Peter Jennings on ecstasy

This coming Thursday, April 1, at 10pm, ABC will air a Peter Jennings special called “Ecstasy Rising,” which looks at both the actual drug problem around MDMA (the chemical people think they’re buying when they buy a pill called “ecstasy”) and the scandal around MDMA research funded by the National Institute on Drug Abuse.

I’m told that the program will take a noticeable bite out of my 15 minutes of fame.

Update: Well, my 15 minutes are still largely intact. And the show had some other good qualities as well. But it was too pro-MDMA, and too undiscriminatingly anti-government, for my taste. Not a bad job overall, though.

The promised crackdown on the pills

I’ve had some calls from reporters on the White House plan to make the abuse of diverted pharmaceuticals a major target for drug enforcement. The general tone of the reporters’ questions has been: “Why don’t they focus on something more important?”

Actually, this looks like a good move to me.

The surge in the abuse of prescription medications, and especiall the narcotic analgesics, over the past decade has been really astonishing, with survey-reported initiation rates at seven or eight times their early-90s levels. Diversion doesn’t usually carry with it the same level of organized criminal activity, disorder, or market-related violence as the street sale of cocaine, or the environmental damage of manufacturing methamphetamine. But the users can get just as hooked as those buying strictly illicit drugs.

Most importantly, though, there’s some low-hanging fruit in the diversion area. The internet pharmacies are certainly violating federal law, and just as certainly haven’t been getting any enforcement attention. A few well-publicized prosecutions will probably make most of them fold their tents.

There are some complicated issues around doctor-shopping and script-kiting, which are the other major sources of diverted pills. The trick is to make life harder for the scammers without making it harder for the legitimate patients.

But it’s good to see the drug czar’s office focusing, for once, on a real problem where there might be some real solutions.

Taking the bottle away from dangerous drunks

When someone gets caught drinking and driving, the first response is to take away his license: his driving license, that is. Why not revoke his drinking license instead?

When someone gets caught drinking and driving, the first response is to take away his license: his driving license, that is. The “license” to drink &#8212 legal permission to buy and consume alcohol in unlimited quantities &#8212 is taken to be irrevocable.

But why?

Someone who drinks and drives may not be a bad driver when sober, but we know he’s a bad citizen when drunk. Probably, sober, he even knows that he shouldn’t drink and drive. Once drunk, however, that knowledge leaves, along with his fine motor control, impulse control, and capacity to handle divided-attention tasks.

So here’s a modest proposal: If someone is convicted of driving drunk, or beating someone up drunk, or spraying swastikas on gravestones drunk, or if he’s simply one of the relatively small number of badly behaved drinkers whom the police pick up time after time for drunk & disorderly (in any jurisidiction, something like a tenth of one percent of the population, consisting of chronic d&d arrestees, accounts for something like fifteen percent of the arrests) &#8212 if, I say, someone shows by his behavior that he is either a menace or a major public nuisance when he gets a skinful &#8212 then why not revoke his drinking license? (No, the masculine pronoun here is not a mere artifact of grammar; like most crime, crime committed under the influence is overwhelmingly a male problem.)

How would it work? The “personal prohibition” imagined here couldn’t plausibly by enforced by the state against the individual, so it, like the (far less justified) ban on drinking under some arbitrary age, would have to be enforced by sellers of alcoholic beverages, required to do so by the terms of their licenses. To do so, sellers would have to verify that each buyer is in fact legally eligible to drink, just as they now have to verify that each buyer is of legal age to drink. And the same document now used to “card” young-looking drinkers could be used to enforce the ban on drinking by those who make their drinking a problem for the rest of us.

California, for the convenience of alcohol sellers, issues to those over 21 drivers’ licenses with the bearer’s photo in full-face, and issues to those under 21 drivers’ licenses with the bearer’s photo in profile. Similarly, someone who loses his drinking license for some period of time as a result of an alcohol-related conviction could have his existing driver’s license taken away and receive a new license, with some marking showing that it is not also a drinker’s license. (Most motor vehicle registries issue a “non-driver’s license,” also called a “personal identification card,” for those who cannot or do not wish to have a license to drive but need a piece of plastic to show who they are and how old they are: not least for the purpose of being able to buy alcohol.)

Such a system would have good deterrent effects &#8212 loss of drinking privileges, and in particular the ability to drink in bars with one’s friends, might be quite fearsome to some offenders and yet not at all hard for a judge to impose &#8212 and good incapacitative effects as well, insofar as reduced drinking by problem drinkers translates into reduced problems for everyone else.

