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March 31, 2006

A Continuing Epiphany

 Since prolonged silence calls for an explanation and this is the first entry since February 3rd, it seems like a good time to note that this was always intended as a different kind of blog. . Rather than a platform for airing opinions on several subjects, it has focused on an unusual project  I started more or less unwittingly in late 2001 when I began screening substantial numbers of applicants seeking a designation as 'patients' under the terms of California's famous 'Proposition 215.'

The intervening four years have taught me considerably more than I bargained for-- and not just about pot. The effort became a 'study' fairly early; as soon as I realized that the symptoms most applicants wanted to stress were not why most (actually, nearly all) of them had become chronic pot users ("heads")  sometime after first trying  it as adolescents. What I now realize is that they weren't consciously trying to deceive ; rather they were telling me what they either really believed themselves--or simply thought I wanted to hear.

My other belated realization has been that what I've really been studying hasn't been the "medical" uses of pot; rather it's a much larger phenomenon: how the now-huge illegal market for cannabis began to develop slowly and steadily right after a federal "war on drugs" was declared back in 1969-  shortly after pot was first discovered by a substantial fraction of the early 'Baby Boomers' who were then coming of age. It's also clear that the same market has grown incrementally as many older adults have remained users while new users were being recruited from each new class reaching Junior High. Finally, I also now understand why survivors of the early 'hippie' era, who are now in their mid-to-late Fifties, constitute a disproportionately large fraction of my applicant population--  while all  those born before 1946 make up less than 5% .

In other words, what has been most strikingly missed in the ongoing 'debate' about pot smoking in America has been its sharply defined generational nature and pot's continuing appeal for users beyond the ages of forty and fifty. That's probably why the first histories I heard from applicants of all ages struck me as being so wide of the mark. In addition to being  an experienced clinician who could decipher their physical complaints with reasonable confidence, I was also from an earlier generation- and  thus able to recognize something they didn't: the fact that nearly all of them had  also tried alcohol and tobacco at about the same time they tried pot was the clue they may have been trying all three as potential self-medications.

Little did I realize what intense denial that observation would provoke. Again, the problem proved largely generational: the great majority of active 'reformers' were also born after 1945; thus, like my applicants,  they are either 'Baby Boomers' or post-boomers who have grown up with the drug war and can't imagine the reality of my own  high school days  (1945-49) when "marijuana" was an exotic curiosity we had only hearsay knowledge of. The only two drugs troubled youth could try then were alcohol and tobacco. Of course neither were considered "drugs;" thus our first  experiments with them  were thought of as 'normal' adolescent rites of passage; and any subsequent repetitive use was 'recreational; not self-medication or the  possible beginning of life-long 'drug habits.'

But they were. The first important change in that dynamic was the addition of pot, as a third alternative to alcohol and tobacco, in the late Sixties;  just about the time several other 'psychedelic' agents were also  discovered. The world was then abruptly changed forever when an insecure  conservative  politician was elected to the Presidency and responded to what he saw as a drug-fueled youthful rebellion by declaring "war" on all (illegal) drugs.

What has become increasingly clear to me as I have gradually processed the revelations of California pot smokers in response to focused questions about their drug use is that when properly analyzed, that data provides both an excellent time-line of American drug prohibition as policy and is also powerful evidence that none of our now-huge illegal drug markets began  growing to their present size until after a minor-- and chronically failing-- drug policy was suddenly reborn as an all out 'war' on drugs.

More later,

Tom O'Connell, MD

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