The Media and Drug Policy: Where’s the Science?

Groping blindly toward a new framework.

As states and the federal government clash at the legal, social, and political levels over legalizing marijuana, the science of drugs and addiction has taken a back seat. The dismal state of the addiction treatment business has recently been documented by Anne M. Fletcher in Inside Rehab, while over the past few years, drug policy officials in the U.S. have had to cope with three major developments: the medicalization and legalization of marijuana, the emergence of new synthetic drugs, and the abuse of potent prescription painkillers.

Major media outlets have largely failed to highlight the relevant scientific issues in each case. What we see instead is that journalists and others who are covering drugs and addiction issues are not making connections with solid scientific sources in the neurochemical research community. All too often, media reports of adverse drug events are sourced solely by police officers, or spokespersons on behalf of for-profit rehab centers, who are no more ready to make science-based pronouncements on these matters than anyone else.

States are now in the process of relaxing strictures on the possession and use of cannabis—and they are doing it well before they have put in place a set of evidence-based policies for the implementation of this new state of affairs. Who is in charge of directing policy decisions in Washington and Colorado? What will be the regulatory structure at the level of county and municipal government? Whose voices will actually be heard? Should the feds leave it to the states, and the states leave it to the counties, who then leave it to the cities? To what degree are the two states taking the medical and health aspects of this sweeping change into account? Can evidence be substituted for opinion in such cases? If so, how?

Even if the Department of Justice decides to shut down all efforts at relaxing marijuana statutes, it will need to rely upon a sound collection of scientific evidence to make its argument. The media play a compelling role in drug discussions, but coverage traditionally has been limited to articles about the legal, political, and sociocultural ramifications of the changes. These are all critical parts of the story, but science journalists need to step forward and direct more coverage toward emerging medical issues and the findings of science. Ordinary citizens will want to have at least a partial grasp of the medical and science-based decisions that state and federal governments will be making about personal health and habits as they legislate and adjudicate these concerns.

The federal government will have to begin working with states rather than against them, if public opinion continues to change on legalization issues. At the same time, the feds will be called upon to provide guidance for the states that is consistent with international drug treaties. Congressional committees will have to grapple with the realities of setting forth the limits and logistics of the market for marijuana in coherent and consistent ways. Incredibly, very little of this is pinned down, firmly understood, or even grasped as imminent problems by either legalizers or their opponents. Many of the issues that took years to wrestle down with cigarettes, such as warning labels on cigarette packages, will present themselves with equal and immediate force in the case of states with legalization plans.

In addition, marijuana policy makers in Colorado and Washington will have to render decisions concerning sales to minors, cannabis in the workplace, DUI marijuana laws, addiction issues, sales outlets, tax issues, and the results of ongoing medical research on marijuana. Some states allow private dispensaries, some have banned them. Some allow private cultivation of cannabis, and some do not. 

As for the newer synthetic drugs—the cannabis-like products known as Spice, and designer stimulant drugs known collectively as “bath salts”— these chemicals exist in a twilight zone of ignorance, with very little sound medical information passing to the public. Few people understand with any degree of certainty just what is inside those shiny foil packages. This glaring disconnect between clinical research and media reports leads to unsupported tales of face-eating zombies and dead teenagers on bath salts, well in advance of the drug testing that might factually answer questions about drug-related behavior. Meanwhile, scientists fear that the continuing effort to ban every substance illegally marketed in this category will close off certain valuable avenues of research, including new drug discovery.

Finally, the ongoing battle to lower the soaring use and abuse of oxycontin, Vicodin, and other opiate drugs has caused problems for legitimate pain patients across the country. Yet this medical aspect of the painkiller panic is rarely remarked upon. Some addiction researchers believe that as prescription painkillers are removed from the market or made more difficult to abuse, those with opiate addictions will migrate to heroin in greater numbers. Scientific research on addiction suggests that this may well be the case. 

