Update Nov. 15: My letter to the editor in Monday’s Alligator.
Recently I wrote about the potential e-cigarettes hold for harm reduction, so when the University of Florida proposed a regulation that would expand its tobacco use ban to explicitly include e-cigarettes, I decided to speak up. Today I sent the following e-mail to Paula Fussell, Vice President for Human Resources.
During Jon Stewart’s interview with Al Gore, Stewart half-jokingly proposes one solution to the problem of oil interests slowing the move towards cleaner energies:
Stewart: Partner up with Exxon and say, “You own the oil and gas now; you can own the new thing.”
I have to admit, granting the oil companies monopolies on the replacement technologies would be a pragmatic solution to the problem. It would be messy, full of complicated conditions, and would horrify those that feel the oil companies should pay for the damage oil is doing, but the alternative we’re facing is a very slow mush toward the new paradigm while the planet suffers.
Moments later Stewart acknowledges that clean technologies will also eventually be controlled by a few large corporations, and of course he’s right. We’re just going to slowly trade one set of executives and lobbyists for another and with the unlikely hope that the new ones will hold the planet’s best interests above the bottom line.
Today almost no credible evidence suggests that cannabis belongs on Schedule I of the Controlled Substances Act, alongside drugs like heroin. This position has stifled medical research of the drug and its component chemicals for 39 years, making research extremely expensive and arbitrarily difficult to secure compared to that of much more harmful drugs.
A few organizations have spent enormous amounts of money going through the formal petition process in good faith to reschedule cannabis, and each petition has been met with blatant obstructionism; lengthy delays, arbitrary dismissals, last-minute over-rulings. The current petition hasn’t been acted on since its submission seven and a half years ago.
Two signs suggest we may soon see a relaxation of the unjustified limitations imposed on researchers.
1. One of the last influential and independent voices claiming that the drug had no medicinal properties (ignoring an absurd amount of evidence) was the American Medical Association. Today they finally fixed that. They make a very reasonable request:
Our American Medical Association (AMA) urges that marijuana’s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines. This should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana, or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription drug product. [AMA statement pdf]
2. Sativex is an oral spray pharmaceutical made from the whole cannabis plant; it should look suspiciously familiar to these medicinal extracts used around the turn of the century. Already approved in Canada, it’s breezing through U.S. phase III clinical trials for M.S. treatment, with FDA approval potentially a couple years away (barring political shenanigans). Upon approval, whole-plant cannabinoids–not just the isolated THC in dronabinol–can finally be easily studied for the treatment of other ailments.
If a cannabis extract proves to be as effective and safe as many scientists expect, I think it’s likely the public will demand more research in this area via some alteration of the Controlled Substances Act. My bet is that politics will keep marijuana in Schedule I, and (a generic name for) Sativex will be placed in Schedule III. This would ease research considerably while ensuring GW Pharmaceuticals enjoyed a healthy monopoly for years to come.
As for why cannabinoid research is so damned important, see GW Pharm’s site.
I first learned about e-cigarettes from Reason’s coverage of the FDA’s rush to ban them, and of the rightful criticism of that intent from the American Association of Public Health Physicians. Without smoke (e-cigs are miniature vaporizers), nicotine use is likely to be many magnitudes less harmful to the body.
The hope is that e-cig use wouldn’t be more harmful than downing a few espressos, but the research to confirm that absolutely needs to be done. In the meantime, we should allow adult smokers to try them. Taking them off the market would be ironic and cruel to today’s smokers and their families, who are absolutely certain that their–now FDA approved–smoking habit is leading them to an early grave.
We should also carefully regulate e-cigs, answering some hard questions. Should we restrict use to places where smoking is allowed? I’m not so sure that’s wise. An e-cig user is obviously taking an expensive step to reduce the harm to herself and others; should we punish her and force her to be around smoke, or use tolerance of e-cigs to encourage other smokers to also switch?
If a bit of vaporized nicotine turns out to be completely benign to bystanders, the public should concede that e-cig use just isn’t smoking (and we should rename it). We coffee and soda addicts enjoy the privilege (burden) of being able to catch our fix nearly anywhere, so we should consider being more accommodating for the sake of public health. We’re often talking about our parents and relatives.
