In the chronicle of higher education yesterday there was a short snippet about academics taking performance enhancing drugs and if you have a nice proxy server you can read the longer article or the commentary in nature (you can also find the Volokh Conspiracy article that brought it to my attention). Now I was quite pleased with the reasonable approach taken in the Nature article. In particular I thought the following paragraph hit things right on the head.

Rather than individuals purchasing substances over the Internet, we believe it would be better to ensure supervised access to safe and effective cognitive-enhancing drugs, particularly given potentially dangerous drug–drug interactions. Such regulation must be evidence-based and a product of active dialogue between scientists, doctors, ethicists, policy-makers and, importantly, the general public. This may necessitate a new form of regulation because the remits of the existing health and drug agencies are for the regulation of medicines for treatment, not for enhancement.

If a new class of compounds (so far most ‘cognitive enhancers’ are effectively less euphoric versions of amphetamines) really is developed that appeals primarily to educated wealthy people rather than being associated with lower socioeconomic classes such a change in our regulatory outlook might actually occur. True, I’m skeptical that more than a modest cognitive enhancement effect is possible from drugs (they can’t fundamentally rewire the brain) but accepting the careful use of drugs as enhancements has the potential for massive increases in utility. While I doubt drugs are ever going to make us all geniuses there is no reason to believe that future pharmaceutical research can’t produce mood enhancing drugs with only mild side effects. The benefits to depressed people alone of not stupidly insisting that depression is always a disease (rather than an unfortunate extreme end of a distribution) and researching medications that might make everyone a bit happier would be huge¹. More broadly I’m sure that everyone has noticed that some people tend to be more happy and energetic than others (and studies have suggested these people are more productive as well). The benefits to society of a compound that could shift everyone’s baseline amount of happiness up to where it naturally lies for these bright happy people would be greater than any other change since the industrial revolution.

However, in the chronicle article we find a much less enlightened view from one interviewee.

The notion raises hackles in some parts of academe. “It smells to me a lot like taking steroids for physical prowess,” said Barbara Prudhomme White, an associate professor of occupational therapy at the University of New Hampshire, who has studied the abuse of Ritalin by college students. Revelations about the use of performance-enhancing drugs in professional baseball have stirred public interest recently, and she sees parallels between athletes and assistant professors. “You’re expected to publish and teach, and the stakes are high. So young professors have to work their tails off to get that golden nugget of tenure.”

Now I’ve always thought it was kinda silly to keep performance enhancing drugs out of sports² but there at least it’s merely a game and fairness is a principle concern. In academics, however, we are supposedly actually producing something of worth. We don’t try and tell academics they can’t spend more time on their work because other people have children to take care of or family obligations. It’s not about being a fair competition but about maximizing academic output. True, perhaps one might reasonably worry that these performance enhancing drugs don’t genuinely lead to more performance in the long run, i.e., they are a way of gaming the system, but short of that I see no reason why they shouldn’t be allowed.

Also I found it amusing the way everyone seemed to assume that it was unacceptable for students to take these sorts of drugs during exams yet no one tries to stop people with ADD from taking ritalin or amphetamine during exams and often even give them extra time. Of course ADD is a real issue but it falls on a continuum and the same drugs that help concentration with ADD have been shown to boost everyone’s scores on the SAT.

So California assemblyman John Benoit announced legislation today that would set up numerical limits for the amount of illegal drugs (I believe schedule 1 substances excluding marijuana¹) one could have in your blood stream and legally drive similar to the .08 BAC limit for alcohol. Apparently the lack of such specific limits is making it difficult to prosecute inebriated drivers (presumably because they must convince the jury of they reached some subjective level of impairment). This is a good reasonable idea that would likely save lives

But of course a proposal as sane and reasonable as this was too good to be true. Benoit has now said (same article) that he is seriously considering making this a zero tolerance law. Yup, that’s right apparently demonstrating our moral outrage that people are taking illicit substances is more important than saving lives on our highways.