What is missing specifically from most drug policy debates is the recognition of the vast metabolic variation among individuals. Different drugs affect different people differently, and for the first time, neuroscientists are building a solid body of information that could help policy makers better forecast the results of their actions. Lethality, side effects, tolerance, and susceptibility to addiction all vary widely due to metabolic differences among people.

But some shared reactions, and basic withdrawal parameters, do exist. Congress, the FDA, NIDA, as well as state health agencies and other regulatory bodies, need information about drugs and drug use that scientists have been busily compiling. The public needs this information, too. We need to search for ways media can more effectively inject science-based drug information into current policy debates. 

Science journalists are perfectly situated to serve as potential communicators between warring parties. What can the media do to markedly enhance intelligent, science-based coverage of drug issues?

Photo: Telstar Logistics

Common Field Test for Marijuana is Unreliable, Critics Say

A 75-year old pot assay is due for an update.

We’ve all seen it on cop shows: The little plastic bag, the officer breaking the seal on a small pipette and inserting a bit of marijuana, then a firm shake, and voila, the liquid in the test satchel turns purple: Guilty.

Here’s an interesting twist they don’t tell you about: The so-called Duquenois-Levine test—the dominant method for field-testing marijuana since 1930—is considered by many to be wildly inaccurate, and frequently doesn’t hold up in court. One U.S. Superior Court judge referred to the test as “pseudo-scientific.”

The test itself works fine. The problem is that, in addition to identifying marijuana or hashish, the Duquenois-Levine, or D-L, frequently reads positive for tea, nutmeg, sage, and dozens of other chemicals—including resorcinols, a family of over-the-counter medicines, which, according to John Kelly at AlterNet, includes Sucrets throat lozenges. This does matter, because in New York, Washington, D.C., and elsewhere, inner-city minority kids are getting busted for pot in record numbers. Lacking a reliable test protocol, marijuana is whatever the officer says it is. In a classic case that continues to bedevil the testing industry, a middle-aged woman was busted for marijuana while bird watching. A “leafy substance” turned purple on the Duquenois-Levine (D-L) test, and the woman was arrested. The material turned out to be sage, sweetgrass, and lavender, and the woman was engaging in a Native American purifying ritual using a smudge, a concept with which the arresting officers were unfamiliar.

So, when push comes to shove, a positive D-L rarely establishes the presence of marijuana beyond a reasonable doubt, without further confirmatory testing. For at least 20 years now, a visual inspection and a NarcoPouch, as the D-L field test is called, were enough to bring on the felony charges. State courts have squabbled over the matter, but state legislatures have been reluctant to intervene, in large part because sending samples to a lab for confirmatory testing is prohibitively expensive, particularly when the busts are small. The D-L test saves money.

According to the official drug policy of the United Nations, a positive marijuana ID requires gas chromatography/mass spectrometry analysis. And even this far more sophisticated test has angered courts in Washington and Colorado, the UK Guardian reports, “because the DEA doesn’t have standard lab protocols to govern its use.” In part, the judges are furious because plea-bargaining depends upon valid drug possession evidence. So, the officers themselves, when it comes to testifying in court, become de facto expert witnesses, able to identify illegal drugs on sight. Ah, those were the days. But now, cannabis-based products come in a bewildering variety of sizes, shapes, colors, smells, and chemical compositions.

But c’mon, if it looks like bud and it smells like bud… except that the research shows there are 120 terpenoid-type compounds involved in the odor of marijuana. No two varieties smell exactly alike. There is no characteristic marijuana smell—there are hundreds of characteristic marijuana smells. Nonetheless, in 2009 the National Academy of Sciences called the testing of controlled substances “a mature forensic science discipline,” according to AlterNet.

In a 2008 article for the Texas Tech Law Review, Frederic Whitehurst, Executive Director for the Forensic Justice Project and formerly with the FBI, concluded: “We are arresting vast numbers of citizens for possession of a substance that we cannot identify by utilizing the forensic protocol that is presently in use in most crime labs in the United States.” In another section of the article, Whitehurst asks: “Why is this protocol still being utilized to decide whether human beings should be confined to cages and at times, to death chambers?” And as Stewart J. Lawrence and John Kelly write in the Guardian, “using manifestly flawed drug identification tests to charge defendants, or pressure them to plead guilty, is hard to square with a defendant’s right to due process.”

