War on Drugs
I fully expect to be called "anti-police" for the lead story this week. One doesn't have to be "anti" anything to decry stupidity, or even to call to task organizations you fully support when they do something wrong. Here's the story: Subscribe for Free
The story, of course, is another in my series on the "war on drugs". I've been fighting against that war on two fronts: I think drug abuse is simply stupid, but on the other hand I don't think our government should be fighting a "war" against its own citizens as long as their drug use doesn't infringe on the rights of others (e.g., by driving under the influence, which is rightfully a crime). That the "war" has escalated into case after case of bursting into innocent people's homes and shooting them to death is a solution that's far worse than the problem it supposedly addresses. In last week's issue there was a story about a guy in court to answer robbery charges who dropped a bag of pot in front of the judge. His defense lawyer (who was also his mother) told the judge her son "is brain-damaged.... This is a boy with an IQ in triple digits. His brain is glued together with Silly Putty. He can't think his way out of a paper bag, but he can do physics." My tagline: "A high IQ, but can't think his way out of a paper bag? Classic symptoms of long-term drug use." That's an example of the first part of my war on drugs. But it led to a reader to rant: Every single commission report from the 1895 British Hemp Commission to the recent one by the Canadian Senate has stated the [sic] marijuana use, including long term use, does not affect cognitive ability. Sociological studies in the late 1960s and early 1970s showed the [sic] marijuana smokers had the higher GPAs. You are an ignorant prejudiced jerk and I do not need to see anymore [sic] e-mails form [sic] you. You want feel sorry for someone [sic] why don't you feel sorry for all of those people you and your ignorance help put and keep in prison for doing something that is strictly their own business. There is no difference between you and someone on the radio in 1930s Germany talking about how all Jews steal and are responsible for the fatherland's defeat in World War I or someone in the pre-Civil War South saying that Blacks needed to be enslaved for their own good. The war on people who use certain kinds of drugs is all about a cheap and easy way for idiots like you to feel superior to other people for no valid reason. So just shut up and cash your check from the ONDCP you creep. --Keith in Maryland I didn't say marijuana, I said "drugs". But Keith couldn't quite comprehend that I'm more on his side than the government's -- he's fighting his own allies (my, isn't that useful? Might his thought process reflect, oh, long-term drug use?) His assertion that marijuana is totally harmless, that "every report" finds that "marijuana use, including long term use, does not affect cognitive ability" is simply wrong. During my column research last week, I came across a report on a new study. After reading Keith's assertion I was able to find it again. It's from The World Today (ABC News, Australia): "A landmark study on the effects of cannabis released today explodes the myth that it's a relatively harmless drug. The report, which was commissioned by the Mental Health Council of Australia, shows marijuana increases the risk of psychosis in the young and makes almost any mental illness worse." (The full report is a 76-page PDF and is just over 1 MB in download size from the MHCA web site.) Not knowing what the ONDCP was, I looked it up: it's the Office of National Drug Control Policy -- the U.S. agency leading the "war on drugs". Paranoid druggies think that anyone who thinks drugs are stupid must be getting paid to say that. Not even, pal. Let me tell you a story that explains why I say it.
Drugs: a Real-Life StoryAfter I wrote that "long-term drug use" tagline last week, I did a shift in the emergency room of a local hospital -- part of the clinical experience I mentioned that I have to go through to recertify as an EMT. Just as I was about to leave, I heard an ambulance dispatched to what sounded like an interesting call: a 38-year-old male in cardiac arrest. I decided to stick around -- 38-year-olds don't often go into cardiac arrest. The paramedics called in from the scene: the patient had sucked down a big line of cocaine and his heart stopped. His wife, hearing him suddenly go silent, checked on him. She started CPR and called 911. She kept him going until the paramedics were able to get his heart going again, but in an abnormal rhythm (AV junctional). They brought him to the ER. He wasn't breathing; I took over "bagging" him until a respiratory therapist could hook him up to a ventilator. The nurse I was working with looked at this young, otherwise-healthy man lying before us. His eyes were open; his pupils were dilated and not reactive to light. His blood pressure, which was very low at first, was slowly rising -- but only the systolic; the diastolic was staying low. That widening "pulse pressure" is an indication of brain damage. I put my hand on his chest: despite him being stripped, I noticed he was hot, and the nurse stuck a thermometer in him: 103.2F (39.4C) -- he was burning up. His face was flushed, his jugular veins were bulging. "Kids need to see people like this," the nurse said. The doctor ordered an emergency CAT scan of his head so he could treat any drug-induced stroke. We pulled him off the ventilator, so I went back to breathing for him as we rolled to the scanner. Once there, the respiratory therapist took over again while they did a quick scan. No sign of a stroke -- the guy's first good news since he arrived. Once we got him settled back in at the emergency room, they let his wife in to see him. She told us he had promised to stop doing drugs. I didn't tell her they all say that, but few do unless given a no-compromise ultimatum. Like so many, he didn't -- whether it was a case of "couldn't" or "wouldn't" doesn't matter. I went home. The next day, another student did a shift in the ER. When we met in class that night and I told the story of this guy, the other student had more details: the guy had gotten worse overnight, and was now in a "decerebrate posture" -- which indicates severe brain damage. The next student, who was there the next day, checked too: the guy had been declared brain dead, but they were leaving him on life support so his family could come say goodbye. I presume that included his two kids. Merry Christmas, kids. This is not an unusual story -- I've seen it before (I was a paramedic in California, where I was also a sheriff's search & rescue deputy). Seeing things like this -- real people -- screwed up like this again and again is why I think drugs are so stupid. Everyone thinks they can control drugs, and maybe most people can deal well with occasional use. But too often, the drugs end up controlling them. Considering how impure many street drugs are, it's hard to tell what you're getting, which reduces the chances that someone can control it. I'm not willing to take that chance.