As we all know from drug testing in athletes drugs can be detected in your bloodstream long after the individual in question has sobered up. Thus if you are a drug user the net effect of such a zero tolerance law would be to decrease the relative penalty for driving while inebriated. If you know that even if you wait till the next morning to drive the police could still throw you in jail because of the residual drugs in your bloodstream then why bother waiting? We’ve already (unreasonably in my opinion) expressed our moral disapproval of drugs by making them illegal but it’s criminally stupid to put our moral outrage over people’s lives. Not to mention the perfectly sober people who partied the night before who will end up in jail under such a program.

Of course if groups like Mother’s Against Drunk Driving are really about saving lives and improving highway safety I expect them to come out strongly against bills like this one. I On the other hand if they are about revenge and getting even with that type of person they will probably support this kind of zero-tolerance legislation. I’ll leave it to the reader to decide which is more likely.

Schwarzenegger said that pot is not a drug but better than that is his totally pragmatic attitude to the subject (”Why should I care if a politician takes sleeping pills every night so long as he can do his job?”).

Of course after the fact his media people rushed out to say he was just joking and that of course pot is a drug but it’s still great to see the mainstreaming of the attitude that pot isn’t a big deal.

Note that despite what sticklers like to assert the claim that, “Pot is not a drug” is not actually false or meaningless. There are clearly two different definitions of drug. One is the technical medical usage on which things like alcohol, aspirin, etc… qualify as drugs but people who have used aspirin or had a beer don’t answer affirmatively when asked “have you ever used drugs?” The meaning of drug in these contexts is something more like, dangerous addictive psychoactive substance¹. Applying the standard rules of conversational charity it is clear that Arnold was (reasonably) saying either that pot isn’t dangerous/problematic like other drugs or that it isn’t really socially forbidden.

So the American academy of actuaries just released a study widely reported as showing secondhand smoking costs nearly six billion, a figure that they suggest under reports the true cost as it does not take into account costs from other diseases. On the American academy of actuaries website their press release trumpets this sort of study as being of importance to help policy makers determine the right response.

Now without being able to find a copy of the analysis I can’t opine about their methodology, in particular what costs we would expect other pleasures to chalk up under this sort of analysis. In general I think studies like this without the analysis are pretty useless.

However, even without reading the study it is pretty clear it is downright misleading. Buried in the fact sheet is the remark, “Note the costs included here do not reflect the social or economic costs to society as a whole. For instance, the cost figures do not include any costs or cost savings to the government through social insurance programs.” In other words this report doesn’t include any savings due to early death leading to shortened social security/pension benefits. Additionally it seems clear from the fact sheet that only cost increases in smoking related diseases are included not the cost savings as a result of smokers dieing and not needing end of life care.

In effect this means that if secondhand smoking causes a terminal cancer patient to die after a $1000 dollars of treatment for pneumonia rather than requiring $101,000 dollars of terminal care this is counted as a $1000 dollar cost for secondhand smoke rather than a $100,000 dollar savings. Additionally it counts against secondhand smoke every day someone doesn’t work because of the effects of secondhand smoke but doesn’t credit secondhand smoke with every day people don’t need to work to fund retirement plans for people who die early. It’s like evaluating the costs of a life saving drug and only counting the costs of the side effects and not counting the benefits of the longer life. Interestingly I seem to remember the economist doing a calculation for smoking that included the early death factors and it came up with a pretty small number for the cost of smoking itself.

I suspect this sort of study is never questioned as it seems cold to complain about not counting the savings from death. However, if you have a problem with coldly adding up these costs you shouldn’t be in the business of trying to add up the costs. Certainly you shouldn’t be advertising your study as a tool for policy makers to judge the costs to society. But what disgusts me the most about this sort of thing is that no one would ever make this sort of mistake about say driving cars or any risky activity that is socially approved.

Apparently on 4/20 at the university of colorado there is a tradition to smoke out at 4:20 on some field. Apparently the campus police don’t like this much but instead of going there and stopping the pot smoking they instead decided to let them smoke pot and use surveilance cameras to take pictures of them. Now they have put those pictures on the web and are asking (and apparently getting) people to identify the photographed pot smokers. I’m not sure if the police would have a good legal case for marijuanna usage (wearing hemp t-shirts and smoking something doesn’t entail MJ use) but usually the accused don’t know enough not to confess.

