HomeMy WebLinkAboutCOM 0193.084 2006-2008
06!01!2007 10:24 7753542378 LESYMAE F'PGE 01
Matthew l3ritrain, LCSW, DCSW
PO Box 1038 ~
Kuttistown,TT196760 T~'~`t + ~;t1 ~
808-968-7104
f"
June lx`, 2007 i '
Dear County Council:
'T'his testimony is to certify my support for the termination of the marijuana eradca.tior. Ur;~;rEnt
in Hawaii County.
As a Licensed Clinical Social Worker it is my duty to advocate for political char~Q,.; at ~:Ir ss
issues that affect society. in this case it is my professional opinion that the harm cau:~r.d `t;y I} e'
helicopter missions to attack marijuana and marijuana growers/users is more harmf I rh,,n , he
effects of the mazijuana itself. I hold this belief based on several observations:
1) Marijuana is much less harmful than the other illegal drugs in comp' Cn a.+: ;,ueh n;
methamphetamine, cocaine, heroin, illegal use of prescription drugs lil;~, ~:rciatr;s and
stimulants.
2) Marijuana is much less harmful than at least two of the other legal ~3 nt; t :u rCr only
used in society, alcohol and nicotine.
3) It is my professional observation, over the course of 20 years of mental Ira3ldt .oerrice
in Hilo, that as the marijuana eradication program has progressed, and t te. e~ n,a ntt: of
marijuana has decreased, wi th a currespunding iuurease im the cult c f uroni ij r;ESi t, u:,e
of methamphetamine has increased dramatically.
used upon these facts (see fact sheets attached) and observations, the Harm Rechu;<i~ e n rut d a of
substance abuse prevention/treatment dictates that availability to less harmful dr r rs (cnu'iit ana,
in this case) rte made, such that use of the more harmful drugs (methamphetamnu;., a(xs iror, artd
heroin} may decline. Please see a very thorough description of the Hann Reductcri a o,d:a
attached, as detailed by Mark Willenbring, MD, and pnhlished in the Rcyrhinrr,~: 1 i:r. a.e, T't
summarize, the Hann Reduction Model bases the needs of society as paramount ar'.I ~srs
public health approach, rather than criminal punishment, on the use of drugs. As si c1 1 s~:Ei;g esr
that the marijuana eradication progam be terminated. Mechanics and mazket forces ~+i;l ~~+~trk in
the following ways:
1) Drug users in society will seek out and use the most cost-effcctive drug . r.;;: lu 1: l: tE ~ ~h: aE.
Most novice users (those not addicted to methamphetamine or other hard d.ni;;is) n.ld
more likely use marjuana and not the harder drugs. As the marijuana eraEdi r.. iio,E
missions cease, the street value of marijuana will go down. Market forces w i C rb::n n.tJce
marijuana a major competitor with hard drugs such as methamphetamineo I'a; th = n•~ rt
cost-effective why for drug users to get high. The end result should be tte rt;d c~,,;inrE oi'
methamphetamine use and the increase of marijuana use.
2) Marijuana users are generally passive and non..violent. ]f they engage in z:m rr.r !d a;rivc
behavior it may be that they tend to be passive, drive more slowly, eat n:arc f~u~d a~ td n:rt
more comedy videw. These behaviors are much praferablc w behaviors certrxr,tly
engaged in by methamphetamine addicts, who aze known to commit mu*drx, ral=;
dectnrctinn of property, theftq hnrglaries, rnhheries and terrorist acts.
Glven the voluminous amount of data that I have submitted with this testimony, rep ~c;er,t:,r p
hundreds of researchers and millions of dollars of investment In said research, th ~ I~IEr~s t I C:c tro.t;~
Comm. No. '
Ref. Tot x..ciJ
Ref. Date~17~0~
06/01/2007 10:24 7753542378 LESYMAE F'PGE 02
Council should not be able to condone a method of intervention (helicopter seiztx:: u:`u:ari uarc:r;
as a legitimate activity. Indeed, it should be patently obvious that such activity has r::.cu 1 Eaa in t:lrn
severe detriment of society on Hawaii Coutrty, with significant harm uuscd.
It is my professional opinion drat marijuana should be taxed and regulated (see f t~:'; t.ae r
taxation and regulation, attached). In this way the various govcmments (county', >':Eil , r ~:I
federal) would receive billions of dollars of tax revenue, while saving billions o1 thaaiar , ir; xr;r[:~
associated with persecution/prosecution of marijuana users/sellers, and incarcerction !rF rain t
Citl7zn5 (see voluminous n:fetences, attached, in the paper titled "Marijuana prohiL-~i:i:or Eao:.b.",
attached). Indeed, Harvard University Economist Jeffrey Miron, a conservative eecutarnist; h.as
calculated that the combined income/savings of taxation/regtrlation of marijuana wi' E s, II i t up
to 14 billion dollars (514,000,000,000) of benefits to local, state and federal govrrnwet; L.
