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Kleiman’s disease model of economic growth

In the previous post, I asked the commenters to discuss Mark Kleiman’s statement:

Just 20 percent of users consume 80 percent of all the weed in the U.S., Kleiman said. (Forty-six percent of all alcohol consumed in the U.S. is part of drinking binges, he added).

“The only way to get a lot of revenue is to sell a lot of marijuana,” he said. “The only way to sell a lot or marijuana is to sell to people who smoke a lot of marijuana. And that’s not a good thing.” Policymakers may not want the state “fostering disease,” he said.

You all did a great job. I just wanted to add my two cents in here (some of which has already been mentioned in comments).

First, let’s define binge drinking:

Binge drinking is defined as episodic excessive drinking.[7] There is currently no world wide consensus on how many drinks constitute a “binge”, but in the US, the term is often taken to mean consuming five or more standard drinks (male), or four or more drinks (female), on one occasion. [wikipedia]

Now, lets’ assume that the two numbers given are correct (45% of alcohol consumed in binge drinking, and 80% of marijuana consumed by 20% of users).

That certainly does not mean that everyone who is has had 5/4 drinks in one occasion is diseased, nor does it mean that 20% of all marijuana users are diseased. It simply points out some distribution-of-use facts as conditions currently exist for those two products.

We know that less than 10% of marijuana users have any dependency, so it’s hardly likely that 20% are problem users. Ironically, it’s likely that almost every single person who uses marijuana for medical purposes (ie, to combat disease) would fall in that 20% of users.

And, of course, these numbers have other limitations. With the alcohol figures, you’d probably have a whole different set of numbers if you break down beer versus wine versus hard alcohol, etc. And, with marijuana, you’ll have a completely different mix of users with legalization.

Mark Kleiman likes to believe that the percentage of users of a drug that are problem users is an absolute fixed percentage (i.e., if 10% are problem users and then you legalize, 10% of all new users will be problem users as well). Of course, that doesn’t fit either reality or logic. There is absolutely no data to support such a viewpoint, and the truth is, with marijuana being readily available, criminalization has vastly more of a deterrence factor on casual users than problematic users; hence legalization mostly results in an increase in casual non-problematic use.

So, can you make money on marijuana as a state without fostering disease? Of course. First of all, you cam make money on marijuana even if there is no increase in use at all. And then, yes, it is quite possible to increase sales dramatically without increasing abuse. (Kleiman’s price point isn’t the only tool available, and it’s a pretty poor one, as it leads to substitution, which we don’t want, and also has more of a deterrent on the casual user than the problematic user within any equivalent economic class.)

I think it’s fine for Mark Kleiman to tell the state that the tax revenue numbers that they were expecting are unrealistic. He has said numerous times that his role is simply to advise them on implementation; the voters have already decided on legalization. However, when he makes wild, unsupported statements like this, it sure does seem like he’s still interested in subverting the will of the voters.

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32 comments to Kleiman’s disease model of economic growth

  • darkcycle

    As I have mentioned before, I am becoming increasingly concerned Kleiman’s true agenda is not to implement this State’s retail scheme. His past comments have demonstrated he doesn’t even believe the Feds will allow it. What he CAN do (and what he seems to be spending most of hs time on) is try to use his position to undermine the patient protections in Washigton.
    I-502 does not change the medical laws in any way. The initiative process is designed to deal only with single issues, so I-502 could NOT have addressed changes in medical laws, it would have been struck down. Yet Kleiman seems obsessed with the belief that the current medical system and the retail plans cannot coexist. I smell a much bigger rat than I had suspected. This guy isn’t neutral at all, he’s a full on prohib, he’s Kev-Kev’s passive-aggressive brother.

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  • allan

    Kleiman is a tee-totaler sado-moralist who believes intoxication is a disease. He’d prolly ban kids from spinning in circles if he could.

