Sentences to ponder

Medical marijuana dispensary on Ventura Boulev...
Medical marijuana dispensary on Ventura Boulevard in Los Angeles, California, U.S.A. (Photo credit: Wikipedia)

Mark Kleiman shares typically thoughtful and serious thoughts about legalizing cannabis. Too bad thoughtful and serious is so rare where cannabis policy is concerned.

2. Everything has advantages and disadvantages. Cannabis legalization will reduce criminal revenue, intrusive enforcement, arrest, incarceration, and disorder around illicit markets, and enhance personal liberty, consumer choice, and respect for the law, and probably reduce bloodshed in Mexico. It might foster safer and more beneficial practices of cannabis use.

3. Legalization will certainly increase drug abuse, including heavy use by minors. Every adult is a potential source of leakage to minors. And if we insist on making minors consume illicitly-produced pot, we reserve 20-25% of the market for criminals. Much better to tolerate leakage and have a grey-market supply to minors like the current system that provides them with alcohol.

4. The polarized nature of the debate means that both sides wind up spending lots of time denying the obvious.

via How to legalize cannabis « The Reality-Based Community.

Sentences to ponder

by karola riegler photography
by karola riegler photography

Snorting chemicals has a bad rap. But as a method of drug delivery, it may be on the verge of a renaissance. Unlike medications taken orally, intravenously or otherwise, those sniffed up the nose gain direct access to the brain. —Scientific American

Pair this with Bill White’s comment, “I can’t tell you what will become the major drugs of abuse in the future, but I can tell you they are already here and someone will find a new way to use them.”

What happened to the “crack babies”?

English: An intubated female premature infant ...
English: An intubated female premature infant born prematurely 26 weeks 6 days gestation, 990 grams. Photo taken at approximately 24 hours after birth. (Photo credit: Wikipedia)

 

 

Dirk Hansen reports the good news about “crack babies”:

 

In a paper authored by Hurt, Laura M Betancourt, and others, the investigators write: “It is now well established that gestational cocaine exposure has not produced the profound deficits anticipated in the 1980s and 1990s, with children described variably as joyless, microcephalic, or unmanageable.” The authors do not rule out “subtle deficits,” but do not find evidence for them in functional outcomes like school or transition to adulthood.

 

And, the bad news:

 

As FitzGerald writes: “The years of tracking kids have led Hurt to a conclusion she didn’t see coming. ‘Poverty is a more powerful influence on the outcome of inner-city children than gestational exposure to cocaine,'” Hurt said.

 

He asks, “How did this urban legend get started?”

 

In the 1980s, during the Reagan-Bush years, Americans were confronted with yet another drug “epidemic.” The resulting media fixation on crack provided a fascinating look at what has been called “drug education abuse.” This new drug war took off in earnest after Congress and the media discovered that an inexpensive, smokable form of cocaine was appearing in prodigious quantities in some of America’s larger cities. Crack was a refinement to freebasing, and a drug dealer’s dream. The “rush” from smoking crack was more potent, but even more transient, than the short-lived high from nasal ingestion.

 

 

 

Regulating the marijuana market

marijuana marlboroThe Partnership at Drugfree.org reports the results of a recent survey:

There is strong support for a wide array of stringent post-legalization marijuana regulations to protect minors and the community wellbeing. The research shows intense support (above or near 90 percent) for:

  • Setting a legal age of 21
  • Prohibiting marijuana smoking in public places
  • Severe penalties for driving under the influence of marijuana
  • Making it illegal to provide marijuana to someone underage (even at home)
  • Prohibiting the sale of marijuana at grocery or convenience stores
  • Industry-financed youth prevention education
  • Taxation for state general fund revenue
  • An outright ban on marijuana advertising

What is particularly interesting is that support for this slate of regulations remains exceptionally strong even among those who approve of the legalization of marijuana.

The poll dug even deeper into attitudes toward marijuana advertising post-legalization, providing respondents with a list of more than a dozen different advertising media ranging from television to movie-theater advertisements, and asking where it would be acceptable for marijuana sellers/growers to advertise. The number one response, among both parents and the general population at large (including in CO and WA) was “nowhere.”

The data are exceptionally clear: There isn’t just a desire for these kinds of regulations, there is an expectation, among parents and among adults nationwide, that lawmakers put these in place if and when marijuana is legalized.

