cannabisnews.com: The Gatekeeper Hypothesis





The Gatekeeper Hypothesis
Posted by FoM on September 08, 1999 at 13:44:50 PT
Open letter to Alan Leshner, director of the NIDA
Source: Naturalism
Dear Alan,You’re the head of the National Institute on Drug Abuse (NIDA), which prides itself on supporting "more than 85% of the world’s research on the health aspects of drug abuse," according to a recent press release. 
You’ve got clout, and use it to push the image of NIDA as an organization wedded to science, altruistically seeking the causes and cures of addiction. Me, I work in relative obscurity at a private firm in Boston which gets funding from the state to conduct applied research and evaluation on substance abuse. I’ve also been a member for the last five years of the NIDA’s Community Epidemiology Work Group (CEWG), a twenty city consortium of researchers that tracks illicit drug use trends in the U.S. Until recently, you didn’t know that. No reason you should, after all. While you’ve been heading up NIDA, I’ve been conducting local surveys and focus groups on adolescent substance use, with occasional getaways to CEWG conferences. I was just a face in the crowd you addressed at our 1997 meeting in Washington. But now you’re at least dimly aware of my existence, and therein hangs a tale. Our lives intersected when the Boston Globe published a Sunday opinion piece of mine on decriminalizing marijuana.http://world.std.com/~twc/marijuan1.htm I took the position that marijuana used in moderation by adults is, from a health standpoint, no more dangerous than using alcohol and tobacco, and that NIDA’s refusal (along with most of the official establishment) to admit as much undercuts its credibility. If you want to impress kids with the dangers of drug use, hyperventilating on the evils of pot is not the way to go. I never suggested that it’s harmless, mind you, or that adolescents be allowed to smoke it. Only that if one wants proportionality between the sanctions against a substance and its danger to life and limb, the prohibition against the private consumption of cannabis by adults should be lifted.For NIDA, as well as state health departments, all this is anathema, of course, so as the article went to press I wondered nervously what sort of fire it would draw. Would I lose my job? (No, I’m still gainfully employed.) Would my firm’s funding from state and federal sources be cut in retaliation? (No, and such retaliation, could it be proved, is of course actionable.) Would someone like White House drug policy chief Barry McAffrey or you, Alan, weigh in with a reply? Indeed you would. Three weeks to the day after the article appeared, your letter appeared in the Globe, the heavy guns brought to bear in defense of NIDA orthodoxy. Most of it was predictable enough. You said "marijuana is a drug with a high potential for abuse" that leads many people to seek treatment, that it affects "learning, memory, emotional state, perception, and the motor skills necessary to drive a car," and that its long term use can affect the lungs and immune system. Although the first of these claims is certainly arguable, especially when comparing pot to alcohol and nicotine, and the evidence for immune system damage is equivocal at best, I won’t debate these points here because another of your assertions is the crux of my concern (and now yours, I hope). You said, and I quote in full, with emphasis added: "Another science-based reason for not condoning marijuana use comes from a recently published study by a Harvard researcher showing that use of any illicit drug, but especially marijuana, significantly increases the probability that an individual will abuse other drugs during the course of a lifetime" (my emphasis). Could it be true? Had the notorious gateway or "stepping stone" hypothesis about marijuana actually received some empirical support?Since you didn’t specify the exact study in your letter, I was left wondering what I’d missed, since evidence supporting the gateway hypothesis, from Harvard, no less, would ordinarily have ignited an all-out media blitz from NIDA. After all, your group never misses a chance to capitalize on bad news about pot. But I hadn’t heard a word about such research, and I usually keep pretty close tabs on this stuff. So what was up?After some fruitless attempts to find out from your office what Harvard study you had in mind, I visited NIDA’s web site and found a press release on a recent, NIDA-funded study led by Dr. Ming Tsuang of Harvard. It had appeared in the November, 1998 issue of the Archives of General Psychiatry, and was titled "Co-occurrence of Abuse of Different Drugs in Men." This had to be it, right? Well, sort of. Going to the Archives web site, I discovered that Tsuang et al. had conducted a large twin study of Vietnam vets showing that individuals who abuse one type of illicit drug are indeed predisposed to abuse other drugs, for reasons having to do with a person’s genetics and environment. As they put it in their summary of findings, "Abusing any category of drugs was associated with a marked increase in the probability of abusing every other category of drugs." But what about marijuana? Did this recent Harvard study show that using it especially leads to the abuse of other drugs? Not at all, in fact quite the opposite. First, Tsuang defines quite specifically what