The War Public Health Struggle Against Drugs

It is encouraging that the Office of National Drug Control Policy (ONDCP) felt a need to address both medical marijuana and general legalization of the plant in its 2011 strategy booklet, which was released today. It is also encouraging that the ONDCP's arguments are so lame:

Confusing messages being conveyed by the entertainment industry, media, proponents of "medical" marijuana, and political campaigns to legalize all marijuana use perpetuate the false notion that marijuana use is harmless and aim to establish commercial access to the drug. This significantly diminishes efforts to keep our young people drug free and hampers the struggle of those recovering from addiction.

Marijuana and other illicit drugs are addictive and unsafe especially for use by young people. The science, though still evolving in terms of long-term consequences, is clear: marijuana use is harmful. Independent from the so called "gateway effect"—marijuana on its own is associated with addiction, respiratory and mental illness, poor motor performance, and cognitive impairment, among other negative effects.

The ONDCP never entertains the possibility that a product could be legal even though it is not harmless. Do the legality of alcohol and tobacco send the message that they are harmless? If you oppose a return to alcohol prohibition, should you be blamed for encouraging kids to drink and making life harder for recovering alcoholics? ONDCP Director Gil Kerlikowske may have renounced the use of martial rhetoric to describe the government's anti-drug crusade, but he still manages to imply that reformers are traitors whose "confusing messages" are undermining morale in the nation's struggle against the existential threat of pot smoking.

The main impact of President Obama's determination to "think more about drugs as a public health problem" is that the ONDCP now sprinkles the phrase "public health" throughout its reports. For example:

The Administration steadfastly opposes drug legalization. Legalization runs counter to a public health approach to drug control because it would increase the availability of drugs, reduce their price, undermine prevention activities, hinder recovery support efforts, and pose a significant health and safety risk to all Americans, especially our youth.

But you know what's totally consistent with a public health approach? "Zero tolerance" laws that treat a driver who smoked pot a few days ago like someone who polished off a pint of bourbon right before hitting the road—a policy that the Obama administration continues to advocate in the name of "combating drugged driving." Also public healthy: increased scrutiny of doctors' painkiller prescriptions, which is bound to leave some patients in agony so that others won't get high.

At least Kerlikowske, who two years ago claimed marijuana "has no medicinal benefit," now concedes "there may be medical value for some of the individual components of the cannabis plant" (hard to deny, since the FDA has approved one of them, THC, as a medicine in capsule form), although he worries that "smoking marijuana is an inefficient and harmful method for delivering the constituent elements that have or may have medicinal value." Actually, smoking pot is pretty efficient compared to swallowing a Marinol capsule, since patients feel the effects right away and can stop once they get the relief they want. As for the hazards of inhaling combustion products, those can be avoided by using vaporizers, another option Kerlikowske does not consider. But he is right that whole cannabis has never been approved as a medicine by the FDA. To use it as such therefore is an unacceptably subversive act of individual autonomy, which is plainly inconsistent with public health.

[Thanks to LEAP's Tom Angell for the tip.]