Starting Points

Points (n.) 1. marks of punctuation. 2. something that has position but not extension, as the intersection of two lines. 3. salient features of a story, epigram, joke, etc.:  he hit the high points. 4. (slang; U.S.) needles for intravenous drug use.

New Developments at the ADHS

Editor’s note: We at Points are thrilled to announce new developments concerning the Alcohol and Drug History Society. Today’s post was provided by Noelle Plack, the organization’s secretary-treasurer, and Virginia Berridge, its president. For more information, check out the society homepage at https://alcoholanddrugshistorysociety.org.

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Over the past 18 months there have been several exciting developments at the Alcohol and Drugs History Society that we would like to highlight.

The Society’s Officers have changed. Professor Virginia Berridge of the London School of Hygiene and Tropical Medicine took over as President in July 2015 from Professor Scott C. Martin. Dr Noelle Plack of Newman University, Birmingham has replaced Cynthia Belaskie as Secretary-Treasurer. Our thanks go to both Scott and Cynthia for their service to the Society. Dr Tim Hickman of Lancaster University has been elected Vice President of the Society. Dr Sue Taylor also of the LSHTM has become the Society’s Media Officer, while Dr Dan Malleck of Brock University remains the Editor of the Society’s journal, The Social History of Alcohol and Drugs.

The Society’s Executive Committee has been refreshed and now contains a mix of established and early career scholars representing a diverse range of specialties from across North American and Europe. The Executive Committee will provide guidance on strategy and developments of the Society; sub-committees have been created to oversee the development of a new Constitution as well as work on the website and future conference planning. The new Executive Committee as well as minutes from Society meetings can be found on the website.

The Society’s journal is also transforming with the intention to negotiate publication with a commercial publisher. Talks have begun with a leading academic international publisher and it is hoped that a formal relationship can begin in 2017. This would be a major advance for the Society and would enable wider circulation, integration into broader academic networks and a lessening of the administrative burden for the current editor. The next two volumes of The Social History of Alcohol and Drugs, 29 (2015) and 30 (2016), should be out by the end of the year. Once these are published, we can then proceed with further negotiations and any proposals will be put to the Society’s Executive Committee.

The Society’s biennial conference will take 22-25 June 2017 at Utrecht University in The Netherlands. The local organizers are Prof. Toine Pieters and Dr Stephen Snelders and the theme is ‘Drinking and Drug Policies in History: Contextualizing Causes and Consequences’. The call for papers has been circulated throughout various international networks and the deadline for abstracts is 15 December 2016. More information can be found on the conference website: https://adhs2017.wordpress.com

We look forward to a stimulating and productive conference next summer and we hope to see many of you in Utrecht! For more information, including Society membership, please visit: https://alcoholanddrugshistorysociety.org

Quarrelsome Cannabis in the UK: Evidence from Canada and Elsewhere

Editor’s Note: Today’s post comes courtesy of Luc Richert (lucas.richert@strath.ac.uk). It was originally featured on Active History Canada.

In September the All Party Parliamentary Group on Drug Policy Reform in the UK stated there was “good evidence” cannabis could help alleviate the symptoms of several health conditions, including chronic pain and anxiety. According to Professor Mike Barnes, a leading consultant neurologist who contributed to the report, “We must legalise access to medical cannabis as a matter of urgency.”

The co-chair of the Group, Baroness Molly Meacher, stated:

“The evidence has been strong enough to persuade a growing number of countries and US states to legalise access to medical cannabis. Against this background, the UK scheduling of cannabis as a substance that has no medical value is irrational.”

The All Party Group obtained evidence from 623 patients, representatives of the medical professions and people with knowledge of how medical cannabis is regulated across the world. It reviewed over 20,000 reports and suggested cannabis could be used for multiple health problems.

By contrast, a Home Office spokesman noted:

“There is a substantial body of scientific and medical evidence to show that cannabis is a harmful drug which can damage people’s mental and physical health.”

To get to the bottom of this, the House of Lords recently asked to hear from Dr Ian Hamilton of York University, where he presented on gender differences in cannabis psychosis.

Meanwhile, on October 11, the Medical Healthcare products Regulatory Agency (MHRA) announced that products containing a cannabidiol or CBD were in fact medicines. And it sent messages to 18 companies in the UK letting them know they had 28 days to get a licence to legally sell such products. These include such products as MediPen, a legal cannabis vaporiser

In Scotland, the issue was driven by government. On October 15, Scottish National Party (SNP) voted overwhelmingly in favour of decriminalising cannabis for medical use and demanded that physicians be given the power to prescribe the drug to patients suffering from painful conditions.

One delegate argued before passage of the Resolution that Scotland was lagging “behind the times” and this, of course, followed Nicola Sturgeon’s lukewarm backing of medical cannabis in May, 2016. Medical marijuana remains a complex policy issue. Yet, as was made clear during the party conference in Glasgow, there many other countries, including Australia, France, Finland, and Germany, which have moved ahead with medical cannabis.

Moving forward, then, questions remain about the suitability and scope of available evidence. Do we possess enough to take a sound policy decision? Or is more research in the basic science and clinical use of cannabinoids needed?