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  • divadab

    I don;t know enough about Kleiman to insult him personally (holy crap Allen – how do you know what you said is true?), but his idea that the 20% of heavy cannabis users have a disease is truly sickening. He apparently considers cannabis use to be a bad thing.

    So – why would the State hire as its cannabis regulation regime advisor a guy who thinks cannabis use is a bad thing? Would they hire someone to advise them on, say, airport design who thinks airplanes are evil and will only take the train?

    I just shake my head. The lunatics are truly in charge of the asylum.

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    • allan

      how do I know which is true? that he’s a sado-moralist is obvious. The spinning kids part I will admit is speculation.

      Many here have read Kleiman’s writings for years. One only need read his work to understand he’s no friend o’ the buzz. Any buzz…

      What Mark won’t do is talk about the fucked-upedness of Prohibition.

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    • claygooding

      “”So – why would the State hire as its cannabis regulation regime advisor a guy who thinks cannabis use is a bad thing? Would they hire someone to advise them on, say, airport design who thinks airplanes are evil and will only take the train?”"

      Someone else said it,,I think Kleiman was put in place when the governor visited the AG recently to ask what they were going to do,,what they are going to do is try to make sure WA and CO fail to see any revenue from legalization and spend billions of dollars if necessary to insure it’s failure,,,while appearing to be doing nothing at all.

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    • So – why would the State hire as its cannabis regulation regime advisor a guy who thinks cannabis use is a bad thing? Would they hire someone to advise them on, say, airport design who thinks airplanes are evil and will only take the train?

      Actually, divadab, many drug policy reformers think drug use is bad and are reformers because they think criminalization is worse. We don’t know if the voters (or to what extent they voted) the way they did because they think cannabis use is a good thing or because prohibition is a bad thing.

      It isn’t necessarily wrong to have someone advising who is personally against use as long as they are advising based on the facts to try to get the best version of legalization out there for everyone. The issue is more that Kleiman seems to be skewing and cherrypicking to meet his own biases about drug use and drug markets.

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      • divadab

        Point taken, Pete. I do know several people who are active drug war reform activists who do not consume. It just seems strange to me that the State would hire as its key guy in implementing the Peoples’ directive to legalize cannabis someone who thinks anyone who is a regular cannabis user has a disease. It’s hard not to think that Kleiman’s contempt for cannabis users also extends to contempt for cannabis legalization. Which makes his selection for the job advising the LCB problematic, IMHO.

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      • allan

        that’s an important point too often forgotten/overlooked/not considered… thanks for bringing it up Pete.

        There are plenty of anti-drug folks on our side. Look at LEAP. Except for a few mmj folks I’d wager that most on the LEAP speakers list would say they’re anti-drug.

        One can be anti-drug while at the same time being anti-prohibition. I’d advise against the use of many drugs. I’m not gonna raid your house with a bunch of my thuggish friends, scare your kids and shoot your dog tho’ if you choose otherwise. And if you do choose otherwise there needs to be a regulated system in place.

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  • Matthew Meyer

    I’m reminded once more of Norman Zinberg’s ideas about the various kinds of “social controls” that shape drug use.

    Prohibition is a “formal control” that tries to impact drug use with criminal sanctions.

    Informal controls are developed within the groups that consume a given substance, and use the group’s sense of propriety as their main tool.

    I think one of Zinberg’s best ideas is that reliance on formal controls like prohibition actually inhibits the development and transmission (often cross-generational) of informal, cultural controls.

    It seems a fault of Kleiman’s here to ignore this aspect completely, as though the fact of legalization in itself will not help people treat cannabis in a more balanced way.

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  • kaptinemo

    I have always taken issue with the ‘disease model’ core of the present addictive drug treatment paradigm. A disease supposes an outside biological actor (like a virus) that attacks the body. Such requires a ‘vector’ to invade the body, penetrating its’ defenses.

