Is Medical Malpractice Even Possible for California’s Marijuana Docs?

A physician friend who supports medical marijuana got a shock as he walked through Venice Beach. A young man in a tee shirt and gym shorts rollerbladed up to him and chirped with alacrity “Hi, I am kush doctor! Would you like to come over to my clinic and get a prescription for medical marijuana”?

We have many such skilled practitioners in California. As a cash only business without any meaningful oversight, a medical marijuana practice is a dream come true for those who graduated at the bottom of medical school. It’s also a godsend to doctors who are one jump ahead of being struck off by the licensing board.

My physician friend, who is from Rhode Island, says that his state is actually trying to regulate medical marijuana, like, well, medicine. I haven’t seen their set up so I can’t say how credible it is. But I can say with certainty that medical marijuana malpractice is virtually impossible in the Golden State.

Many Californians who voted for medical marijuana thought they were being promised a tightly run system that provided cannabis to a small number of cancer and AIDS patients. Such people feel conned today, for the very good reason that they were. But now that a deep-pocketed industry with lobbyists has been created to supply recreational users under medical cover, it probably will not become regulated in a serious fashion.

On the other hand, Arizona is known for its tough, let-God-sort-‘em-out approach to law enforcement. One of its pot docs failed to conduct a required medical history and then lied about it on the certification form. Since he did it 483 times, it is unsurprising that the steely-eyed descendants of the lawmen of Tombstone lowered the boom. They sent the miscreant the dreaded letter of reprimand.

That’ll learn ‘em.

Comments

  1. politicalfootball says

    I’m not seeing the downside here. It’s probably best that these doctors not be entrusted with serious responsibility, and dealing pot seems like a socially productive way for sketchy physicians to make a living.

    True enough, the voters were conned, but the law can always be repealed if it leads to undesirable consequences. And if we actually were going to start repealing laws just because they involved a con job on voters, this case seems like a low priority on a long list. Personally, I’d start with AUMF.

    • MobiusKlein says

      Conned?
      I think voters knew there would be use by non-ill folks. I certainly did.
      If some pot users AND some AIDS patients both get to use it, it’s not such a bad thing, in my mind.

      The DRUGWAR aspect of it all makes it impossible to regulate, since the feds blow any regulations to dust.

  2. Ed Whitney says

    When medical marijuana was being proposed in California back in the 1990s, some of the strongest proponents were oncologists and other medical subspecialties whose patients suffered from intractable pain. I am wondering about the data on the distribution of prescribing practices among physicians in states where medical marijuana is legal. I have heard that X percent of the medical marijuana certificates are written by Y percent of licensed doctors, where X is a large number and Y is a small number. But I am curious about the numbers broken down by specialty.

    Is there a web site that you can suggest to find this information in a reliable form?

  3. SamChevre says

    What is it about medical marijuana (or the California law) that makes regulation so difficult?

    It’s not clear to me why getting legal opiates (and effective management, like amphetamine co-prescribed) is so difficult for chronic pain patients, and getting medical marijuana is so easy for people with no obvious illnesses. It seems that there should be a middle ground.

    • Katja says

      SamChevre: What is it about medical marijuana (or the California law) that makes regulation so difficult?

      Presumably that the law was enacted by voter initiative, tying the hands of the legislature.

      • Keith Humphreys says

        SamChevre: In addition to what Katja said, another factor is that there are a number of people (see a number of the comments on this thread) who oppose any regulation, even though they had put forward marijuana as a medicine, which implies that it would be regulated. Hypocrisy is obviously not new…but I am comfortable calling it out nonetheless.

        • John Beaty says

          There is no hypocricy in thinking that marijuana is useful as a medicine and should be available as such, and that it should be legalized. Like aspirin, for one other example.

  4. says

    The lesson to be taken here is that despite widespread abuse of the system and people being given marijuana who maybe didn’t actually need it medically, there are no bodies and the sky hasn’t fallen, despite all the reefer madness doomsaying promoted by our government for decades.