Evidentiary basis and recognition

The first physician to introduce cannabis to Western medicine was W.B. O’Shaughnessy of Scotland. In 1841, after observing its use in India he tested cannabis on animals to satisfy himself it was safe for human consumption.

Physicians soon began to prescribe cannabis for a variety of physical conditions such as rabies, rheumatism, epilepsy, tetanus and as a muscle relaxant. It was used too for various forms of neuralgia especially treating migraine attacks, epilepsy, depression and sometimes for asthma and dysmenorrhoea.

However, the 1890s found some doctors suggesting that the potency of cannabis preparations was too variable, and individual responses to orally ingested cannabis seemed erratic and unpredictable. According to An Ephemeris of Materia Medica, “Cannabis Indica has fallen considerably in the estimation of the profession, both in the old country and in this, due no doubt to its variability and often noticeable uncertainty of action.”

With the invention of the hypodermic syringe in the 1850s, there was also an increased use of opiates and soluble drugs that could be injected for faster pain relief. Cannabis was difficult to administer by injection because it is highly insoluble.

Yet, “British doctors and scientists consistently acknowledged the potential of cannabis as a medicine for a range of complaints and conditions.” In Cannabis Britannica, James Mills argued that authorities in British healthcare have known “for 200 years” that cannabinoids have therapeutic potential. Recognition of medical cannabis’s possibilities, in other words, has not driven regulatory reform or policy changes in the medical sphere.

Evidence about Canadian cannabis

Medical cannabis has been available in Canada since July 2001, after the Ontario Court of Appeal declared that sufferers from epilepsy, AIDS, cancer and other ailments had a constitutional right to light up. Prohibition of this “medicine” was, in short, unconstitutional.

Since then physicians in Canada have struggled with the science and ethics of medical cannabis, particularly with the evidence issue. At the 147th annual meeting of the Canadian Medical Association in Ottawa in 2014, many doctors expressed serious reservations about prescribing marijuana. Some said they felt threatened into signing authorization forms, whereas others felt as though patients were shopping for doctors. Worst of all, there were reported cases of malfeasance, where doctors charged their patients for a prescription.

The CMA remains divided on, if not outright opposed to, being the gatekeepers of medical marijuana. It has suggested physicians should not feel obligated to authorize marijuana for medical purposes and physicians. A cursory survey of the Canadian Medical Association Journal reveals a mix of ideas that underline the existence of “conscientious objectors” to cannabis use and a vital need to fill “the cannabis knowledge gap.” According to the CMA:
“…marijuana is a complex substance, and there is not sufficient clinical information on clinical safety and efficacy.”

For many physicians, society’s demand for cannabis was far out in front of the available evidence about the safe and effective use of cannabis as a legitimate remedy. And the judicial system – the courts – took the lead.

The College of Family Physicians of Canada has also maintained that the current Health Canada regulations put physicians in a challenging position, one where they were asked to authorize patients’ access to a product with little evidence to support its use:

“Health Canada places family physicians in an unfair, untenable and to a certain extent, unethical position by requiring them to prescribe cannabis in order for patients to obtain it legally.”

Yet, physicians have also questioned whether the medical field as a whole was being unduly cautious and that the anti-cannabis position taken by CMA and other commentators was not entirely evidence-based.

Several physicians involved in the Canadian Pain Society, for example, are on the cutting-edge of research on cannabinoids. Dr Mary Lynch, for example, published a systematic review in the 2011 edition of the British Journal of Clinical Pharmacology and came to the following conclusion:

“Overall there is evidence that cannabinoids are safe and modestly effective in neuropathic pain with preliminary evidence of efficacy in fibromyalgia and rheumatoid arthritis.”

Additionally, Dr Mark Ware, one of Canada’s leading researchers and educators in the area of cannabinoids, who was asked to serve as vice-chair of the task force on cannabis legalization by PM Trudeau, has also published two landmark studies on cannabinoids. In October 2014, Dr Ware authored an article called “Medical Cannabis and Pain” for the International Association for the Study of Pain (IASP) that provided an excellent overview of this therapeutic area.

Do we possess enough to take a sound policy decision? Or is more research in the basic science and clinical use of cannabinoids needed? More research in the basic science of cannabis is clearly necessary. And the evidence needs to be augmented.

Political leadership in the UK

The current discussion over medical cannabis and its evidentiary basis has a familiar ring. Physicians and pharmacists consistently employed this “medicine” during the 19th century, even as many wrote of the potential dangers of cannabis following its introduction into medical circles in the 1840s-1850s.

Most medical doctors understood that cannabis was both potentially helpful and potentially harmful. These concerns stemmed from the adverse events and feelings that sometimes accompanied the use of cannabis medicines, including distortion of space and time, hallucinations, anxiety, and fear of death. And these concerns of course remain.

In Scotland, specific cannabis champions in government have taken a forward-facing position forcing a public conversation. This too is familiar, in that the political and regulatory apparatuses are propelling medical science to resolve the cannabis quarrel – much like in Canada.

From a historical perspective what is most fascinating about the intensifying debate in Scotland and the UK more broadly is how many of these issues are recognizable. Physicians and pharmacists wrote of the potential dangers of cannabis almost immediately following its formal introduction to American and Canadian medicine in the 1840s-1850s.

