05/06/12 Andrew Weil

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Dr. Andrew Weil speaks at Patients out of Time Conf, Drug Czar Gil Kerlikowske at Ctr for Amer Progress + Dr. Nora Valkow of NIDA on 60 Minutes

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Transcript

Transcript

Cultural Baggage / May 6, 2012

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Broadcasting on the Drug Truth Network, this is Cultural Baggage.

“It’s not only inhumane, it is really fundamentally Un-American.”

“No more! Drug War!” “No more! Drug War!”
“No more! Drug War!” “No more! Drug War!”

DEAN BECKER: My Name is Dean Becker. I don’t condone or encourage the use of any drugs, legal or illegal. I report the unvarnished truth about the pharmaceutical, banking, prison and judicial nightmare that feeds on Eternal Drug War.

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DEAN BECKER: Welcome to this edition of Cultural Baggage. This week we’re going to hear from Nora Valkow, the head of the National Institute on Drug Abuse and, lastly, we’ll hear from Dr. Andrew Weil from the University of Arizona and all over television.

But first up we’re going to hear from the head of the U.S. Office of National Drug Control Policy, Gill Kerlikowske, our nation’s Drug Czar. The speech was given this week at the Center for American Progress.

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GIL KERLIKOWSKE: Over the past few years this public debate on drug policy lurches between two extreme views. Let me characterize those views for you.

On the one side we have a very vocal, organized, well-funded advocates who insist that drug legalization is a silver bullet for addressing our nation’s drug problem. Then we have the other side. On the other side of the debate are those who insist that a law enforcement only War on Drugs approach, the one that was just mentioned, is the way to create a drug-free society. You know, “If only we could spend more money on prisons and enforcement and increase arrests and seizures of drugs…” that logic goes, “the drug problem will, at some point, just go away.”

Well the Obama administration strongly believes that neither of these approaches is humane. They are not compassionate. They are not realistic. Probably, most importantly, they are not grounded in science.

The approaches also do not acknowledge the complexity of our nation’s drug problem or reflect what science has shown us over the past two decades. Whenever you can put the answer to a complex problem on a bumper sticker you know you probably don’t have much of an answer.

That’s why two weeks ago we released the National Drug Control Policy and it pursues a third way for our nation to approach drug control. This is a 21st century approach to drug policy. It’s progressive. It’s innovative. It’s evidence-based and represents what we believe is a way ahead for drug policy.

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DEAN BECKER: The Drug Czar rambled on for about 15 minutes talking about how humane they had become, how much more treatment was available and how many fewer people were being arrested even though there was no facts to back it up. Then he took some Q & A from the audience.

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CARD READER: This is from Whitney Mast from DOD. In light of the Summit of the Americas what is your opinion of some Central and South American countries discussion of drug legalization / decriminalization? What impact do you see either of these scenarios having on drug flow to the U.S. and consumption figures?

GIL KERLIKOWSKE: I think we’ve seen a couple of things as a result of the discussion both before and then during the Summit of the America particularly before by some Central American leaders.

I think President Santos, in Colombia, who certainly understands this issue very, very well. He looked for a middle-of-the-road approach. He said that incarcerating vast numbers of people for drugs is probably not an answer and looking at legalization. And so looking at this policies and I believe the President and the Vice President both have advocated for a strong review of policies.

But let’s look at the success in Colombia. I don’t think…I don’t know anyone who doesn’t give Colombia high marks for their reductions in violence, for the improvements in the economy and their security, for their reduction in coca, planting and when I visited a group of people who were both farming fish and also growing sugar cane in the Macaran area of Colombia they said, “You know I might have had a little more money in my pocket when I grew coca but I was always afraid of criminals coming in, taking my crop, terrorizing my family. To have this steady income as a result of…” And these are programs that are strongly sponsored and supported by USAID and others. “As a result of having this steady income it’s better for my family and it’s better for the safety and security of my village.”

So good changes.

CARD READER: This is from Steve Fox of the Marijuana Policy Project. As you must know as an expert on substance abuse both marijuana and alcohol are widely used by adults in the U.S.

Something tells me you might have had some of these questions before.

Given that alcohol causes far more deaths, disease and acts of violence per user, could you explain why you support policies that prevent adults from using marijuana instead of alcohol if that is what they prefer?

