For those who wish to quit, treatment is not the only option

This peer-reviewed paper is several years old, but I thought it was very interesting and brought up some important points about how we in society tend to deal with those who wish to give up a particular “vice.”

The Global Research Neglect of Unassisted Smoking Cessation

It’s a study related to those who quit smoking tobacco, but the relevance goes far beyond that. Here’s the basic point…

As with problem drinking, gambling, and narcotics use, population studies show consistently that a large majority of smokers who permanently stop smoking do so without any form of assistance. In 2003, some 20 years after the introduction of cessation pharmacotherapies, smokers trying to stop unaided in the past year were twice as numerous as those using pharmacotherapies and only 8.8% of US quit attempters used a behavioural treatment. Moreover, despite the pharmaceutical industry’s efforts to promote pharmacologically mediated cessation and numerous clinical trials demonstrating the efficacy of pharmacotherapy, the most common method used by most people who have successfully stopped smoking remains unassisted cessation (cold turkey or reducing before quitting. In 1986, the American Cancer Society reported that: “Over 90% of the estimated 37 million people who have stopped smoking in this country since the Surgeon General’s first report linking smoking to cancer have done so unaided.” Today, unassisted cessation continues to lead the next most successful method (nicotine replacement therapy [NRT]) by a wide margin.

Yet, paradoxically, the tobacco control community treats this information as if it was somehow irresponsible or subversive and ignores the potential policy implications of studying self-quitters.

There is a ton of financial incentive in convincing people that they need help in quitting whatever they wish to quit, including self-interest from the treatment industry and the pharmacological industry. (One of the most bizarre things in my mind to happen in recent years has been the development of drugs to help people quit cannabis.)

Particularly irresponsible in this area has been the incessant emphasis on treatment by the U.S. government and the irresponsible “third-way-ers,” who have practically come out in favor of forced treatment for all illicit drug users. Of course, the truth is that most drug users do so non-problematically and don’t need help. And of those who have a problem with their use and wish to reduce or quit, a very large number could do so on their own.

This is not to say that treatment procedures and medications are without value. For some problem users, they can be life-saving.

But we’re essentially telling people that they can’t quit unless they get treatment. And that’s not only wrong, it’s potentially damaging as it may actually convince people that they are unable to quit.

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‘Legalization’ is coming into focus

We’re just days away from the first legal recreational sales in Colorado. Many are projecting shortages of product to begin with (not surprising as there will certainly be a beginning surge as a kind of celebration of the new status). It’ll be interesting to see how it all shakes out. City of Denver has even put out a map of retail stores.

One of the things that has come from all the discussions about legalization in Washington and Colorado is perhaps a better understanding of the word “legalize” on the part of the general public.

There have been understandable concerns about reformers using the “L” word in past years because the prohibitionists painted it as an extreme, so that many in the public thought that legalization meant anarchy.

Now that they’ve seen the exhaustive (and exhausting) debates over how to regulate legal cannabis, it seems to me that they’re understanding that legal doesn’t necessarily mean unregulated.

This will help in future polls regarding public views on legalization, not only of cannabis, but as we move to legalizing other substances (for which public support in the past has been anemic).

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Open Thread

I’ve got a number of commitments over the holidays so I’ll be in and out here. Yet there’s a whole lot going on, so everyone take shifts and keep active in comments, while having a wonderful, joyous, and safe holidays.

Plenty of eggnog in the fridge, spiced cider on the stove, and someone brought some fresh-baked sugar cookies with sprinkles. I think the fruitcake finally got tossed out last year.

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Possibly the most-studied substance on the planet

Thanks to Paul Armentano for his proper take-down of the ignorant comment so often floated out there — that we just don’t know that much about marijuana.

The Media Should Stop Pretending Marijuana’s Risks Are a Mystery — The Science is Clear

Speaking recently with the Los Angeles Times, UCLA professor and former Washington state “pot czar” Mark Kleiman implied that we as a society are largely ignorant when it comes to the subject of weed. Speaking with Times columnist Patt Morrison, Kleiman stated, “I keep saying we don’t know nearly as much about cannabis as Pillsbury knows about brownie mix.”

Kleiman’s allegation—that the marijuana plant and its effects on society still remains largely a mystery—is a fairly common refrain. But it is far from accurate.

Despite the US government’s nearly century-long prohibition of the plant, cannabis is nonetheless one of the most investigated therapeutically active substances in history. To date, there are over 20,000 published studies or reviews in the scientific literature referencing the cannabis plant and its cannabinoids, nearly half of which were published within the last five years according to a keyword search on PubMed Central, the US government repository for peer-reviewed scientific research. Over 1,450 peer-reviewed papers were published in 2013 alone.

We know plenty about cannabis. We know more about cannabis than most (if not all) FDA-approved drugs, despite their vaunted exclusive process (which often has as much to do with politics and money as science).

The ‘we don’t know enough’ argument is used to delay or dilute legalization efforts (I would place Kleiman’s comments in the “dilute” category, formerly “delay”), and, in some cases, it is merely short for “I won’t be satisfied with any amount or type of studies until we find one that proves cannabis is bad.” (Sabet would probably be an example of that.)

[Thanks, Servetus]
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The ongoing tragic and devastating fallacy of seeing prohibition as a way to help people

Yesterday, Canada’s Supreme Court struck down some prohibition laws as being unconstitutional. It found that the laws were overbroad, and while it agreed that the government had the authority to regulate the activity, it was not allowable for that to happen “at the cost of the health, safety and lives of” those involved.

