Drug Czar: hung by his own report by: Alan Bock I have read some criticisms of the Institute of Medicine report on the state of scientific knowledge regarding medical marijuana that have enough validity to be worth considering. Overall, however, the report (available to read or download here) competently summarizes and synthesizes a good deal of what is known and should prove valuable for those who hope that eventually science and reason will triumph over obfuscatory prohibitionism. Richard Cowan, former executive director of the National Organization for Reform of Marijuana Laws (NORML), notes an excessive emphasis on the dangers of smoking that is curious in the absence of any confirmed cases of lung cancer caused by marijuana smoking (a fact the report had to acknowledge). He also criticizes the report's writers' fixation on what he calls the "single molecule paradigm,'' the unproven assertion that isolation of single active molecules in the plant would be obviously superior to "licensing'' the whole plant. Many advocates of herbal medicine claim the unique combination of ingredients found in natural plants (not just marijuana) accounts for their therapeutic value. Maybe they're wrong, but shouldn't the viewpoint be mentioned, if only to be refuted? Steve Kubby, the former Libertarian Party candidate for governor in California who is a medical marijuana patient (adrenal cancer and high blood pressure) facing criminal trafficking charges for growing his own in his own home, notes that the IOM committee didn't discuss vaporization as an alternative to smoking though it had information about it, and that the study makes no mention of the eight patients who have received 7.1 pounds of marijuana a year from the federal government since the early 1980s, courtesy of the taxpayers. Surely they would have made good subjects for studies on long-term effects. All in all, says Mr. Kubby, "the IOM report is badly flawed science with politically poisoned conclusions.'' It may be true that the conclusions have been politically colored, but that may not be such a bad thing. Perhaps including a few politically correct demurrers like undue fear about the effects of smoking per se in an era in which smoking anything has been so demonized is a small price to pay for enhancing the credibility of the nuggets of valuable truth the report contains. I suspect the report's authors knew what most legalizers believe -- that, as they conclude after extensive documentation, "the adverse effects of marijuana use are within the range tolerated for other medications,'' that "a distinctive marijuana withdrawal syndrome has been identified but it is mild and short-lived,'' and that strict prohibition is a stupid policy. I infer some of this from a single sentence matter-of-factly included in a lengthy discussion of the perception that marijuana is a "gateway'' to the use of other more dangerous illicit drugs. The authors don't bother to tease out the implications but it isn't that difficult. The report notes that one of the main reasons many are so adamantly opposed to allowing marijuana to be used medicinally is "the fear that marijuana use might cause, as opposed to merely precede, the use of drugs that are more harmful.'' The authors divide the issue rather intelligently: "The gateway analogy evokes two ideas that are often confused. The first, more often referred to as the 'stepping stone' hypothesis, is the idea that progression from marijuana to other drugs arises from pharmacological properties of marijuana itself. The second interpretation is that marijuana serves as a gateway to the world of illegal drugs in which youths have greater opportunity and are under greater social pressure to try other illegal drugs. This is the interpretation most often used in the scientific literature, and it is supported by -- although not proven by -- the available data.'' They then discuss various studies and conclude that "there is no evidence that marijuana serves as a stepping stone on the basis of its particular drug effect," a fact even many prohibitionists will reluctantly concede. Then comes the sly kicker: "Whereas the stepping stone hypothesis presumes a predominantly physiological component to drug progression, the gateway theory is a social theory. The latter does not suggest that the pharmacological qualities of marijuana make it a risk factor for progression to other drug use. Instead it is the legal status of marijuana that makes it a gateway drug.'' Savor that apparently innocent sentence for a moment: "Instead it is the legal status of marijuana that makes it a gateway drug.'' What implications can be teased from that sentence? The main rationale for keeping marijuana illegal is not that it is so dangerous in and of itself, but that it can serve as a gateway to other, more genuinely dangerous drugs. But insofar as there is evidence that marijuana use sometimes leads to the use of harder drugs -- and there is some though it's not conclusive -- the reason is that marijuana possession and use is illegal. A nice piece of logic, eh? Take it another step. Those who insist on keeping the plant illegal bear a serious degree of moral responsibility for young marijuana users who do go on to use cocaine, heroin, PCP or other genuinely dangerous or addictive drugs. If Barry McCaffery and other drug warriors were really, seriously troubled by the possibility that use of marijuana might lead innocent or psychologically troubled people to harder drugs with much more severe physiological dangers, they would move as quickly as possible to legalize marijuana. The fact that they don't do so makes their plaintive pleas of compassionate concern for those victimized by addiction and drug-induced disorders ring hollow. In a word, they refuse to take the action that would be most likely to eliminate (or at least ameliorate) the only "gateway'' properties of marijuana that have a shred of scientific support because their drug war -- with all the money it shovels their way, with the opportunities it presents to seize property, kick in doors and shred the U.S. Constitution -- is far more precious to them than the ruined lives of addicts. Give them the benefit of the doubt that they didn't understand about the circularity of the "gateway'' contention before. But with this report -- commissioned by "drug czar'' McCaffery (your tax dollars at work), remember -- they have no excuse left. If they don't take the logical step of legalizing marijuana to reduce harm, how far beneath contempt are they? Alan Bock is senior editorial writer and columnist at the Orange County Register, Senior Contributing Editor at the National Educator, a contributing editor at Liberty magazine and author of "Ambush at Ruby Ridge."