If You Don't Quit Harming Yourself We Will Punish You

Yeah. "If you don't quit harming yourself we will punish you" sounds pretty stupid (to some of us) now a days. But at one time it was all that we had. There was no evidence to support any other way of treating substance addictions. We now know something else. Thanks to people like Alan Marlatt who died on Monday (14 March).

For years, the prevailing approach to confronting addiction in the U.S. could be summed up as "just say no." Abstinence was the only goal; addicts had to agree to quit drugs or booze entirely as a precondition for treatment.

The pioneering work of Alan Marlatt, a professor of psychology at the University of Washington, profoundly changed that attitude in recent decades.

Dr. Marlatt advocated "harm reduction," an approach that meets addicts "where they are" instead of demanding immediate detox and abstinence. Counselors strive to reduce drug or alcohol consumption, for example, while minimizing public-health costs through programs such as needle exchanges.

It's a model Dr. Marlatt called "compassionate pragmatism instead of moralistic idealism." And research shows it works.

And you thought that just because the Communists Utopians were discredited that all Utopians were discredited? Perish the thought. Don't you know that if every one believed in the right God the right way and acted properly on those beliefs we could end misery and suffering forever? It says so in some book or other. Some very old book. It must be true. Trouble is that it is in several old books and the books seem to disagree on several important details. I'm all in once it gets sorted out.

But back to addiction.

While now widely accepted, some of Dr. Marlatt's ideas were considered heretical when he first started writing and talking about them decades ago, colleagues said.

For example, counselors once shunned discussion of relapses when talking with alcoholics, believing it would only encourage further drinking. Dr. Marlatt challenged that as unrealistic. His research showed it was more effective to acknowledge the likelihood of relapses and help patients cope with them.

"When I first heard him talk about that in the late 1970s, people got up and accused him of killing alcoholics," said Frederick Rotgers, president of the Society of Addiction Psychology.

I guess telling the truth is more effective than lying to people. Who knew?

Dr. Marlatt supported Seattle's controversial apartment building for the city's most troublesome street alcoholics. The 1811 Eastlake building, which opened in late 2005, provides a home to dozens of hard-core alcoholics, who are allowed to drink in their rooms.

Though that concept drew plenty of criticism, a 2009 study found it saved taxpayers $4 million a year. That's because the residents were drinking less and not winding up as often in the emergency room or detox.

Now think of all the money that could be saved if we asked police to quit Herding Junkies.

Which is one reason Dr. Robert Marks [pdf] calls the whole exercize:

THE DRUG LAWS: A CASE OF COLLECTIVE PSYCHOSIS

It does seem a bit harsh. But when you consider that we have been at it for nearly 100 years with no substantial effect other than to destroy supplier and transit countries and enrich criminals in America as well, what else explains it but psychosis? A disconnect from reality. Oh. Maybe not the small reality. But the bigger picture. And both Alan Marlatt and Dr. Marks have proved that even the small reality doesn't work the way most people think it does. More from Dr. Marks:

I am a consultant psychiatrist in Widnes, northern England and prescribe hard drugs such as heroin and cocaine. Ironically I may not prescribe hasheesh, nor opium nor coca. This is like being able to prescribe cognac but not wine. Nevertheless this policy has eliminated drug deaths, there is no H.I.V. infection, and a police study of our program shows a 15-fold fall in drug-related acquisitive crime. Most interestingly, the incidence of addiction has fallen 12-fold.

HARM MAXIMISATION AND INHUMANITY

Daniel Roche is a citizen of Widnes. In adolescence he experimented with drugs. He gained a liking for cannabis. Avoiding the black market, he grew his own cannabis on local unused wastesites. He supplied himself, in this way, peacefully, for eighteen years. He was a cable layer, working for a large electrical company. He paid taxes. He had his own house. He was married, with children successful at school. In 1988 the police seized his cannabis, and he was fired from his job. He couldn’t pay his mortgage, so he lost his house. More cannabis was found growing in his garden. He was sent to prison and his family split up. He is now still in prison in Liverpool. I call this policy “harm maximisation”.

So we are harming the drug users. And harming the taxpayers. Who is making out in all this? Uh. Let me think. It is on the tip of my tongue. Give me a couple of days. I'm sure it will come to me.

I have never understood the concept "if we make life more painful for those taking unauthorized pain medications they will stop chasing unauthorized pain relief". You would have to be some kind of Utopian with a very old book to believe such a thing. Because it is very hard to understand how you can come to such a syllogism through logic and reason.

