i fear sane drugs policy might be like the metric system

Which is to say, the entire rest of the planet will adopt it before we are even willing to consider it seriously.

Dan Savage writes:

The Global Commission on Drug Policy released its report this week. Dirty hippies like George Schultz and Kofi Annan declared our five-decade War On Drugs a failure that has had "devastating consequences" for societies, governments, and individuals. The commission called on governments to stop treating drugs users like criminals, to legalize some drugs, to provide more addiction services, and to go after criminal networks, not small producers. The Obama administration's reaction:

"Making drugs more available, as this report suggests, will make it harder to keep our communities healthy and safe."


And for what it's worth: there wouldn't be an Obama administration to react to this report if the president, back when he was using illegal drugs "frequently," had been swept up by the same criminal justice system he's defending today.



Bike Bubba said...

Boy, if there's an argument for continuing the war on drugs, it's gotta be that literally thousands of Barack Obamas now have a criminal record......if only they'd arrested one more..... :^)

Seriously, I'd be all for legalizing some drugs, especially marijuana, if we could figure out a way to correlate THC levels in the blood and fat and say "smoke it if you want, just stay away from driving and operating machinery."

Brian said...

Though I am unapologetically pro-legalization, I also think that a better regime for dealing with impaired driving would need to accompany legalization. I don't want people driving stoned, either. And I think most people in my camp don't acknowledge (or don't know) how relatively complicated that will actually be, because of the peculiar pharmacokinetics and pharmacodynamics of THC.

There is actually some fairly hard science looking at subjective impairment as a function of THC levels in blood, but the relationship is not as predictable and robust as it is with alcohol, i.e., there is a lot more inter-individual variability. The risk curve is also a lot shallower (i.e., it takes a relatively large amount of THC to measurably impair driving ability, compared with alcohol, which starts tipping upward at around 0.08 BAC and puts you at 20x increased risk of a fatal collision by 0.15.) So setting that threshold for THC will be tricky.

The other problem is that the only way to test this reliably is to actually test the blood (i.e., there has to be blood drawn.) Alcohol is highly water soluble, such that it rapidly equilibrates in all your body's "compartments". In other words, the concentration in your blood is the concentration in your saliva, and in your lung mucosa. So it is very easy to test non-invasively. Not so with THC (or really, much else.)

THC levels in the fat don't matter. If it's in fat, it isn't in your brain. Neither do the (major) metabolites of THC matter, because they aren't psychoactive*. THC is released from fat stores at such a low rate that it is metabolized before it could ever cause impairment. So really, the only thing that matters (to a first approximation) is the level of THC in your blood, at levels that are associated with very recent consumption (1-2 hours smoked, 4-6 eaten.)

Most employment drug screens (piss tests) actually look for the major metabolite, with a detection limit that will (generally) detect infrequent usage within the last week, or daily usage within about a month or so (YMMV). This would make absolutely no sense for a roadside impairment test. (I don't think it makes much sense for employment either, but that is another topic.)

Officers (at least in most states as far as I know) currently have the discretion to charge you with DUI regardless of your measured BAC, if they detect evidence of impairment (roadside test, slurred speech, driving like an asshole). So I think that could simply be extended to THC. Personally, I think that given the choice of officer discretion versus a likely very arbitrary blood level, I think the former is the lesser evil.

I also happen to think that legalization will have a much more negligible effect on actual rates of marijuana usage than a lot of people realize. Every person I know who is inclined to smoke it, does. The only people I know who refrain who might not otherwise face random drug tests at work. I seriously doubt there are masses of people anxiously awaiting legalization before they ever try it. The one group where I think where you could see a major change in usage would be kids, and that's because it would likely go down. Drug dealers don't check ID. Legal vendors would have a very strong incentive to do so. And while some degree of black market for underage smokers would certainly persist, I think the illicit supplies would largely dry up (it's not like anyone is making a fortune selling to kids only.)

Sorry so long. I just happen to have a lot to say about all of this.

*Some metabolites of THC are psychoactive, but they generally occur in much less abundance. There is some complexity here, too, but I've written too much already.

Bike Bubba said...

Wait a second. Most of your brain IS fat--you sure that THC in fat won't cause problems? Or are the problems seen due to unpredictable effects as THC and such leach back into the blood?

I'd go for a threshold of "below recent use, above historic use," with a provision for ticketing for reckless driving, though. Maybe a tighter provision for operating semis, planes, and stuff like that.

But arrest Barack for it, please, preferably while he's on the golf course.

Brian said...

Um, yeah, I'm pretty sure. I don't mean to pull rank here, but studying drug distribution is a big part of what I do for a living.

You have just enough info to be dangerous...while the brain is about 60% lipid, there are two other things you have to keep in mind:

1) A big adult brain would be 1.4 kg. So if you are an 80-kg man with 20% body fat, the fat in your brain only represents about 5% of the total fat in your body.

2) The uptake of THC (and nearly everything else) is rate-limited by the blood-brain barrier. So the effective distribution is much less than in other tissues.

There is also the fact that millions of people are walking around with THC slowly being released from their fat cells, and they don't spontaneously get high.

Gino said...

"There is also the fact that millions of people are walking around with THC slowly being released from their fat cells, and they don't spontaneously get high."

does this kinda explain why i could get spontaneously, but briefly, high for a couple days after a binge smoking weekend?

Dave said...

Well, yes ... except that the metric system sucks.