    Given what we now know about the various receptors within the brain respective of the substance(s) in question (and with cannabinoids, throughout the whole body), the disease model IMHO does not fit. Substance use appears more like overloading a system that is hard-wired with a pre-set default rather than an invasion. Chronic use of an chemically addictive substance resets the default at higher tolerances.

    But the disease model helps serve a social and political purpose: removing responsibility for personal behavior from the equation. Blaming the substance, not the behavior. The kind of methodology the Chinese Communists used in their first (often brutally lethal) anti-drug jihad shortly after taking power.

    Hardly applicable when it comes to the issue of cannabis use. And I re-iterate: It is not the definition, but who gets to define what constitutes the difference between use and abuse that is the question, here. A position Kleiman must be happy as the proverbial pig in manure to inhabit, for he now gets a chance to inflict his beliefs regarding that difference (or in his classic, prohibitionist’s opinion, a lack of it) upon the WA cannabis community in particular and the WA taxpayer in general.

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    • darkcycle

      Not a hundred percent accurate, Kap’n. A disease is exactly that….A Dis-ease. Sources of Dis-ease may be equally internal (for example genetic) or environmental (germs, viruses and poisoning). Your point is well taken though…is an addiction in fact a disease if it causes the person no dis-ease? Kleiman and Kev-kev, as well as the current treatment paradigm insist it is.

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  • Servetus

    The disease model for illicit drugs needs a genetic model overhaul in order to eliminate the stigma that’s generated based on false assumptions about drug use and free will.

    More and more research is pointing to the possibility that with the proper chemicals, addiction can be chemically turned on or off on the genome, much like a switch.

    Deficits in the prefrontal cortex are believed to be important in understanding addiction. A recent rat study done at UCSF shows that stimulating the prefrontal cortex eliminates the urge to use cocaine. The method may have a general application to all addictive drugs.

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    • darkcycle

      I believe that if you have a disease model of addiction, you have a bloody obligation not to try to treat it with faith healing and witchcraft. Twelve Steps my rectum. If you have a medical model for a disease you ought to have a medical model for it’s treatment. Not use voodoo.

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      • Jean Valjean

        Seems to me that drug-dependency is a psychological dis(-)ease. There is an age old tradition in human beings to cure dis-ease of the mind with spiritual practices… and these are not necessarily religious/supernatural, but may be psycho-social, meditative, physical (exercise) etc. This is what many 12 Step groups practice. And besides, what’s wrong with voodoo?

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        • claygooding

          I am still trying to understand why being addicted to something is bad if it is not harming you physically and you can still provide for your self..get along with your neighbors and be a productive member in our society.
          People are addicted to all kinds of stuf,,so fucking what.

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        • What’s wrong with voodoo?
          On the face of it, nothing. If someone wants to turn to spiritual/religious organizations that is their perogative.

          However there is everything wrong with court mandating someone attend AA. There is something wrong when the vast majority of drug treatment programs rely on a model that is not amenable to evidence of efficacy. There is everything wrong with a system that says if you do not accept the 12 steps in your life you will end up in “jails, institutions or death.” (patently false, most addicts recover without any treatment at all) It is also wrong to charge “clients” for faith-based services that can access for free in the community.

          AA/NA is faith-healing masquerading as a medical treatment.

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      • DC, this is an interesting critique of the disease model of addiction. It’s a bit long so I reproduced a few paragraphs that seemed relevant.

        Alcoholism: A Disease of Speculation

        With respect to alcoholism, it is beyond the grasp of logic for medical professionals to prescribe 12-step type meeting attendance as a remedy for an “incurable” medical ailment, not to mention a contradiction to the supposed nature of the problem. Medical professionals are admittedly incapable of helping drug addicts and alcoholics so they pass the buck to organizations outside of the medical community. But, because of recidivism rates and treatment failure, the buck is passed right back. Patients in search of help, pay, on average, over $18,000 (BRI 2003) to attend programs based on principals promulgated by 12 step groups. After an array of varying forms of “therapy” the patient is released with a prescription for lifelong attendance to AA or NA meetings.
        [snip]
        The absurdities do not stop with 12 step groups; professionals contribute their own set of absurdities. For example, the AMA’s definition of alcoholism is: “Alcoholism is an illness characterized by preoccupation with alcohol and loss of control over its consumption, such as to lead usually to intoxication if drinking; by chronicity, by progression and by a tendency toward relapse. It is typically associated with physical disability and impaired emotional, occupational and/or social adjustments as a direct consequence of persistent excessive use.”