Obvious problems:

1. The booze industry, and in particular the bar-and-restaurant trade, would hate it. Heavy drinking is their business, and while most heavy drinkers aren’t problem drinkers, such a system would cost them some of their best customers.

2. Having to “card” everyone,rather than just those fortunate enough to look young would be something of an inconvenience for sellers and buyers of alcohol alike. (Though given the proportion of transactions involving credit cards, it’s hard to see how the added inconvenience would be especially great.)

3. If there were enough disqualified persons, they might constitute a big enough market to support illegal production (“moonshining”) or illegal sales outlets (“speakeasies”). I doubt this would be much of a problem, given the importance of brand names in the alcoholic-beverage trade and the difficulty of running a speakeasy in the absence of truly systemic police corruption. The key to controlling this problem would be to limit the number of persons disqualified from drinking to a few million at a time: a small proportion of the total market for alcohol, but (if properly selected) a substantial portion of the alcohol problem.

4. Some people legally allowed to buy alcohol would be willing to procure it for their disqualified friends, thus partially frustrating the intent of the law. That happens now with underage drinking. The problem might be smaller insofar as the idea that drunken drivers and drunken assailants ought not drink probably has wider and deeper social support than the idea that 20-year-old ought not drink.

5. Some people legally disqualified from drinking would secure false identification, just as underage drinkers now do. That would partly defeat the purpose of the law. It would also contribute to the market in fake IDs, which is not a trivial problem. If the proposed policy were combined with the abolition of the drinking age, this disadvantage would be more than offset.

Update: Guy Andrew Hall at Rook’s Rant reports that Minnesota has such a policy, which it tries to enforce on the drinkers rather than on the sellers. Predictably, it’s mostly a dead letter. “Mithras” at Fables of the Reconstruction wonders if I’m serious (yes, I am) and lists some objections, including a due process argument I can’t track at all. Atrios agrees. Kevin Drum (mostly) disagrees: he’s worried about a “slippery slope” toward making a driver’s license an all-purpose ID. (It seems to me that horse is already out of the barn; I just got back from the Bay Area, where you can’t make a credit-card purchase without showing a driver’s license.)

Lots of comments on Eschaton and Political Animal, many of which, like “Mithras,” dance past the point that the proposed drinker’s license revocation would be a (possible) part of a criminal ssentence, imposed by a judge after a verdict or plea. If drunk driving or assault and battery are good enough reasons to take someone’s liberty away entirely by putting him behind bars, objecting to banning that person from drinking seems a lot like swallowing camels and straining at gnats.

Update Jim Leitzel at Vice Squad proposes an alternative: an ankle bracelet that provides continuous remote monitoring of alcohol consumption by measuring the alcohol that transpires through the pores of the skin. Clever, though at $12/day it would have to be reserved for fairly serious cases. Of course the price would probably come down substantially if hundreds of thousands of people rather than dozens were being monitored.

Per a reader’s suggestion, I’m including a link to the alcohol chapter of my book Against Excess, which includes a discussion on this topic.

Get your red-hot medical marijuana here!

A friend driving through Ukiah, CA (a couple of hours north of SF on Highway 101) reports hearing an ad on a local radio station. She wasn’t taking notes, but this is the gist of ad as she recalls it:

Marijuana is a useful medicine for many conditions. At the Medical Offices of Cheech, Chong, and Tokem, our physicians know how to recommend it.

Call this number: XXX-YYYY

Note: The ad doesn’t start with a condition a patient might have and suggest that the physicians might be able to diagnose it if present and find a remedy. It starts with a remedy, which just happens to be a popular intoxicant, and asks patients to imagine what condition they might have for which it might be useful.

This is exactly what the opponents of Proposition 215, California’s medical marijuana initiative, warned against. It also gives a somewhat different twist to the complaint (with which I mostly sympathize) that the Drug Enforcement Administration was going beyond its legitimate powers when it threatened to yank the drug licenses of physicians who recommend cannabis to their patients, as required by Prop. 215 for the patient’s possession of the drug to be exempt from California law. If DEA goes after those radio docs for drug-peddling, I’ll have a hard time working up much sympathy.

That doesn’t change the fact that cannabis is almost certainly a useful treatment for at least some patients with several different diagnoses, and ought to be so recognized by the FDA and therefore sold lawfully at phrmacies under physicians’ prescription. I keep hoping that the National Institute on Drug Abuse will relax the policy which has effectively prevented researchers from acquiring cannabis to use in clinical research, and that the medical marijuana advocates will devote some tiny fraction of their lititigation-and-petitioning budget to the medical research that could take this issue off the table politically.

