May 1st, 2015

In Recognition Of My Work As An Addiction Psychiatrist

Editor’s Note: Today’s post is text of the acceptance speech that I gave yesterday after receiving the Psychiatrist of the Year Award from the Washington Psychiatric Society. I believe that the primary reason I received this honor was in recognition of my research and efforts to educate the medical community about medical cannabis. Last year, I gave approximately 10 presentations or lectures on the topic, and I plan to stay engaged in the ongoing dialogue about the legalization of marijuana. I view this an important part of my work as an addiction psychiatrist.

Good evening, I’m honored to receive this award as an addiction psychiatrist. A little more than a year ago, the Georgetown University Department of Internal Medicine asked me to present grand rounds on the subject of medical cannabis. As an addiction psychiatrist, I thought that this would provide an incentive for me to learn more about this topical issue, so I accepted. What began as an intellectual exercise about the history of cannabis use has become, for me, an emotional experience beginning with puzzlement, progressing to astonishment and disbelief, and culminating in anger at what I was learning.

I discovered that by means of a dishonest, but well-organized and highly effective political campaign, led by an overly zealous and very persistent law enforcement official, pharmaceutical grade cannabis, which had been for many years a mainstream medication, had been taken out of the hands of physicians. While this was done initially despite the opposition of the AMA, physicians have since been subjected to a steady stream of negative propaganda. As a result, anyone suggesting that changes should be considered is in danger of being vilified as being “irresponsible” and “ignorant of the facts” — to quote the president of one of my own addiction specialty organizations.

The restriction process went even further. Administrative barriers became so Draconian that cannabis was made inaccessible not only for medical use but also for medical research. Subsequently, when the possibility of revisiting its medical use has been brought up, the response is often that this should be delayed until the completion of additional scientific research, which in fact could not be done.

This process of restriction was initiated, perhaps not coincidentally, when the nation was emerging from an era of alcohol prohibition. What is disturbing to me is how this narrow cannabis issue has contributed to a much larger issue — a longer and perhaps even more destructive era of prohibition, which has been called “The War on Drugs.” A case can be made that the mismanagement of the cannabis issue, combined with overzealous policing, has resulted in the unnecessary imprisonment, as well as deaths, of too many young people as casualties of this drug war. My hope as an addiction psychiatrist is that the future decisions about cannabis policy will be guided more by good evidence and reason than has been the case in the past

I thank you again for this award and would encourage each of one of you to listen to all sides of this debate and decide for yourselves the proper course of action.



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