Sober Recovery

After eight years of drug war status quo under the GOP, drug reformers are now hoping for positive changes in federal drug policies.

Welcome to North America's only officially sanctioned "supervised injection site."

If lawmakers really wanted to address marijuana use, they would regulate and tax pot like they do tobacco.

Smokeless nicotine comes under scrutiny.

You may never have heard of it—but it’s the newest drug in town. It’s called an electronic cigarette, or “e-cigarette.” Electronic cigarettes use batteries to convert liquid nicotine into a fine, heated mist that is absorbed by the lungs. No smoke, but plenty of what makes cigarettes go, if you don’t account for taste—or ashtrays and smoke rings.

In an attempt to work around the world’s growing ban on cigarette smoking in public places, a Hong Kong-based company developed the first e-cigarette in 2004. Since then, other companies have done the same, claiming that e-cigarettes are much healthier than regular smokes.

Last month, that claim was vigorously disputed by the World Health Organization (WHO). In fact, WHO said electronic cigarettes can be deadly. Stressing that the device had not been adequately tested, Douglas Bettcher, the director of WHO’s Tobacco Free Initiative, told the Associated Press that “there’s no experience in pharmacology yet of nicotine replacement therapies which actually inhale nicotine in the lungs.” Replacement therapies such as skin patches and gum have undergone thorough clinical testing, Bettcher said. For these reasons, “the World Health Organization does not consider the electronic cigarette to be a legitimate nicotine replacement therapy.”

The anti-smoking group Action on Smoking and Health (ASH) doesn’t think much of e-cigarettes, either. In the U.K. Times Online, ASH director Deborah Arnott said that “at the moment we don’t know enough about this product. Quality control in China is not the highest, and our advice is it’s best to use nicotine products like gums and patches. The electronic cigarettes fall into a regulatory gap and they haven’t been chemically tested.”

So far, electronic cigarettes are being actively marketed in China, Great Britain, Canada, Brazil, Israel, Sweden, and other countries. The cartridges containing the liquid nicotine are available in several flavors, and battery life is estimated at one to three days for most units. The e-cigarette web site www.e-cig.org offers a list of “best places to use your electronic cigarette,” such as airplanes, in church, at the mall, in a restaurant, bar or hospital, or “at your kid’s school recital.”

According to China View News , a “changeable filter contains a liquid with nicotine and propylene glycol. When the user inhales as he would when smoking, air flow is detected by a sensor and a micro-processor activates an atomizer which injects tiny droplets of the liquid into the flowing air, producing a vapour.”

The unit, which looks like a long cigarette, is powered by a rechargeable battery. Propylene glycol is a commercial product sold as a low-toxicity version of antifreeze, among other applications.

E-cigarettes are readily available for purchase online, and at least one American firm has announced plans to market versions of e-cigarettes domestically. However, none of the manufacturers to date seems to be working through the existing regulatory framework, which in most countries calls for toxicity analyses and clinical studies. Jason Cropper, managing director of the Electronic Cigarettes Company, told BBC News that e-cigarettes “are certainly healthier than smoking cigarettes. Tests have been done on mice in the lab and they have shown they are not harmful.” However, Cropper said, no human trials had been undertaken because they are too expensive.

The World Health Organization became involved in the matter after several e-cigarette manufacturers began using the World Health Organization’s logo on advertisements and product inserts. “It’s 100 percent false to affirm this is a therapy for smokers to quit,” Bettcher said. “There are a number of chemical additives in the product that could be very toxic.”

Meanwhile, The Ruyan e-cigarette, a joint effort by Ruyan Holdings Ltd. of Hong Kong and Ruyan America, Inc., won Most Innovative Product of 2008 at the Tobacco Plus Expo in Las Vegas last May.

Voters bolster medical marijuana movement—or do they?

On November 4, both Michigan and Massachusetts passed harm reduction measures aimed at eliminating stiff penalties for possession of small amounts of marijuana. Opponents vowed to keep fighting.