        A natural assumption would be that the classification of a disease requires that characteristics and symptoms can be measured or observed. While the majority of diseases fit this requirement, substance abuse does not. The contradiction to these requirements lies within the defined nature of “alcoholism.” This supposed disease’s symptoms are only discovered after the consumption of alcohol. The health risks, dangerous behaviors and repercussions only materialize after the alcohol is consumed and not before. In comparison, the diagnosis for cancer comes after symptoms surface or cancerous cell are discovered. There are physically visible anomalies that can be measured. This measurement does not exist with alcoholics. The majority of time, the diagnoses of alcoholism is a guess, if indeed such a diagnosis actually exists. There is little question that a person exposed to enough carcinogens or radiation will eventually get cancer. With alcohol it is questionable if a person will become a problem drinker if exposed to alcohol. While cancer is a separate entity of its own within the body that first exists without the knowledge of its host, over consumption of alcohol, a substance consumed by choice, is necessary before a diagnosis can be made. That is to say that one must choose to create the condition before the condition can exist and subsequently be diagnosed.
        [snip]
        Then, there is the DSM IV criterion for diagnosing alcohol abuse. It also does not include physically measurable symptoms. It only requires social and/or legal problems. The DSM IV criterion for diagnosing alcohol dependence requires only one physical symptom that is a result of drinking too much, which is alcohol withdrawal. Following this logic, if a person smokes cigarettes they do not have a problem, but, when they stop smoking and go through nicotine withdrawal, they are then diseased. Yet, most treatment professionals seem oblivious to these blatant contradictions. (Keep in mind that cigarette smoking is not a disease according to DSM IV, although it causes far more health problems than does the use of alcohol and all other drugs combined.)

        Sociologist and psychologist have long since been aware of the dangers of medicalising deviant and normal behaviors. Most encourage extreme caution when diagnosing mental illness because of the potential for damage in doing so. People, who are labeled, usually conform to the standards that labels indicate, whether the diagnosis is correct or not. It’s dangerous ground that is commonly tread upon by professionals today.
        [snip]
        While the NCADD (National Council on Alcoholism and Drug Dependence), formally the NCA, claims to “fight the stigma and the disease of alcoholism and other drug addictions,” its happy-go-lucky explanations of alcoholism and its nature are insultingly unsound. The NIAAA and the NCADD are two adamant supporters of the disease concept and 12 step therapies. But, as previously stated, they are not altruistic in their efforts. These two organizations fund most of the treatment research that goes on in the United States. And, like Marty Mann of old, they pick and choose studies that fit their agendas, or they manipulate and reinterpret the outcomes in their own favor. Thus, they receive funding to preserve themselves. This fact is applicable across the board for all certifying governmental organizations and institutions. In truth, whether intentional or not, it is pure genius. By filtering the facts, these organizations have “created” the necessity for themselves. They have created a public perception that they are needed by controlling and manipulating substance abuse information.
        It has been estimated that 5.5 million Americans are in need of help for substance abuse issues. In 1988, 10.5 million U.S. residents could be diagnosed with alcohol dependency as set forth by the AMA and DSM IV, and 7.2 million more abused alcohol. Estimates among the general population indicate that 6-12% have substance abuse problems. The population of substance abusers has slowly increased since the 1930′s coinciding with the spread of the disease theory and governmental interference in individual freedoms. What is interesting is that since the 1970′s substance abuse has increased dramatically and proportionately with the popularity and prevalence of the drug treatment industry. The question is: if the multi-billion dollar war on drugs and the multi-billion dollar treatment industry have been growing, why does the drug problem continue to get worse?

