REVENGE OF THE KILLER WEED, PART III

David Murray of the drug czar's office disagrees with me about cannabis potency and its significance. Click here for my response, with links to Murray's essay and to my original posts.

ARE MOST WELFARE MOMS DRUG ADDICTS?

No. Not even close. Harold Pollack and Peter Reuter try once again to drive a stake through the heart of this undead factoid.

Which raises a different question: How long is Columbia University going to put up with this nonsense?

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COSTS AND BENEFITS OF A COCAINE VACCINE

Apparently there has been great progress toward what is (not quite precisely) described as a "vaccine" against cocaine. At a chemical level, this would be something that, when injected, generated antibodies against cocaine molecules, lasting for several weeks. The result of a "vaccination" would be that taking cocaine would have no, or only very weak, effects; the antibodies would grab it in the bloodstream before it could ever get to the brain. This seems much more promising than something that would prevent cocaine, once in the brain, from doing its thing in the synapses, since it shouldn't interfere with normal brain functioning.

I say the term "vaccine" is imprecise because a vaccination is usually thought of as prophylactic and long-lasting; this would be therapeutic and relatively short-acting. This is more like Naltrexone than it is like a flu shot.

The National Academy has a panel on this, and I've been asked to prepare a paper on benefits and costs. My draft outline is below.

Having thought about this for a day or so, I'm actually quite excited (not by the project, but by the prospect of a "vaccine"), despite my general skepticism about technical fixes in the substance abuse area. If cocaine abuse could be converted into a non-relapsing condition, and if the long-term health and functional impacts of a few months as a heavy cocaine user weren't too awful, we might be able to afford to relax drug controls quite substantially.

Comments welcome.



The costs and benefits of a potential cocaine vaccine depend on:

I. Technical characteristics of the vaccine itself
--Cost
--Side effects
--Efficacy level
--Efficacy duration

II. Populations to which it is applied
-- Voluntary drug treatment clients with existing dependency disorder
-- Voluntary drug treatment clients with abuse disorder, or no diagnosable condition
-- Children referred by parents
-- Drug users detected by workplace or school drug testing programs and offered vaccination as an alternative to separation
-- Offenders subject to criminal justice supervision
--Adults
--Juveniles

--With diagnosable disorder
--Without diagnosable disorder


-- Populations thought to be at risk

III. Health impacts of reduced drug consumption due to vaccination

IV. Drug market impacts of reduced drug consumption due to vaccination

V. Behavioral responses among current and potential cocaine users

-- Effects on initiation and progression to abuse or dependency

Persons considering initiation of cocaine use might be more inclined to do so if the presence of a vaccine limits, or appears to limit, the damage resulting if use develops into abuse or dependency. Similarly, those already using cocaine might become less vigilant about developing an unwanted habit.

-- Time-course of cocaine use after the efficacy period of the vaccination
[Note: May depend on provision and efficacy of relapse-prevention assistance.]

-- Substitution and complementarity across drugs, both contemporaneously and over time

[Note: Assumptions need to be made about the range of drugs for which vaccines exist; a cocaine vaccine might have greater benefits in the presence of a methamphetamine vaccine than it would in the absence of such a vaccine.]

-- Effects of vaccine-induced changes in drug consumption on other outcomes of interest:
-- Crime
-- Property
-- Violent
-- Drug sales
-- Prostitution
-- Public order

-- Employment
-- Family functioning

VI. Other programs and policies

In addition to its direct effects, the availability of vaccination as a response to cocaine abuse or dependency might support changes in a wide variety of other drug-related policies, and in public attitudes about cocaine users.

More on pot, potency, and policy.

John Walters is trotting out the old "more potent pot" canard again.

The California Policy Research Center has published the executive summary of a study of drug testing in three California probation departments. (The full report should be on line in a week or so; in the meantime, I can email the draft to anyone who wants to see it.) The findings, and my take on them, are about what you would have expected: sporadic testing, with most probationers not tested at all; noncompliance (failure to show or a dirty test) of about a third, on a per-test-ordered basis, lackadasical sanctions process. The human subjects Nazis at UCLA decided we couldn't talk to any probationers, so their voices are missing.

RAVE ON:

Senator Joseph Biden has proposed a law to make "raves" -- all-night dance events featuring a special varieties of high-tempo music and MDMA ("ecstasy") -- illegal. Here's his press release. This is a follow-up to an effort by the Justice Department to use the "crack house" law, which makes it a crime to set up a drug use location, to shut down rave venues. Naturally, the proposal has drawn howls of outrage, from, for example, Glenn Reynolds (the Instapundit), among others.

There's lots not to like about this bill, starting with the short title: "This Act may be cited as the `Reducing Americans' Vulnerability to Ecstasy Act of 2002' or the `RAVE Act'." But it's far from obvious that shutting down raves would be a bad idea.

MDMA use has been soaring, as measured both by surveys and by emergency-room visits. My reading of the current evidence does not suggest that the drug's effects are nearly as bad as the drug warriors would like us to believe, (see this news story about a journal article arguing that the dangers have been hyped; but see also the commentary attached to the article, arguing for the opposite conclusion, and the studies referenced there) and last year's Congressionally-ordered toughening of the sentencing guidelines in MDMA distribution cases seemed way out of proportion to the known risks.

But it's also the case that the pattern of MDMA consumption has changed significantly for the worse over the last decade, with a substantial incidence of the sort of high-dose, frequent use that no one thinks is safe. That pattern of use is associated with raves; the drug's powers as a pure stimulant, which remain even after repeated use has dulled its more subtle effects, are greatly valued by people who want to stay up all night dancing, three nights every weekend.

One line of thinking about raves is that they are good places to spread information about safer drug use. But if they are also places where social setting encourages less safe drug use, it might well be the case that shutting them down would, on balance, reduce the aggregate damage done by the drug.

In some ways, this is a reprise of the argument about the gay bathhouses early in the AIDS epidemic. (See Randy Shilts's account in And the Band Played On.) I think it's now reasonably clear that shutting them down would have saved thousands, perhaps tens of thousands, of lives. Now analogy is not identity, and it's quite possible that, even if raves are A Bad Thing, trying to shut them down by legislation will prove futile or counterproductive. But, as always, I'm troubled by the extent to which the reflexive authoritarianism of the drug warriors is matched by reflexive libertarianism on the other side, with no one very interested in the likely actual results of the policies being debated.

MDMA policy is a hard, high-stakes question: too hard, and too important, to be dealt with by the usual round of sloganeering by the warriors and their opponents.