On the day in early December that marijuana became legal in Washington, its the anniversary of repeal of The Volstead Act, which prohibited the production, sale, and transport of “intoxicating liquors”, but not the private ownership or consumption. The Act, the 18th Amendment to the US Constitution, did not define “intoxicating liquors” or provide penalties it was significant in the creation of powerful gangs such as those led by Al Capone in Chicago, along with rampant political corruption, around the various issues of making, moving and selling liquor. Marijuana was made illegal about 5 years after the repeal, in part because the powerful head of the FBI, Harry Anslinger, had made a name for himself fighting bootleggers and gangs and needed a new crime to fight, and he found one, in collusion with William Randolph Hearst, who was afraid of losing his paper-making monopoly to hemp, and they created the “reefer madness” movement, and fueled the subsequent criminalization of pot and much of the war on drugs.
We discuss the similarities and differences, and some of the ramifications of the new laws.
Howard: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions. I am Howard La Mere. It turns out that yesterday is the anniversary of when alcohol prohibition ended in the U.S. with the repeal of the 18th amendment. It was called the Noble Experiment and it lasted for 13 years and of course, begat Al Capone and organized crime in an attempt to get people to do something that they’ve done for pretty much all of human time and that’s alter their consciousness with alcohol. And interestingly, Darryl, today is the day that the legalization of recreationally marijuana, goes into effect in Washington. So, just a little bit of serendipity there. But is there news that you know of in the context of the legalization here in Washington and Denver?
Darryl: Well, I think it’s news we’ve talked about, but maybe we need to look at it in more detail. It was implemented in Washington today, December 6th. The end of marijuana prohibition in terms of recreational use, it hasn’t been implemented in Colorado yet. On November 6, 2012 both states .Colorado andWashington, voted to allow recreational use of this substance. And in Colorado, they haven’t implemented it yet – they might be trying to actually vet it more carefully. The bills were passed but they weren’t well thought out as far as I’m concerned. At the end of prohibition, a lot of thinking went into how alcohol would be distributed, how it would be regulated, how it was going to be taxed and the levels alcohol would be considered to be non-impairing in terms of a person’s legal responsibility to drive or have power over other people. Of course, none of that was done in either Colorado or Washington, so we have a situation now where in Washington the law is being implemented without a lot of understanding of how marijuana will be made available, who can grow it, who can use it that kind of thing. And I heard it’s legal to possess it, but not legal to grow it, not legal to sell it, not legal to pass it around.
Howard: Right. That was a headline I saw today.
Darryl: So, I guess, Howard .
Howard: You can have it, but you can’t get it!
Darryl: How do you get it? Does it just fall from the sky? And you get an ounce of it in your lap or something like that?
Howard: It’s okay if it falls from the sky.
Darryl: And in Washington they think this is going to raise a lot of revenue. Many companies are moving into a position to have the best tobacco shop around, like a cigar bar that has the finest cigars and charges top dollar. They are going to face big business. That’s another consequence a lot of people didn’t think about. There’s no way the individual grower the folks who grow at home and are sort of the mom and pop providers of medical marijuana and now marijuana for recreational use there’s no way they’re going to be able to compete against the big boys – and the big boys, as I told you, were backing these propositions in both states American Tobacco Company and also the liquor industry. “The merchants of death” is sometimes how I refer to them. And the American Tobacco Company and some in the alcohol industry have already snatched patents for names and web domains. They’re already in position to out market and out control monopolize maybe, the marijuana processing. We’re going to have to see how that fits and what happens to the small vendor, small providers I don’t know how it willwork out. Although I think Washington wants to use the tax revenues towards health issues. There’s not a clear idea of how that’s going to happen and there also wasn’t a clear idea of what the tax will be and how it will work. As we’ve seen with tobacco and other things, if the tax gets too far out of whack and people are unable to pay then the black market will open up again and people will start trafficking illicit marijuana to avoid taxes. And then there is the crime associated with that. So there are a lot of things in regards to this landmark.
The same amount of research and work that went into ending prohibition of alcohol did not go into ending the prohibition against marijuana. And also, we fail to look at the fact that as a public health issue, maybe the end of prohibition of alcohol was one of the worst things we did. Certainly people reacted because of the crime and the money from illicit sources and organized crime – but the reality was, we had one of the lowest rates of liver cancer and liver problems and heart disease and lots of other bad things health wise during prohibition and then it ended. We had a return to health and after prohibition returned to the unhealthy biological problems and medical problems that alcohol brought. And who pays for that I wonder? If we believe that nicotine is the reason that 30 to 40% of the patients wind up in our hospitals and emergency rooms and alcohol is responsible for another 25 to 30% – when a third substance is added – one that is capable of doing biological harm, who pays for that? Does it get paid for out of the revenues gained from taxes? That would be a rarity. So there are a lot of differences here between ending prohibition for alcohol and marijuana. So, it’s an interesting experiment and it’s certainly something that is going to test federal authority over state authority and present a lot of questions. So, we’ll just have to sit and wait and see what’s going to happen.
Howard: When did marijuana become illegal? Was that later in the 30’s?
Darryl: It was ’38.
Howard: That’s what I thought.
Darryl: It was ’37, ’38 when the prohibition passed.
Howard: I thought it was ’38, so that’s like 5 years after the end of the alcohol prohibition.
Darryl: And those two are related. Those two are related, Howard. If we recall, it was actually Hoover who was the big head of the FBI
Howard: He needed something else to do.