    And yes, people who voted for medical marijuana may feel conned by the fact that some of the people getting medical marijuana aren’t sick (which still doesn’t negate the value for those who are), but a great larger number are having their eyes opened to the bigger con – the marijuana boogie-man – that has been perpetrated on them by charlatans from Anslinger to Kerlikowske. They’re starting to ask why marijuana is illegal in the first place. And that’s a good thing.

    • MobiusKlein says

      Even as a 216 supporter, I do want to know the downsides. Yes, sky has not fallen. However, are there less severe problems? Has increased access to pot increased teen use? There is something between boogie man and mostly harmless.

      • Jamie says

        I, too, am curious about downsides other than pushy marginal doctors.

        I just moved back to California after being away for most of the time the cannabis market developed. The only downside that I’m seeing is that the dominant strain of pot sold seems to be the stinky kind, which I smell sometimes on the street (and occasionally wafts into my apartment). Smells like a skunk. But I have to put up with car exhaust, too.

        Anyone know of actual harm? Higher crime, accidents, healthcare outcomes that changed, that sort of thing?

        • MobiusKlein says

          Would asthma or other lung diseases be a reason to eschew prescribing smoking M.J.?
          I expect that a sham doctor would not take such issues into account, leading to harm.

          This does assume the person would not use M.J. otherwise, and is using it to treat an actual condition.

  5. Dan says

    Yeah let’s lead all of these posts with a description of the damage done by medical marijuana from now on. I don’t think one of them has contained that inf.

  6. Mark Kleiman says

    The villain of this piece is John Ashcroft, who as Attorney General under W tried to take away the DEA registration of any physician who wrote a medical marijuana recommendation. The Supreme Court, properly, struck that down. As a result, the “herbal recommendationists” are, as a practical matter, exempt from losing their registrations, as “pill mill” docs routinely do. Still, there’s no reason the CA medical board shouldn’t take action.

    • NCG says

      I have no doubt that there may be many many “wink-wink” scenarios being played. I worry more though about people in real pain who can’t get relief — of other kinds besides m.j. — because their doctor is afraid of the feds. It seems to me that doctors should do their best to treat their patients appropriately, but I don’t expect them to be mindreaders. Patients shouldn’t lie.

      I agree though that the Medical Board should deal with problems, not prosecutors, caused by those few problem doctors.

  7. Martin L. Morgan says

    What a horrifying tragedy for our nation! Let the righteous never sleep as long as citizens in California are smoking weed. Onward!

  8. JMG says

    Yes, far better that these bottom tier docs practice in prisons and the military as god intended, right?

    Of course lies in a relationship are damaging and lead to other lies and corrode the relationship. But expecting one party in the dysfunction, the docs and the dopesters, to be paragons of rectitude with a counterparty, the govt, who is insane on matters involving pot, is like expecting domestic abuse victims to not suffer any problems stemming from the abuse.

    We seem to have reached the point where the original sin of slavery and the great compromise needed to sustain it, the senate with its “you can’t amend us out” provision is going to destroy us, as states like California are ruled by corporate fiefdoms like Wyoming and the Dakotas, and the tension is building that seems likely to lead to rupture.

  9. Frank says

    I think this is such a minor, minor issue, not only in terms of drug policy, but how physicians are regulated in the US.

    It is well know that physicians and state-AMA boards are very, very heistant to engage in discplinary action against their own, much less so than attorneys and other professions. Medical and dental boards are very hesitant to discipline their own for strident fraud and unnecessary medical procedures on patients. One could argue that 20% of dental procedures are unnecassry. And states are very heistant to go against fraud by these two professional groups…

    Doctors writing potekim prescriptions for something relatively minor in harm should be one of our least worries.

    • Katja says

      And yet, that is the problem here, isn’t it? The intersection of medical ethics and California’s marijuana laws, I mean.

      Doctors aren’t just businessmen who happen to wear white coats instead of suits. They have a canon of medical ethics to follow that goes a bit beyond what we require of used car salesmen. In particular, there is a certain degree of incompatibility between the concepts of “relatively minor in harm” and “first, do no harm”.