But all I can say to those docs in Ukiah is:

YOU’RE NOT HELPING!

MDMA as a treatment for post-traumatic stress?

A physician in South Carolina has received permission to conduct a clinical experiment using MDMA as a pschotherapeutic adjunct in the treatment of Post-Traumatic Stress Disorder (PTSD).

A reader sent an article (copied below) from yesterday’s Washington Post with the query: “Is this a good idea?”

Quick answer: No one knows whether using MDMA to treat PTSD is a good idea or not: that’s why they call it an experiment. But doing the experiment seems like an excellent idea, and it’s too bad it took three years to accumulate enough bureaucratic signatures to get it started. If the therapeutic work and the subsequent analysis are competently done, we’ll learn something from the study, no matter what the results are.

No one is satisfied with the outcomes of the current methods of treating post-traumatic stress. There’s plenty of anecdote suggesting the treatment might work: before MDMA became a popular “recreational” drug, some therapists were using it to help treat patients (though it was never approved by FDA as a medicine) and claiming good results. The risks to patients from a single dose of the stuff in a controlled setting should be negligible.

On the other hand, the article itself is pretty badly done. See below for a detailed commentary; I’ve highlighted the passage that does most of the damage.

DEA Approves Trial Use Of Ecstasy in Trauma Cases

By Rick Weiss

Capping a 17-year effort by a small but committed group of activists, the federal Drug Enforcement Administration has agreed to let a South Carolina physician treat 12 trauma victims with the illegal street drug ecstasy in what will be the first U.S.-approved study of the recreational drug’s therapeutic potential.

The DEA’s move marks a historic turn for a drug that has long been both venerated and vilified.

Ecstasy, also known as MDMA, is popular among casual drug users for its reputed capacity to engender feelings of love, trust and compassion. The government classifies it with LSD and heroin as a drug with no known medical use and high potential for abuse.

Although the study’s approval is by no means a federal endorsement of uncontrolled use, it will give ecstasy’s proponents their first legitimate opportunity to prove the drug can offer medical benefits.

“MDMA opens the doorway for people to feel deep feelings of love and empathy, which is the core of being human,” said Rick Doblin, president of the Multidisciplinary Association for Psychedelic Studies in Sarasota, Fla., the nonprofit research and educational organization funding the trauma study. “We should be looking at that and learning from that.”

As a result of the DEA action, sometime in the next few weeks the study’s first participant — still to be selected — will check in for an overnight stay at an outpatient counseling center in the Charleston area. (Investigators have asked that the location not be precisely identified). He or she will take 125 milligrams of 99.87 percent pure 3,4-methylenedioxymethamphetamine — probably the highest quality MDMA on Earth — synthesized by a Purdue University chemist.

Michael Mithoefer, the Charleston psychiatrist who will lead the research, emphasized that ecstasy is by no means a benign drug. Indeed, he said, on occasion it has proved deadly at all-night dance parties, or raves, where it is often consumed.

“The fact that we have good evidence that we can use MDMA safely in a controlled setting does not mean it is safe to take ecstasy at a rave,” Mithoefer said.

The goal is to help people with debilitating post-traumatic stress disorder face the pain at the core of their illness, he said, and learn to work with it.

“Because of MDMA’s reported ability to decrease levels of fear and defensiveness and increase the sense of trust, we hope that will be a catalyst for the therapeutic process,” Mithoefer said.

Advocates have been aiming for such a study since 1986. The Food and Drug Administration gave its blessing in November 2001 after long consideration and analysis of three human safety studies funded by Doblin’s group. It was two more years before the study got the required approval of an independent science and ethics board.

The DEA’s issuance last week of a Schedule 1 registration, which allows Mithoefer to administer the drug under the specific conditions of the study, was the last hurdle.

From all indications, it was not a decision made lovingly by an agency that has called ecstasy “one of the most significant emerging drug threats facing America’s youth.” But with all the other federal requirements met, the role of the DEA — whose responsibility is to prevent “diversions” of the drug — was limited to documenting that Mithoefer had a big enough safe bolted securely enough to the floor, a qualifying alarm system and a set of records that would ensure careful tracking of every speck of the stuff.

“Whether we agree with the study is not relevant,” said Bill Grant, the spokesman for the DEA. “All the qualifications were met.”

