MDMA neurotoxicity:
   “An ouchie for George”

Today’s New York Times has a devastating article on the research methods of George Ricaurte, whose studies purporting to show the neurotoxic effects of MDMA (“ecstasy”) were used to support the original prohibition of the drug and have since been used to support stiffer penalties, ancillary laws such as the RAVE Act, and suppression of human research into the drug’s potential benefits. (Full text, and a long list of errors in the story, under “keep reading.”)

As one physician commented on a listserv that follows this class of issues, the story is “what we in the pediatrics world call an ouchie for George.” And Ricaurte has another ouchie coming fairly soon, in the form of a Peter Jennings special that keeps getting delayed as the producers add more and more detail about his problems.

The new director of the National Institute on Drug Abuse, which has funded Ricaurte’s studies to the tune of $10 million over the past two decades, was clearly aware of problems with his work before the latest article, and before Ricaurte’s retractions of two of his papers, including one in Science.

But Hopkins, where the work was done, is apparently still in denial, or at least is trying to sound that way. Given the sensitivity there to human-subjects issues — a couple of years ago, the feds came close to shutting down medical research at the whole institution after the death of a healthy volunteer in an asthma study drew attention to various technical deficiencies in the Hopkins process for reviewing experimental protocols — I’d expect the dean of the medical school to be asking some very serious questions right now.

What doesn’t seem likely to happen, but should, is a review of all the legislative and regulatory decisons made, here and abroad, on the basis of what we now know to be terribly flawed studies.

We didn’t need Ricaurte’s brain imaging to tell us that MDMA does something lasting to the brains of the people who use it repeatedly: the drug’s atypical pattern of quasi-tolerance is strong enough evidence of that. (For many if not most users, the valued effects of the drug, other than its pure stimulant powers, diminish fairly rapidly, in a non-dose-reversible, non-time-reversible fashion, with cumulative lifetime dosage.)

However, open questions remain about how extensive and how damaging those changes are, and what if any steps users could take to prevent or limit them. But the exaggerated claims about MDMA’s neurotoxic effects made it virtually impossible to do the studies that might have demonstrated the efficacy of various precautions. Despite the laws, Americans currently consume tens of millions (perhaps hundreds of millions) of MDMA doses per year. It’s probable that various relatively simple steps could significantly reduce the resulting brain changes, but that possibility has never been the sort of dedicated research effort that has gone into “proving” how dangerous the drug is.

Moreover, the proposed therapeutic applications of MDMA would involve administering it on a very small number of occasions — in some cases, only once. The probability that a single MDMA dose of known purity and quantity administered under clinical conditions could do significant harm seems extremely remote. But here again, the neurotoxicity scare has prevented the relevant studies from being carried out.

With any luck, the latest scandal could lead to a more sensible set of approaches. But as Bill Bennett would no doubt say, don’t bet on it.

Full text of NYT story, with errata list

[Previous posts Sept. 9 and September 25.]

Drug free school zones

After a long hiatus that was almost entirely my fault, the Drug Policy Analysis Bulletin is back in operation, due almost entirely to the efforts of our new managing editor, Douglas Ross.

The latest issue features a study by Will Brownsberger and Susan Aromaa of Join Together, which shows how the Massachusetts “drug-free school zone” law has turned into a general sentence-enhancement law with roughly no relationship whatever to the problem of drug dealing in or around schools. (In older cities and towns in Massachusetts, virtually any location is within the statutory distance of one school or another.)

The next issue, with John Walsh’s analysis of the smoke and mirrors behind the national drug budget, should be out in January.

Why make “structuring” a crime?

Jane Galt thinks (1) that the drug laws are a bad ided and that (2) the money laundering laws are an even worse idea, and show how much too far the drug war has gone.

Neither of those propositions is transparently false. The money laundering laws certainly demonstrate the Hayekian point Jane makes: the more ambitious a law is, in terms of changing behavior, the more additional laws it will need for its support.

But I don’t think it’s quite right to say, as Jane does, that the conduct forbidden by the money-laundering laws, when it comes to money withdrawn from banks by users of illicit drugs to give to sellers of illicit drugs, is absurdly remote from any actual social harm. One of the better arguments against the drug laws is the illicit enterprises they help create. The laws about reporting currency transactions are designed to impede the functioning of those enterprises.