      That this doesn’t always work doesn’t mean that we should just discard medical ethics entirely. Throwing something out entirely is a rather Procrustean approach to reform.

      No matter what you think about the legalization of soft drugs, turning medical practices into points of sale for marijuana does not strike me as a good way to go about it, if only because of the potential lasting harm to the medical profession.

      • Martin L. Morgan says

        “turning medical practices into points of sale”

        I will try to debate this with the legions of pharmaceutical salespeople milling about next time I’m idling in the waiting room.

        • MobiusKlein says

          Don’t be dense. Many M.M dispensaries have armed guards milling about. Understandable given the amount of cash and valuable commodities in place. That is quite different from pharmaceutical salespeople in the office.

          (note I said different, not that one is ok, the other is bad.)

  10. says

    So pot users pulled a con to make their lives a little easier. And some doctors are playing along for a fast buck.

    Maybe it would have been more honorable for those pot users to have started an academic blog instead. Or wrote a book. Or lobbied their elected officials. But those methods have not proved very effective over decades of harmful and irrational drug war.

    I say more power to them. Better this than what we had.

    Also, the drug war is a con, too. The pot users pulled their con to mitigate the harm of another con.

    • Keith Humphreys says

      clark: So pot users pulled a con to make their lives a little easier. And some doctors are playing along for a fast buck.

      I sincerely appreciate your candor, and wish it were more prevalent.

      • says

        Thanks… I think. And I sincerely appreciate your faithfulness to facts and reason, and wish that facts and reason played a more substantial role in this and other public policy debates.

        I can afford candor. You can afford candor. Regular folks who smoke pot must lie about it, hide their behavior from government officials and police, and wouldn’t dare to expose themselves by engaging in public disourse about it.

  11. Warren Terra says

    I support the legalization of recreational marijuana. But the “Medical Marijuana” farce is an insult to the integrity of nearly everyone involved, an insult to the idea of proper medicine, and an invitation to hypocrisy and dishonesty. I live in California, and so I am perfectly aware that as a middle-class person I can arrange to get pot legally under state law for a modest fee in dollars and a higher price in my integrity. Although I would like to enjoy pot, safely and responsibly, I refuse to do this, partly because I will neither lie nor reward a professional liar and partly because I fear what this whole campaign for “medical marijuana” does to Medicine. Yes, there are people with complaints poorly handled otherwise who are assisted by marijuana. Yes, they should have access to it (so should every adult!). But we are subjected to an overwhelming stream of hooey and self-interested credulity and even deliberate lies that we would rightly denounce if it came from faith healers or from homeopaths. We should not tolerate the dishonesty and the nonsense just because the goal of broader access to a mild intoxicant is a worthy one.

    • Keith Humphreys says

      Warren Terra: I admire your integrity, and wish it were more widespread (the number of people endorsing lying is disheartening). If the goal of the medical marijuana initiative was actually recreational marijuana, then that should have been on the ballot in 1996 (of course it later was in Prop 19, but that lost). At least the current Washington State initiative is honest and will allow voters to decide with full information, which is how it should be in a democracy.

      • says

        The Proposition 215* question isn’t as simple as recreational pot under the guise of medical marijuana. Some of those who backed it sincerely wanted both. It’s no coincidence medical marijuana began in the state hardest hit by AIDS. Marijuana’s usefulness in helping AIDS patients was, I think, the key point. The murderous behavior of the federal government during the early years of the AIDS crisis led to an underground network for bringing AIDS medicines available only in other countries into the United States. In that context, why not medical marijuana too?

        Had the prohibitionist forces not forfeited much of their credibility (more on that in a moment), perhaps their accurate claim that Proposition 215 would lead to effectively legal marijuana would have been taken more seriously. It was entirely possible to find Proposition 215 backers who said the same thing. The law as written was so loose that anyone paying attention could have seen that would be the result. As the drug debate had been for many, many years, this was a campaign of propaganda rather than reason, but this time the authorities were out-propagandized.