Even some of ecstasy’s leading critics said they could abide by the study if regulators were satisfied.

“The key issue is that all potential subjects be fully informed of the risks,” George Ricaurte, a professor of neurology at Johns Hopkins University who has studied the drug, wrote in an e-mail.

Ecstasy was popular more than 20 years ago as an aid to psychotherapy. Recreational abuse drew it to the attention of the DEA, which in the mid-1980s began regulating it.

A black market emerged, and millions of young ravers and others have since tried the substance, which can induce what enthusiasts describe as up to eight hours of empathic conversation, contemplation and energetic sociality.

Most users report no long-term negative effects, though some speak of fatigue or depression for a few days afterward. There is a heated scientific debate as to whether ecstasy causes significant, long-term damage to parts of the brain.

All experts agree that ecstasy on rare occasions causes a sudden, inexplicable and fatal form of heat exhaustion. That is one reason there will be an emergency room doctor and nurse outside the Charleston-area therapy room — where each patient will sit and talk for hours with Mithoefer and his wife, psychiatric nurse Annie Mithoefer.

To be chosen for the study, the patients — all victims of assaults unrelated to combat — must have moderate to severe post-traumatic stress disorder unresponsive to other drugs and therapies, and will first engage in preliminary therapy sessions with the Mithoefers. Twelve participants will get the drug, and eight will get a placebo. Each will spend that first session talking, listening to music and lying on a couch as needed — though study rules require that at a certain point each patient must engage in a discussion about the trauma that has left him or her debilitated.

Periodic physical, emotional and neurological checkups will continue for several weeks, followed by a second ecstasy session.

Marcela Ot’alora, who in 1984 — before ecstasy’s use was criminalized — took it under a therapist’s supervision to help her deal with the aftereffects of being raped, lauded the Charleston study’s approval.

For years, she had been unable to wait in lines or stand with her back to crowds because of a fear of being attacked, said Ot’alora, who today is a therapist in a western state that she asked not be revealed.

Ecstasy had a profound effect, she said: “I think for the first time in my life I was able to have compassion for myself, and also felt I was strong enough to face something that was frightening without falling apart.

“It’s not a miracle drug, by any means,” she continued. “But it allows you to go into the trauma and know it is past, and separate it from the present.”

She said she has not wanted to take the drug again, even though she still feels less than fully healed.

“It’s almost like it showed me the path I needed to take,” she said, “and I can do that on my own now.”

Comments:

The story — particularly the head and the lead — is pretty profoundly confused, and confusing.

Dr. Mithoefer applied to the Food and Drug Administration and got clearance for a clinical trial. He then got human subjects approval from an Inistitutional Review Board. (Those two sentences embody three years’ worth of manuvering, which the article doesn’t mention. The website of MAPS, the project sponsor, has some, but by no means, all, of the details.)

DEA had no role in any of that. All DEA did was give Dr. Mithoefer a license to possess the drug, which DEA has to do if he has FDA approval, an adequate safe and record-keeping system, and no criminal record. So to say that “DEA has agreed” to let some patients be treated is really a stretch.

And of course what’s being used isn’t “the illegal street drug ecstasy,” but pharmaceutically pure 3,4-methylenedioxymethamphetamine (MDMA), which is the active agent people think they’re buying — sometimes accurately, sometimes not — when they buy the illegal street drug ecstasy. That sentence as written is about as accurate as saying “Some ophthalmologists use the illegal street drug cocaine on their patients.” It’s true that cocaine is used as a topical anaesthetic in ophthalmic surgery, and it’s true that cocaine is an illegal street drug, but it’s not true that ophthalmologists are using an illegal street drug on their patients.

Note that the the reporter actually knows all of this; more accurate and less sensational versions of both assertions are contained further on in the story.

So I’m delighted the experiment is going forward. I hope it works, and that eventually psychiatrists can add MDMA to their pharmaceutical armamentarium. I’m sorry the Post reporter couldn’t, or didn’t want to, write an accurate lead, and instead decided to say that the DEA had approved the use of an illegal street drug” to treat PTSD victims.

The Ecstasy research scandal

The Chronicle of Higher Education has a thorough review of the MDMA (“ecstasy”) research done, under funding from the National Institute on Drug Abuse, by George Ricraurte and his collaborators at Hopkins.