I believe that it Is my patrlotte dory to support the reduction in harm caused by ti is r~ :ui j <uu w
laws, and to support a positive move towards appropriate use of resources. Asa 7c.c P;: t •ic ,and
acting according m the prinoiples found in the National Association of Social Worke:>' ~;:~;r3c o~~F
Ethics, I must present this testimony such that you aze informed of the facts. [n this, ass; yc a can
come to an informed decision as to ltow best to proceed, for the betterment of societ;r
Sin
lyj`~~~"` _ _
Matthew 13rlttain, J
CSW, DCSW
Licensed Clinical Social Worker
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Ysychlatrlc 1 imes P'a,~c 1 of
6
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Harm Reduction for Substance
Breaking News Abuse in the Psychiatric Settiat~~ r '
i ' f"ram. MedPage Today ay Maoc wrrrenonny, M.D. y
i February 2000, Vol. XVII, Issue 2
Ynflammatory Cy_tokinem ' Fndinf®
littked to Alzjlejmgr_s
~ Risk 05/30/2007 i Psychiatrists are frequently presented with patients w vrse
substance use is either harmful or could become so, 'oi.r: ~ahio
! APA' AtYF3-~ ! refuse a referral for substance abuse evaluation cr t:rear:nir~r t ' I~il
i AntlllssyShc_2tlsl:.~ftectrtte or do not resPOnd to available Drograms. Often these
oC_~.lSlcp&.i.0u.9? ) Reeor
' 06/30/200% ! potlenb require treatment for co existing psychiatric sites.
I !disorders, and many are seriously ill. Alcohol and dru:;i sa r:, nncdrm
APA:_Slmple Semen i may present with Intoxication or withdrawal, and d• e,~ ' !I: P:;ych
improvoe,$uicido Rlsk Itiyher risk for depresslUn, toxic payc.hvsis, 5aickJc: <a-CI
Assessment QS/25/2007 Thee
!violent behavior, delirium, Infectious diseases such a:; I-".i -
APJl,C9,dplpxalaze % Infection and hepatltis, and many medical wmplicatia •is ul'
(Abi11IY) Crs?Iled_Safe.antl `heavy drinking. Although psychiatric treming prepare!:
Effective in Teen ;physicians for diagnosing and treating co-existing De: +:.h r t ri:
SQhizo~hren~a. conditions, training in the management of addictive F1sifiln:d
i 05/23/2007 ,disorders is often inadequate. Consequently, marry rc'rr! :t~„I 1ttNn.~ieai
APA;~S,~RYs More11
j~C~ 'unprepared to manage the addictive disorder itse f.
j [rll_SU.icid_ea than i0 Other ~ especially in the context of general psychiatric prrrti,:~r. • cost~F
Yoytty_Deaths anP±;s
06/25/2007 'Barriers to Management
• bcute_:
Over the past ?0 years, treatment for uncompnrleed
More News! 'substance use disorders has become well-establishes„ Mt•rir: • a~!idey
stars, politicians and sports figures frequently task about adolae
i their treatments at high profile treatment progri ~s, • utyp~~q
Classmeds enhancVng public acceptance and awareness. One ~ Ide~rrt tha: , deores
! California Practice Opportunities patients often accept referral, successfully compirt!!
! :treatment and remain in remission. One characte:isr:i;:
natanwtde Practice ? uncompbcated substance use disorders is that they ha~ ~s a
Op.24[tungies ;relatively high rate of complete remission in comperi:;un Lo 4~"~" ~r~~ ~
Fellowsblps ana Residency otner psycniatric aisomers. unfortunatery, the addicton
treatment system and the mental health care sys'.en^ t:rS
Browse by teak independent of one another, and funding flows i~ se>i:-c t
streams. Psychiatrists find it difricult to obtain
Anxiety and F!anic Disorders ;reimbursement for treating addictive disorders and ;a r:
Blpoiar D64aSe seldom invited into the addiction treatment netwr,rs.
!
C'loa+: PoPu
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rsyc.tuamc > imes Pawl: 2 df 6
j Children and Atlofescents Furthermore, there are many potential barriers tee siar,~;;,; ss1': I
Dementia identifiC.atiOn and referral. AIthOUgh p5yCI11atrISLS are Iae 7 gar. ?r,pnn, c~
' than other physicians at identifying addictive discr;Leri;, o,;! `-<:regn.,n3
Dependency still mess too many cases or fail to address them, f!u:u!•P, Children,
t7epresslve._Disortlers bell0yfng tnat treating the other psychiatric disord~R: I TtaUtnarF
lead to cessation of substance use. Even after su~.t:! I1 I ee!layigr,
E.ating_Disorders identification, many patients refuse referral for a~ ali~~t Sexually
ElecCrotonv_ul5~iy,S Therapy treatment, but still need psychiatric treatment. E~rl!n P t n .A^:'St1tUt3
patients do accept a referral, addiction treatment m?•, C C violence
TmJll flat fontrol. Disorders Daftly or wholly unsuccessful, as in cases where s!.3~s~h:, ~ , e:
Mgod_Disotders use continues when the patient returns to the ref-3. ri •y,i id,r,e emar
olyse6sixsS,pmRUtGV_~Jancefac Psychiatrist. Finally, although programs that fully irlte~r I'ce: A.arry a~
psychiatric and addiction treatment aro becoming nnona n y
I Panic Disorder common, they are Still unavailable in many areas hhn r,,::l, Ahheime
the most well-known model is based on asselt!ve c:+trn,r fly 4"+.thet~g
Personality Disorders treatment ror severe and persistent mental illnex, a,>sgcutl,
Post T[aumatlG stressDtsorder (RachBeisel et al„ 1999). Many dual-disorder pat erns o~ f n violence
i (~D1
eve a tlictive disorders unresponsroe to convent•ena
. i 5 I:Iinically l
` P;ychgthcrapy treatments would not be appropriate for such prog:r;,
I Relationship Issues Until recently, models for addressing persistent addntti4 i in va.DPRS .
