The Tiresome ‘Gateway Drug’ Debate.

July 20th, 2009 1 Comment

The New York Times has a rather specious article up today by about the rising rates of rehabilitation admittance for marijuana users, and boy, does it lay it on thick: the article starts with an anecdote about a marijuana addict from New York City (“Joyce, 52 and a writer in Manhattan”); briefly touches on the relative potency of marijuana today and in the 70s; and then settles comfortably into erecting a number of straw men (variously attributed to “addiction experts”, “Many public health officials”, and “some doctors”) and then gleefully pushing them over.  Key section:

Marijuana, the country’s most widely used illicit drug, is typically not thought to destroy lives. Like alcohol, pot has been romanticized by writers and musicians, from Louis Armstrong to Bob Dylan, and it has been depicted as harmless or silly in movies like “Harold and Kumar.” And addiction experts agree, marijuana does not pose as serious a public health problem as cocaine, heroin and methamphetamine. The drug cannot lead to fatal overdose and its hazards pale in comparison with those of alcohol. But at the same time, marijuana can be up to five times more potent than the cannabis of the 1970s, according to the National Institute on Drug Abuse.

(snip)

More adults are now admitted to treatment centers for primary marijuana and hashish addictions than for primary addictions to heroin, cocaine and methamphetamine, according to the latest government data, a 2007 report by the Substance Abuse and Mental Health Services Administration.

Notwithstanding the massive non-sequitur that comprises the last sentence of the first paragraph, the one thing that the article fails to do is give any evidence whatsoever that marijuana-addiction rates are on the rise.  Instead, it quotes misleading statistics about rehab-attendance that could be attributed to any number of factors.  The rehab rates for cocaine and heroin have fallen because usage rates of cocaine and heroin have fallen in recent years.  At the same time, we’ve acquired a more sophisticated understanding of both the physical and psychological mechanisms of addiction in the last two decades, and that in and of itself could explain the rising rates of marijuana rehab rates: the mere fact that people acknowledge that marijuana addiction exists makes them more likely to seek treatment for it.

Look: there are things we all know.  Chronic marijuana use is not healthy.  Certain people are, for a number of reasons, inherently predisposed to addiction.  Some of those people have a psychological dependence on marijuana, and it probably hasn’t been a positive force in their lives.  The increasing potency of marijuana isn’t a good trend overall (and wouldn’t it be nice to have some sort of government agency to regulate that sort of thing?).  These are all serious problems, and worthy of attention.

But by framing the argument in such unrealistically dire terms – by, say, repeatedly referring to marijuana as a gateway drug, or by comparing it directly to cocaine – the authors of the Times article undermine themselves.  There is absolutely nothing that proves that using marijuana leads to the abuse of harder drugs, and the way we know that is because there are vastly many fewer hard drug users than marijuana users.  (I can count the number of people I know who regularly do heroin on one hand; a similar attempt for marijuana would require rather more fingers.)  And marijuana is neither as dangerous nor as addictive as cocaine, and pretending it is so is simply fearmongering.

There’s a real debate to be had about marijuana.  But without a certain amount of intellectual honesty – on both sides – we’re never going to get there.  And the Times article, by masquerading opinion as fact, doesn’t come anywhere close.

How Our Health Care System Fails Transgendered People

July 8th, 2009 0 Comments

I’ve been meaning to write something about this for a week or so, since I saw it over at Feministe, but I would really recommend that you click over and read Queen Emily’s writing on the trouble that she, as a transgender individual, has with hospital forms.  And in case you don’t, I’m going to pull a rather lengthy quote from it:

The problem is this, my birth certificate says I am male, my gender presentation is female.  They do not match. Until I can afford expensive genital surgery, I cannot change the marker on my birth certificate.  No matter what I put, in a cissexist world, I am situated as a liar.

A small example:  Imagine you went to the hospital, with stroke-like symptoms (it was later found to be “complicated migraines”).  Because you want to actually be treated, you do not out yourself as transsexual.  When the triage nurse filled in the forms, he puts female, and you leave it there.  All is fine, the doctor for once treats you seriously, possibly because of the presence of your mum, aunt and cousin (quick lesson you learn when dealing with doctors while trans: there’s safety in cis scrutiny.  Bring your mum or your partner with you into the examination room).

Fast forward to a week later, and I’m (sorry, you) at a neurology department to see a specialist to organize an MRI, when one of the reception people comes out to see you and starts screaming that you’re a GODDAMN LIAR because your forms say I’m female but some quirk of the computer system has found your birthdate and surname and pinged up an old treatment from when you were six.  Because of this, they decide that your name isn’t real either, and it takes three trips to different departments with your changed birth certificate (changed in name but not in sex).  In the end, they put a post-it on your file, with your name, your legal bloody name, in quotation marks like it’s a fucking nickname.  And these are the people who are supposed to help you.

Now imagine what happens in an emergency situation.

Imagine you’re me, six months before this, and you’re young and naïve and full of stupid, figuring that putting M will help them you treat you better (ha!), checking yourself in to see a doctor because you’re struggling to breathe.   And the dude takes one look at your forms and your barely passing self, and refuses to enter the room.  He just stands there at the edge, asking you to holler symptoms at him, and you sit there knowing that if you collapse, this man will pause and debate whether to save you or not.  This is what happens when forms, bodies and cis prejudice collide.