Now it looks like Philip Morris may buy exclusive rights to e-cigs in the U.S. If their intent is to kill e-cigs, it would be consistent with their evil. On the other hand, PM would likely have the resources to get e-cigs through FDA approval, so literally the lives of many nicotine addicts could be saved if we allow PM to use its marketing muscle to turn smokers into e-cig users. Do we hate Philip Morris more than we care for the well-being of smokers?
Update: Great info on this topic at TobaccoHarmReduction.org, run by Dr. Carl Phillips, Associate Professor in the University of Alberta Department of Public Health Sciences.
Groups that are truly anti-smoking should embrace any alternative, but those that are more interested in making life difficult for smokers or nicotine users do not like these products because they could make nicotine users more comfortable.
One of the site’s headings: “Smokers have more choices than just quitting or dying.” Can’t agree more.
Due to web images being optimized for on-screen display (let’s say 96 DPI), images on printed pages are usually blurry, but they don’t have to be:
The Good News: The printed page will have an identical layout as in (2), but with a higher quality image. This is because–according to my testing–even browsers that use blocky “nearest neighbor” image scaling for screen will scale nicely for print.
Kansas resident Mike Nolan was the victim of a vicious bombing according to news agency “Fox4kc”.
We’re still awaiting word from DHS about troop deployment to Overland Park.
With all the talk of whether or not to increase troops in Afghanistan, and the ethics of killing from your armchair, I think a group needs to sit down and study the full costs and benefits of these wars. As provoking as tragedies like 9/11 are, if we assign value to “innocent” human lives equally and start adding up the numbers and the opportunity cost of our war on terror spending, I think we would be sickened at what we find.
The War on Malaria seems more worthy of resources, or we could just keep the money for silly things like food and health coverage for the unemployed.
The creators of StackOverflow should team up with the Dept. of Health & Human Services and launch a medical Q&A site based on the SO model.
StackOverflow was designed by a few programmers to scratch an itch within the community, and the model they came up with made it the most effective question/answer site I’ve ever used. Got a really, really tough programming question? You can probably get a half dozen answers in 5 or 10 minutes, and if you wait a day, you can see them ranked by quality by several programmers within your field.
As medical professionals contributed answers, comments, and votes in their spare time, a medical version of SO would quickly turn into an amazing resource for public health.
It might require some tweaking. SO users are generally in the same community, though sometimes different specialties. This makes it easier to design behavior-reinforcing tricks to keep user contributing. Every time I get a question answered I almost always end up taking a few minutes to provided input to other questions, and I earn points and “badges” for contributing (what other users deem as) good info.
On a medical Q&A site the advice takers and givers are mostly exclusive communities, but I think professionals would still contribute, and we could create ways to encourage them. Medical schools could require students to earn points on the site; we could reward consistently good contributors financially or with real awards.
(Written in August)
(Obviously started in August)
In the age of Glenn Beck, the town hall meeting paradigm is just the anonymous web forum with no moderator. The people interested in genuine discussion won’t go near it, and “socialist!” is the new “yr gay”. To this extent the tea party folks have certainly been successful at churning out viral YouTube clips, but for better or for worse, no one should get the impression that public meeting attendees are necessarily representative of a constituency.
I see a lot of conservative bloggers and commenters making the mistake of watching these clips and pronouncing that it’s evidence of a silent majority that will surely stand up and “throw the bums out” in 2010. HotAirPundit highlighted a Houston area meeting featuring an obnoxious birther and an angry crowd awaiting outside and concludes, “Something tells me he will get voted out.” Gene Green, the Democrat representative, took office with almost 75% of the vote, but I guess he could always wind up in some scandal and be replaced (probably with another Democrat).
This isn’t to say I’m necessarily behind the proposed reforms; reading McArdle hasn’t given me a lot of confidence in us being able to cut costs using similar actions at the state level, but I feel some brand of insurance reform is inevitable at this point and hope there are people behind this acting in good faith. Democrats are basically putting themselves on the chopping block with this so they may have more persuasive information than I have access to.