Darryl: Yes, he was out of a job basically. His whole office targeted the bootleggers and the whole alcohol scene and all of a sudden alcohol was legalized and he was out of a job – he lost his mission. It is common knowledge that he was a racist – he hated African Americans. He hated jazz music. He hated anything that had to do with the new culture. He was looking for a fight and he found a colleague in William Randall Hurst who feared that paper made from hemp was going to replace the paper derived from the timber lands he owned – because he controlled the paper, he controlled many newspapers around the country and launched a campaign to convince people that “marijuana” was the most evil substance in the world that led to its prohibition in 1937, 1938 and it’s lasted until now.
Howard: And, of course, it still is very controversial because we don’t know how the interaction with the federal laws is going to play out. And meanwhile, more and more states are thinking about legalization. All of course with the eye towards the money that is possible as tax revenue. And of course, if you grow it yourself, it is harder to tax. It’s illegal, as far as I know, to make your own alcohol to have your own still, because again, it’s harder to tax that way. So, we’re going to have to see how this plays out.
Darryl: Where does the responsibility lie? The federal government and the states allowed nicotine to be legalized and processed and when the proverbial thing hit the fan and we saw how medically hazardous nicotine was, well who got sued for billions of dollars? The tobacco companies. So, I don’t know maybe these industries should take a careful look at how deep they want to get into this because if some of the health hazards come about, then I guess they would be the responsible party for damages awarded.
Howard: But of course, we can make the case that there are a lot of things that are legal that are not healthy – not just these 3 particular psychoactive substances. that we’re talking about.
Let’s move on to the prescription drug abuse phenomenon which we’ve been talking about for a number of months, …as the crackdowns on Oxycontin and Vicodin and related opioids continue to work their way through the system, we’ve seen a steady, but very clear increase in the use of heroin, which has become more available and of course, much cheaper than expensive pharmaceuticals. What are you seeing in treatment these days in that context, Darryl?
Darryl: Well I think across the nation and certainly here in Oregon in Southern Oregon we have seen a steady increase in requests for treatment and detoxification from heroin addiction. This does seem to be coinciding with the fact that we are more effectively addressing the diversion of prescription drugs. It’s mainly opiate prescription drugs – that are being diverted the ones responsible for emergency room visits, overdoses and deaths across the nation. Pharmaceutical companies are making it harder and harder to divert their pain medications into an abusable substance by putting the codeines and releasing properties into the mix that make the drugs unavailable to pound up and inject.
Howard: The generic version of Oxycontin just became available here recently and there’s been a large hue and cry, especially in Canada, in the first nation territory of Northern Canada where various aboriginal Native American tribes say it will kill us because it’s already a major problem and it’s just going to get worse.
Darryl: Absolutely – the pharmaceutical firms will claim it is because Doctors are continuing to prescribe the old version of Oxycontin which was easy to crush up and divert and inject, whereas the reformulated Oxycontin that is still on patent is much more difficult to smash up and divert.
Howard: That just happens to be re-patentable
Darryl: You get a patent extension when you reformulate a drug so you’ve got to buy the pharmaceutical version that’s is 10 times the price or more, so that your patients won’t abuse it and that puts the responsibility of stopping the abuse on the practitioner. In our area we have really conscientious physicians who meet monthly to discuss abuse and diversion.
There is news about accessing electronic health records despite the HIPA regulations. There are ways of monitoring what patients are being treated with and that information us used to cut down on the abuses, and identifying patients who are manipulating the system in order to obtain these substances and it seems to be having an effect.
We started this discussion talking about how curbing prescription abuse was making buying street heroin more attractive – its less of a hassle, easier to cook up and shoot, and as effective or even more effective than the prescription opiates. A front page article today on our local paper was all about the rise in heroin addiction here. The most popular heroin here is the tar heroin it is the semi-processed opium made into heroin, leaving it with a lot of adulterants, a lot of buffers, but it is stronger. This tar heroin has a lot of adulterants that cause untoward health reactions – sometimes infections, so this winds up costing us a lot more in terms of healthcare for this population. The first thing we saw after they reformulated Oxycontin was a move by people to Opana and a variety of other opiate prescription drugs that didn’t have that protective covering feature. And as more scrutiny was placed on electronic health records the doctors got together in order to crack down on abuse which had the unintended consequence of moving all the opiate addicts toward heroin. I’m not sure we really wanted to do that. So, it’s again, it is an example of something we didn’t think through enough before we put these measures in place.
Howard: Well, we decide what we don’t want to happen and we neglect to think of what’s going to take its place.
Darryl: On a related thing in view of the heroin situation and also in view of the fact that heroin is a drug that more often lends itself to IV or intravenous needle use, it’s a risk in terms of continuing the spread of HIV. We are not talking sexual transmission – but needle transmission of HIV as well as hepatitis C. , tetanus, syphilis and a lot of other diseases. HIV is the most most dangerous one and so the U.S. Army has been working on creating a vaccine that will vaccinate people against both HIV and heroin at the same time. It is kind of interesting in a way that a vaccine can be created that’s anti infection, to protect against HIV infection, but also immunize against using heroin.
Howard: That’s fascinating.
Darryl: We’re in a new age here.
Howard: Okay, well, we’ll have to follow up on that because it is really interesting. That’s all the time we have for today – thanks for listening and your comments, questions, and suggestions are always welcome. Stop by the website, cnsproductions.com and drop us a note. Darryl, thanks.
Darryl: Thank you, Howard.
Howard: Please check back soon for the next in the series and visit our website, www.cnsproductions.com