The story doesn’t quite make it clear just how outrageous some of the research misconduct involved actually was, party because the author seems not to understand the details. (The famous “hole-in-the-brain” images involved doing odd data transformations and turning up the gain on a false-color-imaging program so that reductions in brain metabolic activity well within the normal range showed up as black areas; the primate deaths should have been queried because the experiment was supposed to replicate the experience of human MDMA takers, who die at rates of less than 1 per million as opposed to 20%.) The story also fails to discuss Ricaurte’s active role in making human MDMA studies virtually impossible.

The fact that Ricaurte is still defending the publication of that study without a prior careful autopsy of the dead primates suggests that he’s close to incorrigible. And if he really believes what he says — that, because 10 is a small sample size, 2 in 10 in the sample is actually consistent with a base rate of 1 in a million — he ought to consider retaking elementary statistics.

I hope someone at Hopkins is looking hard at Ricaurte’s lab, and that the Human Subjects folks at HHS have started to ask hard questions about coaching subjects to lie about whether they meet the exclusion criteria.

I hope that the editors of Science will take this as a wake-up call: that study never should have been published. (The quote from Donald Kennedy is anything but reassuring on that point. The reviewers couldn’t have known about the drug mix-up, but they should have known that the fatality rate was inconsistent with the claim that the experiment modeled ordinary human MDMA use.)

In addition, I have less plausible hopes: that the people in Congress and at the Sentencing Commission who made decisions about MDMA based in large part on Ricaurte’s studies are now rethinking those decisions and have made a mental note to be less credulous in the future, and that the people at AAAS who decided that Alan Leshner would made a good president of the organization feels as stupid as they now look.

The story is well worth reading, and is not without its encouraging moments. As soon as Leshner — who had invested his personal prestige and that of NIDA in an anti-MDMA crusade based largely on Ricaurte’s work — had left, NIDA quickly backed off, even before the retractions. And the current NIDA Director, Nora Volkow, is allowed a last, sensible word:

“The question that comes to light is, why has this attracted so much attention?” she says. “And I think perhaps it’s because some people are exaggerating the adverse effects of drugs.”

That’s true, of course, but it’s quite amazing to hear a NIDA Director — the head of an agency which in the past has done more than its share of such exaggeration — say so on the record.

Full text of the Chronicle article

Victory through redefinition:
    hoking the drug budget

John Walsh reports in the latest Drug Policy Analysis Bulletin that the Bush Administration has satisfied the long-expressed desire to rebalance the drug budget between supply-control spending (enforcement) and demand-control spending (prevention and treatment) the old-fashioned way: by lying about it. Suddenly the costs of prosecuting and incarcerating drug dealers have disappeared from the budget, bring prevention and treatment into parity with enforcement.

In a larger sense, the whole issue is a silly one. as Sally Satel and I explained some time ago, but that doesn’t excuse trying to fix it with looking-glass logic.

At last, some real progress on medical cannabis

A British company called GW Pharmaceuticals has developed a sublingual spray called Sativex which contains all the psychoactive chemicals in natural cannabis, and that medicine is likely to be approved in Britain for the treatment of MS within months. The rest of Europe and Canada will probably follow quickly, and it’s quite possible that the US won’t be too far behind.

Sativex, an extract of the whole plant rather than a blend of synthetics, contains — unlike the whole plant material itself — a constant ratio of the many active cannabinoids. The first version to be approved will have a 1:1 ratio of cannabidiol (CBD) to delta-9-tetrahydrocannabinol (THC). That’s somewhat more cannabidiol than most illicit-market cannabis, which should make using the spray somewhat more anxiolytic and somewhat less intoxicating than smoking a joint. (One of the reasons the only currently marketed cannabinoid medication, Marinol, has not been widely used is that its pure-THC formulation leads to a relatively high incidence of panic and dysphoria.)

The method of administration means that the effects will also be somewhat slower to come on. The manufacturer claims that most MS patients can get relief from spasticity and the related pain without becoming subjectively stoned.

A na├»ve observer would expect to find the proponents of medical marijuana dancing in the streets, and its opponents mourning and grumbling. After all, approval of Sativex would amount to a concession that cannabis has in fact had therapeutic value all along, and that by stubbornly refusing to approve it the government has been denying relief to large numbers of patients, some of them suffering very badly. (Yes, there are advantages to a standardized — and perhaps optimized — cannabinoid profile, and to using a sublingual spray to avoid the throat and lung insult of smoking, but those are clearly second-order questions.)

But in fact the drug czar’s office is cautiously welcoming the new development, while the only criticism of Sativex is coming from prominent advocates of medical marijuana such as Lester Grinspoon and the Marijuana Policy Project.