(Note: While Jane is right that it would technically be a crime to “structure” transactions to avoid currency reporting even if the purpose of the transactions were entirely licit, the reports themselves are not matters of public record. Therefore there’s no actual reason for someone to conceal the cash he spends on his yacht or stamp collection from the IRS, unless he’s doing so to conceal the fact that either he, or the recipient of the funds, evaded or intends to evade taxation.)

Just about the only damage Rush Limbaugh’s drug use did to anyone but Rush Limbaugh and his intimates was the financial support it gave to the illicit drug trade. So his efforts to conceal the money involved were actually more proximate to social harm than his actual possession and consumption of boatloads of synthetic narcotics.

Cash creates the capacity for undocumentable transactions. That is highly convenient not only for drug dealers but for tax evaders, bribe-payers and bribe-takers, and anyone else whose sources of income are illicit.

Making it harder to acquire and spend cash is a reasonable approach to dealing with large-scale transactional crime. Whether the risk to liberty created by the resulting increase in state power is not, justified is a reasonable topic for debate. But I don’t think it’s as silly as Jane makes it out to be.

Bad news for Rush Limbaugh

It’s often hard to tell whether Rush Limbaugh is just deceiving his audience or whether he’s also deceiving himself. But his on-the-air defense against the money-laundering changes he may face simply missed the point, in legal terms. Even if the Florida authorities decide to give him a break, he could be in very big trouble — about three years’ in prison worth of trouble — if the Feds decide to go after him.

The accusation is that when Limbaugh was sending his housekeeper out to buy narcotics for him — and apparently threatening her once when she thought about not supplying him — he withdrew money from his bank in amounts just under $10,000, in order to avoid having to fill out the Currency Transaction Reports (CTRs) that would otherwise be required.

Limbaugh doesn’t seem to deny that. But he told his listeners, “I was not laundering money. I was withdrawing money for crying out loud.”

The bad news for Limbaugh is that, by law, “structuring” transations to avoid the CTR rules for money used in a drug deal constitutes the crime of money laundering.

Here’s the statutory language (18 U.S.C. Sec 1956):

Whoever, with the intent –

(A) to promote the carrying on of specified unlawful activity;

(B) to conceal or disguise the nature, location, source, ownership, or control of property believed to be the proceeds of specified unlawful activity; or

(C) to avoid a transaction reporting requirement under State or Federal law,

conducts or attempts to conduct a financial transaction involving property represented to be the proceeds of specified unlawful activity, or property used to conduct or facilitate specified unlawful activity, shall be fined under this title or imprisoned for not more than 20 years, or both.

For purposes of this paragraph and paragraph (2), the term ”represented” means any representation made by a law enforcement officer or by another person at the direction of, or with the approval of, a Federal official authorized to investigate or prosecute violations of this section.

That’s it. If Rushbo, in order to avoid a transactions reporting requirement, “structured” transactions to stay under the $10,000 trigger with money to be used for a drug buy (“property used to conduct or facilitate specified unlawful activity”), he’s toast.

Not being a specialist, I’m not sure what actual sentence he would likely face. The relevant guideline seems to be 2S1.3 If I read it correctly, “structuring” has a base offense level of 6, plus another two for doing so to facilitate an illicit transaction, plus a number determined by the amount of cash: 6 if the sum is more than $30,000, 8 if more than $70,000, 10 if more than $120,000, 12 if more than $200,000. That yields a total of between 14 and 20, and thus guideline ranges starting at 15 months and ranging up to 41 months.

I have heard from DEA sources that the new Administrator is really on a tear about money laundering and that there’s some interest in making Limbaugh the poster boy. If DEA sticks by that plan, there’s not much anyone else can do about it. The old “Thornburgh memo,” weakened under Reno but now back in full force under Ashcroft, requires federal prosecutors to charge the most servere offense they’re sure they can prove. (And proving this one is child’s play.)

So if DEA wants Limbaugh’s head for a trophy, the U.S. Attorney for the Southern District of Florida — presumably Jeb’s choice, since Florida has two Democrats in the Senate — couldn’t decide to give him a break.