Most medical doctors understood that cannabis was both potentially helpful and potentially harmful. These concerns stemmed from the adverse events and feelings that sometimes accompanied the use of cannabis medicines, including distortion of space and time, hallucinations, anxiety, and fear of death.

Knowledge from Canada can frame British perspectives on cannabis. There’s potential that the Canadian experience can enhance the “evidence about evidence,” as Geoff Mulgan has put it. Doctors are divided. Scientists need to produce more work. And, much like politicians or police officers, these actors are not unbiased.

Cutting through all the haze won’t be an easy task. Cannabis has become a hot-button issue, featuring prominently in Nature and British Medical Journal this month. At the same time, libertarian thinktanks such as the Adam Smith Institute have called for the total legalisation of cannabis. All the participants in Scotland, whether it’s the SNP or physicians or law enforcement, would be wise to use recent examples from Canada’s medical marijuana past to light the way.

Acknowledgements: My thanks go to Ved Baruah, Jim Mills, Alix Mortimer, Murray Opdahl, Matt Smith, and other members of the Centre for the Social History of Health and Healthcare at the University of Strathclyde.

A Points Thanksgiving Retrospective: 2016

Kyle Bridge, Managing Editor (kbridge@ufl.edu)

As it has done in years past, the occasion of Thanksgiving prompted us at Points to consider what we are most thankful for. Personally, I’m perpetually grateful to my colleagues who help keep the blog running efficiently with relevant, informative, and usually quite entertaining content. I’m especially thankful for thoughtful outlets like this one, as well as others sponsoring real investigative journalism, in a time when folks from the Thankgiving dinner table to the presidential debate stage echo “post-truth” claims disguised as reasonable beliefs.

 

Bob Beach, Contributing Editor (blbeach@albany.edu) 

I am thankful for Points. For those I have worked with (Claire, Emily, Amy, Kyle) who give me an opportunity to share some of my insights with our readers. I’m thankful for the Alcohol Drug History Society who continuously push drug alcohol scholarship in fascinating and politically significant new directions. And in a particularly brutal year where Americans are searching for silver-linings, I am thankful for the Americans who have approved medical and/or recreational cannabis regulations in nine states this year. Despite President-elect Trump’s Attorney General pick, who could make the road more difficult for further legalization measures, it appears we are closer than ever to the end of marijuana prohibition. I am thankful for marijuana users who have defied and continue to defy unjust laws defied to achieve their self-defined ends despite folks like Sessions categorization of users as bad people. Their stories, both in the archives and out, are helping historians to better understand these motivations, not merely by imputing agency onto those decisions, but continuing to defy the classifications of Sessions and others.

….And to push the search for silver linings if I may, I’m also thankful that we’ll be seeing a lot more of Alec Baldwin on Saturday Night Live.

David Korostyshevsky, Contributing Editor (koros003@umn.edu)

After a long and winding journey through doctoral coursework and preliminary exams, this Thanksgiving finds me extremely grateful to be moving on towards dissertation research, when I will finally be able to indulge my intellectual interests. I look forward to blogging about them on Points.

Amy Long, Contributing Editor and Social Media Liaison (amyllong@vt.edu)

Even setting politics aside, 2016 was a grim year for me. It started out hopeful. I finished my MFA. I had a book manuscript to polish and an apartment in a new city, which I planned to share with someone I loved and had recently started re-dating, whom I’ll call B. On the Friday before July 4th, I wrecked my car on the interstate and ended up spending a week at B.’s house (I’d planned to be there overnight and finish my drive to Florida on Saturday). It was a really great week, and it mostly reinforced what I already knew about him: he was generous, kind, gentle, funny, affectionate, and a really useful person to have around. But the day I left, B. went upstairs to his bedroom and never came down. His roommate called me the following afternoon and reported that B. had overdosed and died. It has been hard to take. I moved into our apartment anyway, and I’m settling into the new city, but I don’t feel like 2016 gave me much to be thankful for. I promised Kyle (for whom we are all thankful) I’d write this, and then I thought, “Oh, no. What the hell am I going to say?”

I am thankful, however, for that week in July. I’m glad I got to spend those days with B. before I never got to see him again. I’m thankful that I met his roommate, who has been indispensable in helping me through this grieving thing. I’m thankful for books. I’m thankful for Joshua Mohr, who sent me an advance copy of his memoir Sirens, which was weirdly comforting to me (it releases in January and is utterly beautiful; you can read Josh’s Fiction Points interview here). I’m thankful for Sean H. Doyle and his support. I’m thankful for my own writing, which has always helped me process things, but I really needed you this year, writing, so thanks. I’m also thankful to the states and cities that have made Narcan more readily available to their citizens so that fewer people have to mourn their loved ones following overdoses. Let’s make more of those. I’m thankful for the drugs I use to treat my chronic pain condition, even as I am intimately familiar with the pain opioid overdoses have caused families and friends all over the country. I’m thankful I have the ability to hold two conflicting thoughts in my head at the same time. I’m grateful for the many other people of whom that is also true. And I’m grateful for everyone who listened to me cry and/or ramble (especially Trysh Travis, whose humor is exactly as dark as I needed it to be) and also for you, Points readers, for believing that public engagement with the humanities might shape policy and promote understanding. Let’s hope we’re all right.