Schlzophrenla the context of psychiatric practice have not bean e?uilrr. 1::. (~eintlerb
In fact, providing psychiatric treatment in the face ~ ~f giagrosti
Sexual_is_SUes continuing substance use might be criCicized as e~inl:~ i'i<I. 7~iachert
Som;3toform_ Disorders accoMing to the dogma or some treatment systems, AIN1S.lgb
4 Substance Abuse psychiatric treatment should be withheld until the a:Llici erl Moaemar
person reaches bottom, thereby becoming ready :a ~:P:,l~ il~:,• MnQ (1°la
S~~G!_dpi
a~ITav_to~ There is no evitlenc0, howevEr, that Such an ab5olulas+: Qua_st(oni
YI2Lef14e approach Is effective or even not harmful. Additio,~allp,
taking this stance is not ethically defensible in mNnY Al $~i'-`-
Women The intense public debate and ambivalence about dri .I :hose
Workplace and drug policy has intensified and politicized this grl:e!t c rl,
i making it even more difficult to confront and rasowe. ~d~~
Supporter Resources
~ Harm Reduction Strategies
j .Madia._Kit Gradually, over the past few years, a new model for rh e
Glassified/Onh~ Adxetttslog management of active substance use disorders has Gee r ph
Rates taking form. Although newly applied to addictive c.115or:1: • Dapraaai
this model is not really new to psychiaby or' medi<i,te. tl '.i. nl:,nc~unt
Display Ad. Races/Sizes based on the time-honored principles of palliative care, I'33r!_an.c
where paNiative is taken in its broad sense of reliev6n;l, 1lmprovin
auevlating or easing a condition without curing. It do::a i ~nC ~?~Of"`
refer eXCII1aWEly t0 Care for terminal Condltldrls. T y ;61' t t':5 >In:&tQCfLi
way, most psychiatric treatment Is palliative, and nor - In~A;ajgr
t curative care for chronic conditions is somethin most !2!lL2rS1!Lt
s chiatrists are both skilled and comfortable in n :I r "-gIa"L<
P Y P 4 ~ nRedefini
• The general principles of palliative care, as they a-1! r U C i~a~a j2,„spas
to other chronic illnesses, are familiar .(Table,. FPPIf'r) 5chizoph
these principles to addictive disorders is less o4vLnes i'c rir, gff.Clitll7g
so ettquires a new conceptualization of addiction, + Ic cF f7ffirary
treatment and the methods to achieve these goals. IAyppgC
:iChhizppl
Addiction has many Characteristics of a chronic iBne!s<. I! `la . Fj:nctior
remissions and relapses, its course is highly variable:, r i iC: ol3ritlying
I severity varies from very mild and transient to severe: d Efficacy
persistent. Patients with different types and sever'ty ~:~1' PAarwtgo
substance use disorders respond to different interr!!nl' ui ~s, `•ktt'copl
j Substance abuse and dependence are often disorcen'3 .:1 Function
sdolescence and early adulthood, and m05t OCCY rre!nci!:; ,n1
mild to moderate and self-limiting. While hazardous t;:,e :r 'Ius..AD
mild dependence frequently responds to simple at'vlr.!~, gilCism.,.a~
specialty addiction treatment Is usually indicated ^m•
zf!R them
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psychiatric Times P,~;f; 3 ~~f'6
moderate to severe dependence. The purpose of th,l< is r,:icic
i is to address the management of the most eX[rer9E' evr I crt F;erardad
addiction, heretofore not well-delineated or tested ir. F,rychiatri
j psychiatric settings.
Although most psychiatrists understand the chro I:: ~ r ab i'r: >f
severe addiction, they may find it difficult to vies; il: r f I e.
same light as other psychiatric Illnesses such as rnepntrs! In-
anxiety disorders or psychosis. This is primarily due ;c iii e
volitional nature of initial intoxicant use and moil,px'III r ~rtts mitte~~
' against dtvg users. substance users are likely to ba !.ter Ir..
immoral and Irresponsible people who brought thrr
problems on themselves and, therefore, are lase vr:al •~y
our sympathy or support. The association betwe'~ i ;I •di: c :;i: I
and borderline persondlity disorders and addictive r7";ant;~s
reinforces this idea- Tha political dwmnni~atinn of illirir r r y;
I users also promotes punitive, rather than therapeut;%;
measures. New evidence, however, demonstrate!= ionq•
standing changes in brain function and structure ~Yra+ rr r!e
drug use compulsive and extremely difficult to ton^.rtd c' str¢
(Leshner, 1997). Studies have also demonstrated t:hnC L' U:L
` Compliance and outcome in drug dependence ar:: e': r, ~r; t .:e
good as, if not better than, those in other serious psyr;r a:ri:
i disorders (o'9rien and McClellan, 1996, as cited in
j Willenbring, 1999). Moreover, ¢ Is pragmanpNy helf`u far
' psychiatrists to adopt a chronic illness approach t~ a~f:arllcrr,
I not only because it helps us puC aside moral judg r acct:;;, I:,II
i because we can apply the same skills we use to t:Ernt 4'r::r
illnesses to the treatment of substance dependen :r!