Photo Credit: http://www.howardcountydui.com/ 

Addiction in the Courtroom [Guest Post]

Forensic psychology and the paradox of addiction.

Allison Gamble says she has been a curious student of psychology since high school. Though her studies ultimately led her to writing and editing, she keeps her understanding of the mind close at hand in the weird world of internet marketing.

The paradox of addiction presents a legal conundrum when it comes to determining the extent of a defendant’s guilt in criminal court. Although addiction is generally considered a mental health condition, it does not lie within the parameters that typically define mental illness in the courts. Though defense lawyers may present addiction as a mitigating factor--in some cases influencing the jury to vote for a lesser conviction--addiction does not excuse the defendant from being legally responsible for the crime.

Forensic psychology is a field that weaves together psychology and the criminal justice system. Oftentimes these insights prove useful for determining legal guilt or innocence. For example, if a defendant is found not guilty by reason of insanity, it is likely due to the work of a forensic psychologist. However, when it comes to crimes involving addictive behavior, forensic psychology is faced with paradoxical truths regarding addiction, and the relationship between addiction and responsibility for one’s actions.

A commonly held view of addiction is that it is a disease marked by lack of control. An alcoholic cannot stop himself from drinking. Likewise, a drug addict will do things no one in their right mind would ever do just to get the next high. All of these people may thoroughly regret their behavior when the high wears off, but that does not stop them from doing it again. Indeed, they often cannot stop without help.

Paradoxically, however, addiction is all about choice. A crucial part of treatment for addiction requires the addict to take full responsibility for his or her behavior. Addicts must recognize that their addictive behavior is, on some level, a choice, and that they can choose differently. It is not clear to what extent biology plays a role in starting an addiction. Social and emotional factors also play parts, both in forming an addiction and in continuing it.

This creates a huge gray area when an addict commits a crime related to his or her addiction. Did the person have control over their behavior? Is the addiction itself a choice, or something the addict can’t help any more than they could help catching the flu? Especially in cases where the addiction itself is a crime, such as compulsive shoplifting or narcotic use, these questions are crucial in determining the defendant’s responsibility for the crime and an appropriate sentence. Generally if these questions can be answered at all, the answer is often both yes and no, and the legal system often reflects this dichotomy: People convicted of addiction-related crimes may be ordered into treatment as part of their sentences. In some cases, especially for crimes not involving violence or repeat offenses, criminal charges are dropped if the defendant agrees to treatment. However, a defendant being treated for addiction may also be sentenced to jail time, probation, fines, community service, and/or restitution, especially if the crime involved violence or property damage. Since addiction is both under and outside of the addict’s control, someone who commits an addiction-related crime should be both held responsible and offered treatment.

Graphics Credit: http://diaryofasmartchick.com/

The Bong Water Case Revisited

Minnesota v. Peck.

Astute readers will recall the Great Bong Water Decision of 2009, in which the Minnesota Supreme Court determined, 4-3, that water used in a water pipe can be considered a “drug mixture.” Twenty five grams or more of this water, the court ruled, qualified the possessor for a first-degree criminal conviction and up to 30 years in prison.

The decision made the Minnesota Court the punch line in a worldwide joke, but things didn’t turn out so funny for defendant Sara Peck, who was sentenced to a year in jail, with six months suspended, after she pleaded guilty to Controlled Substance violations.  The quirk in the case was that the drug dissolved in the bong water wasn’t marijuana, but methamphetamine--a strange circumstance to say the least.

Nonetheless, Minneapolis criminal attorney Thomas Gallagher thinks that the ruling basically meant that, under the new interpretation, water could enhance the severity of a drug crime: “If trace amounts of criminalized drugs in bong water could be a crime based upon the weight of the water ‘mixture,’ then would not trace amounts of illegal drugs in our drinking water also be a crime to possess?”