Cross Posted at Classical Values

The Evils Of Divorce

A while back Eric wrote a bit on divorce with the theme that state involvement with personal matters is a bad idea. I had a few comments on the subject but nothing worth a blog post.

I now have something I'd like to say. And it came about because Instapundit linked to this video about a boy whose parents divorced and who subsequently got into drugs and then died of an overdose. I think you can get the gist of the video from watching the first 5 or 6 minutes. I couldn't stand watching any more.

I want to start off with a review of Henry Granju's drug use. Why was he a drug user? Consider what follows informed speculation.

People take pain relievers to relieve pain. Under any rational regime we would be looking to fix the pain and consider the drugs symptomatic rather than causative. For “addicts” the pain is in the brain. And some how if the pain is in the brain we do not consider it “real”. But the user has no interest in right or wrong pain. Only in relief.

Now all this pain relief would be a LOT safer under a doctor’s supervision. But doctors have only one allowed treatment for the pain in the brain. Cut users off from all drug use.

We really have only two good options: drug distribution by criminals or drug distribution by doctors. Because “prohibited” does not mean “unavailable”. It means “distributed by criminals”.

That more or less covers the drug and prohibition issues. If you want to look more into the medical aspects you might like:

Is Addiction Real?

OK. Drugs are out of the way as the cause of the event sequence. For that we have to go back a bit further and look at divorce. And why I came to a different conclusion than the video makers after watching as much as I could tolerate of the video.

DIVORCE IS EVIL if you have children. And some times kids turn to drugs to relieve the pain of the divorce. Throw in a step parent and it gets harder. I wouldn’t make divorce illegal. But folks ought to think 2E28 times (that is a very big number) before going ahead with it.

I know a kid (and his mother) who went through the same thing. Friends of our family. The divorce devastated him and then a few years later there was a drug “accident”. I wouldn’t make divorce illegal or harder to get. I would say that more folks ought to man up and find a way to live with their bad choice of mate. For the children. And the children? I would put them under a Drs. supervision at the first sign of drug use – if we got the government out of the prohibition business. In the mean time? Prayer is the best we have got and it ain’t much.

The adults ought to be willing to shatter their world rather than shatter the world of a child.

Let me note that I do not believe any law can fix the divorce problem. Courage and a change of heart is required. The law can provide neither.

If our Drug War zealots put more effort into fixing families (by private efforts) instead of railing on about the evils of drugs we might actually decrease the incidence of these problems. The advantage for the zealots is that fighting drugs is easier than fighting bad parenting. You can at least point to piles of dope, cash, and guns. Proof that "something" is being done. Even if it is counter productive (it is easier for a kid to get an illegal drug than a legal beer). What can you point to that "proves" progress is being made with families? Of course the Drug War gains are illusory in the larger sense. But the efforts are photogenic. What pictures can you show to illustrate that something is being done about divorce; that fewer daughters are getting molested by step dads? That fewer kids are dying of a broken heart? Other than a lower incidence of divorce among families with children. Charts and graphs. That is the ticket.

That is why the work ought to be private. We won't know for 20 or 30 years what works. By that time if it is a government program it will be an empire.

Cross Posted at Classical Values

Pill Outbreak

Southern Ohio is in the midst of a public health emergency. There is a serious outbreak of pills in the area.

Nearly one in 10 babies were born addicted to drugs last year in southern Ohio's Scioto County. Rehab admissions for prescription painkiller addictions were five times the national average. In a rare step, the health commissioner declared a public health emergency, something usually reserved for disease outbreaks.

The culprits putting the rural county at the forefront of a burgeoning national problem are not only the people abusing the painkillers, officials say. They blame at least eight area "pill mills" — clinics or doctors that dole out prescription medications like OxyContin with little discretion. At least two health care providers are facing criminal charges.

"I would describe it as if a pharmaceutical atomic bomb went off," said Lisa Roberts, a nurse for the health department in Portsmouth, an Ohio River city of about 20,000 with falling population and high unemployment.

Health officials say nine of every 10 fatal drug overdoses in Scioto (pronounced sy-OH'-toh) County are caused by prescription drugs. Of those drug deaths, nearly two-thirds of the individuals did not have prescriptions, meaning they bought the drugs illegally or got them from friends or family.

Obviously since 2/3rds did not get their medications legally the "pill mills" are at fault.