        And that’s why I’m uncomfortable with the medical marijuana movement, as well as why I’m nonetheless willing to accept it.

        The lying started on the side of the prohibitionists, who were very well-funded and had the force and authority of law behind them. (It’s taken decades to kill the “pot makes boys grow breasts” story, even though the one anecdotal report was retracted within a year of its publication.) I have a hard time condemning fighting liars with lies, especially when the original liars are the ones who are more powerful, who have more authority, and who are (in my opinion) doing the majority of the harm. I don’t object to Obama having a PAC either, on similar grounds.

        I don’t approve of lying, but it’s not the only sin, and in this specific set of circumstances, I think it’s justified** but still wrong, for the reasons I gave above and for one other: The lesser lie of medical marijuana has led to a situation in which the truth will out.

        De facto legalized marijuana use in California provides a pretty good test case for determining the facts of the matter. Whether marijuana is as harmless as its advocates claim or is as dangerous as those who would prohibit it claim, California’s experience should be able to settle the matter. My suspicion is that it will be proven to be somewhat more harmful than its advocates believe but not nearly so harmful that it should not be legalized–which I hope happens quickly so that momentum does not build for the legalization of hard drugs, which would be a tragedy.

        The case against hard drugs*** is factually sound, yet its credibility is reduced every time it is yoked with the continued criminalization of marijuana. Is there compelling research**** that shows de facto legalized marijuana, and the increased recreational use I assume that brings, has brought about significant harm in California? If not, then perhaps it is time for those who generally oppose drug use yet are not hard-core “screw you, hippie!” culture warriors to accept their losses and move on to more important questions.

        I am uncomfortable justifying any lie, even under the circumstances I outline above. Though I believe marijuana should be legal but lightly***** regulated, and though I believe the medical marijuana movement is achieving that, I have not been able to bring myself to actively advocate it. I’ve stuck with what I believe: That there are some risks to the enjoyment of marijuana, that it should be legal for recreational use, and that there are limited but very real uses of it as medicine. Sometimes I think I’d do more good lying than telling the truth. But I don’t.

        *Let me start a trend here by getting the number right–no one else in this discussion seems to have done so.

        **Just as killing is always wrong but sometimes justified, such as when it is done in self-defense.

        ***The psychedelics are in a category all their own, both dangerous and useful in ways hard drugs are not, and I am honestly unable to come up with a policy about them I like. Perhaps they should remain illegal, and hard to acquire, like all mystical initiation, so they keep their aura of true danger. Or perhaps they should be tightly regulated and legally available only to those who are evaluated to have a low risk of a psychotic break. I incline toward the latter in theory, but theory has proven a poor guide in making drug policy and I distrust it.

        ****The absence of good large cohort studies on marijuana over the years suggests to me that those who fund drug research suspected getting the most reliable answers might conflict with getting the answers they most wanted.

        *****How lightly? Lightly enough that, over time, it is given the best possible chance to displace alcohol as the default drug of pleasure.

        • Freeman says

          John A: Great post. Thoughtful and insightful.

          As the drug debate had been for many, many years, this was a campaign of propaganda rather than reason, but this time the authorities were out-propagandized.

          Exactly. Propaganda is the number one tool used by all sides in public policy debates (Obamacare, anyone?). Authoritarians usually have a large advantage in this area, but this time they were out-done by a bunch of drug-addled hippies. I think that’s what has KH getting out his big brush to paint marijuana legalization activists as particularly dishonest. He seems to forget that the prohibition side has spent decades painting themselves with that same brush.

          (It’s taken decades to kill the “pot makes boys grow breasts” story, even though the one anecdotal report was retracted within a year of its publication.)

          But it’s true! It took almost forty years, but I’m finally starting to grow the man-boobs I was promised so long ago! I’m still a bit disappointed, though — I thought they would be perkier.

          • says

            Yes, those who opposed Obamacare were particularly crude and dishonest in their propaganda. The authoritarianism which underlies so much “libertarian” activism has a lot to answer for.