In Michigan, on a vote of 63% to 37%, voters passed Proposal 1, allowing for the physician-supervised possession and use of cannabis. However, the initiative did not go as far as allowing for licensed medical dispensaries, as California has done. Nonetheless, this was not a happy outcome for the President’s Office of National Drug Control Policy and its director, John P. Walters, who campaigned strenuously against the measure, calling it an “abomination” and said it was likely to lead to marijuana shops in every neighborhood. For its part, the Michigan Coalition for Compassionate Care said that passage of the proposal would mean that “seriously ill Michiganders who use medical marijuana with their doctors’ recommendation will no longer face the threat of arrest and jail.”

Similar scare tactics failed to deter the electorate of Massachusetts, where 65% of voters came down in favor of Question 2, which calls for rolling back penalties for possession of small amounts of marijuana to traffic-fine levels—a strategy which was adopted successfully, if briefly, by Oregon, Alaska, and other states some 35 years ago.

As in Michigan, a full-on campaign against the measure painted a picture of dire consequences for Massachusetts, such as a surge of workplace safety issues and traffic accidents. According to the Marijuana Policy Project, the state’s District Attorneys predicted an epidemic of teen marijuana use. State authorities have the ability to amend the new statute under state law.

Michigan and Massachusetts now become the 13th and 14th states to offer some protection for the medical use of marijuana. Both propositions were heavily endorsed by major newspapers in both states. The city of Fayetteville, Arkansas, as well as Hawaii County in Hawaii, passed ballot measures designed to make marijuana enforcement a low priority for local law officers.

Meanwhile, in California a proposition designed to divert greater numbers of drug offenders from jail to treatment, while decriminalizing the possession of up to an ounce of marijuana by anybody, went down to defeat. Supporters of Proposition 5 had argued that the change was necessary because of seriously overcrowding in California’s state jail systems.

Here's a brief roundup of drug-related propositions on last week's ballots:
Marijuana Policy Project

Graphic Credit: Michigan Coalition for Compassionate Care

Lexington, Kentucky's notorious treatment center.

From 1935 through the 1960s, if you were famous, and you got busted for serious narcotics, there was a good chance of ending up at the U.S. government's combination addiction hospital and mad scientist's dream factory. Novelist William Burroughs may have been its most famous graduate, but everyone from jazz saxophonist Sonny Rollins to actor Peter Lorre did time there.

"Narrated and scored by former inmate Wayne Kramer," according to the film's website, "the film tells the story of this long forgotten American institution through the voices of the former addicts who spent years of their lives locked within its walls."

Scientific American says the film is "based on rare film footage, numerous documents, dozens of interviews of former staff, inmates and volunteer patients, and more than 2,000 photographs unearthed from archives across the country."

The documentary will be showing on PBS channels throughout November. Check local listings. A companion book of the same title is available.

We have an opportunity to re-shape drug policy for a generation.

Three suggestions for how Obama can take immediate, practical steps to reform America's antiquated and punitive pot laws

A video guide for how to exercise your constitutional rights during encounters with police.

Voters dealt what may be a fatal blow to America's longest-running and least-discussed war -- the war on marijuana.

Voters have rejected the Bush doctrine on drugs.

The good old days of tobacco advertising.

The Transform Drug Policy Foundation of the U.K. has an absolutely first-rate collection of early cigarette advertising on display at their TDPF blog.

I’ve always been a sucker for the ones featuring doctors:

The TDPF blog calls this one “particularly awful, featuring a five year old girl proclaiming to her paternal looking doctor figure and radiant young mother that 'I'm going to grow a hundred years old'. It then goes on to inform us that ‘possibly she may - for the amazing strides of medical science have added years to life expectancy.' You can 'thank your doctor and thousands like him--toiling ceaselessly--that you and yours may enjoy a longer better life.’”

It sounds like something Dan Draper and his associates might have dreamed up on "Mad Men."

