Sunday, August 22, 2010

Legal Pot. Public Health. Queers.

Pot is going to be legalized in California. No matter what your stance on the voter proposition, legal marijuana is coming, and Public Health will probably be in the mix in ways it has not been until now. I myself haven't decided how I will vote, but that's not the point. My point is that as marijuana slowly moves from the eagle eyes of law enforcement, public health is the natural next step for surveillance, monitoring, and control.

A couple weeks ago, I had a great conversation with a former (and future?) student about, among other things, what will happen once pot is legalized in California. He's been involved in the efforts to identify tobacco use as a health concern for gay men, lesbians, bisexuals and trans folks for many years, and we were wondering about how the activists who have built such a strong network around tobacco and smoking will react to legal joints in California.
Will the queer tobacco activists see themselves as primarily focused on tobacco (including smokeless tobacco like snuff & snus), or on smoking, which could potentially include pot, or both (which could possibly include vaporizers, brownies, etc.). Or will the idea of sounding like a negative Nancy on pot mean that we will just ignore the health consequences of smoking marijuana on queer folks?

Then, the other thing that got me thinking was looking into the environmental impacts of growing pot, because I'm looking for good material for my upcoming class on environmental health, and I figured that topic might engage some of the students.

At any rate, there are a lot of issues to think about there...
One can hope that the legalization of marijuana in California will lead to more environmental growing conditions - fewer diesel-powered generators, fewer diesel spills, less pesticides and more sustainable farming practices all around. But if there is an increased demand with no change in Federal enforcement efforts, there will still be a lot of pressure to grow pot in ways that are extremely damaging to the environment. What will the role of public health and environmental health be in developing policy and regulations? Will "organic" pot be certified by the same rules as USDA has developed for food?

For many years now, marijuana has been promoted as "medicinal". I'm sure it is for many people. But there are unintended consequences of promoting marijuana as medicine.
For one thing, a lot of people seem to be convinced that smoking marijuana is healthy, is good for you, even if you're not treating any health condition with it.
For another, a lot of people seem to think that smoking marijuana is just not dangerous compared to smoking tobacco.

If marijuana has been promoted as good for you, and now it becomes legal, it is complicated to modulate that message to be honest about ways in which it is not good for you, too.

So, where does public health come in on legal marijuana? We've gotten a pass because regulating marijuana has been the province of law enforcement. The "soft power" of Public Health has not been called on, and the research, as stunted at the field has been, is very polarized, with some researchers claiming that marijuana has virtually no down side, and others saying that marijuana smoke is more hazardous than tobacco smoke, and most researchers just not making much of it one way or another, because being illegal, it is assumed to be a bad thing anyway.

But that brings up another point - it is really hard to get any decent epidemiologic data on the health effects of smoking marijuana. On the one hand, the illegality of pot has led to the polarization above: the researchers are often so devoted to one side of the debate or the other that it is hard to trust their work. On the other, the illegality of pot makes asking questions about people's use a bit more ethically complicated, and also hard to trust people's self-reports of engaging in an illegal activity. And then on the third hand, there's the simple fact that most (but certainly not all) people who smoke marijuana also smoke tobacco, which makes teasing apart the effects of marijuana on health very tricky.

So where am I after thinking about all this?
Not much farther from where I began. I don't see myself likely to get very engaged in this debate. But, I will be interested to see what happens as the desire for society to somehow curb and contain the use of this substance moves from law enforcement to public health. And I will be curious to see how the message that "marijuana is medicine" gets tagged with the small print we're now familiar with from ads for pharmaceutical drugs, and tobacco products, for that matter. What will the Surgeon General's warning be? What will the breathless, low volume pitch-man sound like when rattling off the unpleasant side effects? And when will the large cohort studies needed to answer the fundamental health questions get funded?

Saturday, August 7, 2010

invalid votes

I've been thinking a lot about similar gender marriage lately. And its proponents.
I followed the prop8 trial very closely, even going to observe it two days. I watched every second of the proposition 8 trial re-enactment on YouTube. I've even listened to Family News in Focus to try to understand where the other side is coming from, and how they've interpreted the trial.

I've been absolutely mystified by the approach that the prop8 defendants ( took during the trial. It seemed like they opened up a shotgun on one foot, then the other, then still not satisfied, started gnawing off their hands. Their defense was really that incompetent. It can't be unintentional. They must have wanted to lose the case. But why?

I still don't have a good theory on that.

Were they just so cocky that they are going to win in the Supreme Court that they decided not to invest any resources in the trial? That doesn't make sense to me. Why sabotage their own trial if they thought they might have to defend it in the Supreme Court?

Were they hoping to portray the trial as a miscarriage of justice - in essence setting up Judge Walker to take on the unwitting role of an "activist judge"? That makes some sense to me, because they certainly have been making hay in their news broadcasts about how San Francisco justice is about to be foisted on the whole country. But how often (if ever) would they get the opportunity to get a new trial rather than have it appealed up to the 9th district? And is it worth losing the war in order to get a few bucks out of scaring people with the threat of having an activist judge force everyone in the country into a similar gender marriage?

In a related vein, maybe they really need a new front in this battle in order to keep donations up. Now that every state with a voter initiative process has had a marriage restriction amendment of some sort on the ballot, they need a new bogey man, and have found it in this trial. But that is just too conspiratorial for my taste. I believe that these people are earnest in their beliefs. I think that there are some people like Karl Rove who have done some truly cynical manipulation of them, but I think that the vast majority of them, the people giving money, even those running television ministries and organizations to "protect" marriage, are honest and heartfelt, if (from my perspective at any rate) misguided.

And that brings me around to the thought that I started out with when sitting down to write tonight. In the circles I travel, it is easy to be flip and dismissive about the millions of people who voted for proposition 8. I mean, what were they thinking, right?
In response to claims that one wacko judge in California had just over-ruled the entire voting public, I recently posted on FaceBook:

"Correction: one judge AND THE CONSTITUTION invalidated the votes of millions of Californians".

Hey, it's good for a laugh, but after posting that, I've been thinking, you know, invalidating the votes of millions of Californians is really no laughing matter. It's pretty serious business.
It was the right thing to do, but it's also unreasonable for our side to just think, OK, no biggie, now that's over and we're on the right path again. A lot of people did vote, and a lot did vote against us. And now they've just been told that their votes were wrong, unconstitutional, un-American.
It shouldn't be surprising if a lot of them resent having their votes invalidated, and there will probably be some who might be swayed to the right side of the issue, but will resist it just because they feel like their vote was stolen from them.

And that got me thinking about how should we go about acknowledging the hurt of having their votes taken away from them, and still trying to convince them that their position was wrong in the first place? Its thoughts like that that make me glad I'm not a political consultant. I mean, how can you square that circle?

day of decision

This is moments after Judge Walker's decision was announced, before the "whoop" that you've probably heard on TV.

And this is after the "whoop", as the cameras were swinging around trying to find some "human interest".

Then, of course, there's the inhuman interest...

A procession towards City Hall to try to get a couple married. The judge's stay was ordered while these folks were en route.

I had a chat with this lovely couple, who were thrilled to share their special day.

Seth is beaming.