MARIJUANA MONKEY OFF YOUR BACK When National Institute on Drug Abuse scientists recently announced that test monkeys would self-administer marijuana's key ingredient, THC, the BBC reported Monday that "Cannabis may be as addictive as hard drugs such as heroin and cocaine." But that's not what the report said. The study findings, published in the November 2000 issue of Nature Neuroscience, "suggest that marijuana has as much potential for abuse as other drugs of abuse, such as cocaine and heroine." The BBC reporter played a little loose with his vocabulary. "Abuse" and "addiction," despite the common connection in the minds of many readers, are not the same thing. The reporter's error is not uncommon. One of the biggest obstacles in talking about drugs is having to talk about drugs. The meanings of the words we use are often slippery, painted with a heavy coat of definitional grease. Addiction and addict are powerful, attention-grabbing words, perfect for headlines and slogans -- but what do they really mean? Everyone throws around the word addiction; colloquially, it gets tagged to just about any compulsion, habit or intense desire someone might have. Today we've got addicts galore: sex addicts, gambling addicts, Internet addicts, food addicts, sports addicts -- you name it, we've got an addiction to it. Or do we? Is every habit or compulsion an addiction? Medically, addiction specialists are typically concerned with three ideas: reinforcement, tolerance and dependence. That triangle helps to form an operational definition that describes what researchers are looking for in particular, rather than leaving definition up to varying man-on-the-street notions of what the word means. In terms of animal research especially, like the NIDA monkey-marijuana test, reinforcement has to do with the rewards; "it is a measure of whether, and how hard and long, an experimental animal will 'work' for administration of a drug," explains Yale Psychiatry and Pharmacology Professor Robert Byck. According to the NIDA, the monkeys worked hard enough. To start, the animals were first given cocaine through a catheter, which could be self-administered with a lever. When the cocaine was swapped with saline, the monkeys quit doping, but when researchers switched the salt water with THC, they commenced hitting the lever, giving themselves a dose researchers claim to be comparable to typical human use. For NIDA, this established one of the characteristics of addiction -- the monkeys liked it and actively worked to dose themselves. Regardless of any immediate criticisms of the test itself, the trouble with studies like NIDA's is that they rarely stay in the laboratory; studies that reconfirm our fears about drugs or incite worry are guaranteed to be hyped by the press in the pubic square seconds after the results are made known. NIDA's study is no different. You can easily spot the political undercurrent carrying the results of the study beyond the medical community and straight to the media desks and beyond. "This study is simple and its findings are clear," said NIDA Director Dr. Alan I. Leshner in an Oct. 15 press release. "Animals will work to get THC. This emphasizes further the similarity between marijuana and other abusable, addicting substances. Both animals and humans will work to acquire access to marijuana in the same way that both animals and humans change their behavior to get other drugs of abuse, like cocaine and heroin." While Leshner never says that marijuana itself is "addictive" in the medical sense, he makes the link, allowing people to mistakenly conclude that marijuana is little different than heroin and cocaine, which is spurious to say the least. First of all, cocaine, marijuana and heroin are different chemically and affect users differently, depending on the dose, form of the drug, plus method and frequency of use. Next, opiates like heroin are highly addictive not just in terms of reinforcement, but also tolerance and dependence. Tolerance, for addiction specialists, generally implies decreased sensitivity to a drug the longer it is used, requiring users to boost their dose to get the desired effect, while dependence refers to a user's reluctance to quit a drug due to psychological and physical difficulties caused by withdrawal. "Kicking dope sucks," writes an anonymous heroin user in the Oct. 11 San Francisco Bay Guardian, describing the pain of withdrawals. "Kicking makes you not sleep, makes you lose your appetite, makes you s--- uncontrollably, makes your bones and joints hurt from the inside out, and makes your muscles scream. You may have insane crying fits, muscle spasms, and hallucinations. "This is normal. It's just the drugs leaving your body." As "normal" as that may be for heroin users, this does not describe the average cocaine or marijuana user. "Although they share some characteristics with the opioid drugs," writes Byck, "neither cocaine nor marijuana has a pharmacologically significant withdrawal syndrome that would, by its