There is absolutely NO justification of this behavior by the police, NONE WHATSOEVER Let’s say you actually believe in the war on drugs and buy into all that crap about how marijuanna is so much worse than alcohol and is harming our youth. In this case you believe it is justifiable to arrest people and otherwise inflict harm on them (denying financial aid as a result of drug conviction etc.. etc..) because you are saving youth from the ‘life deystroying’ effects of drugs.

If you really believe this and know people are going to be smoking at a particular time and place you have a responsibility to go STOP them so they won’t damage themselves and no one will try pot for the first time at this location. Remember it isn’t like these are hardened drug dealers or something these are college students, the very people the war on drugs is supposed to be saving from drugs. Not stopping the drug use and then getting people to inform on them afterwards is just vindictive cultural warfare.

This sort of tactic won’t deter people from smoking pot. Most pot smoking happens indoors or other places they don’t have security cameras. If they just didn’t want the field being used for pot smoking on 4/20 then they could have stuck a cop in a lawn chair out there. The only motivation for this is to strike a blow against a pro-pot culture these police officers don’t like.

I hope enough people are upset about this that the police are getting deluged with calls full of false information or that just waste their time.

Thanks to concurringopinions for the pointer

Recently the supreme court issued an opinion in Gonzales v. Oregon. In this case Oregon was challenging Ashcroft’s decision deeming assisted suicide not to be a “legitimate medical purpose” and thereby threatening doctors with loss of their ability to prescribe controlled drugs and potentially even criminal penalties. The supreme court decided 6-3 in favor of Oregon, holding that the controlled substances act (CSA) does not give the attorney general the power to prohibit doctors from prescribing drugs for assisted suicide. Roberts joined Scalia in a dissent and Thomas filled his own separate dissent.

I’m inclined to think that the result (allowing doctor assisted suicide in Oregon) is positive. While their are some coherent concerns about the effect on medical practice and doctor-patient relationships of allowing doctors to end life as well as preserve it I actually think the effects would be positive. Indeed, the very perception that just because a life is ended instead of saved assisted suicide is in tension with the a doctors role as a healer or the hippocratic injunction to “do no harm” is reason to believe that medicine suffers from overly simplistic notions of harm/healing and could do with a reminder that the ultimate aim of medicine is to alleviate suffering and improve the human condition. As an aside the common argument that doctors should repudiate assisted suicide in order to comply with the hippocratic oath is just absurd. Not only is this a brute appeal to the minority viewpoint of a small ancient sect but the original oath is obviously inapplicable to modern medical practice (abortion is proscribed, nepotism demanded). As a consequence there is no one hippocratic oath sworn by modern doctors, instead each medical school chooses each own version many of which avoid the controversial prohibitions. However, a full discussion of the consequences of physician assisted suicide will have to wait for another post. Here I want to focus on the legal question.

My motivation in writing about this decision is to correct some common misconceptions on the left (though this link is just the best argument I found on point not someone on the left) about the hypocrisy of Scalia and Thomas in voting to uphold such an obvious federal invasion of state’s rights and illustrate the danger of evaluating the justices and courts with only casual knowledge. I myself fell into this trap when I first heard about the decision in this case. Aware of Scalia’s strong record on state’s rights surpassed only by Thomas’s I was convinced that Scalia’s intellectual integrity had become a victim of his catholicism and that Thomas had also been unduly influenced by personal values. Having found my first impressions radically in error before, and generally (but not always) impressed with Scalia’s arguments (though not his assumptions) I actually went and read the opinion and dissents. Having seen the arguments and issues I find my opinion has changed radically. I now think that Thomas’s dissent was right on target and Scalia’s dissent was required by his judicial philosophy. Lest this seem like too much of a Scalia love fest I want to point out that I have serious doubts about his ability to consistently justify his concurrence (scroll down) in Raich and I am beginning to suspect that Scalia’s focus on the text of statute inadvertently encourages personal bias to sneak in through the choice of definition.