Yes, toiling ceaselessly—and, one may add, perversely—to convince an increasingly wary public that popular slang like “coffin nails” and “smoker’s cough” were the results of misguided thinking.

The TDPF, in turn, found the extensive collection at Stanford University’s wonderful “Not a Cough in a Carload” site.

The exhibit is intended “to tell—principally through advertising images—the story of how, between the late 1920s and the early 1950s, tobacco companies used deceptive and often patently false claims in an effort to reassure the public of the safety of their products.”

Smoking doctors were everywhere in the ads. The Stanford site states: “Among the more reprehensible tactics was the utilization of the image of the noble and caring physician to sell cigarettes: Doctors were depicted both as satisfied and enthusiastic partakers of the smoking habit ("More Doctors Smoke Camels"). Images of medical men (and a few token women) appeared under soothing reassurances of the safety of smoking. Liberal use was also made of pseudo-scientific medical reports and surveys.”

The print ad above is lamentably undated. The collection covers advertising from the 1930s through the 1950s.

“On first impression,” says the Stanford site, “most viewers will find these images outrageous, humorous, and so blatantly false as to trigger incredulity. But tobacco industry ad men also excelled in creative genius and had high levels of artistic skill. The best talent money could buy was recruited for this effort. Tobacco advertisers faced a daunting challenge: How do you sell a product which shortens the life of the user by an average of about 8 years?”

Californians have chance with the NORA initiative to reject decades of fear mongering and try alternatives to jail for drug abuse.

Californians have chance with the NORA initiative to reject decades of fear mongering and try alternatives to jail for drug abuse.

Treatment graduates ask CA voters to give others the opportunity they had, to get treatment and turn their lives around.

The NORA initiative would invest $65 million annually into developingdrug treatment programs for at-risk California youth under 18.

Supporters of California's Prop 5 argue it would dramatically improve the way non-violent offenders are treated.

Overeating, drug abuse, and the D2 receptor.

A genetic variation in the dopamine D2 receptor predisposes women toward obesity, according to a small but potentially significant study published in the October 17 issue of Science.

While numerous twins studies demonstrate the likelihood of biological factors in obesity, there are few rigorous studies that back up the contention. Now researchers from Yale University and the University of Texas have used brain scans to show that a dopamine-rich structure called the dorsal striatum exhibits “reduced D2 receptor density and compromised signaling” in obese individuals.

Why would this matter? The dorsal striatum releases dopamine in response to the consumption of tasty food. Going right to the sugary heart of the tasty food cornucopia, the researchers used chocolate milkshakes. Women volunteers underwent MRI scans while researchers administered either squirts of milkshake or squirts of a tasteless liquid. The lower the dopamine response to the milkshake dorsal striatum, the more likely the woman was to gain weight over the following year. Reduced dopamine receptor density in the dorsal striatum “may prompt them to overeat in an effort to compensate for this reward deficit,” the study authors concluded. The all-female study lends more evidence to the notion that dopamine D2 variations “are associated with both obesity and substance abuse....”

Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), told Associated Press: “It takes the gene associated with greater vulnerability for obesity and asks the question why. What is it doing to the way the brain is functioning that would make a person more vulnerable to compulsively eat food and become obese?”

Historically, however, the D2 allele has been a controversial locus of research in addiction medicine. In 1990, a research team reported in the Journal of the American Medical Association that the A-1 allele controlling production of the dopamine D2 receptor was three times as common in the brains of deceased alcoholics. The aberrant form of the gene was found in 77 per cent of the alcoholics, compared with only 28 per cent of the non-alcoholics. But attempts to replicate the research did not meet with much success. (See Bower, Bruce. “Gene in the Bottle.” Science News, September 21, 1991. p.19). In addition, the findings from the nationwide Collaborative Study on the Genetics of Alcoholism were not supportive of the D2 hypothesis. (“We believe it doesn’t increase the risk for anything,” one researcher said bluntly.) Well-known researcher Robert Cloninger weighed in with a paper demonstrating that when you broadened the samples and took another look, the D2 connection faded away, suggesting that the D2 allele in question may play a second-order role of some sort. (See Holden, Constance. “A Cautionary Genetic Tale: The Sobering Story of D2.” Science. June 17, 1994. 264 p.1696 ).