        • says

          I hope my deep ambivalence on what I consider a difficult question showed through. If I could edit that comment, I’d change one thing: Rather than saying this particular lie was “justified but still wrong”, I’d say instead it was “wrong but justified”. I really don’t like lying.

          The self-defense analogy I’d leave in, but I’d make more explicit reference to the ethics of wrong action (such as lying) under coercion.

      • Jamie says

        I guess I’m not seeing the point of the pearl clutching.

        Are people similarly up in arms over people saying particular words to their doctors about anxiety to get Valium or analogues for plane flights? But that’s an upper-middle-class thing, and we probably knew someone’s mom who had a case of the nerves, so that’s different.

        • Keith Humphreys says

          Valium was a leading cause of emergency room admissions in many U.S. cities in the 1970s, and yes there was a huge outcry, just as there is now about prescription opioids.

          • Jamie says

            My point exactly. Valium was rife with abuse. And it is still available, and present wherever someone wants it, assuming one is slightly well-off and has a health plan, or is willing to spend absurd amounts for it on dodgy websites. I know people who take way too much of it (well, related analogues) entirely legally, and under the supervision of entirely respectable doctors. I wish they would do something else to deal with stress, but ultimately, it isn’t my business.

            How many emergency room admissions, now, about pot? I’m still looking for the harm that pot is causing. We should have some numbers by now, as we do for alcohol, meth, opiods, etc. I live in San Francsico, in a not-great neighborhood, and, well, I smell it nearly every time I go to or come from work. I’m really not seeing the damage. Those folks may not be participating in debate at the Commonwealth Club, but I don’t think they are too abusive of our public services, either, and I don’t see a lot of shouting at each other, or worse. By way of comparison, I really wish the alcoholics I see on the street every day were stoners, instead. I think they would be much healthier and cause less suffering to themselves and the people who live around them.

            I’m not making a claim about substitution, just dreaming of a slightly better world.

          • Freeman says

            The ’70′s surge of Valium (ab)use had a lot to do with Vietnam and PTSD. Practically every vet I knew at the time was on it, and taking a lot. Most drank alcohol too — not a wise combination. And they always carried guns. I was always a bit worried about those guys, but I know several of them still and most of those have come through the tunnel to the light side over the years.

        • says

          My best friend’s daughter died in 2002 in large part because she was given Xanax (which I understand to be the Valium of today) as a substitute for therapy. She was under its influence when she killed herself. She was not even middle class, let alone upper class. We worked a minimum-wage job together. And yes, her needless death bothered me quite a bit. The primary responsibility is, I think, on Ronald Reagan, who destroyed the public mental health care system, but even given the constraints they operated under, her therapists were careless at best.

    • del2124 says

      Good look with that principle. Your refusal to lie is perhaps admirable in some theoretical sense, but the whole campaign to criminalize marijuana in the first place was full of lies (dope crazed Mexicans stealing your stuff and raping your women, I believe). There’s nothing to respect about the policy. The whole thing is BS; I have no problem engaging in a little BS to get around it.

  12. noseeum says

    How would malpractice be possible for a substance that can’t kill you and is still arguably only habit forming, not physically addictive? For malpractice to occur, I believe it requires “undue injury” to the patient.

    Even in the most extreme example you can find, the patient is fine, and happy, I might add. Where would malpractice come into that equation?

    Maybe there are some other laws you can pin on a doctor over prescribing pot, but without a “victim” of malpractice, you don’t have malpractice.

    • MobiusKlein says

      malpractice, if you prescribe something for the symptom (pain) without properly researching the cause.
      That back pain may actually be a growing cancer that is treatable now. But with only palliative care, becomes fatal.

      That is malpractice. It’s not over proscribing pot, it’s under treating whatever else.

      • noseeum says

        Right. So back to the question at hand, is malpractice even possible for marijuana docs? Probably not when it comes to marijuana. But it’s not the law’s fault. It’s the drug’s fault for not being deadly or addictive.

        Any doc can still cause malpractice to a patient prescribed marijuana for any other cause, like the example you cited, but it would be a very tough sell to specifically pin malpractice on the act of prescribing pot.