 

Why “medical” marijuana gets little respect here

English: Discount Medical Marijuana cannabis s...
Discount Medical Marijuana cannabis shop, Denver, Colorado. (Photo credit: Wikipedia)

 

Mark Kleiman, the Washington state pot czar,  explains his use of “scare quotes” when writing about medical marijuana:

 

Yes, cannabis has medical value for some people. And yes, the sustained effort of the federal government to make medical cannabis research as difficult as possible is a national disgrace.

And then, on the other hand, there’s this, from a report of the Colorado State Auditor:

As of October 2012, a total of 903 physicians had recommended medical marijuana for the 108,000 patients holding valid red cards. Twelve physicians recommended medical marijuana for 50 percent of those patients, including one physician with more than 8,400 patients on the Registry.

Some physicians have recommended what appear to be higher-than-reasonable amounts of medical marijuana. In one case, a physician recommended 501 plants for a patient. In another case, a physician recommended 75 ounces of useable marijuana for the patient.

Do the arithmetic on 8400 patients for one physician. Assume a 50 40-hour workweeks and zero time spent on administrative tasks. That’s a little bit less than 15 minutes per customer. Medical practice? No. Just dope dealing.

 

He adds:

 

The strategy of using quasi-medical legalization as a means of normalizing consumption and moving the political acceptability of full commercial legalization has been a great success … And I’m not unhappy with the outcome. … Still, the whole deal – and especially the role of the “kush docs” – makes me a little sick to my stomach.

 

 

 

What would legalized pot look like?

marijuana marlboroA RAND analyst lays out seven important questions regarding the establishment of legal marijuana:

1. Production. Where will legal pot be grown — outdoors on commercial farms, inside in confined growing spaces, or somewhere in between? RAND research has found that legalizing marijuana could make it dramatically cheaper to produce — first because producers will no longer have to operate covertly, and second because suppliers won’t need to be compensated for running the risks of getting arrested or assaulted. After lawmakers decide how it will be grown, production costs will be shaped by the number of producers and other regulations such as product testing.

2. Profit motive. If there is a commercial pot industry, businesses will have strong incentives to create and maintain the heavy users who use most of the pot. To get a sense of what this could look like, look no further than the alcohol and tobacco industries, which have found ingenious ways to hook and reel in heavy users. So will private companies be allowed to enter the pot market, or will states limit it to home producers, non-profit groups or cooperatives? If a state insisted on having a monopoly on pot production, it could rake in a decent amount revenue — but for now, that possibility seems far off in the United States since marijuana remains illegal under federal law.

3. Promotion. Will states try to limit or counter advertisements in the communities and stores that sell marijuana? U.S. jurisprudence against curtailing what’s known as “commercial free speech” could make it tough to regulate the promotion of pot. While a state monopoly system could help control promotion, those advertisements you see for state lotteries should give you pause.

4. Prevention. If pot is legal for adults, how will school and community prevention programs adapt their messages to prevent kids from using? While some proposals to legalize marijuana would divert tax revenues to prevention efforts, the messaging and strategy should probably be in place before legal marijuana ever hits the streets.

5. Potency. Marijuana potency is usually measured by its tetrahydrocannabinol content, or THC — the chemical compound largely responsible for creating the “high” from pot, as well as increasing the risk of panic attacks. Much of the marijuana coming into the U.S. from Mexico is about 6% THC, while the marijuana sold in medical dispensaries in California ranges from 10%-25% THC. Meanwhile, the Dutch are now considering limiting the pot sold at their famed coffee shops to no more than 15% THC.

While THC receives the most of the attention, don’t forget other compounds like cannabidiol, or CBD — which is believed to counter some of the effects of THC.

6. Price. With marijuana, like any other commodity, price will influence consumption and revenues. A growing body of research suggests that when marijuana prices go down, the probability that someone might use marijuana goes up. So retail prices will largely be a function of consumer demand, production costs and tax rates. If taxes are set too high, pot will become expensive enough to create an incentive for an illicit market — exactly what legalization is trying to avoid. The way taxes are set will also have an effect on what’s purchased and consumed — that is, whether pot is taxed by value, total weight, THC content, or other chemical properties.