i'
Appruachiny dray addiction as a true chronic illness, nryiilreo~
a different view of goals and outcomes as well, Lcng-:~: ni
abstinence from drug use is, of course, the optim ~i g::a It s
a cure with permanent remission from the sympt<~n•: r.1 c r.r3
dependence. Historically, any goal short of germane rt
abstinence was considered a failure. Cure is not aWvay ,
possible, however, and it is not the only outcomr: Deft • c l~
represent Improvement or response to treatment. '15tr•ip ~r!uy
cessation or reduction of use, reduction In symptorris oaf
addiction, or reduction in severity of co-existing prober: a"e
• all improvements short of cure that are nevertheless ~,uo •:hy
of pursuit. To accopt a goal short of permanent abzci •~rrr cu i;
pragmatic, not "enabling," because it is realistic and
appropriate, considering the natural history of the ~ais::rr,:cr.
Approaching addiction realistically allows psychizl.-i;ra~ ;lo
what we can (which is often quite a bit), while ac:aaa~-c :I•~!t
~ our treatments are only partially effective.
In the debate about national and international dn,g pc~lh t',
harm reduction is an approach that follows something al a
middle path between harshly punitive prohibitiort And Ili iSe::
faire legalization (Reuter and Caulkins, 1995). Many i4e; a!ri
European nations, such as the Netherlands, Swltnz•t;rii i •u:
Spain, have ufricielly adapted berm reduction pufici,::a hlern-
reduction is also commonly referred t0 as the public. Ir::irui•r
model because of its focus on treatment and overall soc tl
ana nearcn policy, rather than on punishment (orucl<:e ,
i 1995)- This term is now being applied to dinica4 prac~,:ice srml
refers to an approach that seeks to minimize harm an a
I improve health and well-being, without taking an a1:3oluC 5':
stance regarding an abstinence requirement. It Pence w
also to dlstingWSh long-term management of a chr~:rnic
illness from conventional intensive substance abu-:r!
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Ysychiatric'I'imes !?qqe 4 0}•6
rehabilitation.
In other words, harm reduction is palliative care a:; ap F i t::1
to drug addiction. Because of the intensity of the nnti::n el
dobate, however, harm reduction is a term that i.; :r;ul, c
{ with symbolic meanings. To those unhaDDY with curre:nl
i policy, harm reduction is either prohibition in disguise a ~ a
sign of progress. To defenders of current policy, harry
reduction is seen as a first step toward legalizatic r .
~ rn currant practice, methadone maintenance Is tl hr:
known harm reduction approach. Maintenance trFzd,r•ucr t
with along-acing opioltl such as methadone, LA,f,hl lrr, c cr
i acetyl-mcthadol) or buprenorphine (Buprenex) is h•. icu CI•u:
most effective treatment for Opioid addiction (Nations)
Institutes of Health, 1997). Although ongoing use of
medication is generally required, it leads to substantai
reductions in illicit drug use, associated crime anc.i h ea L t erd
social problems. currently, oplold maintenance can :-i :s:
prescribed through a licensed program, but office
f prescription of methadone under the auspices of a lin:a:.~a~a
program by Dsvchiatrists and other physicians is like^y 1, a I:r_
approved in the future. When combined with naloxea<!
(Norton), sublingual buprenorphine Is as eMeetlve as
methadone, but has much less abuse Or diverslar :w C::r t ;n.
j When it is aDProved for this indication, it also will br
' available. These developments are Likely to result in
Incrcasod access to treatment for a substantial numtr.• of
j addicts not now receiving it.
The best-known integrated treatment for co-occum np
mental and addictive disorders is based upon assertiv
community treatment (RachBeisel et al., 1999). "h'l: is ; i
hamt reduction model that stresses pragmatic fle < al z
I methods, long-term Supportive management and yl:rl~.l
progress toward goals. Relapses and exacerbatior•s arc:
j expected to occur, but proponents of this model zrf: r~cq: a t`ul
that they can be reduced. However, this type of pr:~l,re r i is
only appropriate for patients with severe and per=is'ent
mental illnesses. Furthermore, rc is not widely aveu5iblr:;, Frrr.,
a high degree of fidelity to the program model is ,i~a~ass a•y
to achieve good outwmes (McHugo et al., 1999).
I Consequent{y, psychiatrists treat many patients v.i•:I•r ~;nai~~~e
psychiatric and co-existing substance use disorde a nr. t
has not been very clear how best to manage then i. 'Y:: ti;:~is:
In this area, new tllnlcal practice guidelines for the
management of substance use disorders are being rlcr~e c ord
by [he U.S. Department of veterans affairs, whrr_r It
outlined a Systematic approach, In the guideline, th•>
approach is called care management, a term mcr:
descriptive than harm reduction.