        But Humphries clearly seems to be saying to us in this post that not being able to find an example of malpractice for pot must be a problem rather than a basic feature of a relatively harmless drug. Shouldn’t he first state why this is a problem at all? What are the negative consequences? There are plenty to cite, like blatant flouting of the intent of a law and so forth, but they don’t seem at all related to malpractice.

        “WE CAN’T SUE FOR MALPRACTICE!!!!” Not much of a rallying cry. Seems there should be a problem identified first and malpractice ain’t it.

        • Warren Terra says

          You know that “Reply” button you pressed? It’s not a “Reiterate” button. The ideal use of the button would have been to express a considered reaction to MobiusKlein’s comment, not to ignore it completely and climb back upon the exact soapbox you had been on when MobiusKlein was so impertinent as to attempt to engage you in conversation. As MobiusKlein indicated. a terrible doctor who’s prescribing marijuana is committing malpractice because they’re being a terrible doctor, not because they’re being a terrible doctor in order to sell access to marijuana. They could prescribe sugar pills, or more traditionally good old fashioned snake oil, thereby avoiding all the various issues associated with marijuana, and they’d still be committing malpractice by taking payment in return for an “examination” in which they purport to assess a patient’s complaints and decide upon a proper course of action, when in truth they fully intend to essentially ignore anything said by the patient and give the exact prescription they give to everyone.

          • MobiusKlein says

            M.J. could be even worse than sugar pills, since it would mask the problem longer than just a placebo.

            M.M. for the pain AND corrective action for the problem is the right course.
            In fact, M.M. might not be the right drug for the pain, which would also be cause for malpractice.

          • NCG says

            Hey you two, settle down or they’ll delete your comments. I am pretty sure we are not allowed to use the “p” word, directly at anyone anyhow.

            I do think KH’s post was more directed at the idea that MM is too easy to get for people not actually sick, leading to cynicism, not that the people getting it have undiagnosed ailments that the bad doctors are missing. But, I could be wrong about that. He can speak for himself.

            My own faith in the initiative process has been abused so oft that this idea never occurred to me, so, I guess it is good he brought it up.

  13. says

    Well, it is slightly off-topic, but can’t help noting once again that the distinction between medical and non-medical uses of a drug is not clear enough to lead to significantly different consequences for users. If using a drug (including having a glass of wine) makes someone feel better or less tense, then is that a medical or a non-medical use? One of the reasons that the currently prohibited drugs should be made available for recreational use — though in some cases regulated quite strictly — is to avoid these illegitimate leaps in legal consequences.

  14. Keith Humphreys says

    All: Two different people posted gratuitous insults to others here and were deleted. I don’t know why drug policy debates have more of this kind of incivility than any other topic, but please cut it out or go elsewhere — there are plenty of websites in the world where name calling and other abuse are normative…but RBC doesn’t want to become one of them.

    • Ed Whitney says

      Even if insults are off limits, I hope it is still permissible to be a bit of a pest and ask again if you happen to have any information about the physicians who are writing the marijuana “prescriptions.” My recollection of the physician support during the ballot measures in California was of oncologists (and some AIDS docs) being some of the strongest advocates of the initiative, which provided a much needed option for palliative care medicine.

      I doubt that they account for a large proportion of the permits being issued today. They were a pretty dignified bunch and I do not remember any of them roller blading around in shorts and T-shirts hustling for patients to come to their “clinics” situated in strip malls between a pawn shop and a massage parlor.

      Any data on the distribution of specialists writing for marijuana in California or in other states? It is OK if there is not; I just hoped that an RBC person would know.

      • Keith Humphreys says

        Hi Ed

        You are not a pest. I don’t have the data, although the Arizona news story linked above notes that a small proportion of docs wrote a very large proportion of the prescriptions, which has also been the story in Montana and California. For that reason, I doubt you can learn much about your question of what is the data by medical specialties, because the cells would be too small when you cut into what is already a small number of providers.