7. Permanency. The first jurisdictions to legalize pot will probably suffer growing pains and want to make changes later on. They would do well to build some flexibility into their taxation and regulatory regime. For example, while it may make sense to tax marijuana as a function of its THC to CBD ratio, 10 years from now we may have research suggesting a better way to tax. Just in case they change their minds, some pioneering jurisdictions may want to include a sunset provision that would give them an escape clause, a chance — by simply sitting still — to overcome the lobbying muscle of the newly legal industry that will no doubt fight hard to stay in business. As the sunset date approaches, legislators or voters could choose either to keep their legalization regime or to try something different.

 

Legal weed

English: Marijuana plant. Español: Planta de m...
English: Marijuana plant. Español: Planta de marihuana. (Photo credit: Wikipedia)

 

Fresh Air recently aired a great interview on the marijuana legalization. It spent a lot of time looking at the medical marijuana regulation in Colorado and how that will be the model for full legalization.

 

The interview was balanced and informative. (A very rare thing for drug policy discussions.)

 

He also wrestled with the potential toxic marriage of capitalism and marijuana.

 

“We’ve seen legalization in two states — that’s the first step toward legalization in other states. That’s a step toward legalization nationally. So you have a third vice industry like tobacco and like alcohol. The problem with that is that 80 percent of the profits tobacco companies and alcohol companies make comes from heavy users. The business model is based on people consuming more than they should. And so there’s a strong economic incentive for big marijuana companies to create as much addiction as possible. And yeah, sure, marijuana is less harmful than Jack Daniels, but it’s not the same thing as safe or helpful in the home or helpful in the workplace, or good.

“And so the long-term worry is that you have sophisticated marketing programs in place, distribution programs in place, that create a double or tripling of the current level of marijuana usage. And … by the way, Americans [already] use marijuana at triple the global average. So we’re talking about a tripling of a tripling, and that’s a big deal. It’s something to think about, which is why many people are in favor of — or I believe will become more in favor of as they realize the risks — of severe limitations on the size of marijuana businesses and the advertising that they can undertake.”

 

 

NA gives its members opioids?

Marc Lewis discusses an important role of endogenous opioids.

Some very prominent emotion scientists have theorized that opioids (made inside our brains) are at the root of human attachment. Mother’s milk is rich with opioid molecules. In other words, nature found a surefire way to soothe the baby with its mother’s milk, using the same chemical formula that’s responsible for the soothing feeling of heroin. Jaak Panksepp theorizes that all social attachment is based on the release of opioids within the brain.

Then about research finding endogenous opioid production may be activated by had holding.

The brain regions that got calmed down by hand-holding (including regions of the ventral ACC, ventral prefrontal cortex, striatum, and insula) are the same brain regions that have a high density of opioid receptors! The authors speculate (and I think it’s very likely) that opioid release is what causes the deactivation of these emotional hot spots. The subjects also reported less unpleasantness when they were holding hands while anticipating the shock. And, get this, the reduction in unpleasantness was correlated with the reduction in brain activity in these hot spots.

Then he suggests these findings may explain some benefits of 12 step meetings.

In a recent debate on this blog, I argued that a supportive group like NA makes sense as a primary treatment for addiction–not a secondary one. Certainly members of NA or AA see their group experience — with or without hand-holding — to be the most powerful antidote to their feelings of anxiety, stress, loneliness, and all the other negative variants that can lead to relapse. Now we can point to a very concrete, biological mechanism responsible for the soothing function of the group: when you are in close contact with people who care about you (even a little), your own brain releases opioids. And, in a sense, those opioids replace the opioids you’d otherwise be buying on the street.

This begs a question about medications that interfere with pleasure responses to drugs and alcohol.  Do these meds also interfere with endogenous opioid responses? I had a friend who was going research on it nearly 20 years ago. He told me that he was frequently approached after presentations by people who were on the drug and reported weird effects like no longer liking cheesecake.

I found one study on the issue and it found no adverse effects, however is was funded by the manufacturer of the drug. It’s worth noting that researchers use naltrexone to “disrupt opioid neurotransmission in mouse pups and their attachment relationships with the mother.”

So…might this medication, and others like it, interfere with the benefits of 12 step groups? It seems like a question worth asking.

This is your culture on pot

Medical Cannabis Growing Operation in Oakland,...
(Photo credit: Blazenhoff)

Keith Humphreys and Mark Kleiman offer some great commentary on marijuana legalization and what a legal marijuana market might look like.

First, Humphreys:

About eighty percent of the market is “commercial grade” cannabis, which has a THC content of about 5% and sells for $70 to $230 per ounce, depending on how far a buyer is from the producing farm and in what amount he or she buys. If that level of potency and price surprises you, you are probably an observer or participant in the small, nationally unrepresentative marijuana “upmarket“.