There are other "pill mills" around the country that are getting attention.

By publicly defending Stephen and Linda Schneider, a Kansas doctor and nurse accused of running a “pill mill,” pain treatment activist Siobhan Reynolds irked the prosecutor assigned to the case. Assistant U.S. Attorney Tanya Treadway was so annoyed that in April 2008 she sought a court order telling Reynolds to shut up. Concluding that such an order would be an unconstitutional prior restraint of speech, U.S. District Judge Monti Belot said no.

But by the time Belot sentenced the Schneiders last month, he was so irritated by Reynolds’ advocacy on behalf of the couple that he could not contain himself. He said he hoped the harsh sentences—three decades each—would “curtail or stop the activities of the Bozo the Clown outfit known as the Pain [Relief] Network, a ship of fools if there ever was one.”

Reynolds, who founded the Pain Relief Network (PRN) in 2003 to highlight the chilling effect of drug law enforcement on the practice of medicine, evidently has a talent for getting under the skin of people in power. But that is not a crime. By treating it as such, Treadway has used grand jury secrecy to cloak an unconstitutional vendetta.

The previous link leads to the PRN in case you want to learn more.

Of course I have written about the war on pain patients before. Just another advantage of having a war on pain relievers. What is the new motto in American jurisprudence? "Better 10,000 in pain than one additional drug abuser." You have to look at this in a positive light though.If you are in pain there is a thriving black market if you can afford it.

Here is a book that addresses current policy:

Pain Control and Drug Policy: A Time for Change

Here are some short reviews:

"A captivating and a powerfully expressed condemnation of the mindless folly of drug policy. Its great strength is the clarity of thought and power of expression." Paul O'Mahony Ph.D., Criminologist, Trinity College, Dublin.
--Book Review

"A dispassionate and multifaceted analysis of the harmful effects of drug policy in the US and abroad [that calls for] re-legalizing all illicit drugs." Jeffrey A. Miron, Ph.D., Harvard University, Cambridge, MA --Book Review

"Faguet's book is the latest classic in a growing literature on the divisive and counterproductive nature of drug wars. In passionate terms, he describes the history and development of current legislation and reveals that, far from protecting society, current drug policy undermines the fragile social, political, and legal infrastructures of producer countries and penalizes millions of petty offenders and pain sufferers in consumer countries. Strongly argued and uncompromising, this is essential reading for anyone with an open-mind, and an interest in drugs and drug legislation." --John B.Davies BA., Ph.D., C.Psychol., FBPsS., FRSM, Professor of Psychology, Director, Centre for Applied Social Psychology, University of Strathclyde, Glasgow, Scotland

I have to agree with the reviews. A well working prohibition (yeah a logical prohibition - a novel idea) should keep drugs from those who supposedly don't need them and get them (through legal markets) to people who do. Instead our policies insure pretty much the opposite. Not to mention that for 30 years it has been considerably easier for kids to get an illegal drug than to get a legal beer according to government surveys. What is the point of that?

Cross Posted at Classical Values

Genetics And Trauma

I got the video from Reason Magazine via Instapundit. What is interesting is that two of his three key markers for psychopathy are: genetics and trauma or abuse. Those are the two markers that I have been saying for years are the cause of chronic drug use.

You can follow my trail some by reading these articles in order.

Is Addiction Real?

Heroin

PTSD and the Endocannabinoid System

Addiction Is A Genetic Disease

Now does this particular information prove my point? Of course not. I do think it means I'm on the right track and some further exploration is in order.

Cross Posted at Classical Values

It Is Official

NASA agrees with me on the nature of drug abuse.

Initial low-level involvement with drugs may result from peer pressure, drug availability or other risk factors in an individual's social or family environment. Subsequent escalation to and maintenance of higher levels of drug use is likely to result from biological, psychological or psychiatric characteristics of the individual user. In some cases, vulnerability may be inherited in the form of heightened susceptibility to a certain type of drug. In most cases, however, escalation will be caused by psychological traits or psychiatric conditions, some of which may also be inherited.