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        • darkcycle

          Yeah…I’ve seen that one before, Opie. I have always had an issue with the way this society handles addiction and it starts with how we’ve chosen to define it. But that critique is already out of date (or soon will be). The DSM-V is coming out with a new, loosey-goosey-treatment industry-friendly definition that basicly says if you got caught out once, you’re an addict. So it is getting worse, not better.

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  • darkcycle

    See? What’d I say at the top of the thread? See? See? Take to your keyboards! The battle is joined!
    http://www.thenewstribune.com/2013/04/03/2540772/despite-i-502-illegal-pot-threatens.html
    I left this: “Dr. Kleiman and the authors of this article are being more than a bit disingeuous. I-502 was voted on and passed to deal with RECREATIONAL marijuana, not medical marijuana. This State has, as was noted,a medical marijuana law. It has been in place for more than a decade and passed with a larger majority of voters than I-502 enjoyed. The voters of this State were well aware of it’s existence before I-502 was passed. The difference between the two initiatives and their purposes is reflected in the differing quantities allowable under the different statutes. One ounce for recreational users, 24 ounces for medical users. These differences (as well as the cooperative garden supply model) were intended to address very different needs of two very different groups of people (patients using the drug to treat illness, and the recreational user who smokes a joint on Friday to unwind).

    Furthermore, the initiative process in this State requires an initiative to address a single issue. I-502 does not in any way modify any laws except those that criminalize RECREATIONAL use. If it had attempted to modify other laws, or address medical use in any way (remember, medical use is already ALLOWED under existing law) it woulld have been struck down.

    Dr. Kleiman’s job description was very narrow. Study the recreational users needs in this State and advise the State how best to implement I-502. Not run around in the media attempting to chip away at current patient protections enacted under a seperate and distinct statute that is established law. The attempt to use I-502 to whittle away at the Medical protections is underhanded and sleazy. Not to mention, possibly illegal.”

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    • claygooding

      “”The idea behind the initiative was to replace illegality with legality, and reduce the use of marijuana. But the measure may wind up reducing the stigma and cost of the drug as the black market continues to boom – the worst of both worlds.”"

      Kleiman believes reducing the stigma of marijuana use is wrong,,that is his true beliefs showing through,,he thinks marijuana users should be stigmatized and persecuted and any law that removes the stigma is a blow against prohibition,,and this guy is hired to “help” start up a successful retail market for something he wants prohibited,,,plus,,he injected that I-502 was supposed to”reduce usage”. I don’t recall any claim by anyone that I-502 would reduce usage,,until he muttered it.

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    • strayan

      They are going to try and shut down the dispensaries. First they will blame them for the lower than projected tax revenue; despite the fact they have been refusing to collect revenue for more than 50 years. Second, they will use Kleiman to add credibility to the lie that dispensaries are being abused by people who are not really sick.

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      • divadab

        You don’t need a storefront to operate a dispensary. No one can shut down a non-profit organized as a mutual benefit society dedicated to the health of its members using cannabis medicine.

        Let’s not put the cart before the horse, strayan. They haven;t even managed to set up their legal recreational cannabis distribution regime yet. And with Kleiman advising the LCB, it doesn;t look like it will happen anyway.

        SO what. They can only slow down the inevitable at this point. The prohibs have lost the battle and that is good.

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    • darkcycle

      I added this addendum: “This area of the pacific Northwest has the highest rates of Multiple Sclerosis found anywhere in the world. This is not a trivial matter, it takes regular and often heavy dosing with Cannabinoids to relieve the neuropathic pain M.S. sufferers deal with every day of their forshortened lives. Most patients with M.S. that I know do not smoke, and instead dose with concentrates and edibles. Processing into these forms requires a large ammount of raw cannabis, since there is an inherent ammount of waste involved. One ounce per patient simply is not enough. It is insufficient to treat the majority of conditions for which marijuana is recommended. To end the Medical access to theraputic quantities is cruel, and CLEARLY not what the voters had in mind when I-502 was passed.”
      Never hurts to sting ‘em with the cruelty they try to ignore.