The current Science study concludes that “individuals who show blunted striatal activation during food intake are at risk for obesity.... behavioral or pharmacologic interventions that remedy striatal hypofunctioning may assist in the prevent and treatment of this pernicioujs health problem.” NIDA’s Volkow, quoted in the Washington Post, said: “Dieting is a complex process and people don’t like it. Physical activity, which also activates the dopamine pathway, may be a mechanism for reducing the compulsive activity of overeating.”

Dr. Eric Stice of the Oregon Research Institute, the lead scientist on the study, told AP that the findings might have implications for parents. Since most parents don’t know if they possess the suspect variation, Stice suggested than parents could start attending more to the diets of children, “and not get their brains used to having crappy food.”


Photo Credit: Cell Science

There is a raging battle in the treatment community over how much carrot vs. stick we should use to help people who need treatment.

Scientists have discovered evidence suggesting Stone Age peoples used herbal mixtures to get high.

Ceramic bowls and tubes discovered--but what were they sniffing?

Archeologists have never doubted that prehistoric man liked to get high. Previous excavations in Mexico and Texas have yielded indirect evidence of the New World use of peyote and mescal several thousand years ago. However, researcher Quetta Kaye of University College, London, says she has found the actual works—“The objects tested for this study are ceramic inhaling bowls that were likely used for the ingestion of hallucinogenic substances,” Kaye wrote in the Journal of Archaeological Science.

Such physical finds are not uncommon, but the estimated age of these ceramic items caught the attention of archeologists. In a report published in the London Sunday Times, science editor Jonathan Leake writes that the bowls likely originated in South America between 100 and 400 B.C., and were carried to the Caribbean island of Carriacou, where Kaye, along with Scott Fitzpatrick from North Carolina State University, discovered the artifacts.

So what, exactly, were Stone Age Caribbeans snorting or smoking? It wasn’t cannabis, since the plant was not growing in the Caribbean at that time, experts say. Some form of psychoactive fungi or mold, like ergot, or a mind-altering mushroom are always possibilities. But according to the Times report, “Kaye believes one of the most likely [drugs] was cohoba, a hallucinogen made from the beans of a mimosa species.” This DMT-containing plant is known to have been used as a hallucinogenic snuff by the Taíno, a Caribbean people who dominated the islands of Puerto Rico, the Dominican Republic, Haiti, Cuba, and Jamaica from 1200 A.D. until the time of Columbus.

Jonathan Ott writes in “Pharmacotheon” that “during Columbus' second voyage to the Americas, 1493-1496, the Admiral himself commented on a mysterious ‘powder’ which the ‘kings’ of the Taíno Indians of the island of Hispaniola would ‘snuff up,’ and that ‘with this powder they lose consciousness and become like drunken men’" (Torres 1988; Wassén 1967).

Cohoba was also sniffed in Trinidad, and in parts of northern South America. DMT is a powerful, short-acting hallucinogen with striking visual imagery, often combined with an MAOI inhibitor for maximum effectiveness. Ayahuasca is another potent South American brew with similar effects. Cohoba is reportedly still in use by shamans in the Amazon basin.

Richard Davenport-Hines, author of “The Pursuit of Oblivion,” and a former history professor at the London School of Economics, told The Times: “Drug use became widespread in many early agriculture-based societies simply because it was the only way people could cope with spending long hours working in the fields, often in horrible conditions like baking sun.”

That’s one theory, anyway. Other archeologists and anthropologists have long maintained that humans have used psychoactive plants for thousands of years primarily in shamanic practices and religious rituals.

74% of all Americans busted for pot are under 30 -- it's long past time young people joined ranks and helped end this drug war.