Recent scientific research shows that characteristics of the individual, rather than of the drug, play a dominant role in vulnerability to drug abuse. The social and psychological maladjustment that characterizes most frequent drug abusers precedes the first drug use.4 One study that tracked children from an early age to adulthood identified predictors of future serious drug use that could be identified in children's behavior as early as age seven. 5

Although psychoactive drugs do have potent addictive properties, addiction does not follow automatically from their use. Most people who experiment with drugs or even use them regularly for a while do not become abusers or develop dependence. For psychologically healthy youths, some experimentation with drugs does not normally have adverse future consequences. For others who already have some emotional or psychological problem, drug use easily becomes part of a broad pattern of self-destructive behavior.6

Poorly adjusted individuals who do not become involved with illegal drugs will often become involved with some other non-drug addictive behavior that fills the same psychological void.

A study based on a sample of 20,291 individuals drawn from the community at large found that more than half of those who met the medical criteria for diagnosis as drug abusers also suffered from one or more mental disorders at some point during their lifetime. This included 28% with anxiety disorders, 26% with mood disorders (depression), 18% with antisocial personality disorder, and 7% with schizophrenia. Some had multiple disorders. The prevalence of mental disorders varied with the drug being abused, ranging from 50% of marijuana abusers to 76% of those who abused cocaine. Almost half of the drug abusers also suffered from alcohol abuse at some point during their lifetime.7

Note the bolded parts. I have blogged every one of those points well before they became common knowledge. Every single one.

Just to give one example: food, sex, and exercise junkies:

Big Mac Heroin Attack

You can go through some of my other articles on the nature of addiction at Drug War Articles. Or look at my sidebar under "Drug War" or "Addiction" in the list of topics.

Here is a book on the subject:

The Science of Addiction: From Neurobiology to Treatment

Here is what one reviewer said about the book:

First, let me say that I am a doctor specializing in alcohol and drug studies and the author of over a hundred publications so I have a good perspective of science books, etc. In a sentence, Carl Erickson's book, The Science of Addiction is one of the best books ever published on the subject. Anyone in the field of addiction medicine (e.g., physicians, psychologists, drug/alcohol counselors) or with a personal or other professional interest in addiction will learn from this book. While a bit more advanced than Drugs The Brain and Behavior: The Pharmacology of Abuse and Dependence, by the same author, it is still very readable, fully referenced and current. Two thumbs up to Dr. Erickson.

The question in my mind is: what is so special about illegal drug use/abuse? We don't go after alcoholics unless they are harming others. We certainly don't legally persecute food addicts. Exercise addicts? Not even on the radar.

The one thing I can think of is that there is a LOT of money in the persecution of illegal drug users. Which reminds me of another book I can personally highly recommend.

Drug Warriors and Their Prey: From Police Power to Police State
I wrote a review of that book a while back: How To Put An End To Drug Users. Just in case you are interested in a preview of the contents.

H/T Drug Policy Forum of Texas

Cross Posted at Classical Values

Cheaper And Easier To Find

The Charlotte Observer has a story about a new way to herd junkies. Interesting in and of itself. But this bit really caught my eye:

When officers knocked on Ross' door Thursday afternoon, dogs started barking before the door opened.

"Are you a heroin user, sir?" an officer asked.

"I used to be," said Ross.

Ross, 30, who didn't want his last name published to protect his identity, said a girlfriend introduced him to the drug. He was already on painkillers, but heroin was cheaper and easier to find.

Some one care to tell me again how well drug prohibition is doing in keeping drugs away from people who want them?

Pot is easier for kids to get than beer. How is that possible? In theory pot is impossible to get and beer is only restricted.

America is a nation of law breakers. It puts limits on what government can actually accomplish. I like that. Politicians and crusaders need to keep in mind that without 99%+ voluntary compliance laws are in effect unenforceable. And in some cases not even 99%+ is enough.

I do find the faith in government guns as a viable solution to social problems interesting. It always starts out with turn the guns on the other guy and then goes bad from there. And always the refrain "This time it will be different." Yeah. Right.

H/T Drug Policy Forum of Texas

Cross Posted at Classical Values

Putting A Dent In Religion

Alan W. Bock writing in the Orange County Register has some interesting things to say about how decriminalization in Portugal is going.

Since decriminalization lifetime prevalence rates (any consumption over a lifetime) have decreased, especially for the critical adolescent-young-adult population cohort. For 13-15-year-olds the rate decreased from 14.1 percent in 2001 to 10.6 percent in 2006. For 16-18-year-olds, the lifetime prevalence rate, which had increased from 14.1 percent in 1995 to 27.6 percent in 2001, fell to 21.6 percent in 2006. Perhaps most significantly, heroin use, which officials felt was the most socially destructive drug, fell from 2.5 percent to 1.8 percent from 1999-2005.