      • says

        I must admit, I wasn’t terribly troubled by the records of the two doctors that led off the story in the Bee. The woman who got caught writing one bad set of prescriptions in a twenty-five year career is, I suspect, not out of the norm. (They wrote loricet prescriptions like candy for me at the neurosurgeon’s office–I was taken aback.) The guy with the foot fetish is problematic, but it sounds like he’s being managed responsibly. It’s hard to say about the guy with bad records management–could be anything from sloth to fraud–and the other guy is still under investigation.

        What strikes me about the three that we know about is that they sound capable of practicing medicine effectively under the appropriate supervision, though in at least one case not independently. Perhaps the problem is that they aren’t being given the right opportunities to do so?

        Or am I simply naive? That’s entirely possible, but I hate to see training and talent go to waste needlessly.

    • says

      Keith,

      I think the level of abuse is a bit of a “goes around–comes around” situation. The level of stigma directed at people who are thought to be soft on drugs is high (you should pardon the expression). It’s understandable that those who are stigmatized react poorly to those who consciously stigmatize them. I think there’s also an expectation gap. Mark in particular is, in my opinion, a voice of reason: An actual moderate on drug policy. I think reacting to that is more frustrating to some people than reacting to culture-war fundamentalism.

      On the other hand, those who have had first-hand experience with serious drug abuse–I’ve had several dear friends who’ve been consumed, or nearly so, by hard drugs–tend to be a little touchy with those who don’t seem to understand that caffeine isn’t crack or meth. I try not to be insulting to folks who don’t get that, having libertarian legalization theories (more about that in a moment) in my own past–but I do get scornful and I don’t always feel wrong to do so.

      The other factor is the extent to which opinions on drug policy are based in theory. Libertarians have a theory, not entirely grounded in reality but easy to apply to it. Without knowing nearly as much about the recovery movement, I suspect it, too, has a theory, one better grounded but still not entirely in touch. From the outside, it appears to tolerate a rather low success rate without questioning whether it might not be the only or the best possible solution to the problem. That seems unusual in such a young discipline.

      Again, I’m looking at this from the outside. Having been in the thrall of theory myself, I try to stay aware of when it captures people. Perhaps I see it where it really isn’t–I try to keep a watchful eye on my own theory about theory–but I think I’m not entirely wrong.

      • Freeman says

        On the other hand, those who have had first-hand experience with serious drug abuse–I’ve had several dear friends who’ve been consumed, or nearly so, by hard drugs–tend to be a little touchy with those who don’t seem to understand that caffeine isn’t crack or meth.

        If you’re referring to my recent comments here about caffeine (I haven’t noticed anyone else discussing it), you seem to have missed my point. It isn’t that caffeine is the same thing as crack or meth, it’s that prohibiting popular mind-altering recreational drugs has predictable effects — it matters not what the drug is. Outlaw caffeine and I think you’ll see just how similar the effects of that can be to any other prohibited drug.

        Oh, and I’ve had first-hand experience with serious drug abuse as well. My first wife died of an overdose during the height of the ’80′s cocaine epidemic. I’m certainly not a proponent of cocaine abuse, but I’ve seen first-hand that prohibition fails to prevent that and for some people (rebellious types, like the vulnerable teen and early-adult period we all go through) it can be an incentive.

        • says

          Oh, and I’ve had first-hand experience with serious drug abuse as well. My first wife died of an overdose during the height of the ’80′s cocaine epidemic.

          My generalization, based on my anecdotal experience, proves to be wrong in your case. I should have qualified it. It’s a factor you should consider in your own thinking.

          • Freeman says

            My generalization, based on my anecdotal experience, proves to be wrong in your case.

            I say, nice shot, man!

            It’s a factor you should consider in your own thinking.

            How presumptuous of you!