GIL KERLIKOWSKE: So I think the issue always gets around a debate about why alcohol is more dangerous or alcohol causes more deaths. So certainly nobody’s going to roll a clock back and say, “Well, gee, we need to institute prohibition on alcohol.”

But there are no good reasons to legalize marijuana. I often hear about tax, regulate and control as an answer. Then I look at prescription drugs which as I mentioned take over 15,000 lives a year let alone the number of people that come into emergency department and the number of people who are treated.

Prescription drugs are already taxed, are already regulated, already controlled and we do a very poor job of keeping them out of the hands of abusers, misusers, and young people so I don’t see that we would do a very good job with a substance that can easily avade the tax scheme because it doesn’t take rocket science to grow marijuana. I think I become concerned when it’s sold as something…

You now if I look back at California and it was sold as “it will reduce violence. It’ll fix your economy. It will reduce or eliminate vast amount of criminal justice costs.” And on and on. I look back at that and said, “Well, I’m glad the voters of California recognized that perhaps there wasn’t as much truth in all of those claims for legalizing marijuana as had been put out in the press releases.”

CARD READER: This follows on that a little bit. Neil Franklin<?> from LEAP. As a 33 year law enforcement veteran who has arrested hundreds of people for non-violent drug offences I am pleased to hear your report that we cannot arrest our way out of this drug abuse problem.

We currently arrest 1.6 million non-violent drug offenders every year. What is your new annual arrest target and strategy for reaching it.

GIL KERLIKOWSKE: I think what isn’t in having a law enforcement background people don’t quite understand that the vast majority of this enforcement work gets done at the state and local level not by the federal level and not by the Drug Enforcement Administration.

The changes that I’m seeing across the country in reductions for incarcerations for low-level drug offences is important. I think one of the other things that’s kind of helpful is the police chief for those that would have talked about this a few years ago – you would have been characterized as either soft on drugs or soft on crime. It’s pretty hard to characterize somebody with 37 – wow 37 years as being soft on either of those things.

So a policy that begins to say they are other alternatives to incarceration and there are ways to reduce some of this problem I think are particularly helpful and important. I think the national drug control strategy directs and demands how the federal agencies operate. It doesn’t do that for the states and yet a strategy that is science-based and well-constructed, in my opinion, can be a template for a state governor and state legislatures to say we could look at this differently from that level.

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DEAN BECKER: Before we go to Nora Valkow’s visit to 60 Minutes, a little business to take care of.

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(Game show music)

DEAN BECKER: It’s time to play: Name That Drug by Its Side Effects.

Ventricular fibrillation, vasoconstriction, inhibition of the pump, increased concentration of calcium in sarcoplasm of cardiac cell, a positive inotropic effect that is caused by digitalis…

{{{ gong }}}

Time’s up!

The answer MEODMT, piedra, lovestone, Jamaican stone or chinese rock from Bufo alvarius, skin of the toad. The doctors say the safest and surest way is not to eat it or lick it and sure as hell not to smoke it, but simply to sniff it. Otherwise, you could wind up dead.

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[ghostly voice]

This is your Drug Czar. Do not listen to the Drug Truth Network. It’s evil – pure evil.

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Corruption charges! Corruption? Corruption is government intrusion into market efficiencies in the form of regulation. That is Milton Friedman. He got a goddamn Nobel Prize. We have laws against it precisely so we can get away with it. Corruption is our protection. Corruption keeps us safe and warm. Corruption is why you and I are prancing around in here instead of fighting over scraps of meat out in the street. Corruption is why we win.

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(machine and rumbling sounds)

The last bastion of the drug warriors is that using marijuana requires you to smoke it. Vapormed out of Germany has now produced a machine that takes the smoking out of smoking marijuana. It’s called, the Volcano!

(eruption sound)

They say the vaporizing method involves permeating the herbs with hot air.

Their website: vapormed.com.

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DEAN BECKER: When I was in Tucson at the cannabis therapeutics convention I learned that VaporMed is no longer available to U.S. citizens. Check it out.

But if you look at a drug story, especially on the New York Times or the Washington Post, an ad will pop up offering to sell you a Volcano from Storts and Bickle.

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DEAN BECKER: The following comes to us courtesy of CBS News.

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MORLEY SAFER: What’s your poison? Your addiction? Is it legal or illegal?