The number of drug-related HIV and AIDS cases has declined substantially every year, as have Hepatitis B and C infections and drug-related mortality rates.

When compared with the rest of the EU, usage rates in Portugal, which had been among the highest in Europe, are now among the lowest. Portugal now has the lowest lifetime prevalence for cannabis (marijuana) usage in Europe, 8.2 percent, while in Europe generally it is 25 percent. Portugal has a lifetime rate of 1.6 percent for cocaine, compared to 4 percent for Europe generally.

For whatever bundle of reasons, we should start getting accustomed to the idea that harsh anti-drugs laws are often correlated with a worsening of drug problems and decriminalization with bringing them into manageable bounds. Mr. Greenwald cites a 2008 survey of 17 countries showing that the U.S. had by far the highest level of cocaine use over a lifetime (16.2 percent to second-place New Zealand's 4.3 percent) and the highest level of cannabis use. As Greenwald writes, "stringent criminalization laws do not produce lower drug usage, and some data suggest the opposite may be true."

There appear to be second order effects of prohibition (profit to dealers - forbidden fruit) that overwhelm the first order effects such as punishment. It happens.

Mexico recently decriminalized small amounts of most drugs. Alan has some comments on that.

I would add that Mexico makes no provision for acquisition of drugs, which is likely to leave the black market largely undisturbed and still powerful. Decriminalization combined with a determination to end trafficking can leave users still dependent on the black market – as is still the case for all too many medical patients in California. The way to undermine a black market is to allow a white market to emerge.

Nonetheless, Mexico's move, combined with a court decision in Argentina last week that will have a similar impact on small-time users, has the potential to put a significant dent in the religion of prohibitionism. Now if we can just get politicians in the U.S. to pay attention.

Prohibitionism is a faith based on the idea that prohibiting substance abuse and the substances associated with it will lower the incidence of abuse at relatively low cost. It happens with all faiths, if the disconnect from reality is severe the faith loses ground. As with most sincerely held beliefs - it is the youth who see the Emperor Without Clothes first. After that it is just a matter of the faithful dying off.

H/T Drug Policy Forum of Texas

Cross Posted at Classical Values

Passing The Smell Test

Anxiety Insights reports that the inability to identify odors may be an indication of severe PTSD.

A world first study of Vietnam veterans' sense of smell has revealed that an inability to identify smells indicates extreme symptoms of Post Traumatic Stress Disorder (PTSD).

Researchers from the University of Melbourne and Austin Health conducting smell tests on 31 male war veterans with PTSD, recruited from Austin Health's Veterans Psychiatry Unit.

"The worse their ability to be able to name a smell, in a smell test of over 40 'scratch and sniff' odors, the harder it is to manage their emotions," said John Dileo of the University's School of Behavioral Science, who conducted the study.

Dileo says that the difficulty Vietnam veterans suffering PTSD have in putting the name to a smell may be indicative of weakness in brain pathways related to emotional processing. He says the same areas in the frontal region of the brain that are involved in identifying smells are also involved in regulating emotion.

Of course a sample size of 31 is not very definitive. It is about the smallest sample size where Gaussian statistics apply. The results are interesting and definitely warrant a larger study.

There is a connection between the amygdala, smell, and memory.

Here is something I wrote a while back on the connection between the amygdala, PTSD, and fear memories. PTSD and the Endocannabinoid System. Here is one about PTSD Pot Alcohol & Substance Abuse.

We are really closing in on PTSD. I think a time will come when we realize the utter stupidity of making war on the self medicating.

Cross Posted at Classical Values

The Pain In The Brain

I just learned somethin new today abou pain. What I learned is that Arthritis pain is processed in the brain's 'fear center'.

Researchers at The University of Manchester have discovered that arthritis pain, unlike that induced as part of an experiment, is processed in the parts of the brain concerned with emotions and fear.

So repeated pain trains you. It causes your experience of pain to be more painful. Which is a good thing since it will tend to reduce the stress on the areas in pain. The more it hurts the less you use it.

"We thought that arthritic and acute experimental pain would be processed within the same areas of the pain matrix," Dr Kulkarni continued. "But, although both activated both the medial and lateral pain systems, arthritic pain prompted increased activity in the cingulate cortex, thalamus and amygdale within the medial system - the areas concerned with processing fear, emotions and aversive conditioning.

