money angle that bothers me the most and whether or not legalization would result in greater or lesser use of this drug specifically. I’m not so sure. I know that in Portugal, legalization did lead to a decrease in use of harder drugs, like heroin, cocaine, but in terms of ecstasy and marijuana, the last reports I saw, there was an actual increase in their abuse. So, it might affect that culture, but it’s still something to look at from our point of view.
HOWARD: We’re in the midst of the holidays here and we mentioned talking about the holiday blues. There’s a story that came out, citing the day before Thanksgiving as a day college students typically drink to inebriation. I guess that bespeaks the beginning of party time for college students in general. I mean it is a party time in general for everyone. But, are there special issues that we should talk about here?
DARRYL: You know, I really feel bad we didn’t talk about before Thanksgiving. I had a number of people in my groups relapse and I chose to speak with them after Thanksgiving, to prepare them for Christmas and New Years and the big December holidays of which - regardless of the culture - are major, major times of religious or spiritual celebration. It's the darkest time of the year and cold in the northern hemisphere and people historically had less food and struggled more so every culture came up with some way to change people's mood - to liven them up before the winter solstice on December 21st and 22nd when sun begins to shift and the northern hemisphere starts to get more and more daylight time. The holidays seem to be a way to get over that hump. Today Thanksgiving is overshadowed by the whole Black Friday thing - which started earlier, hours earlier because of the money to be made. Because this is the biggest economic time of year in retail, companies were calling in their employees earlier. Black Friday used to start at regular business hours on the Friday after Thanksgiving then it was 4 am - now its midnight. In that same vein, the holiday blues start earlier and now on Thanksgiving we have lots of arrests for drunk driving arrests, a tremendous amount of people with drug toxicities from drinking too much, overdosing and a lot of relapses within treatment because there are … for a lot of people - too many triggers at this time of year. College kids want to cut loose and drink - it's the first long school break and it's a time many cut loose and do a lot of things they don’t normally do. And that is a real threat to people who are struggling in recovery - watching everybody else get loaded and it triggers their urge to use. In addition to that, within every family there is trauma and there is drama and there are all kinds of competitions and struggles and resentments and whatever that must be faced at Thanksgiving and Christmas when you go home and get reconnected with your family. Families at odds with each other cause stress, which is a major trigger to use. Then there are feelings of not being effective during the year - not succeeding in what you wanted to accomplish, struggling with your addictions, struggling with your problems, looking at all the guilt and shame that has been piling up during the year caused by things you’ve done and that’s also a big trigger. These things all conspire to make holidays a difficult time for people who are struggling or people who are depressed or people who have mental health issues. They’re enough of a struggle for people who don’t have any of those problems, so I can’t imagine how people with those problems.
HOWARD: Well, the holidays are both a joyous time and also a treacherous time. So, I guess the bottom line is just watch out and don’t shout and be careful and keep your dancing shoes on.
DARRYL: Dancing shoes! Alright!
HOWARD: Okay, I guess that’s about all the time we have today.
DARRYL: I just want to quickly mention, an article I just came across today. The University of California Irvine is conducting research that is beginning to unlock the way the endocannabinoids are metabolized. It is fascinating that they have found a transporter enzyme, transporter protein that takes the endocannabinoids after they have synapsed and shepherds the ones that aren’t recycled into the re-uptake transporter mechanisms over to the enzymes that breakdown endocannabinoids. This is an unusual method and endocannabinoids have an unusual method of how they work in the body. But what they’ve figured out is how to block the enzymes that break down and the proteins that transport them and therefore magnify the effects of the endocannabinoids – your own natural brain chemical. It would be analogous to how we treat depression. We try to magnify your own internal serotonin, your internal chemicals and now if we can magnify your own internal endocannabinoids, we may have a much safer and more effective way of replacing medical marijuana really…its medical endocannabinoids. It’s your own medical substance. It’s not taking any substance from the outside and I find that fascinating.
HOWARD: It is very fascinating and I’m sure we will hear more about it as it evolves. That’s all the time we have today. If our audience has comments, suggestions or questions, drop us an email. Please check back for the next in the series.