Care management (Takla 2) is a harm reduction z,fgsrc::h t:a
atldlctlve dlsortlers that can be appued In a varlet! of
settings, including psychiatric care, Uke other pallia•tivF;
approaches, it emphasizes pragmatism, compass!Snatr:• :a •e
and gradual progress toward goals (which may hE l¢ss: t can
ideal, especially initially). Care management is not the a•n~:
as case management, where the focus is on coorcina; ar ~ rf
j care. Care management will often include some cosy:
management, and some models heavily depend of is
~ Evidence for the effectiveness of care management is ur?alca~r
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Psychiatric Times 1?ag,; 5 o1'G
in primary care settings than psychiatric settings $a. pier; iC
i has no[ been LeSted a5 much, except for asSeC[IV•.
community treatment) (Willenbring et al., 1995; Vii1•:^L•r r!7
and Olson, 1999), although care management Is a ~ r :n•
sense approach that has virtually no risk and is rnl: ti nn
consuming. Greater Comfort and more effective
communication between physician and patent are Iil:ra, r..
improve trust, motivation, treatment compliance a. irl,
therefore, outcome. Care management will allow a IU le
t integration of addiction treatment techniques into pep<r iala• c
` care. How much outcome is improved, or what sferi=u::
outcomes are most affected, are questions requirmq
I additional research.
{ Summary
The frustration many psychiatrists feel when [reaanc
! substance dependent patients can be reduced by reccg; i::irg
the biological basis for the disorder and Its chronic re i~laiitc
course. I hrs leads to a broader conception of goa s a~?I : • r.
adoption of long-term management techniques s;mi a ~
j those for other chronic and incurable disorders. Tie :e ri
harm reduction has been used when this palliative ;:Err.
I aDDroach is applied to substance use disorders. Carc
management, as defined in the VA Clinical Practice ;_i.ild :litre
I for the Management of Substance Use Disortler5, is G ra: used
as a more accurate and Less politicized alternative. C:tlrtl
i management is a low-risk, effldant approach that drP I!it! s:
improves the doctor-patient relationship and may leacl t: ~
improves outcomes as well.
i Dr. Willenbring is director of the addictive disorder,; 6iorl iorr
at the MlnneaOONs Veterans A%airs Medics! Center.
Acknowledgement
Dr. Wlllenbring'S work was supDOrted by the Qua! tp
Enhancement Racearch Initiative of VA Health Saroir. a!:
Research and Development.
i
References
Drucker E (1995), Harm Reduction: a Public Healtt `.Slre~:e,y..
Current Issues in Public Health 1:64-70. Available at:
• www.lindesmith,erg/liprary/Clotlruck.html. Aocessad 7~ r!.
2000.
L.eshner AT (1997), Drug abuse and addiction tr®etrn ar:~:
research: the next generation. Arch Gen Psychiab'y 5~~
(8):691-694.
McHugo GT, Drake RE, Teague GB, Xie H (1999), Fidr'M ~ :c•
assertive community treatment and client outcomes h ~ t t<'
New Hampshire dual disorders study. Psychiatr Sa~rv ii(I
(6):818.824.
i National Institutes of Health (1997), EPFective merilcal
i treatment of opiate addiction. NIH Consensus Staecr^e:ni t.5
(6):1-38. Available at:
odp.od.nlh.gov/consensuslcons/108/108_statemert.h:r r.
Accessed Jan. 4, 2000.
O'Brien CP, McClellan AT (1996), Myths about the tr:: el:n oa•:I
` of addiction. Lancet 347(8996):_237-240.
i
RachBelsel J, Stott Dixon L (1999), CO-oaurnn~ ?o•rE
mcntoi illness and substance use disorders: a revie,~r r.~l'
http://www.psychiatrictimes.com/p000255.htm1 S C31 !2007
06!01/2007 10:24 7753542378 LESYMAE F'R(iE 06
I'syelllatnc dunes ('age 6 a:i 6
:recent research. Psychlatr Serv 50(11):1427-1c?+I.
Reuter P, Caulkins ]P (1995), Redefining the gcn s r,F
national drug policy: recommendations from a wa •Icir g
,group. Am 7 Public Hwlth 85(8 Pt 1):1059~~1063 (ere '
comments].
i
i Willenbring MI (7999), A harm reduction approa~:h';a
i treating substance abuse in a medical setting. M19c:dlGre is.
Behavior 2(2):31-32.
I Willenbring ML, Olson DH (1999), A randomized friiii :.1
i :integrated outpatient treatment for medicaly ilf al~:cr•u:dl:
:men. Arch Intern Metl 159(16):1946-1957.
Willenbring ML, Olson DH, Belinski l (1995), Inteq~,:r:~::
j outpatient treatment for medically ill alcoholic me_n: rls all_,
from aquasi-experimental study. J Stud Alcohol 'ii5C:i;::li;'•
343.