"This suggests that arthritic pain has more emotional salience than experimental pain for these patients, which is consistent with the unpleasantness scores they themselves gave. The increased activity in the areas associated with aversive conditioning, reward and fear, which are less commonly activated during experimental pain, suggests they might be processing fear of further injury and disability associated with the arthritic pain."

This is very important because I think fear, if it reaches a high enough level, is experienced as pain. On top of that it is likely that extreme fear memories can be experienced as pain as well.

Which points out something another study looks at. Fear memories are at the heart of PTSD as I discussed in PTSD and the Endocannabinoid System. One of the keys tying this all together is this study: Fear memories, the amygdala, and the CB1 receptor. It turns out that cannabinoids are a part of this signaling mechanism and that the strength of the signal is in part genetically determined.

All this corroborates what I have been saying for years. The idea that "drugs cause addiction" is superstition. People in chronic pain chronically take drugs for pain relief. It doesn't matter if the pain is from a broken bone or rape memories. The same drugs work to provide relief.

The drug war is a persecution of people in pain.

Cross Posted at Classical Values and at The Astute Bloggers

Alcohol Eases Anxiety

I have been looking for this information for a long time. Alcohol in large enough quantities is a depressant. However used in moderation it has anti-anxiety effects. Similar to anti-depressants.

Alcohol is a drug, but for many people it's also a tool.

Many people have a drink or two from time to time to feel more comfortable and relaxed.

Dr. James Bolton, a psychiatrist at Health Sciences Centre and an associate professor at the University of Manitoba, said the use of alcohol as a sort of social lubricant is nothing new.

"Alcohol is the oldest anxiety remedy known. People drink because it works," he said.

"For most people, enjoying a few alcoholic beverages as a social lubricant is fine. It's people who have anxiety disorders or other mental illnesses who are at risk."

Bolton was one of the authors of a recent paper involving people with anxiety disorders who self-medicate with alcohol.

They are more likely to use alcohol as a social lubricant and more likely to run into problems with drinking, he said.

"People use alcohol with the intention of relieving anxiety, but unfortunately the effects of alcohol seem to worsen the symptoms of anxiety and actually lead to other problems with mental illness," said Bolton.

After drinking, people who self-medicate with alcohol often feel even worse, said Bolton.

"The withdrawal effect the next day leaves people more anxious," he said. "What seems to happen over the long term with chronic alcohol use is that people have elevated rates of anxiety."

So the anti-anxiety effects are immediate and the depression doesn't set in until later and long term use as an anti-anxiety medication can lead to a worse psychological state.

Is there something better out there? You bet.

WASHINGTON, Oct. 13, 2005 (UPI) -- Scientists said Thursday that marijuana appears to promote the development of new brain cells in rats and have anti-anxiety and anti-depressant effects, a finding that could have an impact on the national debate over medical uses of the drug.

Other illegal and legal drugs, including opiates, alcohol, nicotine and cocaine, have been shown to suppress the formation of new brain cells when used chronically, but marijuana's effect on that process was uncertain.

Now, a team led by Xia Zhang of the department of psychiatry at the University of Saskatchewan in Saskatoon may have found evidence the drug spurs new brain cells to form in a region of the brain called the hippocampus, and this in turn reduces anxiety and depression.

Marijuana appears "to be the only illicit drug whose capacity to produce increased ... neurons is positively correlated with its (anti-anxiety) and anti-depressant-like effects," Zhang and colleagues wrote in the November issue of the Journal of Clinical Investigation.

Well what do you know? Marrijuana has positive short and long term effects when it comes to treating anxiety. I also looked at the issue in Brain Growth.

In the aftermath of the American Civil War alcohol was considered an acceptable drug for treating PTSD (although it didn't have a name back then). I covered that in The Soldiers Disease. Typically we used anti-depressants these days although some doctors think Cannabis is the Best Medicine.

H/T Anxiety Insights

Will The Real Cause Of Addiction Please Stand Up?

I just got a comment on my piece Capitalism, Pain, and The War On Drugs. My commenter is long on ignorance and short on facts.

First of all, in order to prove that drug addiction is inherited, one would need to identify the gene responsible. So much for that theory. My opinion: bullshit.

Some of the genes have been identified. You can read about them: Genetic Discrimination Note that I wrote that in Dec of '05. We know more now than we did then.

In addition the NIDA says Addiction Is A Genetic Disease.

So right away you are on weak ground. i.e. the government says you are full of it.