The real problem behind all of this is the decision in Raich. As Thomas points out in his dissent there just isn’t any principled way to distinguish this case and Raich (he is basically saying I told you Raich was a bad decision see what it entails). Despite all the distracting issues the real issue underlying Raich is whether or not the federal government has the power to deem a type of treatment supported by respectable medical organizations and states doesn’t count as a valid medical treatment. The reason there was a conflict between state law and federal law in Raich was not because the federal government deemed marijuana so dangerous that even legitimate medical purposes could not be tolerated. The CSA does not permit that sort of prohibition. The conflict existed only because the government deemed marijuana to both, have no currently accepted medical use in treatment in the US and lack accepted safety for use under medical supervision. While the exact wording may be different this is essentially the same issue at play in Gonzales v. Oregon: does the CSA give the federal government the power to override state judgments about the legitimate use of controlled substances?

Any attempt to argue that it would be unconstitutional to ban assisted suicide also runs directly into Raich (hence the reason this wasn’t really argued). Sure one could argue that congress is seeking to regulate the interstate commerce in marijuana and banning the intrastate use of marijuana is sufficiently related to this end to qualify but this would be mere sophistry. It is plainly obvious that the congress wanted to prevent the use of drugs and the interstate market in drugs was merely a vehicle which let them achieve that end. If one wants to interpret the commerce clause so broadly that the mere connection of the activity to interstate congress is enough to warrant regulation that is fine but the same argument now applies here. The intent of the CSA was to limit the interstate market in controlled substances to those going to legitimate medical purposes and to accomplish this interstate regulation it is necessary to ban the entirely intrastate activity of assisted suicide. Quite simply the court choose to give congress essentially unfettered power to regulate items which are sold on an interstate market and controlled drugs are such an item. I believe the court should distinguish genuine

Basically I think there is more than enough blame to go around on these cases about drug law. The conservative justices should be striking down federal drug laws on federalism grounds and liberal justices should be obligated to uphold a right to drug use for the same reasons they supposedly favor Roe (privacy, right to control your body). However, before one blames anyone remember that the supreme court is in a political bind. It just isn’t politically feasible for a court to dismantle federal drug prohibitions but as their primary intent is to combat an entierly intrastate activity (drug use) not regulate commerce in drugs even a moderate approach to federalism that sought to restrict congress’s intrastate power to just that which is necessery to genuienly regulate commerce or interstate transport would be forced to strike them down.

Ultimately though I think all the opinions in this case are defensible. The majority is right that congress probably did intend the CSA only to infringe on state roles only in regulating drug ‘abuse’ where abuse is not just any misuse but the thing that heroin addicts, steroid users etc.. all have in common. I’m unsure if this is a valid distinction for the court to make as ‘abuse’ in this sense is a moral judgement but it is certainly a reasonable position. However, this is not a deciscion that someone like Scalia with his focus on the text of the statute could consistantly support.

Below I will go into the actual arguments in the decision and explain why the situation is alot more complicated than a quick look would suggest.

UPDATE: Clarified that link is just to someone making the argument that Scalia and Thomas are betraying their federalist principles in this case not someone on the left themselves. The better criticisms usually come from your own side, at least that is what I want to believe given all the liberal arguments I try to repudiate here. (more…)

Alright so I thought I had heard it all in terms of stupid drug laws but then I heard this (different version of story) on NPR. Apparently Tennessee has created a public database of meth dealers on the internet. Yes that’s right you can go on the internet and SEARCH FOR A DRUG DEALER (alright so you can’t technically google for one but close enough). Apparently the hare-brained idea behind this scheme is that meth manufacture is dangerous (explosions, fumes etc..) and this will warn others in the vicinity like the sex offender databases. Really though it seems like it is an attempt to curb the problem by shaming those who are caught. I’m not a fan of the sex offender databases but this seems even less likely to work. I just don’t see what method (aside from the minor effect of keeping people with previous cooking convictions out of hotel rooms) could possibly make this program effective at keeping the type of people who cook/sell meth from cooking/selling meth.

What I find most amusing though is that for all the carping by conservatives about the sex, drugs and other bad stuff on the internet a conservative southern state now lets you find a local dealer from the comfort of your own home. If you don’t believe me check it out. If I was looking for a meth dealer this sure would be a good place to start.