Jeremy Milloy, Contributing Editor (jeremymilloy@trentu.ca)

I’m thankful to have the opportunity to contribute to Points, and build on work done by scholars from whose research I have learned a great deal. Although we had Thanksgiving last month, I’m also thankful that so many in my home country of Canada are working, with real momentum, to shift responses to drug use from prohibition and repression to emerging directions, including expanding safe-injection sites and preparing for marijuana legalization.

 

Happy Thanksgiving 2016 from Points!

We at Points hope you have a rewarding Thanksgiving this year! Though we’re taking time off for the holiday, we’ll be back next week with our usual brand of insights into drug history – and its implications for the present. Stay tuned! In the meantime, consider: how do intoxicants influence your holiday? (Even something as mild as tryptophan.) Happy holiday!

 

Rumor and Libel: Regulating Cannabis in the Panama Canal Zone, 1914-1935.

Nelson Rounsevell
Nelson Rounsevell

On October 2, 1935, in the midst of Reefer Madness, Nelson Rounsevell was convicted of a single libel charge in a Panama Canal Zone District Court. Rounsevell, editor of the bilingual Panama American had published a series of editorials in the summer of 1935 alleging that Colonel James V. Heidt and Major General Harold B. Fiske were running a “suicide post” at Ft. Clayton, after reports surfaced of four suicides in six weeks at the fort. In one editorial, Rounsevell referred to Heidt as, “the Simon Legree of the zone, [relentlessly] driving his men by day and [ignoring] marihuana smoking by night.”

While the story seems have all the trappings of reefer madness discourse, his conviction on libel charges might seem curious. Surely, if Harry Anslinger had been involved, he may have led the charge against Heidt and Fiske himself. In fact, Rounsevell was indicted on five separate charges of libel during this episode and was only convicted on a single charge. I suggest that understanding the Rounsevell libel case involves understanding the evolution of marjiuana regulations in the Canal Zone that predate the conflicts of reefer madness in the U.S. Soldiers overworked, bored, and isolated had been using marijuana as a solution-seeking activity to pass time and cope with the tremendous stress and isolation of military life in the Canal Zone. Rounsevell’s error was not reporting marijuana use, it was misunderstanding the motivations for use. Marijuana use did not cause the suicides, but the factors that did were factors that also influenced an individuals use of marijuana.Read More »

Contribute to Points!

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Courtesy, Breitbart News

At Points, we rely on our network of contributors to deliver the best in drug-related commentary on the past and present. If you have an idea to share with our readers, pitch it! Email managing editor Kyle Bridge (kbridge@ufl.edu) to develop an individual post or to inquire about becoming a contributing editor. We welcome informed perspectives on drug policy, substance use in culture, media, and politics, addiction and recovery/maintenance, harm reduction initiatives, and more! Past contributors hailed from academia, clinical practice, policy arenas, and the storied armchair (among others), but with plenty more room for inclusion.

Again, please don’t hesitate to reach out to the Points team with questions, comments, or ideas; we want to know what you want to know!

Dissertation Abstracts: Policy and Public Health Edition

Editor’s note: Of potential interest to Points readers, the following drug-related dissertation abstracts were compiled as part of a running bibliography of relevant scholarship by Jonathon Erlen, History of Medicine Librarian at the University of Pittsburgh (erlen@pitt.edu). The abstracts were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Today’s batch, released one week after the conclusion of tumultuous election, deals primarily with the policy and politics of public health. 

An analysis of National Youth Tobacco Surveys: Using substantive risk predictors to target communication campaigns

Author: Hong, Moonki

Abstract: Health and communication researchers have studied tobacco related risks and behaviors, and associated variables for more than 20 years. Some of their studies have produced consistent findings, while others have produced findings that are inconsistent and complex. To address these problems, this study used a common set of comparable samples, a common set of variables, and a common set of measurement techniques that are found in the 1999, 2000, 2002, and 2004 National Youth Tobacco Surveys (NYTS). In this study, secondary analysis techniques were used to identify substantive predictors of youth susceptibility to smoking, lifetime smoking, and current smoking. When considering the NYTS sample results for adolescents ages 11 to 18, there is clear evidence that youth susceptibility to smoking has not declined since the Master Settlement Agreement in 1998. By comparison, there is good evidence that lifetime smoking and current smoking have declined, though the effect size measures for these changes are minimal. The study results further point to the utility of measures documenting peer (best friends) smoking and receptivity to pro-tobacco promotions as predictors of adolescent susceptibility to smoking. Measures of favorable attitudes toward smoking/smokers are somewhat less consistent positive predictors of smoking susceptibility. The results further confirm that age, peer smoking, and receptivity to pro-tobacco promotions are substantive, positive predictors of lifetime smoking and current smoking. A cluster analysis produced two adolescent audience segments reflecting tobacco-related risks. The first cluster represented household smoking and receptivity to pro-tobacco promotions risks and the second cluster represented peer smoking and favorable attitudes toward smoking/smokers risks. The cluster segmentation of adolescents was particularly useful in predicting lifetime and current smoking behaviors. The cluster segmentation results, however, indicate that additional variables are needed to explain and predict the sample observations. This study concludes with a discussion of factors that possibly limit the empirical findings. Several theories are identified for inclusion in future research. Recommendations are also made to focus attention on identifying the anti-tobacco campaign components that have been successful following the MSA.