Second, just because people with problems tend to have drug problems says nothing about drugs themselves.Logic is not commutative, unless one is willing to assume that cause and effect are interchangeable. Then again, conservatives often rely on religious mysticism for intellectual guidance, to the chagrin of physicists around the globe.

Funny thing is, I was a physics major in college and spent a major portion of my career as an aerospace engineer. One step short of rocket scientist.

The NIDA says that besides genetics there is some kind of envionmental trigger. I believe that trigger is trauma. I cover that in Heroin.

Third, PTSD is such a novel concept that there is no reliable information about it, never mind a genetic test for susceptibility to it.

PTSD is not a nebulous concept. It is about fear memories. Here is a study on the subject: Fear memories, the amygdala, and the CB1 receptor done at the Max Planck Institute in Germany.

Further we have research by the discoverer of the CB1 receptor, Dr. Raphael Mechoulam, that looks at PTSD and the Endocannabinoid System and explains the applicability of the mice studies to humans.

In addition a genetic test is being developed for PTSD by the very same discoverer of the CB1 receptor: A Test For PTSD.

Fourth, most 'graduates' of AA go on to become responsible social drinkers. Some day I must find out how they managed to alter their genomes. Did asking Christ into their hearts do it?

Well no. It is actually explained by Fear memories, the amygdala, and the CB1 receptor. Fear memories decay over time. The rate of decay is variable and is genetically dependent. No need to go to AA meetings or asking Christ into your heart. Just wait and try to keep youself comfortable while the fear memories decline. (Any way I'm pretty much Jewish and claim that you only need to go to the head man, but that is a minor theological dispute.) The science is out there for any one truly interested in the subject. It amazes me that with research so easy in these internet days so few people avail themselves of the opportunity.

Finally our friendly commenter finishes with:

But then, I am just a radical lefty liberal, with no credibility, so go ahead and ignore me.

I will assume you are correct in your self description - radical lefty liberal. I also agree that you have no credibility. However, you are not being ignored. Just ridiculed for you ignorance. As usual for a lefty you are weak on science, strong on opinion, and unwilling to put your name (not even a pseudonym) next to your opinions. My condolences.

Childhood Trauma Leads To Depression

Anxiety Insights has a post up about childhood trauma and its relation to depression.

Childhood trauma, but not adult trauma, is strongly associated with depression and coronary heart disease in adulthood, say Emory University researchers and colleagues presenting at the American Psychosomatic Society Annual Meeting, being held March 7-10 in Budapest, Hungary.

"Little is known about the long-term emotional and physical consequences of childhood trauma and whether it poses greater long-term health risks than other types of stressors," says study leader Viola Vaccarino, MD, PhD, professor of medicine (cardiology) at Emory University School of Medicine and professor of epidemiology at Emory's Rollins School of Public Health.

"Trauma occurring earlier in life is particularly harmful because it may disrupt the development of adaptive responses to stress. Future research on stress and disease should focus on early life stress," says Dr. Vaccarino.

Child abuse is one of the most pressing problems we have in the world because it leads to all kinds of maladaptive behavior and can also lead to illegal drug use as a form of self medication.

According to the study results, twins in the highest quartile of the Early Trauma Inventory were twice as likely to have major depressive disorder than other twins. Of the childhood traumas, emotional trauma was the most strongly associated with major depressive disorder.

Study participants with childhood trauma were also more likely to be exposed to trauma as adults and to develop post traumatic stress disorder. After adjusting for smoking, twins in the highest group on the inventory were two to three times more likely to have a previous diagnosis of coronary heart disease, including previous myocardial infarction, coronary revascularization and hospitalizations for coronary heart disease.

In contrast, no significant associations were found for adult general trauma and combat trauma with either major depressive disorder or coronary heart disease, notes Dr. Vaccarino.

Tobacco is an anti-depressant. So is cannabis.

We are wasting untold billions every year fighting drugs when we should be dealing with the root cause - child abuse.

Scam

We are being scammed big time by the "drug abuse" industry.

People take drugs for otherwise untreated medical problems.

Rich folks go to their doctors for their anti-anxiety medicine. Poor people buy a dime bag. In fact some rich folks are now saying - for me the dime bag works better. Fewer side effects. Easier to calibrate the dose.

Or take tobacco. It is an anti-depressant. Do we deal with it that, and look at the underlying depression? No. We treat them like the addicts they are and punish them accordingly.