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~ PrlvaGy StstgtnanL I Terms_,cf Ser.Y,iee
http://www.psychiatrictimes.com/pOOO255.htm1 ~ /3 ].!21107
06/01/2007 10:24 7753542376 LESYMAE F'CGE 39
MARIJUANA PROHIBITION ~=~'!~i,C;;;:'I"!s
_ _ 2006
? Very few Americans had even heard ahout marijuana when ? A recent study Of prisons in fotu 1~4:clneat::tn !tarts found
it was fltst federally prohibited in 1937. Today, between 95 and that approximately one in ton male iota ..t r.','~e 1~_rtcd 1:aat t:1C'7
100 million Americans admit to having tried it, and about 11.5 had been rapedwhila in prison.'a'Y,e~;q'. o'` r q;~r: a x ~.~exr[1 zssault
million say they use It at least monthly.' against women prisoners, who s:re c~oa 111 :e tc be ~ibvsed
try male staff members, have L7cen rrp: tb:c to I:~e zs higYl as
? Attording to grn-crnmtnt-funded rescazchas, high school 27 percentin someinstihztions.'~'
senlorx cansistentiy report that marijuana is easily available,
despite decades of a nattonwide drug war. With little variation, ? Cwii forfeiture laws allow polio ee ; rir:: tar. mo:7zr~ :md
eveey yaae about a5% coneid~ marijuana "fairly eaey" eX 'bory propeety of suspected marijuana afli+. r,ar r h:ugas need not
eery"toolrtain.zbatahomtheU.S.CentersforI)iseaseCAntrol cvenbeflled.Theclaimisxgainsttitepn:~p~ri•q, luf'[hede•fend:mt
and Prevention show that more U.S. high school students The Ocvncr must then prove th.Ft fv; p rq;e~t7 I:: "i~mc,rent'
currently .zmolw marijuana, which is romplMely umeaulated, [nLSreemenr atmcec crl=mminf; I`-. x•I f•nfi li: n 1.arnrbJtlr,d.
than smoke cigarettes, which are sold by regulated businessu. °
? According to estimates by }:a, n.:d 1L•ii7<rstly a<:ml0roist
? There have been over seven million marijuana arrertz in the ]affnyMimn, rcplarinF marijuana -~rd~~i'r P n ~ a^~hh a svstent of
United$tates since 1995,indudfng 771,9tl4 arrests in2W4-more taxation and n:guladun would savt Lr.I~~vlec.:110 b'..Ilivn amd 514
than for all violent crimes ax7mhined, and an all-time record, billion per year in reduced gnvernrne~-u L a:rrvlli ;:¢.d increased
(lnrSrnl:cnn icnrteKed fnrmarijuanar+very 4l. anrr,ndc Ahrntt R4N tax rrvmnes.'s
of ail marijuana arrests are for possession -not manufacture or
dlRMbunon. ` ? Many patients and their doraor:, lil ri n a:ijuana a us~Yul
medicine as part of the rreatmer t for ,11 C?., rz m::x, i;iaclxana,
? Every cOmprehenslve, objective government commission multiplesderosis,andothenllmeVr,. Yct-f el~sl erall1ovranmcm
that has examined the marijuana phenomenon throughout allows only seven patients inthc'hrnal:4<lie;•cus:lnatijulna~
rhP past 100 years has recommended that aduits should not be as amediefne, throuYhaproEram r,ow r,li ced :c ne.r applicants.
alminaltzedforusingmarijuana.° Federal laws heat all other paYa-ats ruC.e"ri„ using medical
marijuanaas criminals. Doctors arep[eseti a'dowed to Frresn16e
? Cultivation Of even one marijuana plantisdfederal felony Cocaine and morphine-but not mari'~a>[a
? t.engthy mandatory minimum sentences apply to myriad ? Organizations that have em':~r!:r, ncnlic:J access to
offenses. For example.apersonmustaerveafive-yeazmandatory marijuanalncludeaheAlASActiont:er:.r..-Lr!netirmAetdem'%
minltslum sentence 1! federally mmicted of cultivating 100 of Family Physicians, Amertcar. Pui: G~ l b a th .15sOCiatiOn,
marijuana plants-inchrding seedlings or bug-infested, sickly American Academy of IiIV lredb: n'e, ar3tsi<an "Nurses
plants- Thls is longer than the average sentences for auto theft Assodation, Lymphoma Founcatior. u1 rin~erial, National
and manslaughter) r Association of People Wich AIDS, the a:e~,.e mr:d ice. ;nsociation s
of New Ynrk, Cahftznia, and Rhate I's;:.nr,, ;.n i xlan'Y oth~zrs.
? A one-year minimum prison sentence is mandated for
"distributing" or "manufacturing" conholled substances within ? A few of the many editoria, be ~ ixl I I rl rt !i ice cnJO[se<S
1,000 Peer of any school, university, or playground. Mast areas medical access m marijuana irchldc. 9:uir m c-,'obr, C'ifira~y
In a ctty fall within these "drug-free zones." An adult who livts TribiMe, Miami IferalA, New Ynrk Thar.! ~ Tzm fe C'cvmy Regi2n,
three blocksfrom auniveesityis subject toaone-yeaz mandatory USA TOAay, lialtimOre's .Sun, and Ti: C:.~il ~~ahs Tirlrt.