None of this is nearly as bad as what he’d face as a “drug trafficker” (defined by the quantity he possessed, not by any intent to sell) under Florida law, but it’s plenty bad enough.

While I’m on the subject, two other Limbaugh-related notes:

(1) William Bennett, who used to be so enthusiastic about sending middle-class drug users to jail because they serve as such a bad example to everyone else, seems to have decided to make an exception in Limbaugh’s case. If Bennett had any integrity, he’d be asking why the nation’s radio broadcasters are willing to give someone who undeniably has committed felony violations of and state and federal laws a national audience every day. But then if my grandmother had had beizim, she would have been my grandfather.

(2) Rush’s PR folks seem to have persuaded the newspapers to refer to his oxycodone and hydrocodone habit as “prescription drug abuse,” as if he had simply been dealing with overgenerous doctors. The drugs he was abusing are indeed available by prescription, but he wasn’t getting them prescribed. He was buying them on the illicit market.

The sad story of Limbaugh’s drug addiction wouldn’t be a total loss if it helped his fans and political allies rethink their position toward drug addicts in general. Noticing that they aren’t actually willing to apply the principles of tough love and zero tolerance to someone they care about, they might start to wonder whether those principles are really the ones we ought to be applying to drug addicts who aren’t famous or rich or well-connected. Instead, they’ve just gone into denial about the fact that Limbaugh’s case strongly resembles the case of other drug abusers.

Too bad.

New wisdom (?) from Washington

Some Native American peoples traditionally used hallucinogens, notably the mescaline-bearing peyote cactus, for ritual purposes. Staring in the 1880s, a specific version of ritual peyote use has spread widely among Native Americans, including many from tribes without hallucinogen traditions of their own. While peyote use long predates the introduction of Christianity to the New World, today’s peyote rituals are essentially Christian. The Native American Church (not a single organization, but a collection of local bodies with somewhat different practices) now claims 250,000 members. After a long political and legal struggle, federal regulations were changed to exempt Native American ritual peyote use from the drug laws in 1965; the American Indian Religious Freedom Act Amendments of 1994 codified that exepmtion and made it binding on the states.

In recent years, freedom of exercise for the peyote religion has been largely uncontroversial. Even drug war hawks supported AIRFAA, and the Drug Enforcement Administration offered no opposition and has stressed its good working relationships with the NAC. The House Committee report on AIRFAA bill asserts what has become the conventional wisdom on the topic:

Medical evidence, based on scientific studies and. opinions of scientific and other experts, including medical doctors, former directors of the Indian Health Service and Enthropologists, clearly demonstrates peyote is not injurious to the Indian religious user, and, in fact, is often helpful in controlling alcoholism and alcohol abuse among Indian people.

In that context, the last two paragraphs of this otherwise unremarkable Philadelphia Inqurer article about peyote use among the Huichol of Mexico are rather chilling. After citing a scientist who is studying ritual peyote users and finding no health damage, the story continues:

Others, such as David Murray of the Office of National Drug Control Policy in Washington, see more serious risk. Working among the Navajo, he said, he found long-term peyote use was “counterproductive to education and social mobility.”

Because the peyote comes from a natural plant, he said, “you’re taking in a powerful chemical stew,” with some toxins in addition to the psychoactive ingredient. “It is, without question, a risky undertaking.”

It seems unlikely that Murray, a close adviser to John Walters, would talk that way for publication without clearing it. Is this a trial balloon for a policy change? If Murray, an anthropologist, has any research to back up his claims, we’d all like to see it.

Prison time for drug users?

I don’t really want to see Rush Limbaugh spend the next twenty-five years of his life in prison, which is what would happen if the laws of the State of Florida were enforced. But I really do want to see the politicians and pundits who support both Limbaugh and the drug war explain why that particular law shouldn’t be enforced in this case, and why it shouldn’t be repealed.

And I’d also like to hear their defense, if they have one, for sending a woman to prison for thirteen years after convicting her of murder when it turned out that her stillborn child had traces of cocaine in its bloodstream. Of course, it’s obvious that homeless people with borderline mental retardation ought to be held strictly accountable for their actions, unlike multimillionaires with logorrhea and strong political connetions.