Emily lives in Australia, but the truth is that the health-care system in the United States is similarly incapable of treating transgendered patients.  My uncle is an ER doctor, and he told me a story once about a man who was admitted to his hospital with internal bleeding.  As it happened, the man was a female-to-male whose gender reassignment surgery was only partial; he had also been presenting as a man for several decades and no one (not even his adopted son in the waiting room) knew of his past gender.  The man’s mere existence in the hospital caused no end of confusion – a nurse assumed that his records had gotten mixed with someone else’s; his former hospital stays were woefully documented; and when it turned out that he needed a hysterectomy it took some time to explain the situation to the gynecologist and convince him that the man did, in fact, have a uterus.  And all the while the patient was bleeding internally and in a great deal of pain.

I don’t have specific figures on how often this sort of thing happens in the United States, but I don’t think it’s implausible to think that situations like this occur on a fairly regular basis.  The outright bigotry – as with the doctor who wouldn’t enter Emily’s room – is horrifying, to be sure, and I’m certain that there are many, many places in this country where that scene would play out.  But more disturbing, I think, is the undirected, systemic bias against transgender people in our medical system, a bias that stems from our almost pathological unwillingness to talk about or acknowledge the existence of transgendered people in our society.  No one in my uncle’s hospital was trying to give their patient substandard care; no one was refusing outright to treat him or enter his room.  It was just that, from the system’s point of view, he shouldn’t have existed.

In a recent article in the New Yorker, Hendrik Hertzberg looked back at the Stonewall Riots and talked about how far we’ve come, in terms of LGBT rights, and how far we have to go.  In his article he quoted a 1966 Time Magazine article called “The Homosexual In America” that is almost breathtakingly repulsive:

Beyond the pros and cons of legal reform, there is a separate moral issue. The clear-cut condemnations of the Bible or of traditional moral philosophy have come to be considerably toned down. An influential 1963 statement by British Quakers held that “homosexual affection can be as selfless as heterosexual affection” and therefore is not necessarily a sin. A surprising number of Protestant churchmen accept this idea. Most will still assert that homosexuality is an offense against God and man, but usually with qualifications. Says Los Angeles Methodist Bishop Gerald Kennedy: “The Lord made man and woman, and this implies a sexual relationship and sexual harmony which is in the center of nature.” He is echoed by Harvard Divinity School’s Harvey Cox, who, from a theological viewpoint, sees “the man-woman relationship as a model of the God-man relationship.”

Lack of procreation or of marriage vows is not the issue; even Roman Catholic authorities hold that an illicit hetero sexual affair has a degree of “authentication,” while a homosexual relationship involves only “negation.” Roman Catholic thought generally agrees that homosexuality is of and in itself wrong because, as New York’s Msgr. Thomas McGovern says, it is “inordinate, having no direction toward a proper aim.” Even in purely nonreligious terms, homosexuality represents a misuse of the sexual faculty and, in the words of one Catholic educator, of “human construction.” It is a pathetic little second-rate substitute for reality, a pitiable flight from life. As such it deserves fairness, compassion, understanding and, when possible, treatment. But it deserves no encouragement, no glamorization, no rationalization, no fake status as minority martyrdom, no sophistry about simple differences in taste—and, above all, no pretense that it is anything but a pernicious sickness.

Imagine reading that in any major publication today and you can see how far we’ve come.  But read through Emily’s story and you can see how far we have to go.

Department of Idiocy.

July 7th, 2009 0 Comments

It isn’t often that reading a straightforward news article makes me laugh uncontrollably, but this bit, from a recent ABC News article on Sarah Palin’s resignation, did it for me:

If she were in the White House, she said, the “department of law” would protect her from baseless ethical allegations.

“I think on a national level, your department of law there in the White House would look at some of the things that we’ve been charged with and automatically throw them out,” she said.

There is no “Department of Law” at the White House.

I don’t know whether that last line is meant to be purely informative, or if it was some sort of wry, sly wink that somehow made it past the news editor’s red pen, but either way it just kills me every time.

On a somewhat related note, I think it’s obvious to everyone that too many column-inches have been wasted on Sarah Palin already and if she disappears for a time I don’t think anyone – Republican or Democrat – will much miss her.  Some people are calling her resignation a first step toward a 2012 Presidential run; it’s possible that’s what Palin has in mind, but it won’t happen.  She won’t win a single primary.  Palin has been an unmitigated political disaster since August of last year.  She has proven herself to be uninformed, intellectually lazy, ethically shaky, and, now, uncommitted.  She might be able to get some sort of media job exciting the base – fulfilling a sort of Ann Coulter role – but I think her career in higher office is done.  Heck, given that Mark Begich isn’t up for reelection until 2014 and Lisa Murkowski is immensely popular, I don’t think that Palin can even mount a credible Senate run in her home state.

So good riddance to bad rubbish.  And if she tries to come around again I say we get our department of law to deport her across the street to Russia.