It follows logically that “every citizen of Minnesota [is] a drug criminal” if they use tap water, since trace amounts of dozens of prescription drugs are routinely present in tap water (I live in Minnesota, but, as the fates would have it, draw my water from a well, which should protect me from prosecution).

A bill introduced in the Minnesota House is designed to correct the situation. The bill would have the state determine the volume of illegal drugs in an arrest by “weighing the residue of a controlled substance” rather than the entire weight of the compound or mixture the drugs might be a part of.  (I can already envision a legal argument regarding the possession of unsmokable, discardable marijuana plant stems, by far the majority component of high-volume pot busts.)

The problem is obvious: “The Minnesota Bong Water case has helped undermine what public confidence there was in criminal drug laws and their enforcement,” writes Gallagher, citing a portion of the written dissent in the original court ruling in the Peck case:

“The majority’s decision to permit bong water to be used to support a first-degree felony controlled-substance charge runs counter to the legislative structure of our drug laws, does not make common sense, and borders on the absurd.”

Photo Credit: http://www.pigginempire.co.uk

U.K Considers Tougher Pot Law

Health officials claim 500 hospitalizations per week.

In a reversal of previous policy, Prime Minister Gordon Brown signaled his likely approval of a move to stiffen marijuana enforcement by upgrading cannabis to so-called Class B drug status. If approved by Brown’s Advisory Council on the Misuse of Drugs, the reclassification would mean a prison term of up to five years for possession of marijuana.

Meanwhile, the London Daily Telegraph, citing high-level health authorities, claimed that official figures showed a 50 per cent increase in the number of people requiring medical attention after cannabis use. “Almost 500 adults and children are treated in hospitals and clinics every week for the effects of cannabis,” the article claimed.

The Telegraph went on to assert that the figures “proved Labour’s decision to reclassify cannabis in January 2004, which made the penalties for its possession less severe, was badly mistaken and had sent out the wrong signals about it being a ‘soft’ drug.”

Previously, the British government under Tony Blair had downgraded cannabis to a Class C drug in 2004, putting it in the same group with steroids and prescription antidepressants. Class B includes amphetamines and cocaine.

Home Secretary Jacqui Smith, in a letter to the Advisory Council, said that “there is real public concern about the potential mental health effects of cannabis use, in particular the use of stronger forms of the drug, commonly known as skunk.”

Last July, Mr. Brown explained his intentions: “Why I want to upgrade cannabis and make it more a drug that people worry about is that we don’t want to send out a message, just like with alcohol, to teenagers that we accept these things.”

DrugScope, a British drug policy organization, sent a letter to the Telegraph opposing the move, charging that the Telegraph had misrepresented figures given out by the Minister of State for Public Health. “We have ascertained that the figures supplied by the Minister do not relate to actual hospital admissions,” said the DrugScope letter. “The figures instead relate to those who have come forward to community-based drug treatment services seeking some form of help, advice or treatment relating to their use of cannabis.” Drugscope’s analysis of the figures yielded a national figure of 14 hospital admissions per week. “This is 14 admissions too many,” DrugScope wrote, “but still way below the figure quoted.”

The debate harkens back to a mental health story run by the London Daily Mail in August, which claimed that smoking a single joint of marijuana increases the risk of developing schizophrenia by 41 per cent—an erroneous statistic that was also hotly contested by various U.K. drug experts.

The tighter pot laws envisioned by the Prime Minister dovetail neatly with the current emphasis by U.S. Drug Czar John P. Walters on teenage cannabis use--a stance that has enraged many U.S. officials, including Iowa Republican Senator Charles Grassley, according to a recent, well-researched article in Rolling Stone. “What I’ve never understood,” said Grassley, “is why they took marijuana so much more seriously that methamphetamine, when methamphetamine is a much more serious drug.”