Publication year: 2008

University/institution: Florida State University

 

Essays on drug and alcohol policies in the United States

Author: Crouch, Randall

Abstract: This dissertation consists of two essays that explore the unintended consequences of drug and alcohol control policies in the United States. They both examine policy changes at the state level using a difference-in-differences approach. These two studies shed light on outcomes that were not likely to be considered when policy decisions were made and may have important implications for future policies. In the first essay, I analyze the effect of minimum legal drinking age (MLDA) laws on non-cognitive skills. The National Longitudinal Survey of Youth 1979 (NLSY79) is used to investigate the effect of changes in MLDA on the onset of regular drinking, self-esteem and self-control. Surprisingly, I find that a legal drinking environment is associated with an increase in self-esteem for females in the short-run and long-run. Then, I test several possible channels through which self-esteem may be indirectly affected by the MLDA. These channels include alcohol and drug use, marriage, sex and childbirth. Although the MLDA has a significant effect on some of these channels for females, using the channels as controls in the self-esteem analysis does not affect the magnitude or significance of the effect of the MLDA on female self-esteem. In the second essay, I examine the effect of marijuana decriminalization in Massachusetts on the black-white gap in arrest rates for several different criminal offenses using Uniform Crime Reporting (UCR) program data. I use a difference-in-difference model that allows for a heterogeneous treatment effect by race to estimate this effect for marijuana possession and sales, non-marijuana possession and sales, violent and theft-related offenses separately for adults and juveniles. Results indicate that marijuana decriminalization leads to a decrease in the black-white gap in adult and juvenile arrest rates for marijuana possession and sales, non-marijuana sales and adult arrest rates for theft-related offenses. These findings are consistent with decriminalization leading to a shift in police resources away from areas where blacks are more likely to be arrested.

Subject: Economics

Publication year: 2015

Advisors: Juhn, Chinhui; Lin, Elaine

University/institution: University of Houston

 

A community trial to speed the diffusion of smoke-free policies in multiunit housing

Author: Gentzke, Andrea Susan

Abstract: Given the regional and socioeconomic differences in the smoke-free housing movement, we set out to implement a community-based educational intervention trial aimed at increasing the adoption of smoke-free policies in multiunit housing (MUH). Methods: This dissertation provides the results of two distinct projects. The first project is the community-based educational intervention trial conducted in 3 pairs of communities (1 intervention (I), 1 control (C)) across the U.S.: Bismarck (I) and Grand Forks (C), ND, Charleston (I) and Columbia (C), SC, and Fort Collins (I) and Pueblo (C), CO. This project included three primary data collection efforts: (1) a baseline survey of knowledge, attitudes, and experiences with secondhand smoke and smoke-free policies among MUH residents living in these communities, (2) a baseline survey of knowledge, attitudes, and experiences with smoke-free policies among MUH operators in these communities, and (3) a follow-up survey among MUH residents (from baseline) to assess changes over time in secondhand smoke exposures, smoke-free rules in the home and building, and attitudes toward smoke-free policies. Between baseline and follow-up, a multi-faceted educational intervention was disseminated to key stakeholders in our intervention communities. We worked with local community partners to create and disseminate all materials involved in the intervention. We hypothesized that exposure to the educational intervention would have resulted in faster rates of adoption of smoke-free policies compared to what was observed in the control communities. The second project is an environmental assessment of secondhand smoke (SHS) and thirdhand smoke (THS) exposures inside smoke-free and smoke-permitted subsidized MUH buildings. Data were collected between December 2014 and June 2015 in two large subsidized housing buildings near Buffalo, NY (Fredonia, NY and Batavia, NY). During the assessment periods, we collected data on particulate matter (PM), airborne nicotine, and surface nicotine, a marker of thirdhand smoke contamination. These markers were compared between buildings and units with varying smoking rules, and were also compared with each other to determine the best marker(s) to assess tobacco smoke pollution in these environments. Results: From the baseline survey, 76% of residents enforced smoke-free home rules, but a substantial proportion (50%) of these individuals reported SHS incursions into their units in the previous 12 months. The majority of residents overall (67%) reported there were no rules about smoking set by the MUH operator inside the building where they lived. Preferences toward smoke-free building policies were high (56% overall), but were mostly restricted to non-smoker residents. Differences in these outcomes were noted by community, indicating the importance of utilizing locally collected data in intervention materials. Results of the operator baseline survey found that 38% of operators across all communities reported having at least one smoke-free building. However, among those without smoke-free policies, many were reluctant to implement a policy citing concerns about resident resistance or the potential for higher vacancy rates. Positive effects of smoke-free policies were cited by those who had implemented a smoke-free policy, but operators without policies generally lacked this knowledge. At follow-up, we did not observe any statistically significant findings over time contingent on our intervention. However, we did find positive changes over time in each outcome overall, suggesting that the temporal trends in the smoke-free housing movement may have outweighed the effects of our intervention. We also found that enforcement of smoke-free policies remained an important issue over time. The results of this follow-up survey suggest that disparities in SHS exposures may be widening due to smoke-free policies in MUH. Over time, subsidized housing residents were significantly less likely to implement/enforce smoke-free home rules, and were also less likely to report the implementation of smoking rules inside their buildings. The results of the environmental assessments found significant differences between levels of SHS and THS exposures between buildings and units with smoke-free home rules. These results also indicate that voluntary smoke-free home rules do not confer full protection from tobacco smoke exposures. Comparing units occupied by non-smokers across buildings, levels of particulate matter, airborne nicotine, and surface nicotine were all higher among units in the smoke-permitted building compared to the smoke-free building. Discussion and Public Health Impact: Although we did not observe any significant changes over time due to our educational intervention, these findings are not in vain. Overall, important data and themes were gleaned from this study which can be utilized in future campaigns that are aimed at smoke-free policy adoption and enforcement. Moreover, these results indicate that there is positive momentum in the smoke-free housing movement. Although these temporal trends may have outweighed our intervention, there will likely be strong gains in public health due to reduced SHS exposures in the home as well as in changing social norms regarding smoking due to this momentum.