            The point you seem to be responding to was that prohibition — not drugs or demand for them as often attributed — causes predictable ill effects, and to illustrate I have pointed out that caffeine is a very popular mind-altering recreational drug in high demand that doesn’t cause violence in the provision of supply. I’ve always considered your comments worthy of contemplation, and continue to do so, but if you’re honestly willing to take what I said and draw from that the conclusion that I “don’t seem to understand that caffeine isn’t crack or meth”, then of course I should consider that in my thinking during such contemplation, particularly anywhere you describe what other people think and say.

            Now, I’m always open to persuasion, so if you (or anyone) can describe a plausible* scenario in which caffeine could be prohibited worldwide, vigorously enforced and prominently featured in a war on drugs for decades, without resulting in widespread non-compliance and associated (and often openly-demonstrated) disrespect for the law, a violent and absurdly lucrative black market to supply the huge demand, minors using at younger ages and dealing to other minors, higher use among adolescents and young adults wishing to impress their peers and rebelliously assert their independence, higher levels of abuse and dependency, higher rates of ER treatment, a body count of innocent collateral damage slayed by both sides of the war, out-of-control violent cartels in 3rd world supplier countries, and the rest of the long list of horrors routinely wreaked upon us all worldwide — if you can honestly do that you’ll have convinced me that my thinking could benefit from your evaluation. You’ll also have solved the drug prohibition problem. Good luck.

            * Read this before telling me caffeine prohibition itself is implausible. Caffeine abuse is putting thousands of our youth in the hospital annually and killing some of them. In a country where marijuana, which never killed a soul (and even hemp — not psycho-active enough to get high on but nonetheless banned ostensibly due to it’s resemblance to mj) can be prohibited for 75+ years and wildly popular and universally ubiquitous alcohol prohibited for 13+, you’ll have a hard time convincing me that this potentially dangerous “killer” drug couldn’t be outlawed. I’ve been around long enough to know anything is possible.

            Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years. Several countries and states have debated or restricted energy drink sales and advertising.

    • JMG says

      I think it has to do with the whole jailing, property forfeiture, loss of children to the state, inability to get a security clearance, problems getting a job or credit thing caused by criminal convictions for pot while monsters like Cheney and Hank Paulson walk the earth as free men instead of being made to dig the graves of all the people they murdered or impoverished with small spoons in the burning hot sun in Gitmo.

      Anyway, that’s my theory about why pot posts get people a little excitable …

      • NCG says

        Yes, those things, plus usually there is little attempt — and none that convincing — to distinguish alcohol abuse. You could say all the same things about it.

  15. Quercus says

    I agree with Frank. My thought was “Is this an issue with marijuana or an issue with the way doctors are disciplined?” I’m no expert, but the Arizona example sounds like a typical response to similar (non-pot) medical malpractice.

    And my guess is that the voting public was divided between ‘conned’ by medical marijuana and ‘winked right back at’ the proponents of ‘medical marijuana’ (wink-wink).

    Sure, the (minor) corruption of the medical profession is an undesirable side-effect of medical marijuana, but it’s hardly a society-ruining effect, and it’s not like doctors haven’t already faced equal corrupting influences. Certainly I could see it as the lesser of two evils in many, many, many situations.

  16. Andrew Laurence says

    I think one of the major problems with the medical marijuana regime is that doctors who wish to be marijuana doctors have to register as such, and no reputable doctor who is part of a reputable practice is going to do so. So if I want to get marijuana, I have to see a doctor with whom I neither have, nor desire, a true doctor-patient relationship. As for lying about my symptoms, just about every middle-aged person has one or more symptoms which marijuana might alleviate, so I can be perfectly truthful and still get a card. The fact that my symptoms are easily ignorable or treatable with ibuprofen (OTC) or lorazepam (prescribed by my real doctor) is irrelevant.

    The California Medical Association has endorsed full legalization because the current regime puts its members in the awkward position of recommending (though not prescribing) something which is not medically proven to be therapeutic, mainly because the studies that would be necessary to prove its therapeutic efficacy would never receive government approval. But everyone who’s ever used pot knows that pot makes most people hungry, and in many cases it can turn a person with no appetite, which is common among chemotherapy patients, into a person with a slight or moderate appetite, which can’t help but be a good thing.