Whatever it is you’re hooked on from coffee to cocaine, smoking pot to pigging out, Nora Valkow has your number. She’s the head of the National Institute on Drug Abuse. For 3 decades now Valkow has been looking, literally, into the brains of addicts. Not just hard drug users but smokers and overeaters too. Nobody knows more about how we get hooks and why bad habits are so hard to break.

Dr. Valkow grew up in Mexico in a family with a famous ancestor and a tragic history. She’s made history herself by challenging many of the old ideas about our addiction to addiction.

What do you make of that common phrase, “Just say no.”?

NORA VALKOW: If it were so easy I think we would have no problem of obesity. We would have no problem with drugs. I think that we have to be honest. We’ve all been in a situation where we were tempted by something and we didn’t want to do it and we didn’t have the self-control to stop it.

For example, I love chocolates. Everybody knows that. And I love, also, coffee. But I’m a very wired person so I shouldn’t drink more coffee. But sometimes I can’t resist it and that is because not always I have the same level of self-control.

So saying to someone “Just say no” is magical thinking.

MORLEY SAFER: Valkow’s thinking has revolutionized how science and medicine now view drug addiction – as a disease not a character defect.

Her research pinpoints how drugs affect learning, memory and, above all, self-control.

NORA VALKOW: We know that drug addiction is a chronic disease. It changes, drug changes the brain – physically change it – and those changes are very long lasting and persist for a long period of time after the person stops taking the drug.

MORLEY SAFER: She’s been a pioneer in using MRIs (brain scans) to figure out the chemistry of addiction.

RADIOLOGIST: Remain still and just relax with your eyes closed. OK?

MORLEY SAFER: This subject is a recovering heroin addict, one of hundreds of drug abusers Valkow and her staff have examined over the years zeroing in on the critical substance – dopamine.

NORA VALKOW: Dopamine…to have it is to be one of the main chemicals regulating pleasure centers in the brain. As such it is therefore the mechanism by which nature motivates our behavior.

MORLEY SAFER: At the most basic level dopamine has saved us from extinction by making the key elements for survival of the species – food and sex – pleasurable. Dopamine sends signals to those receptors in the brain saying, “This feels good!”

What is it? A hamburger?

NORA VALKOW: It’s a hamburger.

MORLEY SAFER: Show a hungry person a hamburger and their brain scan shows a dopamine rush.

NORA VALKOW: It just basically stimulates the release of dopamine. The more they release the more they want the food.

They always say, “Why do we have a problem with obesity in our society?”

I say, “My God, we’re surrounded by stimulants which we are conditioned…”

If you like hamburgers you may see the McDonald’s yellow arches and then dopamine goes inside your brain and you want it. You don’t know why you want it.

MORLEY SAFER: Valkow has found images of alcohol and drugs produce similar signals which the addict can’t resist.

NORA VALKOW: When a person is addicted they get conditioned just like Pavloian’s dogs.

MORLEY SAFER: During a brain scan a cocaine addict was shown a nature scene. The image created no change in dopamine levels. The same test with a picture of someone using cocaine – result, a marked rise in dopamine.

NORA VALKOW: That’s why drugs are so malignant. You see a stimuli. Dopamine goes up in your brain and that, in turn, drives the behavior of the person to try to get the drug. That’s an unconscious thing. It’s not even conscious.

MORLEY SAFER: Her budget reflects the urgency of the work - 1 billion dollars a year for a wide array of research projects. She was the first to demonstrate how cocaine can damage the brain by triggering small strokes and she’s identified a common trait most addict share involving receptors – the molecules that receive dopamine signals.

NORA VALKOW: We’re seeing consistently a reduction in the levels of these dopamine receptors. In this case heroin, alcohol, methamphetamine, cocaine but also marijuana and cigarette smokers.

MORLEY SAFER: The problem is the brain just isn’t wired to handle the intense high that drugs give. A kind of shut-off valve kicks in reducing the number of receptors in the brain that receive dopamine’s feel good message.

NORA VALKOW: What happens with the repeated administration of these drugs is the ability of them to generate the sense of pleasure decreases and decreases and decreases and there’s a point where the person starts to take them not to feel good but to feel normal.

MORLEY SAFER: And other changes in the brain explain why so many addicts no matter how hard they try just can’t quit.

There is that school of thought that says, “Look, all you need to be is strong-willed. Your problem is you’re weak. Show some determination and you can beat this addiction.”