Medical marijuana has been one of the very few drug-policy issues where the public sided with the “reformers” rather than the “drug warriors,” and Sativex may represent a way for the warriors to get out of an argument they can’t win without taking the (to them) unthinkable step of admitting that pot-smoking can actually be therapeutic.

LA Times story on Sativex

NY Times story on Sativex

Information from GW Pharmaceuticals website about Sativex and planned additional products with higher and lower THC:CBD ratios.

[More here in this post on The American Street.]

Obituary for a useful data series

Fox Butterfield has the details on the cancellation of the Arrestee Drug Abuse Monitoring (ADAM) program in today’s New York Times. Other than paying entirely too much attention to the views of a well-known loudmouth from UCLA, it seems to be a very competent story.

This is bad news for those of us who think about drugs and crime, but there’s also a larger lesson here. The indifference of the Bush Administration to the actual facts about the world is among its most salient characteristics, and the country will be paying for that indifference for a long, long time.

Previous post here.

Update My old friend John Coleman, who used to be the #3 at DEA as Assistant Administrator for Operations, has some thoughts:

The Justice Department has decided to end the ADAM program (see NY Times article below). The importance of ADAM always has been its stark statistics showing the large percentage of criminals high on drugs and alcohol at the time of their crimes. ADAM surveyed arrested felons and then drug-tested them to confirm their statements about drug use. It was all voluntary but showed, nonetheless, extraordinary levels in some cases of drug use by criminals. I recall several years ago reading that more than half the juveniles arrested for homicide in Washington DC tested positive for pot. ADAM was effectively the only data system designed to test felons and have the info confirmed by urine tox screens. Without ADAM, we can only speculate about the connection between drug use and crime. Chalk up a victory for the pro-drugs crowd on this one and shame on Justice and the White House for going along with their eyes and purses closed. Back in the days when I debated druggies on legalization issues, ADAM was the only data source they couldn’t rebut because it was factual and scientific and validated with testing. The best that they could argue was that the screens didn’t tell us how much dope the felons took or when. Recent developments in urine tox screening techniques have overcome some of these earlier limitations and we can now determine ranges for how much and when drugs were taken. But it won’t matter. Good-bye, ADAM.

Perhaps even more surprisingly, my old pal Mark Kleiman sees this the way I do! We are usually on opposite sides of these issues. And, he is right about the National Survey on Drug Use and Health (the former National Household Survey on Drug Use). It’s overloaded with demographic and social info and rests much of its analysis on a factor it defines as “lifetime use,” which means — quite contrary to what it sounds like it should mean — a person who has ever used an illicit drug even once in their lifetime. I wish someone could tell me the significance of this and why it’s worth $50 million a year to know this perfectly worthless “fact.” The pols these days are criticizing the intelligence community for not knowing what was happening in the streets in Iraq and other places in the Middle East prior to last year’s war. They may have a point. Given the billions spent on drug control here in the US, it would make sense that we would be improving, not removing, our essential drug intelligence collection systems, like ADAM, so that we know what’s happening in our streets and we don’t continue to waste money and time measuring the fact that someone out there smoked a joint 25 years ago. Wouldn’t it make more sense to know whether robbers, rapists, and other felons are high on drugs when they commit their crimes against us? I can’t do very much about the guy who smoked a joint 25 years ago and I’m not sure I need to do anything at all about him. But, I can and should do something about crime by drug users or drug use by criminals. Good-bye, ADAM!

John and I agree this is terrible news, but disagree about its political valence. The true hard-core “drug warriors” have always been more concerned with middle-class drug use, and in particular juvenile pot-smoking, than with the heavy chronic use or hard drugs by criminally active uses that constitutes the bulk of the actual drug problem as measured by illicit-market dollars, health damage to users, infectious disease, and crime. That’s what all those “use a drug, sponsor a terrorist” ads were about. Concentrating on the kids is partly a way to pander to the fears of middle-class parents, partly a wedge issue designed to make opponents look “soft on drugs.”

Gathering data showing that the real drug problem doesn’t fit that Bill Bennett image doesn’t help that political program at all. Worse, (as John points out to me in an email I quote with his permission) information about heavy drug use by people who are nominally under criminal justice supervision cries out to have something done about it. (That’s what my pet testing-and-sanctions-for-probationers program is all about.)

So the ADAM data were, as John puts it, like a red dashboard warning light pointing to the need for an expensive repair. It’s cheaper — in the short run — just to take out the warning light.