Washington's latest prescription for patients in pain is the statement issued last week by the Food and Drug Administration on the supposed evils of medical marijuana. The F.D.A. is being lambasted, rightly, by scientists for ignoring some evidence that marijuana can help severely ill patients. But it's the kind of statement given by a hostage trying to please his captors, who in this case are a coalition of Republican narcs on Capitol Hill, in the White House and at the Drug Enforcement Administration.
They've been engaged in a long-running war to get the F.D.A. to abandon some of its quaint principles, like the notion that it's not fair to deny a useful drug to patients just because a few criminals might abuse it. The agency has also dared to suggest that there should be a division of labor when it comes to drugs: scientists and doctors should figure out which ones work for patients, and narcotics agents should catch people who break drug laws.
The drug cops want everyone to share their mission. They think that doctors and pharmacists should catch patients who abuse painkillers — and that if the doctors or pharmacists aren't good enough detectives, they should go to jail for their naïveté.
This month, pharmacists across the country are being forced to lock up another menace to society: cold medicine. Allergy and cold remedies containing pseudoephedrine, a chemical that can illegally be used to make meth, must now be locked behind the counter under a provision in the new Patriot Act.
Don't ask what meth has to do with the war on terror. Not even the most ardent drug warriors have been able to establish an Osama-Sudafed link.
The F.D.A. opposed these restrictions for pharmacies because they'll drive up health care costs and effectively prevent medicine from reaching huge numbers of people (Americans suffer a billion colds per year). These costs are undeniable, but it's unclear that there are any net benefits.
In states that previously enacted their own restrictions, the police report that meth users simply switched from making their own to buying imported drugs that were stronger — and more expensive, so meth users commit more crimes to pay for their habit.
The Sudafed law gives you a preview of what's in store if Representative Frank Wolf, a Virginia Republican, succeeds in giving the D.E.A. a role in deciding which new drugs get approved. So far, despite a temporary success last year, he hasn't been able to impose this policy, but the F.D.A.'s biggest fear is that Congress will let the drug police veto new medications. In that case, who would ever develop a better painkiller? The benefits to patients would never outweigh the potential inconvenience to the police.
Officially, the D.E.A. says it wants patients to get the best medicine. But look at what it's done to scientists trying to study medical marijuana. They've gotten approval for their experiments from the F.D.A., but they can't get the high-quality marijuana they need because the D.E.A. won't allow it to be grown. The F.D.A. actually wants to know if the drug works, but the D.E.A. is following the just-say-know-nothing strategy: as long as researchers can't study marijuana, they can't come up with evidence that it's effective.
And as long as there's no conclusive evidence that medical marijuana works, the D.E.A. and its allies on Capitol Hill can go on blindly fighting it.
I'm not sure why marijuana is so frightening to politicians. It has been so as long as I've been alive. Now, lest the DEA decide that it's time to do a "sneak and peek" in my house, let me advise them that they'd be wasting their time; there's absolutely no reefer, pot, gage, or jive in my house, nor has there been for years. But one does not have to be an active partaker to realize that the government's position on marijuana is completely untenable.
Here's an administration that in June 2004 announced a plan to screen the entire U.S. population for mental illness ("mental illness" presumably defined as "Disagreeing With Anything We Want To Do To Screw You Over") and put everyone diagnosed with anything on the DSM-IV list on medication:
Bush established the New Freedom Commission on Mental Health in April 2002 to conduct a "comprehensive study of the United States mental health service delivery system." The commission issued its recommendations in July 2003. Bush instructed more than 25 federal agencies to develop an implementation plan based on those recommendations.
The president's commission found that "despite their prevalence, mental disorders often go undiagnosed" and recommended comprehensive mental health screening for "consumers of all ages," including preschool children. According to the commission, "Each year, young children are expelled from preschools and childcare facilities for severely disruptive behaviours and emotional disorders." Schools, wrote the commission, are in a "key position" to screen the 52 million students and 6 million adults who work at the schools.
The commission also recommended "Linkage [of screening] with treatment and supports" including "state-of-the-art treatments" using "specific medications for specific conditions." The commission commended the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan that "illustrates an evidence-based practice that results in better consumer outcomes."
Dr Darrel Regier, director of research at the American Psychiatric Association (APA), lauded the president's initiative and the Texas project model saying, "What's nice about TMAP is that this is a logical plan based on efficacy data from clinical trials."
He said the association has called for increased funding for implementation of the overall plan.
Except that TMAP was founded in 1995 as an alliance of individuals from the pharmaceutical industry, the University of Texas, and the mental health and corrections systems of Texas and was funded by a Robert Wood Johnson grant and by drug companies.
And therein lies the problem: Marijuana can be grown just about anywhere, and if legal, could be free. And that flies in the face of an entire industry. And corporations must be protected at all costs.
So there's your motivation for the DEA insisting for the last 40 years that marijuana has no legitimate use.
The Sudafeds of Mass Destruction issue is even more ridiculous. I use Benadryl for hayfever. The active ingredient is diphenhydramine, which is not even RELATED to pseudoephedrine. Diphenhydramine is an antihistamine. Psuedoephedrine is a decongestant. And yet, I can't seem to find the 100-capsule bottles of Benadryl anymore. I guess here in NJ, anything with "ine" at the end of its name is regarded as "it's all the same to me."
If you have a cold and go to your local Eckerd or any other pharmacy, you're now greeted with an ominous-looking sign which tells you that by order of the Department of Homeland Security, you now have to go to the pharmacy counter and wait in line behind 27 people before you can get a box of 24 Sudafed tablets. And you may only buy them one at a time.
Are there people who use Sudafed to make meth? Certainly. How many of them are there, vs. the number of people who just need to get to work even though they have head colds? I understand the Doctrine of The Assholes Ruin It For Everyone, but this is ridiculous.
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