NORA VALKOW: There are certain areas of the brain that are directly implicated in our capacity to exert free will. The frontal cortex is one of them – crucial, crucial. So if drugs damage the areas of the brain that we need in order to exert free will then it’s like driving a car without brakes. You don’t want to hit someone but if you don’t have brakes how do you stop the car?

One of the areas that’s most sensitive to marijuana is the area involved with memory and learning.

MORLEY SAFER: Valkow pays particular attention to educating teenagers about the harsh realities of addiction. Her agency does a yearly survey of their drug use. The good news is there’s been a continuing decline in smoking and drinking. The not so good news – marijuana use remains high with one out of 3 high school seniors surveyed saying they’ve smoked it in the past year.

And the really bad news is the massive increase in both teens and adults using prescription pain killers to get high – mainly Vicodin, Oxycontin and other opiates.

NORA VALKOW: You know how many prescriptions there were for opiate medications last year in this country? 210 million prescriptions for opioid medications. 210 million prescriptions in one year.

MORLEY SAFER: That’s enough pain pills to keep every adult in the country medicated 24 hours a day for a month. There’s been a huge spike in hospital emergency cases and overdoes for pills killed nearly 15,000 people in a year’s time.

NORA VALKOW: Either we are a nation on severe pain or we’re over-prescribing.

MORLEY SAFER: When doctors prescribe these very powerful pain medications do they know what they are doing?

NORA VALKOW: Being honest I think that many physicians have not been properly trained on how to prescribe opiate medications.

MORLEY SAFER: Even as a teenager in Mexico’s National University Valkow, herself, was no stranger to the heartbreak addiction has caused to so many families. Addiction research became an obsession.

NORA VALKOW: As a medical student I was very frustrated by the fact that people addicted to drugs were not helped with symptoms as individuals suffering from a medical disease. I had seen that actually from my own family because on my mother’s side there is a family history of alcoholism and it was never considered that my uncle had a medical disease. And, therefore, he never received the help that could have benefited not just him but his family.

MORLEY SAFER: The road has taken Nora Valkow to a place of influence in Washington. She starts each day with a 7 mile run getting a healthy dose of dopamine. And looking forward down the road she sees a day when science might banish the curse of addiction.

NORA VALKOW: A cure would be fantastic. That means you get the medication like an antibiotic that might cure you.

MORLEY SAFER: Valkow’s labs and others around the country are working to develop vaccines to block drugs from entering the brain. The complexities are enormous and progress is slow.

NORA VALKOW: We’re not there yet but perhaps, one day, we may be. And in my brain it is only fair to think very ambition things will never be there.

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DEAN BECKER: And now, as promised, from a speech given last week in Tucson, Arizona at the Cannabis Therapeutics convention, Patient’s Out of Time – Dr. Andrew Weil.

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ANDREW WEIL: It’s been almost 45 years since I did the first double blind human experiments with marijuana. When that work was published in 1968 I predicted that marijuana would be legalized in5 years because I thought it was just a matter of ignorance. Then when people learned how benign marijuana was – especially relative to alcohol and tobacco – that was all it would take. I did not realize that it was irrationality and prejudice that really maintained these prohibitions and that people did not want to know the truth and that when you told them the truth they simply put that aside and didn’t pay attention to it.

That was before we knew anything about the endocannabinoid system or the vast medical potential for marijuana that traditional uses were known about the anti-nausea effect and possible effect with asthma, glaucoma, muscle spacicity but really nothing about these tremendous potentials with cancer and very serious diseases.

First of all let me tell you that I welcome you on behalf of the University of Arizona, College of Medicine. I also have to say that I’m somewhat embarrassed that my University did not provide CME credit for this conference and I’ll just read you one comment when we approached our university for CME. The person that was to pass this onto a higher committee wrote back, “My understanding is that there will be sampling done at the conference and this has caused concern from the university.” But - this is Arizona.

Now I have to tell you - and this is especially directed at physicians and other people in the health care professions here – it really is our responsibility that we are not able to use marijuana medically. I think if you don’t know the history of drug legislation in this country and the response of the medical profession and allied health professions to it you really want to learn that. I’ll just briefly summarize this for you.

Prior to the passage of the Harrison Narcotics Act in 1914 there really was no legislation controlling narcotics which were mostly opiates and cocaine. These substances both in crude form and refined form were widely available in over the counter and patent medications which sometimes did not list the content on the labels.

