It's been over nine years since California voters endorsed the concept of 'medical' "marijuana" (therapeutic use of cannabis). Thus two different drug czars have had to contend with the shocking idea that a plant used medicinally in the East- possibly, as long as five thousand years before its 'discovery' in 1839-  then  by Western physicians for another hundred years before it was banned by a know-nothing US Congress (1937-- might actually be a safe and effective medicine.

Czar number one, Barry McCaffrey,  was prevented by injunction from punishing physicians for merely discussing cannabis with their patients. Later; frustrated by the IOM report he'd paid for-  he jumped all over the its placatory emphasis on the dangers of smoking. Who ever heard of a "medicine" that has to be smoked, McCzar asked rhetorically. His predecessor, John Walters, who seems even more reactionary and less informed than McCaffrey, was all over the "smoking" argument soon after taking office. His medical advisor, Andrea Barthwell, went on a junket to condemn the absurdity of "smoked  medicine" just before being briefly hired away from federal service- first by commercial interests touting a different route of cannabinoid ingestion (and a different axe to grind)- and then an even briefer exploration of a Senate nomination.

Back to the smoking controversy: neither czar had apparently heard about the relatively new technique of "vaporizing" cannabinoids to permit their safer inhalation. I'm not surprised;  because before I began screening patients in 2001 I hadn't either. Despite a heightened awareness since then, I have yet to see any reference to vaporization in either the popular press or peer reviewed literature. I've also been quizzing applicants on what they knew about it and continue to find that nearly all first timers- including those who've been using pot for years- are still very ignorant. Even those who'd heard something are relatively uninformed: the most common guess of the few who had heard about it is that it's a "safer way to smoke."

One would think the drug czar's office would be on the same page as the DEA on pot issues- and that both would have heard of vaporization in the past nine years; especially since the DEA has been busy blocking a responsible request by a researcher to grow enough high grade cannabis for a credible study on vaporization. Of course, such hypocrisy is of little surprise to anyone familiar with the the way the feds do things; it's just that they  are usually a little less obviously hypocritical.

Which brings me, in roundabout fashion,  to my main point- not that 'reformers' wear white hats and the feds wear black- but that all humans seem to exhibit two major characteristics: a need to compete and a willingness to cheat when they think they can get away with it. Both the DEA and ONDCP rely on the ignorance of the mainstream media and their relative unwillingness to embarrass the drug war; thus their hypocrisy is both safe and deniable.  Even worse for 'reform' is that while it isn't clear whether Walters' ignorance of vaporization is real or feigned, neither possibility is very hopeful for their political cause.

From my better informed (and even more ignored) vantage point, I realize that 'reform's' behavior confronts me with exactly the same dilemma: are they that cynical, or do they really believe; that s__t?

The subject of vaporization-- and of the critical role played the varying ways pot can be ingested-- will be explored in considerably more detail in the near future.

Tom O'Connell MD

Posted by tjeffo at December 7, 2005 11:30 PM

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