No, it wasn’t drugs, but it certainly seems familiar.

“Parliament has the power to regulate against nuisances, but not at the cost of the health, safety and lives of prostitutes,” wrote Chief Justice Beverley McLaughlin, who referenced the case of convicted serial killer Robert Pickton. Pickton targeted prostitutes in British Columbia.

“A law that prevents street prostitutes from resorting to a safe haven such as Grandma’s House while a suspected serial killer prowls the streets is a law that has lost sight of its purpose.”

Living off the profits of prostitution, a law aimed at criminalizing pimping, was found to be “overbroad” in that it also criminalizes those who “increase the safety and security of prostitutes,” like legitimate drivers, managers and bodyguards.

While the Supreme Court would probably have been right to strike down the laws effective immediately, it actually gave the government a full year to find acceptable laws to replace these before they would be void.

And yet, predictably, some people are screaming.

Kim Pate, executive director of the Canadian Association of Elizabeth Fry Societies called it a “sad day.”

“We have now confirmed that it’s okay to buy and sell women and girls in this country,” she said. “I think generations to come, our daughters and granddaughters will look back and say, ‘what were they thinking?’ ”

Really? Is it possible to get any more ridiculous in your reaction to the news than that?

It sounds a lot like some of the drug war prohibitionists here who think that legalizing and regulating drugs means we don’t care about the welfare of those who use drugs (when it’s exactly the opposite).

The true-believer supporters of prohibition laws (as opposed to the profiteers) are either too stupid to understand, or too blinded by the certainty of their beliefs to be educated about, the true nature of prohibition laws. Time and again, against all evidence, they act as if these laws are an appropriate and effective use of power to advance their pet agenda.

From the right, that often connects to a desire to use power to coerce people into acting in an arbitrarily “moral” manner, whereas from the left, it more often stems from an ironically paternalistic belief that some people (prostitutes, drug users) are incapable of making decisions for themselves and therefore must be coerced for their own good.

Not only are both extremes completely and offensively wrong from a humanistic standpoint, they are wrong practically as well.

Prohibition doesn’t save lives. It ruins them.

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Rape

Scott Greenfield does an excellent job discussing the latest outrageous bodily intrusion serving the war on drugs: A New Low: Vaginal Probes At The Border

And then there are the doctors, happy to stick whatever they’ve got into unwilling women (as was the case with David Eckert) because an agent said so. So that it’s clear, a warrantless ”forced gynecological exam” is rape. A warrantless forced “rectal probing” is rape. Jane Doe was raped. Unlike Eckert, neither the agents nor the physicians can hide like the sick cowards they are behind a judge’s warrant to excuse their conduct.

And they found nothing. Jane Doe was clean. Absolutely, totally, perfectly innocent of any wrongdoing. Not that it’s acceptable if she wasn’t, but she was.

The list of atrocities that our society has somehow accepted in order to achieve some kind of impossible goal in the war on drugs is astonishing (and should be frightening to a free people).

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Country of the Year

The Economist

But the accomplishments that most deserve commendation, we think, are path-breaking reforms that do not merely improve a single nation but, if emulated, might benefit the world. Gay marriage is one such border-crossing policy, which has increased the global sum of human happiness at no financial cost. Several countries have implemented it in 2013—including Uruguay, which also, uniquely, passed a law to legalise and regulate the production, sale and consumption of cannabis. This is a change so obviously sensible, squeezing out the crooks and allowing the authorities to concentrate on graver crimes, that no other country has made it. If others followed suit, and other narcotics were included, the damage such drugs wreak on the world would be drastically reduced.

[…] Uruguay is our country of the year. ¡Felicitaciones!

Excellent choice.

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Kids and pot

The 2013 Monitoring the Future survey results are out, and you’re going to be hearing about them in the news. The Government will be parceling out bits and pieces of information to the media in ways that are useful to their prohibition story.

What you won’t hear:

  • Past 30-day use of marijuana for 12th graders actually decreased from 2012-2013. This, despite all the legalization stuff.
  • Young people used tobacco much less than marijuana, despite the legal status of tobacco.

What you will hear:image

  • 60 percent of 12th graders do not view regular marijuana use as harmful. My reaction… and? Maybe they’re learning something. Remember that, as far as I know, the word “harmful” isn’t defined in the survey. If someone asked me if water was harmful, I’d probably say “no.” And yet, you can drown in water and overdose from it. Words matter, even to 12th graders, and failing to agree that something is “harmful” is not the same as affirmatively stating that it is 100% “harmless” in all situations.
  • One third of 12th graders get their marijuana from someone else’s medical marijuana…. Um… think about it. Would you rather they had gotten it from a criminal dealer?
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Barney Frank on the Gateway

I miss having Frank in Congress. Nice to see he’s still involved… Barney Frank: The myth of marijuana as a gateway drug

To the dismay of the marijuana prohibitionists, the results of these steps toward legalization have been benign. In those jurisdictions where marijuana has been legalized in general, as it was in Washington and Colorado, or made available for very broadly interpreted medical purposes, or treated more as a minor offense than a crime, there have been no outbreaks of marijuana-induced violence – no significant increase in people getting into accidents while puffing, and no apparent upswing in cocaine and heroin use brought about by people entering through the marijuana gate.

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Twitter discussion on Wednesday

U.S. Drug Policy (@ONDCP)
12/16/13, 3:45 PM

What: Twitter chat on #druggeddriving
When: Wednesday, Dec. 18
Time: 4 p.m. EST
Join: Use #druggeddriving
Follow: @ONDCP @NTSB @NHTSAgov

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