One of my pet peeves is people who hide their moral disapproval behind a mask of public concern. Two recent incidents on the radio reminded me this sort of faux good samaritan attitude is still alive and well. The first was a report about a safer kind of cigarette developed by a British company. Instead of cheering this result as potentially saving the lives of smokers anti-smoking advocates condemned it out of fear it would encourage more smoking. The second was a discussion about the number of highway deaths caused by drunk drivers which called for lower limits on blood alcohol content (BAC).

It is not that either position is necessarily wrong, it could be that the safer cigarette will actually increase smoking deaths and it could be that a lower threshold for drunk driving will save lives. What infuriates me is that both claims are made without looking at the statistics. It also could be that a safer cigarette would save far more lives than it would cost. It also could be (in fact I think it likely) that most alcohol induced accidents are caused by people already violating the drunk driving laws. It is entirely possible that stricter limits on BAC would cause people to take the drunk driving laws less seriously in addition to spending time and money prosecuting slightly tipsy drivers which could have been used to enforce the existing laws.

Contrast these knee jerk reactions to cigarettes and alcohol to the reactions people have to similar, but less morally charged, situations. Where are the condemnations of low fat cheesecake? After all that too could encourage people to engage in an unhealthy activity. What about laws making it illegal to drive on less than four hours of sleep? After all being sleep deprived can have just as severe an impact on reaction times as being drunk. The reason we don’t hear these laws being pushed is because the motivation behind these comments is as much moral disapproval as public safety. The reason the anti-smoking campaigners don’t feel the need to look at the statistics is because they find smoking morally distasteful. They want to eliminate smoking not make sure the enjoyment people get from cigarettes outweighs the cost. Many of these same advocates even oppose completely tobacco synthetic nicotine cigarettes which eliminate or drastically reduce the vast majority of smoking dangers.

Similarly the motivation to strengthen laws against drunk driving is as much to punish those bad people who drink and drive as it is to actually save lives. When people consider laws that restrict tired people from driving or old people from driving they worry about issues like compliance and inconvenience for these groups. In contrast people don’t consider the inconvenience to party goers or sports fans when advocating more stringent laws on drunk driving and instead of measuring costs and benefits they adopt the same ‘get tough’ attitude we see in other morally charged issues like drug abuse.

It is annoying enough when people try and unnecessarily force their value judgments on others. Just because you value your health more than the pleasure of nicotine doesn’t mean everyone does. However, it is absolutely infuriating when people do so in the name of public concern. This is especially outrageous when the attitude actually harms public welfare as I think is happening in the smoking situation. I’m not sure if that is actually the case in these two particular situations but the replacement of measured consideration with moral outrage tells me it is only a lucky coincidence if that isn’t happening here.

So I just heard a very well done interview on NPR talking about journalistic hysteria about drug use. They exposed the fact that respectable papers have reported on meth babies with arms growing out of their necks despite total absence of any first hand documentation. Additionally they attacked the newsweek story, asserted to be representative of much drug content, as inferring an epidemic of meth from anecdotal evidence despite the fact that governmental figures show no recent increase in usage. However, what really took the cake and inspired this post was the ridiculous statistics from the meth is death campaign. A campaign linked off of the DEA website and run by the Tennessee district attorney’s office.

Amazingly all on the same page this campaign claims the following:

• “First, there’s the fact that 99 percent of first-time meth users are hooked after the first try.”
• Amazing on the same page we see: “95% of those who are hooked on meth became hooked after the first time.”
• “Only 5 percent of meth addicts are able to kick it and stay away.”
• “From the first hit to the last breath, the life expectancy of a habitual meth user is only 5 years.”

There are plenty of other ridiculous claims on the website, for instance the argument that cockroaches will live through a nuclear disaster but stay away from meth labs (does anyone here think there was a peer reviewed study about cockroach behavior around meth labs?). However, the claims I mentioned (pointed out by the NPR report) really take the cake. Once you combine these claims with the easily locatable (not an endorsement) information that 4.7 million US citizens have tried methamphetamine one is lead immediately to the absurd conclusion that 4.5 million americans should be dying from meth related fatalities.

I realize that bad reporting about drugs is unlikely to surprise anyone reading this but it still drives me to rant. How the hell can such ridiculous misinformation be published by governmental sources and not generate outrage? What is it about illegal drugs which causes them to be regarded as moral infractions as well as potential health problems?