One of the biggest stories kicking off this new year is the execution of the Colorado law legalizing marijuana. The historic ruling went into action yesterday to much fanfare, some dubbing the momentous occasion “Green Wednesday”. The day went off without a hitch, with police officers and state officials on-hand to make sure the crowds lining up to be the first to buy bud didn’t get too rowdy. However, one of the biggest controversies stemming from the law is not the purchasing of marijuana itself, but what smokers will do with it when they need to get home.
Thirteen year-old Jahi McMath went into Oakland Children’s Hospital on December 9 for a tonsillectomy. Three days later she was declared brain-dead. Severe complications from the surgery resulted in cardiac arrest and the eventual tragic demise of Ms. McMath; and while neurologists and pediatricians at the hospital have declared Jahi brain-dead, her family refuses to accept the doctors’ diagnosis, fighting to keep her on life support.
This heartrending battle between hospital and family is sadly not a new one, and there is often little that can be done to compromise the two sides. However, neuroscientific research in recent years has made substantial developments in more empirically determining if there are still signs of consciousness in vegetative state patients, which can either bring hope to a desperate family, or provide stronger footing for doctors trying to do the more difficult but often more humane thing.
So I know I’ve written a lot about drugs and addiction recently (it is my profession after all!), but I have one more important thing to say on the nature of harm reduction for those who do choose to use drugs.
Some of you may have heard of several tragic and avoidable drug-related deaths that have occurred over the last couple of months at clubs and festivals in both the UK and the US. This has largely been in people who think they are taking MDMA, a relatively safe drug that has a low toxicity level and low risk for dependence, but instead have consumed a much more dangerous analog of MDMA called PMA.
On Law and Order: SVU, the story stops when the bad guy is caught. The chase is over, justice is served, the credits roll and we can all sleep easier at night knowing that Detectives Benson and Stabler have successfully put another criminal behind bars.
Of course in the real world, things are never that simple.
Our criminal justice system operates on the tenets of punishment and reform. You do the crime, you do the time — and ideally you are appropriately rehabilitated after paying penance for your sins. But unfortunately it doesn’t always work that way. Recidivism rates in the U.S. have been estimated at 40-70%, with most former inmates ending up back behind bars within three years of being released.
ONE IN FOUR of us will struggle with a mental illness this year, the most common being depression and anxiety. The upcoming publication of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM) will expand the list of psychiatric classifications, further increasing the number of people who meet criteria for disorder. But will this increase in diagnoses really mean more people are getting the help they need? And to what extent are we pathologising normal human behaviours, reactions and mood swings?
The revamping of the DSM – an essential tool for mental health practitioners and researchers alike, often referred to as the ‘psychiatry bible’ – is long overdue; the previous version was published in 1994. This revision provides an excellent opportunity to scrutinise what qualifies as psychiatric illness and the criteria used to make these diagnoses. But will the experts make the right calls?
I recently finished Professor David Nutt's new book, Drugs Without the Hot Air, on minimizing the harms of drug use, both legal and illegal. Professor Nutt's tone is light and his writing is accessible to readers of all scientific backgrounds, but his message is an important one. He explores the history and culture surrounding many drugs of abuse, ranging from the popularization of caffeine and nicotine, to the original medicinal purposes for cocaine and heroin, to the widespread use of prescription stimulant drugs today. He also discusses previous governmental endeavors, both successful and unsuccessful, on limiting drug abuse. This includes the floundering War on Drugs waged by the United States since the Nixon administration, as well as the more effective reduction in tobacco use seen in the U.S. and U.K through smoking bans, higher taxation and tighter restrictions on marketing campaigns.