The reason for the current dominance of commercial grade pot is simple: It’s an inexpensive product for a price-sensitive population.

But, he argues price would likely drop and …

The cannabis-using population would experience a vast increase in average drug potency. Caulkins and colleagues estimate that in the past 15 years, average potency of marijuana in the U.S. has doubled. But after legalization, with the 80% commercial grade market share being almost completely supplanted by sinsemilla, average potency would roughly triple very rapidly.

This increase in exposure to highly potent cannabis is one of the mechanisms through which legalization would result in a higher prevalence of addiction (Some of the other mechanisms are discussed here). It at first seems reasonable to assume that experienced users would simply titrate their dose of higher-potency pot, making higher or lower doses equivalent from a biological viewpoint. But surprisingly, laboratory studies of experienced marijuana users show that they are in fact poor at judging the potency of cannabis.

Kleiman isn’t so certain. Here are a few of his reasons. Read the entire post for the rest of his thinking:

  • Even if high-potency product were legal, it could be heavily taxed, as whiskey is heavily taxed compared to beer.
  • In the current illicit market, “quality” and “potency” are conflated in consumers’ minds. Post-legalization, …THC could be extracted from the vegetable matter and used to “fortify” pot to any desired potency. That may push consumers’ ideas of “quality” away from potency and toward other factors.
  • Unlike alcoholic beverages, which mostly contain only a single psychoactive, cannabis contains a mix. Some consumers will want lower-THC, higher-CBD product.

Alcohol remains our one experiment with legalization of an intoxicant. Two-thirds of the alcohol consumed in the U.S. is taken in the form of beer rather than higher-potency forms.

As is so often the case, the answer here is “Hard to say; it depends.”

K2, Spice and legalization

I do not consider myself a drug warrior. (Though, few people do these days. It can be a little like racism. People attribute it to others, but never themselves.) I oppose incarcerating people for possession of quantities consistent with personal use. I favor policies that target demand rather than supply. I’m also skeptical of hype around new drugs that are predicted to lead the the decline of western civilization.

There’s been a lot of talk about the evolving, softening public position on marijuana. We’re seeing more and more public discussion about straight up legalization of drugs, domestically and internationally. (Those NYT discussions should be so great, but they are nothing approaching great.)
Then you have K2/Spice. It’s been a few years since it’s appeared in Michigan and the reflex to ban it does appear to slowed.

However, this small scale experiment with tolerating a drug appears to be coming to an end.

I have a few observations:

  • I’ve been reluctant to buy into the hype and, to be sure, there has been hype. At the same time, many people have responded to the hype by arguing that it’s just a cannabis analog and is no more or less harmful than cannabis. I don’t know a lot about the drug, but anecdotal reports seem to suggest that it’s not just marijuana by another name. There appear to be as many negative Erowid reports as there are positive or neutral reports. And, many of them state that there are differences between K2 and marijuana.
  • I find the marriage of legal capitalism and the drug troubling. Local gas stations, smoke shops and party stores display dozens of varieties more prominently than anything else in the store. (This NORML post describes the marketing.) The packaging uses images like cartoons, ninjas, yoga and Bob Marley to market it. A lot of it looks like it could be candy packaging. (Ugh! I feel like such a geezer saying this, but some of it reminds me of Warheads packaging.)
  • There does not appear to have been an attempt to regulate the drug(s). Could this have worked? I don’t know. Regulation seems to do little to hamper the marketing of legal drugs. I’d still prefer a ban with less harsh criminal penalties. My sense is that, with the possible exception of marijuana, the public doesn’t have the stomach for legalization. I wonder if tide will turn on marijuana as marketing increases. Time will tell.
UPDATE: I wonder what would happen if is wasn’t banned. I’m guessing you’d start to see some large manufacturers get more market share, more wealth, more clout and market in a more organized and effective way.
On the flip side, I also wonder if these kinds of companies would end up enjoying the kind of immunity that alcohol manufacturers maintain. We have a special place in our culture of alcohol and guns. Tobacco lost this protected status. It’s hard to imagine these companies enjoying this status. As suppliers go corporate, they become a target for lawsuits and risk management becomes necessary. What kind of risk management would they employ and what kinds of marketing restraint or checks would the create? I dunno.