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      • Duncan20903

        .
        .

        Did you know that the OMMP registry says that 27.432% of patients on the registry claim “Persistent muscle spasms, including but not limited to those caused by Multiple Sclerosis” as their qualifying condition? This is also peculiar to Oregon and I’ve been wondering how that happened until I read darkcycle’s post above. Remember the State of Washington doesn’t have a registry or collect statistics the way that other States with medicinal cannabis patient protection laws do.

        Perhaps you didn’t know about all the people listing conditions other than “severe pain” because the prohibitionists love to claim that 96.432% of those on the registry list “severe pain” as the qualifying condition but never bother to mention that 53.874% on the registry claim a condition other than “severe pain.” This is just a typical example of a prohibitionist half truth designed to cause the casual observer to make an incorrect inference. Why tell a bald faced lie when you can make a half truth serve your purpose?

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      • Duncan20903

        Doggoneit, what would I have to pay for a free pass to strangle Steve Sarich?

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  • kaptinemo

    If there is ever a choice between a clean, clear, and simple alternative to cannabis prohibition and a Rube Goldbergian, Gordian Knot nightmare of a policy, you may always safely lay money down on the odds that prohibs will opt for the latter.

    But the problem is that all that unnecessary gadgetry has to be paid for. That’s what has to be shown to the public, time and again. In these hard times, it doesn’t take much convincing.

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    • allan

      hah! I was just thinking almost that exact thing the other day Kap… except I was gonna add Murphy to the equation. Damn I love how memes get around.

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      • kaptinemo

        (Slapping forehead) Murphy! How could I forget Murphy!

        “There is no god but Finagle, and Murphy is his prophet.” Murphy, the engineer’s bane. That b@st@rd has made my life miserable since I started pushing electrons at age 14.

        (Shaking fist in the air) Cursed be Murphy, and all of his brood!

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  • Through the looking glass

    .
    .

    “When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.”

    “The question is,” said Alice, “whether you can make words mean so many different things.”

    “The question is,” said Humpty Dumpty, “which is to be master— that’s all.”

    I think we’d do better to define the word “disease” instead of presuming its definition. That presumption is exactly what the prohibitionists are counting on when they make these arguments. Despite the fact that it annoys me to no end the prohibitionists are using that word appropriately under one of the generally accepted definitions of that word. But it isn’t the definition everyone presumes.

    http://dictionary.reference.com/browse/disease

    3. any harmful, depraved, or morbid condition, as of the mind or society: His fascination with executions is a disease.

    3. any situation or condition likened to this: the disease of materialism.

    Sometimes the key to the hysterical rhetoric of the prohibitionist is not in the word they use, it’s the words that they leave out. In this case they don’t qualify the word disease using the word “medical” as an adjective. Even though they trot out people wearing lab coats and even some with “M.D.” attached to the end of their names it’s all designed to cause the casual observer to make the presumption that they want made.

    Another example of this very annoying habit of theirs is to rail against “smoked” marijuana as a medicine. In this case they’re omitting the fact that cannabis need not be smoked to gain the benefits, whether for medicinal need or just for enjoyment.

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  • allan

    I crack myself up…

    so how come no one noticed Pete’s coining new WOD terminology? It’s been there, right in front of us. You’re so subtle Pete!

    From the blogpost title – Kleiman’s disease.

    I’ll leave the definition wording up to the Prohibition Isn’t Free Foundation brain trust (or “the couch” as some know it).

    First thing that came to my mind is Firesign Theater’s Globbner’s Disease, a condition often highlighted by shortness of pants.

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