Publication year: 2016

Advisor: Hyland, Andrew

University/institution: State University of New York at Buffalo

Department: Epidemiology and Environmental Health

The Points Interview: Alexandra Chasin

Editor’s note: Today’s interview comes courtesy of Dr. Alexandra Chasin, associate professor of literary studies at Eugene Lang College, the New School, and author of the new book, Assassin of Youth: A Kaleidoscopic History of Harry J. Anslinger’s War on Drugs.

9780226276977

1. Describe your book in terms your bartender could understand.

Assassin of Youth explores the origins of the war on drugs in the United States with a focus on Harry J. Anslinger. Anslinger was the first drug czar, commissioner of the Federal Bureau of Narcotics from 1930, when the bureau was set up, until his retirement in 1962. Anslinger believed in harsh penalties, compound penalties for repeat offenders, and mandatory minimum sentencing. And he didn’t rest until they were in place. More of a bureaucrat than an ideologue, Anslinger was nevertheless a propagandist with a knack for hanging particular drugs on particular social and immigrant groups. With these beliefs and powers, he helped create a criminal justice system that very disproportionally convicts young African American and Latino men on minor nonviolent drug offenses.
Assassin of Youth asks what was in Harry’s drinking water as a kid. What made him so sure that marijuana made people violently insane, that the specter of harsh penalties would ever deter drug-taking or inhibit drug trade, and that racial others and immigrants were the cause of the narcotic menace?
Going back to 1820, noting the rise and fall of alcohol prohibition, immigrant waves, the rise of government bureaucracy – but also relativity, Wallace Reid, gangster lore, and popular magazines – Assassin of Youth looks at the cultural origins of the Anslinger and his war on drugs. The book tracks Anslinger’s career, beginning with his first jobs at the Pennsylvania Railroad Company in Altoona where he grew up, and following through to his legacy.
Using pictures of all kinds of historical documents from deeds to charts to city maps to a photograph of the Coast Guard busting a rum running boat, the book ranges from more traditional historical methods to more playful ones, using screwy language to twist up the account of Harry J. Anslinger and his war on drugs. Assassin make the point that we don’t just need to retell history, we need new ways to tell it in order to gain fresh insight into the history of now.

2. What do you think a bunch of alcohol and drug historians might find particularly interesting about your book?
Assassin of Youth places the emergence of drug law and policy against a backdrop of cultural history. In this way, new juxtapositions arise, for example, the slow and public death-by-addiction of movie star Wallace Reid unfolded in the early 1920s, just as the right of doctors to prescribe narcotics to addicts was being challenged in thousands of court cases.
The book is promiscuously interdisciplinary, complicating the history of drug policy by poking into the social sciences to look at the growth of statistics, the Sociology of the inner city, and resonances between the participant observer of twentieth-century Anthropology and the undercover agent.
Finally, it often interests people to know that the war on drugs started well before Nixon’s War on Drugs and the Rockefeller Drug Laws of the early 1970s. The Harrison Act of 1915, the stamp act that was used to criminalize all those doctors mentioned above, went on to serve as the cornerstone for a century of prohibitionist drug law. By 1937, Anslinger had installed federal anti-marijuana laws, and by the early 1950s, mandatory minimum sentencing was in place.
The racist effects of drug prohibition legislation – championed by Harry J. Anslinger at every turn – were already at work in the culture that allowed his legislation to take root in the first place. Neither did Anslinger invent equations between certain narcotics and certain social and immigrant books – though he cemented them and carried them forward, adapting them as new drugs came on line. These equations have a long history. It is the history of the present.