Oh, and speaking of “junk science”: there is precisely no medical evidence that maternal cocaine use can cause stillbirth. That is not the case for alcohol, which turns out to be the actual cause of most of the damage once attributed to prenatal cocaine exposure: women who use cocaine are likely to drink heavily.

In case you hadn’t noticed — the liberal media didn’t bother to cover it much — the Supreme Court just turned down Regina McKnight’s last appeal.

One of the big disadvantages liberals have, compared with conservatives, is that liberal outrages (even imaginary ones) are known to the whole world, while so many conservative outrages are passed over in silence.

Oooo, is that awful, nasty left
    being mean to poor widdle Rushie?

Kevin Drum [*] catches Jonah Goldberg trolling for examples of people on the left making fun of Rush Limbaugh’s narcotics addiction. I don’t think he’ll find much; our side, with a few exceptions, has been remarkably well-behaved. (Due not at all, I have to assume, to my earlier plea for compassion. [*])

Rush and his defenders, by contrast, have been behaving rather badly. They’ve been pushing the line that because Rush (if you believe his account) got into the pills after being prescribed them for physical pain and was taking illegally purchased pharmaceuticals rather than white powders sold in baggies, he wasn’t really anything like all those nasty junkies out there for whom Limbaugh always expressed such hatred and contempt.

Limbaugh was rich enough not to have had to stick up any liquor stores to support his habit. That’s the only moral distinction between him and a street drug addict. He, and his friends and admirers, ought to learn something from his addiction. It shouldn’t, as my grandmother used to say, be a total loss.

The limits of drug law enforcement

One idea about drug law enforcement is that by making the illicit traffic more expensive and dangerous for the people who sell drugs, enforcement can push up the prices of drugs and therefore reduce consumption.

The old criticism of this approach, based on the notion that demand for illicit drugs was highly inelastic, turns out to be incorrect; cocaine and heroin, at least, seem to have greater-than-unit elasticity, so a price increase will actually decrease the total amount consumers spend. So increasing drug prices would seem to be a useful goal.

The bad news is that, in the face of mass distribution, enforcement has a very hard time increasing prices. When I learned about the illicit drug markets around 1980, heroin traded at wholesale for about $250,000 per kilogram and at retail in New York for between $2 and $2.50 per pure milligram, reflecting a kilo-to-street markup of about 10x.

Now, after twenty years of intensified drug law enforcement, the wholesale price is about $70,000 a kilo and the retail price in New York about 20 cents per pure milligram. [*], a factor-of-three reduction at wholesale and a factor-of-ten reduction at retail, reflecting a greatly reduced markup. The general price level, as measured by the CPI, has roughly doubled over that period, so the inflation-adjusted price of a pure milligram of heroin is actually down about 95%.

The price drop for cocaine has been a little bit smaller: from about 80 cents per pure milligram in 1980, the price fell very rapidly until about 1988, and has since stablilized (in nominal-dollar) terms at about 15 cents per pure milligram, which adjusted for inflation is a deline of about 90%.

All of this happened in the face of an enforcement effort that increased the number of drug dealers behind bars from about 30,000 in 1980 to about 450,000 today.

The policy implication would seem to be that enforcement has limited capacity to increase the prices and thus decrease the consumption of mass-market illicit drugs, and ought to focus instead on reducing the violence and neighborhood disruption associated with the illicit trade, by targeting the meanest dealers and the ones whose trafficking is most flagrant, rather than the largest.

Zero tolerance, Zero intelligence

Two new stories of the damage done by dimwitted “zero-tolerance” policies: one about “weapons” [*](in this case a butter knife packed in a middle school girl’s lunch) and “drugs” [*] (asthma medication given by one student to another in a potentially life-threatening situation).

Zero tolerance is the bastard child of dim-wittedness out of litigiousness. It sounds good to concerned parents and voters, and it helps defend against charges that discretion has been abused for some discriminatory purpose by abolishing discretion altogether.

But as Madison said about liberty and faction, to try to prevent discrimination by abolishing discretion is like fighting fire by abolishing oxygen. Not a good deal.