presence, enforce the continued taking of the drug," explaining, "For both drugs the tolerance and physical dependence are not the driving forces behind the self-administration." While tolerance is not a requirement for the addiction label, it is a helpful benchmark because, as a standard, reinforcement alone is close to meaningless. Ditto for dependence because it indicates some level of physiological effect by the drug, as evidenced by a physical reaction to withdrawal. If avoiding the pains of quitting drives you to continue taking the drug, goes the thinking, you're hooked. Thus, if you don't have to get more and more to keep the high going and don't have a problem quitting, it'd be hard to suggest you were genuinely addicted. A monkey repeatedly pressing a lever for THC does not proves addiction. Stuck in a cage with little else to do, dope is about the best thing going. "What this study proves," said Steve Kubby, 1998 Libertarian California gubernatorial candidate and national director the American Medical Marijuana Association, "is that a restrained, stressed-out monkey will choose cannabis for relief if it's available." The real question for addiction is what the monkey does if the drug isn't available. All sorts of things are fun to do, and doing them, even a lot, doesn't necessarily imply addiction. The pleasures of sex, good food, sports and physical activity, leisure, and more may all reinforce desire to participate in the activities, but this doesn't equal "addiction" in any real sense. I love every item in that list - -- get 'em when I can -- but if my wife is tired, the refrigerator is low, or I'm trapped at the office instead of hiking or lounging, I don't get the shakes. Neither do I have to go in vain searches for greater thrills. For me, hiking five miles is just as good as hiking 10 (maybe better if my feet are sore), and eating two bowls of Breyers instead of one will just upset my stomach. The same is surprisingly true for marijuana and even cocaine. Says Byck, "It is important to note that drug seeking and drug taking behavior can be maintained at doses that do not cause noticeable tolerance or physical dependence" for either marijuana or cocaine. In other words, medically speaking marijuana and cocaine fall short of traditional benchmarks establishing addiction. While a person may binge on cocaine, it certainly isn't a regular drug for most of its users. In other words, folks use it when they want to and, despite it's potency, it's not typically habit-forming. The same is true even more so for marijuana, as the Institute of Medicine makes clear in its March 1999 report on pot for medical use. Even though many, including the National Organization for the Reform of Mari juana Laws and Harvard Medical School professor Lester Grinspoon, called the report "tepid" and "political," the IOM basically confirmed what people have been saying for decades: Marijuana does not foster addiction, exhibiting only, if any, mild symptoms of dependence and withdrawal. "A distinctive marijuana and THC withdrawal syndrome has been identified," notes the IOM report, "but it is mild and subtle compared with the profound physical syndrome of alcohol or heroin withdrawal." In fact, the IOM's chief concern seems to be that pot is usually smoked, not that it might be addictive. Of course, as the NIDA study actually found, marijuana is "abusable." What isn't? Anything can be used to the point of harm. Are we going to start regulating how many times people have sex in a day, week, month? What about a federal bureau to establish proper serving sizes for family meals? Can't let people do too much exercise either -- endorphin abuse; better get a Federal Gym Commission established pronto. This is obviously nonsense. What people need to ask themselves is that if it's nonsense for sex, food and exercise, why isn't it nonsense for marijuana? The only abuse the government should concern itself with is people abuse. Are folks being harmed? That's the question for government. If not, butt out. Unfortunately, that makes government irrelevant in this area, and if there's one thing the government can't stand it's being irrelevant. So to continue looking like it has an important role to play, the government needs people to feel as if they are at personal risk from marijuana users. Ergo, the addiction card. As soon as you play that, you create everyone's worst enemy: the junkie. Now -- especially when you link it to heroin, as the NIDA allowed the media to do without any clarification -- you've got all the crime fears aggravated by the idea of needle-to-arm druggies. It's the perfect hobgoblin, the creation of which H.L. Mencken pointed out is the primary goal of government. Manufacturing problems is the surest way for the feds to guarantee their job security -- somebody's got to solve them. Given that, it's increasingly clear that marijuana isn't the monkey on our backs; it's the federal drug warriors.
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