minimum xnsrntt foz selling an Ounce Of marijuana to another
adult - Or even RrOwing One marijuana plant in his or her ? Since1996,amajOdtyOfvotetstn AI.:.:'•a,, Rri.:ona,Cali[crmia,
basement. ° Colorado, the DisMd of Columbil, h•I:n i a, t Qonl snr, Nevada,
Oregon, and Washington state la•:c -r; t:d r tz vnr of bal]oI
? While exact figures are anavailablc, conservative eSNmatcs initiatives to remove criminal petalGrv; <; r:r ously i!I necple
indicate that between 32,500 and 40,000 Americans arc in who growor possess medical mar`jua~ml
prison or jail on marijuana chazges right now -more than the
cM(rc prison populations of eight individual European Union ? Fifty-due percent of Ametica-f:, be:ie:.~: •:r assrssion of small
countries combined.' amounts of marijuana should ^v:f: b.: C~E~T e~i as a cr uninal
offertiE. Scv<ntyeight percent r.~p:'.t' "n ax ag to atijuantl
legally available for dottozs to prtscr;t;r i~t nri[n:0 reduce pain
and atffering."'^
MnR11UANA POllCr PCOIacT . D.O. aOX 774R2 /~1R[rOl HILL ~ WASNMGTnA~, J. ~.1'
TEL2@.4a2.Sra7 . FA%102-132-0441 . MPP@MM',ORC • IfTTP:/M'kAgMPP.pR~:
06!01!2007 10:24 7753542378 LESYMAE F'P(iE 10
V nDeaimina]izaHnn" involves the rrm oval of miminal ?PTOhfMtixminiritescorsupnom qa:c i9'a:ah n'rali'rsax:eryanvm
penalties for possession of marijuanafpr personal use.Small 6nc5 bygivingoffidalseary,[emptingop7)rturtisiusCa;ptt'lib~,stea.l
may be issued(somewhatsimflarlytotrafhctlckets),butthereis andsei]marijuana,andplantevictca;r.':::I::r::a;anpmFl9.
typically ?O aTTCSC, inCarf.PrAhnn, nr rriminal t'ro'd '~f, r11v. na
is prs'sently dtt'riminalized in 11 states-(aiVornia, Colorado, ? Because marijuana fs typicar y as;:u 'r ~,r va~:r, r;atnpiing
Maine, Mirinesota, Mississippi, NebidSka, Nevada, New Yark, the Bill Of Rights isaroutine pa,t of nrlr to-I1asr enforcement
North t:arnlina, Clhio, anA Oregpn. In these states, cultivation - eg., usv of drug doges, urine taa;:, Isl:: r.s t:p:, govr!r :come
and dishibution remain criminal offenses. informants, curbside garbage sear_'i es, nl ~ 1'. far y t ell,:aplxts, and
infrazedheatdetectors. ¦
? Decriminahzat;nn savrs a rremendovs amutmt in
enforcement costs. Califomta woes 5100 million per year.'' NOTFS
? A 2001 National Research Council chtdy cpnncnrrd Try rho 3. Subxrnec Abuse a.,d Mrnbl Health Atanw~rhn: C.i a wunmlr x x~man ,nr.
U.S. governmrnt found "little apparent relationship between ,loco'°'`~"`~'N~rn"`rs°mr""°"av,c u;n:,',t c:i,~~rh 1.
the severity of Sanctions prescribed for drug use antl prevalence x T. „'cNN tall ,r:dun,,'rn„r, Nw. 9, mr. I~xr':,- P:: ;I +<:..:,;a ~ t y n,d Mrj
otfrequency of usC,dnd... perceived legal risk cxplainsvrry littlr m° urns rntt,
in the variance of individual drug vse.x'Tlrc primary evidence )~~uu;Sao,;,',,°~y~„~`~'nM,.e.rh,n=,.la+rs:r„I ,h:.r ).¢;t:'r:.n,h:, rd,zxs'
prnenr Aalnamxur,PY"u rrc'r, r.r f l,. a m rw,npm ~ :,rna.,rve,
cited camefmm comparisons between stares that have and have rnwal.wner",ryxnMrd„rsn Nos ma as: iianlcr:. r'•:u nu "rose. sr.
not deaiminaliieA marijuana.'" fmrrtr ter rnaaxrcnnnm non nmv.mum, iuJn ~;n ,rn,n c. v.mm.n ..,mn,NHnrn,
2003, Mar ZI,2WI.MMWRZOaay1NP.5y.2 ,,"gl¢:JU. P' i11
? In the Netherlands, wheic adult possession and purchase s. erarbl vencsn M Imrsomnm+, tmllmm ~ ant ;,r~, n.:. <rou he umud r..+,.
n( small amounts of mariiuana arc allowed under a rcgutated °""`"'a''
system, the:ate of marijuana use by teenagers is tar lower than s. Po, example, xcpwt n(ae mmm ermp rn,v tarn+.."„ ue h con ta,mn, cn,., rnro
a.lr Maaary mwvlreuwrs, IPasl rnn Mm(6un-. r:,rxa,.~ A~ s, y ,/.w,r ar:: Icauunan,
1tt the U.S. Under a regulated system, licensed merchants c:omm,meNepmd,lPAn;4m;wnnn:aa;~~,r,/A'.,,n„.',,,,In, Iru;mr-r r, reu<oorr),
have anincenitverochecklDandavoidselhngttominors.Such +PrzmAn.rxu,^fMnrrmnnnFousrcNauurn,:,itrr'o~~i~nc~llvlr:am:mAtrrhu~
a errs also se a[atvs marl uana from the trade in hard dtu s Fmnrmn P""c9nuelnn rM,la rou<Y rnrpr"r a. nn, t .1;, na (:e:mmlarr •lir9.+l
~ P 1 B Deural.zmz.anamhers.
such as cocaine and heroin. 21¢sCAd,roltl r(R): ,m sourcrda9t 9r ,*s;vN sv~'m dl~ r, Ih srN:, vs. scornncn);
CUmmWlun. ]99r: o. N.
