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May 08, 2006

Why the 'Serious Illness' Notion has been a Serious Mistake

In the last entry I promised to discuss why I think the notion that permission to use cannabis on medical grounds should be granted only to those with ‘serious’ diseases  is 'unrealistic.'

Actually; I think it's both silly and self defeating

Although several good reasons for thinking that way might become apparent to  an experienced clinician after a bit of critical analysis, most working doctors have already been so intimidated by the drug war they have long since excused themselves from thinking seriously about cannabis. Thus, even the most cogent clinical arguments I might make (and there are several) wouldn’t help much-- and would be Greek to non-clinicians.

No problem; a perfectly good case can be made from basic human nature if we simply consider the almost universal bans on two other human behaviors widely regarded as ‘sinful:’ gambling and prostitution. Those proscriptions have also tended to survive in secular democracies despite their perennial failure. Although cloaked in the garb of Public Health from the time of the Harrison Act, our drug war had its roots in the same quasi-religious logic that led to bans on commercial sex and wagering; they simply had much longer histories in Western society.

One key to understanding the underlying connection between the three bans is that, from the outset, they all relied heavily on the state’s powers of arrest and prosecution. The biggest difference was that, in the case of drugs, the first clamor for a ban came from the top down. However, that difference is also readily understood: our drug policy, like many others, had complex origins. Early in the Twentieth Century there was a desire to curry favor with China; along with an increasing public awareness of ‘addiction’ as an exotic problem. Combining them under the circumstances that existed at the time was both logical and effective.

The next point to be made is that historically,  policies criminalizing specific behaviors which were not regarded as directly threatening by a significant fraction of the affected population have tended to fail. Beyond that, increasing attempts at top-down enforcement in the face of such failure has usually tended to corrupt both law enforcement agencies and the affected society. One would think that such a history— especaiiy if repeated several times— might have triggered some recognition among politcal analysts that moral prohibitions do not make good policy; but such critiques are noteworthy for their absence. All one has to do is search for academic treatises either analyzing or condemning moral prohibitions as failures to be struck by their relative absence–– either in the past, or in the modern glut of books dealing in detail with every imaginable subject.

The only possible conclusion also applies directly to the drug war itself: morality-based policies, no matter how irrational they prove to be, tend to be treated with undue deference at every level of society. Once understood as an intrinsic part of human nature, that scruple goes a long way in explaining both the  persuasive nature of ‘politically correct’ ideas, and the undue deference accorded certain notions in the absence of evidence that they are at all realistic. Examples are the ‘will of the people,’  the 'essential' nobility of humanity, and the idea that we humans were intended to 'rule' over other species.

It thus appears that the ‘seriously ill' scruple is simply the logical default for (typically human) critics of the drug war; the down side of such thinking is that it has prevented them from understanding— and promulgating— solid clinical evidence that our drug policy has actually had far worse consequences than most people imagined.

It also explains why I must rely on this blog to communicate with the demonstrably small nucleus of drug war resisters that 'gets it.' I am still forced by history (and basic human optimism) to believe that truth and logic are ultimately contagious; however, the process is usually erratic and was always been unpredictable. Whether modern IT will accelerate full recognition of the drug war's social consequences is still an unsettled question.

Doctor Tom

Posted by tjeffo at May 8, 2006 05:32 AM


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