Deep inside every man is a screaming monkey trying to get out. Civilization quiets the monkey. Wine and good cigars. And what ever else you need. Including hope. Even if it comes out of a bottle. Or a baggie.

More Vindication

It has been my contention for the last three years that what we call drug abuse is self medication for pain/anxiety. It turns out that independent (of the government) research is beginning to confirm what I teased out of the limited information available to me three years ago on the subject.

The research Cannabis Use in Adolescence: Self-Medication for Anxiety was done by Dr. Tom O'Connell, a long time opponent of prohibition.

Dr. O'Connell is mostly interested in general social factors that predispose adolescents to drug use. The most important factor he found was a missing or ineffective father.

In attempting to determine the origin of the symptoms motivating this population’s aggressive adolescent drug sampling, the most obvious place to start was family background. A common element was the absence of their biological fathers from their early lives —either physically, through early death or divorce, or emotionally, through a variety of other mechanisms...

He goes on to look at school careers as another determining factor. He sees a lot of ADD and ADHD. One thing he mentions early on is that the boys outnumber the girls in his practce (where he interviewd the kids) by a
4 to 1 ratio.

His study looked at the substitution effect. The replacement of tobacco and alcohol with cannabis. (Do you suppose this is why the alcohol companies are so heavily invested in the drug war? And the tobacco companies before they became an embarassment?)

Repeat use of both alcohol and tobacco tended to be aggressive. More than half had binged in high school or as young adults; 35% had experienced alcohol black-outs; and 12.5% had received DUI citations. Yet essentially all who have continued to use cannabis on a regular basis subsequently moderated their alcohol consumption. Few are teetotalers, but nearly all who still drink do so moderately. Most have reduced alcohol consumption to 20% of their peak levels —or less.

Cannabis also has enabled patients to reduce tobacco use. Although 68.1% of cannabis applicants became daily cigarette smokers for a while, over half (53%) of the smokers have since been able to quit and almost all the rest are trying. Even inveterate tobacco smokers (those unable to remain abstinent) uniformly relate their cigarette consumption to both stress and access to cannabis: when the former is high and the latter is low, they tend to smoke a lot more tobacco.

There are three important points I think the doctor has left out of his study. Child abuse, PTSD, and genetics. I cover child abuse and PTSD in Police and PTSD. I cover genetics in Genetic Discrimination.

He has a few thing to say about the government's interest in this type of research. It explains a number of things including why big pharma is heavily invested in the drug war.

Evidence that cannabis is capable of benignly and effectively palliating the psychotropic symptom complexes so often encountered in juveniles and young adults was clearly beyond the scope of any research funded— or even permitted— by NIDA. That such symptoms tend to persist into mid-life for many who suffer from them is now endorsed in psychiatric literature and has spurred development of a host of pharmaceuticals intended to treat them. Yet most of applicants for whom these pharmaceuticals were prescribed report that cannabis provides more effective and durable relief.

This is very interesting because I said someting similar three years ago in Addiction or Self Medication?:

It turns out that anxiety disorders are the most common mental health problem in the United States. They are worth $46 billion a year to the pharmaceutical industry. You don't suppose this fact has any thing to do with the pharmaceutical industries being in the forefront of the Drug Free America campaign do you? Of course not. They are just trying to keep you from being addicted to natural products at the cost of 1/10th of a cent per dose when they are more than willing to sell you an FDA and doctor approved, pharmacy sold product that will do the job for a dollar a dose. They have only your best interests at heart. Just ask their accountants.

Dr. OConnell summarises his work this way:

Proposition 215 encouraged many individuals who had been considered “recreational” users of cannabis to apply for “medical” status. Interviews placing their cannabis use in broader context showed that it is frequently an alternative to the use of alcohol, tobacco, and “harder” drugs.

The federal government, by imposing a Prohibition based on biased, inadequate studies, is depriving the American people of a safe and effective medicine.

Beyond that concern, the increasing enthusiasm for drug testing and punishing those who test positive for cannabis wth either criminal or social sanctions is destructive to the large —but at this writing unknown —number of Americans treating emotional symptoms with what may be, for them, the best agent available.

Dr. O'Connell also thinks that even anti-prohibitionists are not acknowledging the anxiety factors and that all use may in some sense be medicinal:

Data from the author's practice show that many Californians use cannabis to treat emotional conditions. Government studies obscure this reality and some reformers seem reluctant to acknowledge it.

There are a lot of interests working together to keep pot illegal. I think as the science gets better known they will not stand.