? "ZCIC, tolerance" polities against "drugged driving" can n, avscasnw:.rnmro-am COnarnoVmn R.cnrh>r ,','nett used,
resuit ;n "DUI" convictions of drivers who are not intoxirated
at all. Trace amounts of THC metabolites -detected b- r' ze10enbera'g'"°"swc"Ibum. tame. Fattr g. ~'~I~P:' nu nnrnrlnmcr Frayanrr u~
5 MPMU0nP Pn1lrmMPor at.,tmnrri'nllry imrvnr an}r. ,t,na
rommonly used tests -can linger in blood and urine for weeks
after any psychoactive tffects have wgrn off- This is equivalent lo. is
mxmn
Arhson
rm vM
Tn~rnl,o~M1rk~, ~i~ «~~''.z~ arx~mrn~ an,~.arr-,,'
r am ,v avr.a,_
to conviding someone of "drunk driving" wc~cks after he or she a srr.,eAmanga,,.,.,m.c"ay.."eswewnx"a.~F., , , ~a, . n,-~
e sex.mc,s.,,
dIdllk On! hPet. W V]t].'bethe rnnfrteeun'Nm Hnn(~hr irr 0^r.rn ~ r, I riu. cr Rtpc; n<t. IP.Ia01.
la. VS.Nep. Henry NydrlN-Ii.l, w7nfhrr Ure Pr:xrf~)':•ulrr liv ?gnr!y.:y. ex,,,.GI:mM;
® Thearbirtdtyaiminalizatlonoltens0l.'ttlillionsofAmericans rarnmsmnclPSS.
who Consume madjuana rosults in a large-scalp lack of respect la. Mirxal.).anyt..rata,dr~yrnpurarr,,,nn,-u„n:,,.,':+aan.l,r,as.
for the lawand the entire criminal justieesystem, ss, l,,;nq,ewn, terse., M.o., ana wlxai., u„ .u.. Nm" m iteasd,r,: n ne. v",
pmm~pdcmtlon;'/w"nal o/fln•APx'riran M?d w4uaca.b,:ur e: I,' PP!.
? Mari1uana protubition subjects usezs to added hczlth ,s. Manlunna 'coley nnlett, MC6iralMmuuert A. ~Gb;; ,,,:n~2vi;.
ha2ards: lA. Nunonm c.u„p pon.xw.tzum.
• Adulteranh, contaminants, and im urines -Mariluarid ~r' a]rnn. Mrcnan, rn.u., ana MlAnnya, ma, u I:., II, m s uor:h,, s,enp.am ~W
P j 9.nhwarmrnt Cents AraiWteble ro the M"u xn A:, s ID'S ....:nmm y,' Imm~4 M
pu[chased through afminal mazkets is not subject fU the same i'a'drorrriveD,yj6 VnL aoQ),1an -Mann 19A!;,p. n,r
quality conh0) standards as are legal rnnsumrr goods. Illicit 18. NatlowlNaearch CnuM1,M/amlMr Ammm•ib'b :n l'H Ji: r6 x'"'M1rlYk UenY.tnn.v
man~uana may be adulterated with much more damaging nrrFxmnr't[u,,,N"nonnncaaemyprcn,znc t,.I!.:.n.
substances; contaminated with pastidAes, herbicides, or Ir. NalPnole De,yMmdem.Annu.rarpoa NOMZtrs, n:~,a„x h,v s-e. st¢•.
fercili¢Cra; and/or infected with maids, fungi, or baeterta, zv. sworn, e, "TIx Neil auk cf anon aeled'Nrn, In,.-,, , ore; ' n„~rcnv ~,nnaMy
ALL~wlfm, rnxdles rr/Cummb(mMdusMrn(F.a a:Ui
• inhalation of hot smoke -One wail-established hazaad zl, MLAa.:, ar.r+. 'v,rn.h.., rm MMlrnl Ale, lung; Ai, nr,u cool NMr, nr1,.
of marijuana Mnsvmption is the fact that smoke from burning September I'>+z
plant material is bad for the reiplratOTy system. Laws that
prohibit the sale or possession of paraphernalia make it difficult
to obtain and use devices such at vaporiters, which can reduce
lhc+v rl%ks."
? Pecause vigorous enforcem ant Of the marijuana laws forces
the toughest, nivsl dangezvus crindnats tv take over maIlluene
aafficldng, prohibition ]inks marijuana sales to violence,
predatory crime, and terrorism.
RerltM SnlmA
06/01/2007 10:24 7753542378 LESYMAE F'PGE L1
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