Doctors, when they got their hands on morphine and heroin and cocaine, dispensed them like candy for everything completely unaware of the potential dangers of addiction. They got thousands and thousands of patients addicted to these drugs and when they were called to account for what had happened their response (and this has been consistent over the years) is very predictable. They, doctors, say this had nothing to do with us and our prescribing practices - these are inheritantly bad drugs so please take them away from us.

The Harrison Narcotics Act was passed as a revenue act that was intended to monitor the movement of these drugs in society. To keep records of them so we knew how much was where, where they were going and so forth. There was no intent to interfere with medical use of these drugs or physicians prescribing practices.

The Justice Department, on its own, in the 1920s began going after doctors who were using opiates, especially, to help patients who were addicted get off them. There were widely publicized cases in which the Justice Department prosecuted physicians for dispensing opiates to addicts.

The AMA knuckled under completely to this. They put up no resistance whatever. In the course of a short space of time this legislation was transformed into an act of criminal prosecution and doctors were terrified that they would lose their licenses and wanted nothing further to do with this kind of prescribing.

In England the same pattern, same sequence of events occurred and the medical profession put up very stiff resistance to government attempts to interfere with the prescribing of these substances. As a result what happened here never happened there completely.

For example, British doctors retained the right to use heroin as a medical drug. Heroin has some advantages over morphine. It’s immediately metabolized to morphine in the body and there’s really no difference in addictive potential. But heroin is more potent as an analgesic meaning you can produce the same results with a lower dose.

One of the problems in using morphine in patients is that it sometimes causes unacceptable side effects especially extreme nausea and itching. Sometimes you can relieve pain with heroin at a lower dose that does not cause those side effects. So there’s an advantage there. There is no reason why we don’t have heroin as a medically useful drug but in this country it was declared to be a demon drug that had no redeeming therapeutic purpose.

The same thing happened when the Marihauna Tax Act was passed in 1937. Not one member of the medical profession steeped forward to protest that legislation. In fact, the AMA supported it. In fact, the only opposition in congress when that legislation was discussed was a representative of the bird seed lobby which didn’t want to have to go through the trouble of sterilizing marijuana seeds that it put into bird seed.

So I would say to you that a big portion of the responsibility of where we are today is with us. It is our right to dispense the drugs that we deem to be safe and useful.

AUDIENCE: [applause]

ANDREW WEIL: We need to take that right back which was taken away from us so long ago and very unfairly. So I would love to see the medical profession in this country get some spine to it and begin to stand up and declare that we know that cannabis is a safe drug and, in fact, there’s no safer drug out there.

You can’t kill people with cannabis. You can kill people with every drug you see advertised on television today. And with really every drug that we use in conventional medicine. It’s just a matter of dose but you can’t do that with cannabis.

So there’s nothing that matches its safety record and the potential usefulness of this substance is vast so why don’t we have it. Why aren’t we able to recommend it? It’s our fault and I would charge you with the responsibility with taking that right back.

I would also say that my sense it that most doctors that I know are not comfortable with recommending a medicine in the form of something to be smoked nor are they comfortable with recommending something whose use is not clearly distinguished with recreational use of an intoxicant. So I think it’s a vital necessity to have forms of cannabis available for medical use that look like medical drugs. That common forms that doctors are familiar with, that are standardized, that are predictable and so forth. I think it’s also worth all of our time to make those kind of products appear in our country. I think that will make acceptance by the medical profession much easier.

So that’s really my main message to you this morning. I’m going to stop. Thanks.

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DEAN BECKER: Once again, that was Dr. Andrew Weil from the University of Arizona speaking in Tucson, Arizona at the Cannabis Therapeutics Convention put together by Patients Out Of Time. Their website is http://medicalcannabis.com.

Thank you for joining us on this edition of Cultural Baggage. Please be sure to check out this weeks’ Century of Lies as well which follows next on many of the Drug Truth Network stations and features more interviews from the Cannabis Therapeutics Convention as well as some stuff I captured on my recent visit to Washington D.C. to share a message with my elected officials.

As always, I remind you that because of prohibition you don’t know what’s in that bag. Please, be careful.

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DEAN BECKER: To the Drug Truth Network listeners around the world, this is Dean Becker for Cultural Baggage and the Unvarnished Truth.

This show produced at the Pacifica studios of KPFT, Houston.
Transcript provided by: Jo-D Harrison of www.DrugSense.org
Tap dancing… on the edge… of an abyss.