3. Now that the hard part is over, what is the thing YOU find most interesting about your book?
Assassin of Youth does not reveal a lot of new information beyond what is already known about Harry J. Anslinger. The book’s unique contribution is not on the level of information. Instead the book uses innovative form and language to craft a rhetorical rejection of the kind of thought – couched as information – that Anslinger mobilized to criminalize drugs.
The book makes unusual claims about what the trouble was with Harry: rectilinearity, fear of the tropics, and bureaucratic mind. And the book activates a set of characters rarely seen in books of history. There are Martha sprinkled throughout the text, and wherever they appear, they stand for alternatives views of, alternative ways of telling history. History is not a social science; telling it, reading it, understanding it, require imagination. And the book also takes up the Lotus Eaters, tropical characters – first seen in Western Literature in Book 9 of the Odyssey, when Odysseus almost loses three scouts to local Lotus Eaters, whose fruits are irresistible. Latter-day Lotus Eaters – like Leopold Bloom and William Burroughs – lead the text on lyrical side trips, keeping the book flakey and fun.
The Lotus Eaters and the Marthas hold and turn the kaleidoscope of the subtitle. They turn this text from a straight history into a genre-busting investigation into modes of knowledge.

4. Every research project leaves some stones unturned. What stone are you most curious to see turned over soon?
Having traced the proto-origins of the War on Drugs through an investigation on the life and career of Harry J. Anslinger, the book leaves off in 1962, when he retires. Though there is a vertiginous tear through the last few decades in especially lyrical fashion, the present is largely untreated…. You could say the book leaves some turns unstoned.
BONUS QUESTION: In an audio version of this book, who should provide the narration?

Martha. Only a Martha, or better, multiple Marthas, could narrate this book.

Hillary Clinton on Drugs: Election 2016, Part II

Editor’s Note: Be sure to check out Part I of our Election 2016 series. And, if you haven’t, go vote! 

Last week went about as well as Donald Trump could have realistically hoped for. His polling crept upward as allegations of sexual assault faded to a dull roar and FBI director James Comey delivered to the anti-Hillary Clinton rumor mill what appeared to be an October Surprise: yet another trove of unreleased emails. Trump even had the distinction of a Points breakdown of his positions on hot-button drug policy issues. (However critical the post, it seems most press is good press for the former reality TV star.)

Fortunately for the Clinton campaign, Comey backpedaled this weekend, halting any late-game momentum for Trump generated by the latest virtual controversy. In fact, as of this writing polling indicates Clinton will become the next president of the United States. Today’s post subjects her to the same scrutiny he endured last week. Hopefully it will engage Points readers curious about the policy aims of the probably-incoming Clinton administration, or perhaps even the minority of Points readers still on the fence on election day.

Marijuana

hillaryweed_0
Courtesy, Mother Jones

Back in August, the Drug Enforcement Agency denied for the fourth time a petition to downgrade marijuana from the hyperprohibitive Schedule I to the slightly less onerous Schedule II. DEA did, however, ease restrictions on research institutions to grow their own supply.

In response, Clinton policy advisor Maya Harris issued a statement to the Cannabist, promising that “Hillary will build on the important steps announced today by rescheduling marijuana from a Schedule I to a Schedule II substance.” Clinton had publicly supported the idea earlier but made no definite commitment to rescheduling. Such a reclassification would acknowledge that cannabis has a currently accepted medical use and open doors for further research into its effects.

Clinton’s longtime “wait and see” attitude toward marijuana, which generally pointed to states as “laboratories of democracy” for both medical and recreational initiatives, has over the past year evolved into something like “proceed with caution”: she supports states moving in either direction and, in typical technocratic fashion, wants more facts and figures on its utility. “There’s great, great anecdotal evidence [about what marijuana can do for people],” she told Jimmy Kimmel in March, “but I want us to start doing the research.”

Policy reformers have some room to doubt Clinton, who received only a B+ (to Trump’s C+) grade from the Marijuana Policy Project, and whose non-inhaling husband signed the infamous 1994 crime bill into federal law. Others question the real value of rescheduling marijuana at all. But even if Clinton drags her feet, President Barack Obama recently wondered aloud if federal prohibition would be “tenable” if (when) California goes fully legal this year.

Opioid Addiction

“There are 23 million Americans suffering from addiction,” Clinton wrote in an op-ed for the New Hampshire Union Leader last fall. “But no one is untouched. We all have friends and family who are affected.”

Unlike Trump, who has given some lip service and even less thought to opioid addiction, Clinton has repeatedly offered inclusive rhetoric and policy ideas to combat the ongoing epidemic.

Specifically, she proposes a new $7.5 billion dollar federal fund to reward states with innovative solutions to drug addiction. Her plan also increases funding for the Substance Abuse Prevention and Treatment Block Grant by 25 percent, and she would coordinate between Medicare and Medicaid to ensure all levels of government are making it easier for individuals to seek treatment. Clinton also believes all first responders should carry naloxone, the opioid overdose-reversal drug. Finally, she would require physicians to complete additional training and consult a prescription drug monitoring program before writing any new scripts.

Less specifically, Clinton holds vaguely progressive notions about prioritizing treatment and rehabilitation over prison for “low-level and nonviolent” drug offenders, while also reducing the stigma of addiction as a disease rather than a vice or moral failing.