he calls the "marijuana gateway model": "…the shared genetic and environmental influences operate through their influence on marijuana abuse, which in turn influences the abuse of every other category of drug. The gateway model of drug abuse…presents a sequential theory of lifetime patterns of drug initiation in which cigarettes, alcohol, or marijuana represent phases in drug use that facilitate involvement with "harder" drugs."Second, he tests the gateway model against the twin study data, seeing to what extent it matches the actual patterns of co-occurrence. It doesn’t. Tsuang explicitly rejects the marijuana gateway model in favor of a model in which genetic and environmental influences on drug abuse don’t operate via marijuana. Visit the site, read for yourself: http://www.ama-assn.org/sci-pubs/journals/archive/psyc/vol_55/no_11/yoa7286.htm It’s hard to imagine a more blatant conflict between your supposedly Harvard-backed claim that pot in particular leads to other drugs and Tsuang’s finding, a finding, by the way, which NIDA has been careful never to mention, even though it funded the research. This means either that there’s yet another recent Harvard study on co-occurring drug abuse that contradicts Tsuang’s (highly unlikely, since the world would have heard about it) or that in making this claim, you badly compromised NIDA’s vaunted commitment to scientific integrity, by inverting the findings of your own research. Given NIDA’s penchant for intimidation and its selective reporting of data on marijuana, the second possibility, unfortunately, seems most probable. What agency, after all, put pressure on the World Health Organization to drop from its 1998 report on international drug trends a section comparing cannabis favorably to alcohol and tobacco? What other agency would stoop to trumpet, as evidence of pot’s addictiveness, studies (reported in Science) in which rats were injected with massive doses of THC and then chemically withdrawn using potent antagonists, as if this had the least relevance to how people use cannabis? NIDA’s official stance on cannabis seems increasingly disingenuous considering the recent Institute of Medicine’s report on medical marijuana, which concluded that pot is neither a gateway drug nor particularly addicting. So why, pray tell, would you so mislead the readers of the Globe? If unintentional, it shows a stunning carelessness with the facts; if intentional, an equally stunning disregard for science and the public trust. Either way, it looks bad, very bad. My wild guess (you might call it the "gatekeeper" hypothesis) is that your agency, which conducts 85% of the world’s research on drug abuse, is also heavily invested in defending our failed 60 year policy of marijuana prohibition, and so must carefully control access to and interpretation of evidence on the health effects of cannabis. Sounds crazy, but maybe you need to divest yourself of policy commitments to honor your commitment to science. Just a thought. But remember, with published research only a mouse-click away, it’s getting harder and harder to pull a fast one.Yours,Thomas W. Clark, Bostonhttp://world.std.com/~twc/leshner.htm
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Comment #4 posted by Doctor Dave on September 08, 1999 at 17:58:24 PT
EXCELLENT piece
This is one of the finest analyses of this issue that I have ever seen. It clearly points out the the prohibition of cannabis is political, not based on science.Doctor Dave"A nation that makes war on huge numbers of its own people can never truly be free."
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Comment #3 posted by kaptinemo on September 08, 1999 at 17:13:22 PT:
Prostitution of science for political gain
In 1930's Soviet Russia, a so-called scientist named Lysenko curried favor with Stalin by stating that he could prove that he could change the genetic structure in two or three generations of any organism by manipulating it's environment... thus 'proving' Stalinist doctrine. He did so by falsifying test results, bullying his fellow - and better academically qualified - scientists, and always ensured his future paycheck by telling Stalin what he wanted to hear.Today, in academic circles, the phrase 'Lysenkoism' is the basest of pejoratives, connoting an intellectually dishonest, untrustworthy practitioner of science whose only goal is the furthering of his own power at the expense of the truth and all those who profess it.Adam Leshner, meet Trofim Lysenko. Given your penchant for bending of the scientific truth vis-a-vis cannabis for personal political benefit, I'm sure you have a lot in common.
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Comment #2 posted by observer on September 08, 1999 at 15:58:36 PT
pressure on the World Health Organization ...
>What agency, after all, put pressure on the World Health Organization to>drop from its 1998 report on international drug trends a >section comparing cannabis favorably to alcohol andtobacco? see:What the WHO doesn't want you to know about cannabis http://marijuana.newscientist.com/nsplus/insight/drugs/marijuana/news.html
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Comment #1 posted by rainbow on September 08, 1999 at 13:58:25 PT:
WOW
My comment is WOW. A great letter, I wish I could be so eloquent.Rainbow
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