But...Yet even in the face of that, I do not think I (or the government "of the people") should have the power to stop people from using drugs, as long as they don't commit crimes under the influence -- which infringes on my rights, and others'. Using drugs is their moral choice, not society's; I simply think that morality should not be legislated. "But what about the damage, like to those poor kids?" some readers will wail. I have a one-word answer: alcohol. If that's legal, why isn't cocaine? Or pot? We don't have a war against booze, shooting down people who sip a pint in their homes. What's the difference? Prohibition against alcohol didn't work (instead, it created massive organized crime); prohibition against other drugs also isn't working (and is helping fuel continued organized crime -- and terrorism, and despotic regimes). It's time to regulate drugs in the same way alcohol is regulated. Yes, it will still be a problem, but maybe we can get some productive use out of people who are in jail for victimless crimes (and free up the prison space for people who commit crimes under the influence). We can put the resulting tax money to use in funding clinics to treat alcohol (and other drug) addicts, and put our efforts toward educating kids on what drugs really do so they can make an intelligent decision about them. And regulate the quality to reduce the chance of overdose and bad interactions. If you agree, don't tell me, tell your congressional representatives (U.S. House of Representatives, U.S. Senate). If you don't, then tell them what you think should be done. The status quo -- shooting people to death while trying to defend their own homes -- just can't be the way to go. Related: Skirmishes in the War on Drugs Blog Updates
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Such cases continue: last month a suburban Washington DC mayor was held by police at gunpoint for hours, and shot his docile dogs -- because drug couriers chose his house at random as a drug drop. More at Huffington Post.
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More evidence that the "War on Drugs" is really more of a war of U.S. government troops against the country's own citizens. It must stop. -rc
Posted by: Nelson, Virginia | August 9, 2008 1:45 PM
In my 18y as medical examiner I have posted many drug overdoses, including a 35y/o this morning. Little is said about the behavioral alterations of banned substances vis a vis legality, but my take is an overly simplified dichotomy.
COROLLARY #1: Stimulants=bad (illegal e.g. cocaine, speed); depressants=not so bad (legal e.g. alcohol, marijuana). My obvious focus is on the direct social effects, not on long term social effects. If adults injure themselves I'm not paternalistic enough to feel obliged to protect them, I'm more interested in protecting myself (and friends and family). This doesn't mean I won't render all necessary aid to someone in distress who has done something stupid like your ER patient, I just won't get all emotional about it. Kids are different. And I was more than a little angry (still am angry 20y later) at the anesthesia resident I knew who died with a Fentanyl needle in his arm. Which gets us to
COROLLARY #2: Low therapeutic index=bad (e.g. digoxin, Fentanyl); High TI=not so bad (e.g. Valium). We should criminalize drug use that is directly hazardous to others i.e. stimulants and simultaneous use of motor vehicles and depressants.
Posted by: George, Michigan | August 10, 2008 12:56 AM
Nick in Washington stated "More importantly however, I submit that this study indicates that people know what is right and safe, and most will do what they want regardless of the law."
Nick, perhaps your mind was befuddled here. "People" do NOT know what is right and safe. If they did, we wouldn't have deaths and injuries from high speed driving and ignoring of road rules. As for ignoring the law, yes, they will. At least until they become statistics. Brevity now ends this post with a word of advice:
Please slow down your use of illegal drugs. Most all of them affect reasoning ability. Best wishes.
Posted by: Catmoves, Albuquerque | August 10, 2008 7:46 AM