Conclusion

In the aftermath of California’s 1996 referendum legalizing medical marijuana, when the first (Bill) Clinton administration threatened to prosecute dispensaries to the fullest extent of federal law, legal journalist Anthony Lewis wrote that American drug policy is often “immune to reason.” And his point remains essentially true today: drug politics are usually more beholden to belief than fact, as are policing patterns that disproportionately target people of color when they use at similar rates to their white peers, to name two examples.

The challenge for the second Clinton, notoriously bad as she is at tramping out of the policy weeds and actually selling an idea to the American people, will be navigating this dizzying interplay.

It will be interesting to see how the drug war plays out under a Clinton presidency. Her ideas on drug policy in particular, and criminal justice reform in general, which markedly diverge from the “Blue Lives Matter” ethos of Trump and his conservative ilk, offer some promise of a less punitive approach.

Perhaps a policy-wonk-in-chief is just what the country needs to make it a little more susceptible to reason.

 

Donald Trump on Drugs: Election 2016, Part I

In response to Donald Trump’s sniffly debate performances over the last month-and-a-half of the 2016 presidential campaign, the Twittersphere erupted in wild speculation that the alleged billionaire had prepared with lines other than his taking points. “Notice Trump sniffling all the time. Coke user?” ventured Howard Dean, former chair of the Democratic National Committee, one-time presidential candidate, and, not incidentally, licensed medical doctor. Others consulted drug authorities, of a sort. Self-described cocaine “expert” Carrie Fisher told a curious fan that she “ABSOLUTEY” thought Trump appeared like a “coke head.”

Dean’s jab, relatively on par with some of Trump’s own supposed zingers, was immediately scrutinized and dismissed by commentators. But it is curious that drugs have only sporadically entered the national conversation when, in recent years, opioid overdoses – usually in combination with other substances – routinely kill about 1,000 Americans a month. Moreover, four states are voting on medical marijuana and five, including the hugely influential California, may fully legalize.

While Trump probably doesn’t toot key bumps before going onstage, it is worth considering in a serious way what a potential future commander-in-chief believes about an issue near and dear to Points readers: drug policy. What follows is an attempted breakdown of Trump’s position on the three key topics mentioned above. I say “attempted” because, like with most things, his often contradictory stance on drugs is characteristically hard to pin down.

Medical Marijuana

Sitting for an interview on the O’Reilly Factor in February, Trump displayed some surprising compassion for others after host Bill O’Reilly called medical marijuana a “ruse”: “But I know people that have serious problems and they did that, they really – it really does help them,” Trump professed.

He didn’t offer any clarifying details but said that he was “in favor of it a hundred percent.”

Of course, Trump would take no action for or against such an initiative at the federal level. “Marijuana is such a big thing. I think medical should happen, right? Don’t we agree? I think so. And then I really believe we should leave it up to the states,” he told a Reno crowd during the primaries last year.

Recreational Marijuana

Still toeing the small-federal-government line of the party that gave him its nomination, Trump similarly left recreational weed for states to decide. I think.

During a debate last summer, he opined that “[regulating marijuana] is bad. Medical marijuana is another thing, but I think it’s bad and I feel strongly about that.” When pressed by the moderator about states’ rights to set their own policy, he verbally shrugged: “If they vote for it, they vote for it. But they’ve got a lot of problems going on right now in Colorado – some big, big problems.” (Again, no specifics.)

Later, at the same rally he proclaimed medical a state issue, he softened his tone. “In terms of marijuana and legalization, I think that should be a state issue, state-by-state.”

Notably, during the cultural hysteria of the crack epidemic, Trump supported full legalization. “We’re losing badly [bigly?] the War on Drugs. You have to legalize drugs to win that war. You have to take the profit away from these drug czars.” When pressed about his 1990 statement last year, Trump must have misremembered. “I said it’s something that should be studied and should continue to be studied. But it’s not something I’d be willing to do right now. I think it’s something that I’ve always said maybe it has to be looked at because we do such a poor job of policing. We don’t want to build walls. We don’t want to do anything. And if you’re not going to do the policing, you’re going to have to start thinking about other alternatives. But it’s not something I would want to do.”

Opioid Addiction

Trump calls the problem of opioid addiction “tremendous.”

He may very well believe that his proposed wall on the U.S.-Mexico border will stem the tide of heroin into the states, but traffickers are responding to demand cultivated domestically.

In any case, don’t expect any enlightened harm reduction rhetoric from a man who idolizes Vladimir Putin. Earlier this year, hardline Russian delegates to the United Nations General Assembly’s Special Session on Drugs insisted that that very term – “harm reduction” – appear nowhere in the resulting document outlining the contours of future global drug policy. Among the common treatment modalities in Russia are reportedly hypnosis, flogging, and comatose electroshock therapy. Unsurprisingly, addiction and HIV transmission through injection drug use are pressing social problems in Russia.

It remains unclear whether the experience of Trump’s own brother Freddy, who died addicted to alcohol in 1981, inspires any empathy for the plight of users. He did, however, give a second chance to at least one Miss USA accused of drug use.

I guess he’ll keep us in suspense!

Check back next week for part II of Point’s election 2016 candidate breakdown.